Teach-Back Method was brought to my attention by Angela Peters, APN in the Pain Management Department. Angela has been using Teach-Back successfully for years and now uses it in her practice to make sure that prescribed opioid and adjuvant pain medications are taken correctly for maximum pain relief. Please use this link to learn more about Teach-Back Method, and how it can improve the quality of whatever you need to convey to patients about their medications, treatment plan, and self care. Please watch both videos, and read the power point.
Questions
- Name four barriers to learning an oncology patient might experience that would increase their risk for noncompliance to treatment.
- What resources are currently available at our hospital to assist patients with learning about their treatments and medications?
- After using Teach-Back Method, how would you document it on the chart?
Discussion Question
How can you personally use Teach-Back in your unit or area of care? Note: I am using Teach-Back Method for the Discussion Question :)
I use the teach-back method daily but especially when I discharge a patient.
ReplyDeleteAt first when I meet my patient for the first time I go through my speech of using the call light and asking for my assistance if they want to ambulate ect. and before I leave the room I say "and what are you going to do if you want to get up". Patients always look at me funny and I say i'm serious and they repeat what I told them but, that way I know they know I'm serious. But, when I discharge a patient I always ask two main questions: Who are you going to call if you have any questions? (care manager) and How are you going to get a hold of them? (I highlight the number for them). That way if something comes up they don't have to fret looking for who and what number to call.
I spent the past 24 hours thinking about how I as a Nurse Navigator could use the Teach-Back Method. Interestingly this afternoon I was explaining to a patient the process that they needed to follow which was not as much complicated as it was detailed. I said to the patient, “now tell me what are you going to do tonight?” He was able to walk through the process verbalizing back to me the step by step process.
ReplyDeleteI am of the opinion that this method of communication is highly effective and can be used in most everyday discussions. While it is very good when teaching someone something specific, it is highly effective in creating accurate understanding in general conversation.
Discussion Question
ReplyDeleteHow can you personally use Teach-Back in your unit or area of care? One example of how I utilize Teach-Back is for pre-operative instructions. I give the instructions step-by-step, then I repeat the instructions in a short summary. I ask the patient if they have any questions or concerns. If patient verbalizes they agree and understand with current plan of care, I give them my card and instruct the patient to contact me at any time for any other concerns. If the patient is unable to reach me, they should contact the 1-800 care management number that is available 24 hours a day.
Discussion Question
ReplyDeleteHow can you personally use Teach-Back in your unit or area of care? I feel I can use the Teach -Back technique when doing preoperative teaching and preparation with my surgical patients. I think we have been doing it but just not calling it that. I think it is a good way to see how your patient, and even peers understand what one is trying to convey ; and how one can adjust their technique if warranted. Our optimum goal is for the patient to understand for optimum benefit and success. I also think we can employ it in relationships with our peers and even in other interactions so everyone is on the same page.
Theresa Rodriguez - Infusion:
ReplyDeleteThe "Teach-back" method is self explanatory: A patient is to reverse roles and instruct you, the RN, on the information you provided to him/her. A patient is to use his/her own words and essentially repeat what you said. This is what we mean (or are supposed to mean) when we write "verbalized understanding!"
As a care manager I am frequently involved in educating patients and caregivers, especially regarding symptom management, how to take medications appropriately, and precautions related to low blood counts. When I have these conversations with patients and caregivers, I often suggest they write down what I am saying and read it back to me. That way I know they understand it and have notes to refer to when they return home.
ReplyDeleteExample questions might be: Can you tell me in your own words: "What will you do if you have a temp of 100.4 or above?", "Why is it important to get your blood work done at home?", "What will you do if you cannot get your nausea, or diarrhea, or constipation under control with the medication prescibed to you?" "When will you remove your dressing?" "How often do you take your oxycontin and oxycodone?" "When is your return appointment?"
