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Document Type

DNP - University Access Only

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Nicole Gibson


discharge, hospital discharge, discharge education, discharge education tools, discharge phone call


Emergency Department (ED) utilization has increased across the United States (U.S.) leaving a majority of patients to be evaluated and discharged home with complex medical diagnoses, new medications, and follow-up appointments. Most ED’s lack a standardized, evidence-based discharge instruction process, and follow-up transition plan. The purpose of this project was to educate nursing staff on the Teach-Back method and create a standardized discharge teaching process including a follow-up call back system to assess patient’s comprehension of discharge instruction in the ED and to improve patient satisfaction with their care by monitoring Hospital Consumer Assessment of Healthcare Providers and Systems Scores (HCAHPS) scores. This project utilized a three month prospective approach, and data from two groups was analyzed using various tests including Fisher’s exact tests, paired t-test, sign rank test, and Mann-Whitney U Test. A descriptive comparison of historical HCAHPS percentage scores one year pre-implementation versus the three months during implementation was also reviewed. Demographically there was no statistically significant difference found between the two groups in gender, marital status, race, method of discharge, and consent for call-back. Using a 5% level of significance for all statistical testing, it was determined there was no association between the variable age and the number of correct responses at discharge or call back. Group one, the usual method (Pr >=S 0.0043) found there were more correct answers given during discharge as compared to at the time of call-back. Group two, the Teach-Back method (Pr >=S 0.0023) found there were more correct answers given during discharge as compared to at the time of call-back. Overall, there was no statistical difference between the method of teaching used and the number of correct responses given at discharge or call-back. A descriptive comparison of historical HCAHPS percentage scores showed an overall improvement in the average scores for the three months of the study versus 2014, although trending scores for 2015 indicated an overall downward trend when compared to 2014.

Library of Congress Subject Headings

Health facilities -- Discharging planning
Patient satisfaction
Hospitals -- Emergency services


Includes bibliographical references (pages 68-71)



Number of Pages



South Dakota State University


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