Date of Graduation

Summer 8-12-2022

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions


MSN project

First Advisor

Dr. Susan Mortell



The field of nursing prides itself on two critical functions: safety and patient education. One of the mechanisms for both education and safety is the discharge process. Improvements in the discharge process have been shown to increase patient comprehension and safety. This study is grounded in the (Barach & Johnson, 2006) healthcare organizational framework called the 5 Ps microsystems assessment to explore the impacts and improvements in the discharge instruction process on a postpartum unit in a large organization. It was found that HCAHPS scores regarding discharge instructions were 55-60%, which is below what is considered satisfactory. Utilizing the microsystems assessment, a gap was found in different discharge instruction delivery by staff nurses on the postpartum unit and a lack of knowledge of key elements to meet discharge instructions standard practice and policy. A focus on three of the five Ps: the professionals, the patients, and the processes, led the study of the quality improvement project. Staff nurse surveys revealed that staff nurses needed further education and training to increase competency to follow the organization’s discharge policy. Education was provided to the nurses on what is expected to be explained during discharge instructions to be best practices. Once the nurses received more training and education there was a direct correlation in the improvement of patients’ recall of the discharge instructions. The patients’ recall of discharge instructions improved to 64% after education. This project explored that continued education, standardization of delivery of instructions, and increased accountability will close gaps in nursing staff knowledge, and delivery of discharge instructions, and increase patient comprehension and safety.