December 17, 2017
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Nurses Achieve Excellence with Teach-Back

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Fort Kent ~ Northern Maine Medical Center (NMMC) has embarked on many initiatives over the last several years to stay ahead of the demands of the constantly evolving healthcare system and to address the organization’s commitment to providing excellent patient-centered care. The most recent improvement initiative was developed to ensure that patients have a good understanding of their new medications before they leave the hospital.

According to the World Health Organization (WHO), approximately fifty percent of patients do not take medications as prescribed. Many reasons explain why people may not take their medications and one of them is due to the fact that a person may not have sufficient knowledge about the new medication. The likelihood of adherence to the health-optimizing medication when patients are educated about why they are taking their medication along with knowledge about possible side effects, leads to a reduced risk of being re-admitted to the hospital and an increase in patient satisfaction.

In the latter part of 2015, a small group of NMMC caregivers came together to strategize around how to best educate patients about new medications, with a focus on improving care, resulting in better patient outcomes. The group was represented by several departments including: Nursing, Pharmacy, Administration, Patient Experience and Quality. Nurses received education on the use of a best practice called Teach Back, which utilizes the Teach 3 Ask 3 approach. In this strategy, the nurse teaches the patient about the common uses and side effects of the medication for three consecutive administrations and then confirms understanding from the patient by asking the patient to repeat the information. This process engages and empowers patients in their own care. The patients are also provided a medication sheet and are encouraged to always ask questions. In addition, pharmacy staff provides education upon a patient’s discharge home if the patient needs additional education or if there were multiple medication changes while the patient was hospitalized. Through the Courtesy Home Visit program, a free service where a nurse from the inpatient unit visits patients when they return home, the visiting nurse again confirms understanding of the new medication with the patient.
A positive response to the Teach Back approach has been noted in patient survey responses since implementation of this initiative in January 2016. According to Jill Daigle, RN and Nursing Supervisor, “This process has been working very well. Nurses are enjoying the time they spend educating the patients and seeing them learn about their medications and improve their overall health. And the patients seem to be very receptive and excited about learning and taking control of their health.” Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey responses also demonstrate the benefits to patients. With the nurses consistently educating every patient every time, survey scores in the domain, Medication Communication, have risen above the ninetieth percentile and have remained consistent over the last few months.

NMMC has been and continues to utilize results from surveys and patient feedback as a way to improve patient care. The We’re Listening Campaign was instituted in 2015 and all comments on surveys are reviewed. NMMC is also working to establish a Patient Advisory Council as a means to gather additional feedback from the community. To be part of this Council or for more information, contact Courtney Deprey, Director of Patient Experience at 207-834-1304.

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