Medicine and Health Sciences Commons^™

Nurses' Experiences Implementing Eped: An Ipad Application To Guide Quality Discharge Teaching, Carol Klingbeil, Cori A. Gibson, Norah L. Johnson, Michele Polfuss, Karen Gralton, Stacee M. Lerret

College of Nursing Faculty Research and Publications

Quality discharge teaching prepares patients and families to transition safely from hospital to home. Technology can enhance and support quality discharge teaching by promoting patient family engagement during the transition. The purpose of this mixed methods study was to explore clinical nurses' experience with using Engaging Parents in Education for Discharge, an iPad application to guide quality discharge teaching. Twelve nurses at a large Midwestern Children's Hospital participated in small focus groups after use of the Engaging Parents in Education for Discharge application and completed a questionnaire on their perception of the acceptability and feasibility of the app. Findings revealed …

Implementation Of Teach-Back For Discharge Teaching In A Critical Access Hospital: A Quality Improvement Project, Katie Beth Notch

Theses and Dissertations

A lack of comprehension of discharge instructions may cause high readmission and emergency room revisit rates for organizations. At the project site, there was no current evidence-based practice to ensure patient comprehension of discharge instructions. The purpose of this quantitative, quasi-experimental quality improvement project was to determine if the implementation of the Institute for Healthcare Improvement (IHI) Always Use Teach-Back Toolkit would impact emergency room revisit rates among adult medical-surgical patients in a critical access hospital in rural Minnesota over four weeks. Afaf Meleis’ transitions theory and the Iowa model for evidence-based practice were the scientific underpinnings of the project. …

The Implementation Of A Standardized Car Safety Seat Discharge Teaching To Improve Self-Efficacy In Neonatal Intensive Care Unit Nurses., Madeline Sass

Doctor of Nursing Practice Papers

Background: There is a lack of standardization for car safety seat education to caregivers before hospital discharge. Nationally, 59% of motor vehicle accident deaths occur because the car seat is misused (Greenwall, 2015). The American Academy of Pediatrics (1999) states this is a gap in care because all caregivers need to receive proper car safety seat instruction before discharge. Purpose: This quality improvement project aimed to increase nursing self-efficacy and compliance of registered nurses (RNs) by implementing a standardized CSS discharge intervention. Methods: RNs on the unit were educated with a 7-minute presentation video titled “Car Seat Safety: Discharge Teaching” …

One Size Does Not Fit All: Discharge Teaching And Child Challenging Behaviors, Norah L. Johnson, Stacee M. Lerret, Michele Polfuss, Karen Gralton, Cori A. Gibson, Sheikh Iqbal Ahamed, Riddhiman Adib, Rosemary White-Traut, Kathleen Sawin, Roger L. Brown

College of Nursing Faculty Research and Publications

This study compares quality of discharge teaching and care coordination for parents of children with challenging behaviors participating in a nursing implementation project, which used an interactive iPad application, to usual discharge care. Unlike parents in the larger quasi-experimental longitudinal project, parents of children with challenging behaviors receiving the discharge teaching application (n = 14) reported lower mean scores on the quality of discharge teaching scale–delivery subscale (M = 8.2, SD = 3.1) than parents receiving usual care (n = 11) (M = 9.6, SD = 4.7) and lower scores on the Care Transition Measure (M = …

Implementation And Preliminary Testing Of A Theory-Guided Nursing Discharge Teaching Intervention For Adult Inpatients Aged 50 And Over With Multimorbidity: A Pragmatic Feasibility Study Protocol, Joanie Pellet, Marianne Weiss, Franziska Zúñiga, Cédric Mabire

College of Nursing Faculty Research and Publications

Background

Discharge teaching by nurses during hospitalization is essential to provide multimorbid inpatients with the knowledge and skills to self-manage their health conditions. However, available disease-specific teaching guidelines do not address the cumulative complexity of multiple chronic diseases that occur with greater frequency in older adults. Therefore, there is a need for a discharge teaching intervention which uses concepts that specifically address the needs of these patients, such as considering their level of activation (i.e. knowledge, skills and confidence to self-manage their health) and the burden of multimorbid disease. The objectives of this pragmatic study will be to (1) test …

Improving Quality Of Care Through Discharge Planning, Maria Pasillas

Master's Projects and Capstones

Providing good education for the new mother is key to improving the quality of care for both mom and baby. Since nurses are frontline health care providers who perform the most postpartum education, it is imperative they work to improve discharge education so information provided is consistent, appropriate, and evidence based (Suplee et al., 2016).

The aim of this project is to improve the discharge planning process of a local community hospital utilizing evidence-based research (EBR) with the intent to increase patient satisfaction scores in care transitions to above 65% within 3 months.

