Date of Graduation

Summer 8-11-2026

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)

College/School

School of Nursing and Health Professions

Program

Kaiser cohort MSN capstone

First Advisor

Catherine Coleman

Second Advisor

Sara Horton-Deutsch

Abstract

Problem: The transition from hospital to home places heart failure (HF) patients at risk for medication errors, nonadherence, deterioration, and rehospitalization. In a 28-bed medical-surgical telemetry microsystem, Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores indicated an opportunity for improvement: “Communication About Medicines” composite score of 47.9%; 62.5% of patients reported being informed about the medication purpose, and 33.3% reported that staff described potential side effects.

Context: A cohort of HF patients was selected to test teach-back methodology and improve patient understanding. Nurse champions volunteered for a 5-month improvement project.

Interventions: Teach-back methods were implemented. Nurse leader rounding and visual education reinforcers were instrumental in promoting staff and patient understanding.

Measures: HCAHPS scores were reported monthly. Process measures included nurse leader rounding (3-5x/week) and champion participation in biweekly meetings. The Conviction and Confidence Scale (CCS) survey (n=13) was monitored at 3 intervals. Qualitative data from champion meetings (n=6) was tracked.

Results: Hospital tracking systems omitted unit-specific HF data. Critical results emerged from nurse rounding, CCS, and champion testimonials. Rounding results included verbal patient/family feedback. CCS data revealed increases in nurse application and engagement; nurse confidence showed a slight decline. Qualitative responses from champions indicated strong engagement and collaboration.

Conclusions: Teach-back methodology should extend beyond CHF education; it can be applied across diagnoses and care settings. Nurses understand the importance of patient education; the challenge is to mitigate competing priorities. Realistic change management requires engaged staff and leadership, patient/family feedback, and a work environment where continuous learning will thrive.

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