Hinnershitz, Jill, MSN, RN

Peter, Debra, MSN, RN-BC

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksPatient Care Services / NursingTeach-Back Translation: Overcoming ChallengesDebra Peter MSN, RN-BCLehigh Valley Health Network, Debra.Peter@lvhn.orgJill Hinnershitz MSN, RNLehigh Valley Health Network, Jill_S.Hinnershitz@lvhn.orgFollow this and additional works at: http://scholarlyworks.lvhn.org/patient-care-services-nursingPart of the Nursing CommonsThis Presentation is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works byan authorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtResearch Day 2012: Transforming Culture Through Evidence-Based Practice, October 29,2012, Lehigh Valley Health Network,Allentown, PA.Teach Back Translation:  Overcoming Challenges!   Debra Peter, MSN,RN,BC,CMSRN  - Patient Care Specialist Jill Hinnershitz MSN,RN,     - Products Nurse  Lehigh Valley Health Network 10/29/12  Objectives   ■ Summarize the development of a teach back standard work process focused on improving learning outcomes.  ■ Discuss strategies used to translate teach back evidence.  Our Journey Summarized ■ Invitation to join Value Stream ‘Reducing Readmissions by Improving the Discharge Process’  ■ Convened subgroup – ‘Providing Effective Patient, Family & Caregiver Education’  ■ Collaborated with the Institute for Healthcare Improvement (IHI) Key Points r/t Patient Education – Typical failures: •Assuming patient is key learner •Failing to ask clarifying questions re:  instructions and care  – IHI recommended strategies: •Accurately identify the key learner  •Use teach back as an effective strategy to evaluate outcomes of learning  Got Evidence? ■ Patients recall or comprehend as little as half of what physicians convey during an outpatient encounter.     Schillinger et al (2003).  Closing the loop:  physician communication with diabetic patients who have low health literacy.  Arch Intern Med., 163, 83-90.     ■ Staggering amount of hospitalized patients receive no education regarding how to care for themselves at home.   Jack, B., Chetty, V., & Anthony, D. (2009, February 3). Annals of Internal Medicine., 150(3), 178-187.   ■ Nurses and other healthcare providers have conflicting priorities and historically teaching falls to the bottom of the priority list.  Jack, B., Chetty, V., & Anthony, D. (2009, February 3). Annals of Internal Medicine., 150(3), 178-187.    What Do We Remember?  ■ After 2 weeks  – 10% of what we read – 20% of what we hear – 30% of what we see – 50% of what we see & hear – 70% of what we say – 90% of what we say & do Edgar Dale, Audio-Visual Methods in Teaching (3rd. Ed)., Holt, Rinehart, and Winston (1969) What is Teach Back?  ■ An effective communication strategy that is: – Easy to use – Improves learning outcomes – Engages patient and families in realistic goal setting – Improves health service utilization   Schillinger D, Piette J, Grumbach K, Wang F, Wilson C, Daher C, Leong-Grotz K,Castro C, Bindman AB.  (2003).  Closing the loop:  physician communication with diabetic patients who have low health literacy.  Arch Intern Med., 163, 83-90. WE Are Accountable ■ “So that I know I did a good job teaching you, I will ask you a few questions.”  ■ “If you are in your backyard this evening talking to your neighbor, what would you tell him we talked about?” Teach Back Standard Work Process 1. Identify key learner and learning style 2. Identify opportunity to use teach back 3. Enter on-line ‘Teach Back’ order 4. Provide appropriate educational content and verbally review with key learner(s) 5. Use teach back to evaluate learner’s knowledge 6. Document progress and plan for additional resources, as indicated Demonstration Challenges of Translation  ■ Awareness of teach back evidence  ■ Time  ■ Confidence r/t teaching  ■ Conflicting network-wide initiatives  Overcoming Challenges of Translation ■ Involving staff nurses in the project  ■ Involving champion nurse leaders  ■ Devising an effective education plan – including evidence, case studies, on-line module, workshops  ■ Providing tools to support standard work  – Prompter on med screen – Sample scripting incorporated into reference screen resource – Unit worklist to identify teach back orders  ■ Assessing competence and validating staff by using a standardized performance checklist  ■ Sharing metrics identifying areas for improvement & successes  ■ Adding teach back indicators to unit quality action plan     YOUR Time to Teach Back “So, that we know we did a good job teaching you . . . “ Contact Information: Debra.Peter@lvhn.org Jill_A.Hinnershitz@lvhn.org  

Showcase of projects: Teach-Back Translation: Overcoming Challenges

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Showcase of projects: Teach-Back Translation: Overcoming Challenges

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Lehigh Valley Health Network: LVHN Scholarly Works