The community hospital is a 122-bed acute …

Engaging Parents In Education For Discharge (EPed): Evaluating The Reach, Adoption & Implementation Of An Innovative Discharge Teaching Method, Norah L. Johnson, Stacee M. Lerret, Carol Klingbeil, Michele Polfuss, Cori A. Gibson, Karen Gralton, Mauricio Garnier-Villarreal, Sheikh Iqbal Ahamed, Riddhiman Adib, Rachel Unteutsch, Louis Pawela, Rosemary White-Traut, Kathleen J. Sawin, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Purpose

This paper describes the evaluation of the implementation of an innovative teaching method, the “Engaging Parents in Education for Discharge” (ePED) iPad application (app), at a pediatric hospital.

Design and methods

The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to guide the evaluation. Three of the five RE-AIM elements are addressed in this study: Reach, Adoption, and Implementation.

Results

The Reach of the ePED was 245 of 1015 (24.2%) patient discharges. The Adoption rate was 211 of 245 (86%) patients discharged in the five months' study period. High levels of fidelity (89.3%) to …

Using The Engaging Parents In Education For Discharge (EPed) Ipad Application To Improve Parent Discharge Experience, Stacee M. Lerret, Norah L. Johnson, Michele Polfuss, Marianne E. Weiss, Karen Gralton, Carol Klingbeil, Cori A. Gibson, Mauricio Garnier-Villarreal, Sheikh Iqbal Ahamed, Riddhiman Adib, Rachel Unteutsch, Louis Pawela, Rosemary White-Traut, Kathleen J. Sawin

College of Nursing Faculty Research and Publications

Purpose

The purpose of this study was to evaluate the use of the Engaging Parents in Education for Discharge (ePED) iPad application on parent experiences of hospital discharge teaching and care coordination. Hypotheses were: parents exposed to discharge teaching using ePED will have 1) higher quality of discharge teaching and 2) better care coordination than parents exposed to usual discharge teaching. The secondary purpose examined group differences in the discharge teaching, care coordination, and 30-day readmissions for parents of children with and without a chronic condition.

Design/Methods

Using a quasi-experimental design, ePED was implemented on one …

Nurses’ Perception Of Discharging The Medically Complex Pediatric Patient, Stacie Camille Licon

Doctoral Projects

The purpose of this study is to query the nurses for their perceptions of the barriers and facilitators of discharging medically complex pediatric patients from a freestanding children’s hospital in central California. Using a mixed methods research design via an online survey, 90 nurses identified 3 distinct themes that act as barriers. Those barriers include: 1) knowing the plan of care, 2) time, and 3) disposition of the family. Several implications for improving the discharge process for medically complex patients and overcoming the identified barriers include strategies to improve multidisciplinary communication, implementation of a Family Learning Center, use of video …

Teaching Students To Teach Patients: A Theory-Guided Approach, Lori Candela, Linda B. Piacentine, Kathleen L. Bobay, Marianne E. Weiss

College of Nursing Faculty Research and Publications

Nurses in every setting provide patient teaching on a routine basis, often several times a day. Patient teaching skills are essential competencies to be developed during pre-licensure nursing education. While students learn what to teach for specific conditions, they often lack competence in how to teach in ways that individualize and optimize patient learning. The ultimate goal of patient teaching is to arm patients with the knowledge and skills, and the desire and confidence in their ability to reach their targeted health outcomes. We describe the creation of a theoretical framework to guide development of patient teaching skills. The framework, …

Relationship Of Exposure To Heart Failure Discharge Teaching To Readmission Within 30 Days, Becky Ann Pogacar

Dissertations (1934 -)

Heart Failure (HF) patients are at increased risk for higher rates of hospital readmission within 30 days. Previous studies have demonstrated educational interventions delivered by nurses reduce readmission but the relationship of the dose of teaching to HF readmission or ED utilization remains unclear. A retrospective correlational design framed by the General Outcomes Effectiveness Model was utilized to (1) establish a relationship between the dose of discharge teaching documented by acute care nurses and the outcomes of hospital readmission and ED utilization within 30 days of a previous hospital discharge and (2) identify the teaching components included in an evidence-based …

Discharge Teaching, Readiness For Discharge, And Post-Discharge Outcomes In Parents Of Hospitalized Children, Marianne E. Weiss, Kathleen Sawin, Karen Gralton, Norah L. Johnson, Carol Klingbeil, Stacee M. Lerret, Shelly Malin, Olga Yakusheva, Rachel Schiffman

College of Nursing Faculty Research and Publications

Purpose

This study explored the sequential relationships of parent perceptions of the quality of their discharge teaching and nurse and parent perceptions of discharge readiness to post-discharge outcomes (parental post-discharge coping difficulty, readmission and emergency department visits).

