Degree Name
Nursing Practice, DNP
Publication Date
9-28-2026
First Advisor
Lisa Drake
Second Advisor
Elizabeth L'Heureux
Abstract
Deficits in health literacy and inconsistent discharge education contribute to patient misunderstanding and avoidable return visits. This quality improvement project evaluated a standardized teach-back discharge education process at a community urgent care clinic. Lewin's Change Theory guided the change process, the Iowa Model guided implementation, and Donabedian's Structure-Process-Outcome Framework guided evaluation. A quantitative one-group pretest-posttest design included eight participants: three nurse practitioners, two licensed practical nurses, and three medical assistants. Participants completed a 30-minute teach-back educational session followed by a 12-week implementation period. Measures included the five-item Confidence Scale, discharge audits, and aggregate electronic medical record data on seven-day return visits. Confidence increased from preintervention (M = 18.63, SD = 2.13) to postintervention (M = 24.63, SD = 0.52), t(7) = 9.17, p < .001, d = 3.24. Across 33 post-intervention audits, adherence ranged from 21% for documenting completed education to 100% for using plain language, reviewing key instructions, and asking patients to explain instructions. Changes in adherence could not be determined because comparable baseline data were unavailable. The aggregate seven-day return-visit rate decreased from 7.40% to 4.41%, an absolute reduction of 2.99 percentage points. Findings support continued use of standardized teach-back, with additional attention to written instructions and documentation.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Smith, Pearlean, "Standardizing Discharge Communication in Urgent Care: A Teach-Back Quality Improvement Initiative" (2026). Doctor of Nursing Practice Projects. 411.
https://arch.astate.edu/dnp-projects/411
