Is "Teach-Back" Associated with Knowledge Retention and Hospital Readmission in Hospitalized Heart Failure Patients?

Patients who received self-care instructions from nurses using the teach-back method, retained information but it did not reduce 30-day hospital readmission rates.

Nearly 6 million people in the United States have heart failure, with 670,000 new cases each year. Some 21 percent of heart failure patients are readmitted to the hospital within 30 days of being hospitalized. Many readmissions are believed to be preventable with self-care: adherence to diet and medication regiments. While patients receive discharge information, many do not comprehend or retain it.

These researchers tested the effectiveness of an interactive education strategy called teach-back. Hospitalized patients are provided information and then asked to restate it, allowing the educator to assess understanding and recall, and adjust their teaching.

Heart failure patients in a San Francisco hospital were educated by a registered nurse coordinator for an average of 34 minutes (some as long as an hour). The patients were then asked four questions to test their understanding. Seven days later they were asked the same questions by telephone.

Some 84 percent of patients answered three of four questions properly when hospitalized; 77 percent on follow-up. The amount of time spent teaching was associated with properly answering the teach-back questions. Correctly answering the questions, however, did not significantly reduce hospital admissions:16 percent who answered incorrectly were readmitted; 15 percent who answered correctly were readmitted.