Design/methods

In this secondary analysis of data from a longitudinal pilot study of family self-management discharge preparation, the correlational design used regression modeling with data from a convenience sample of 194 parents from two clinical units at a Midwest pediatric hospital. Data were collected on the day of discharge (Quality of Discharge Teaching Scale; Readiness for Hospital Discharge Scale), at 3 weeks post-discharge …

A Comparison Of The Effectiveness Of Two Educational Interventions Developed To Teach Early Infant Hunger Cues To Junior Level Nursing Students., Melissa D. Gainer

Williams Honors College, Honors Research Projects

Due to multiple learning styles, it can be difficult to teach to large groups of students. The purpose of this study is to compare the effectiveness of two different educational interventions designed to teach infant hunger cues to undergraduate nursing students to increase the knowledge and confidence levels needed for the future teaching of infant hunger cues to new parents. Flemings VARK theory was used to guide this quasi-experimental study. A pretest posttest two-group design was used to evaluate both knowledge and confidence levels in the participants (N= 86). Data was analyzed utilizing a paired t-test. The results noted significant …

Readiness For Discharge In Parents Of Hospitalized Children, Marianne E. Weiss, Norah Louise Johnson, Shelly Malin, Teresa A. Jerofke, Cecilia Lang, Eileen Sherburne

Norah L Johnson

Parental preparation for a child's discharge from the hospital sets the stage for successful transitioning to care and recovery at home. In this study of 135 parents of hospitalized children, the quality of discharge teaching, particularly the nurses' skills in “delivery” of parent teaching, was associated with increased parental readiness for discharge, which was associated with less coping difficulty during the first 3 weeks postdischarge. Parental coping difficulty was predictive of greater utilization of posthospitalization health services. These results validate the role of the skilled nurse as a teacher in promoting positive outcomes at discharge and beyond the hospitalization.

Improving Patient Outcomes Through Use Of The Teach-Back Method In The Post Anesthesia Care Unit, Kathleen Osullivan

Master's Projects and Capstones

The setting for this Clinical Nurse Leader (CNL) project was the Post Anesthesia Care Unit (PACU) at a level I trauma center in the Bay Area. The goal was to improve the discharge education performed by the PACU nurses to improve patient safety and decrease the chance of complications or readmissions to this hospital. With no clear instructions for how discharge teaching should be done, the nurses have many differing styles which leaves room for gaps in discharge planning. This influenced the implementation of the teach-back method during discharge planning in order to ensure proper education and increased patient understanding. …

The Use Of Motivational Interview Intervention In Discharge Teaching Of Patients With Heart Failure, Jason O'Brien

Jason O'Brien

It is widely recognized in healthcare that there are many different behavioral choices a patient can make that can have an impact on their health and disease management outcomes. One of the more prevalent diseases that requires consistent compliance is heart failure. The literature suggests that the different areas of management are often something the layperson in the home can have control over, provided they have the confidence and conviction to do so. There is a call for a new way of teaching these patients upon hospital discharge as the old way of lecturing instruction is not effective. It has …

Predictors And Outcomes Of Postpartum Mothers' Perceptions Of Readiness For Discharge After Birth, Marianne E. Weiss, Lisa Lokken

College of Nursing Faculty Research and Publications

Objective: To identify predictors and outcomes of postpartum mothers' perceptions of their readiness for hospital discharge. Design: A correlational design with path analyses was used to explore predictive relationships among transition theory-related variables. Setting: Midwestern tertiary perinatal center. Participants: One hundred and forty-one mixed-parity postpartum mothers who had experienced vaginal birth or Cesarean delivery of normal healthy infants. Methods: Before hospital discharge, patients completed questionnaires about sociodemographic characteristics, hospitalization factors, quality of discharge teaching, and readiness for discharge. Three weeks postdischarge, mothers were contacted by telephone to collect coping difficulty and health care utilization data. Main Outcome Measures: Readiness for …

Patients' Perceptions Of Hospital Discharge Informational Content, Lynn Rose Maloney, Marianne Weiss

College of Nursing Faculty Research and Publications

Ensuring that patients' informational needs have been met prior to hospital discharge sets the stage for successful self-management of recovery at home. This secondary analysis study aims to identify differences in the amount of discharge teaching content needed and received by adult medical-surgical patients on the basis of their sociodemographic characteristics and hospitalization-related factors. The Quality of Discharge Teaching Scale (QDTS) is used to measure patients' perceptions of the amount of discharge-related informational content they needed and received. Eighty-nine percent of patients receive more informational content than they perceived they needed. Nonwhite patients report more content needed than White patients. …

Readiness For Discharge In Parents Of Hospitalized Children, Marianne E. Weiss, Norah Louise Johnson, Shelly Malin, Teresa A. Jerofke, Cecilia Lang, Eileen Sherburne

College of Nursing Faculty Research and Publications

Parental preparation for a child's discharge from the hospital sets the stage for successful transitioning to care and recovery at home. In this study of 135 parents of hospitalized children, the quality of discharge teaching, particularly the nurses' skills in “delivery” of parent teaching, was associated with increased parental readiness for discharge, which was associated with less coping difficulty during the first 3 weeks postdischarge. Parental coping difficulty was predictive of greater utilization of posthospitalization health services. These results validate the role of the skilled nurse as a teacher in promoting positive outcomes at discharge and beyond the hospitalization.