Applying Process Standardization and Health Literacy Precautions to Increase Older Adult Patient Satisfaction with Medication Teaching

PURPOSE: The purpose of this project is to use quality improvement methodology to improve how nurses teach older adult patients about newly prescribed medications on a senior care unit (SCU). PROCEDURES: This project applied the DMAIC (Design, Measure, Analyze, Improve, Control) method and findings of a literature review to the new medication teaching process on a SCU. Three interventions were piloted for six weeks: standardization of the new medication teaching process, universal health literacy precautions via use of simplified medication handouts, and verification of understanding using Teach Back method. Data was collected via chart audits, pre- and post-implementation nurse surveys, and comparison of pre- and post-implementation Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores. OUTCOME: Five of seven metrics showed improvement: documentation of teaching (pre-3%; post-24%), self-reported use of handouts \u3e50% of the time (pre-17%; post-64%), HCAHPS mean medication domain (pre-59.96; post-65.6), HCAHPS score for nurses explaining side effects (pre-46.64; post-62.5), and HCAHPS scores for knowing purpose of medication at discharge (pre-55.35; post-60). The two metrics that did not improve were nurses’ self-reported use of the simplified handouts compared to other resources and HCAHPS scores for nurses telling patients about the purpose of new medications. IMPACT: Application of quality improvement methods to standardize an evidence-based process for medication teaching on a SCU showed improvement in five of seven metrics after a 6-week pilot. These findings suggest patient satisfaction with medication teaching can be improved with the interventions of process standardization, health literacy precautions, and Teach Back method