ReplyDeleteI use the teach-back method daily when I give a patient a new medication or teach them about chemotherapy. I often times ask patients to repeat what the medication is being given for and how and when they are going to take it. It's harder when a patient starts chemotherapy because they are often overwhelmed. This is when the "Chunk and Check" technique comes into play. Basically, chunking together 2-3 most important things and then check for understanding. It also helps that written documentation is supplied to patients.
ReplyDeleteI use the teach-back method daily, especially when I have a patient
ReplyDeletethat has just had a port inserted and we are accessing for the first time. We ask the patients if they can tell us the signs of infection. Who do they contact when they are not here? We also give them handouts that they may have already received after their surgery and review it w/them briefly.
How can you personally use Teach-Back in your unit or area of care? I can use the teach -back method in area of care managment when I review the patient's treatment plan summary and symptom managmenet booklet. I have areas highlighted of importance for a quick view by the patient when in need. I also have pt repeat s/s of when they need to call cm for symptoms issues before the phone call ends or the 1 on 1 teaching ends. The questions of when, where, how and what are always a great way to start the teach back method with. Tami
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ReplyDeleteHow can you personally use Teach-Back in your unit or area of care?
I have personally used the Teach-Back in the many phone conversations with patients to be sure that they were able to repeat back what they were to do and other information when explained. Asking the patient open ended questions helps the patient to state what they know in their own words. It is a great way to assess patient knowledge, and if patient will comply with instructions and why or why not and if more teaching is needed. Terry W
There is no shortage of teaching opportunities on the floor. I can have a patient return demonstrate how to empty a drain for instance. Also at discharge you have to go over medications, amongst other things. I could ask them to go over the medications with me and explain when they are supposed to take them. And always make it apparent to them there are always references such as care management if they have any further questions.
ReplyDeleteA significant potion of my daily patient interactions involve teaching. I do not do teach-back enough. I always ask if they have questions or understand the instructions, but the video helped me identify that a "yes-no" question is not enough. To assess patient retention along with providing respect, dignity, and a shame-free, safe environment are crucial components for effective teaching.
ReplyDeleteWe saw a patient in clinic today that needed a J-tube unclogged. We showed him the equipment/supplies needed. Then we explained each step as we actually unclogged the tube. We put an extra set of supplies in a bag for him to take home. The patient was able to describe step by step what he would do if the tube clogged again. He was also given a business card with contact information for questions as needed/Care Manager as well for after-hours.
ReplyDeleteI like to use the teach back method when reviewing with patients the port placement and care document during their port access. I review with them the type of port that was placed and ask that they point to it on the handout. I highlight the S/S of infections and blood clots and ask that they name some of these and explain what to do should they occur.
ReplyDeleteIn the infusion center I like to use the teach back meathod when giving the patient their discharge instructions. I have them 1st read their instructions and give them time to review it. Before they leave I ask them questions like do they know who their care managers are? What will they do if running a temp., and what is considered a tempature for them? And I go through the whole discharge like that.
ReplyDeleteWe use the teach-back method when patients get admitted to stem cell unit by orienting them to their surroundings, use of call light/TV controls, bed controls-also making sure brakes are on at all times,the string to pull in the bathroom for emergency purposes, the telephone extension to dietary,the string to pull to adjust or turn off the overhead light, use of telephone at the bedside. These we go thru with patients by demonstrating and then letting them do it by themselves. We give patient an admission packet that consist of what to expect during their hospital stay-safety rules, daily weight, taking routine vital signs, intake and output-make sure they put on the counter of nurse servers the empty bottles of water/juice so we can take credit and write down on I&O column in computer. Upon discharge, we give a packet to our transplant patients that will discuss the signs and symptoms to watch(esp. for graft-versus-host disease such as diarrhea, skin rashes), the nutrition they need if they are put on neutropenic diet, the neutropenic precautions such as frequent handwashing and wearing mask in public places, taking their temp.-if 100.3 and above, to call the care manager at the 1-800 number. Also, when patients get discharge, i write down the name/color of meds, time to take it, what the meds is for,and the side effects/precautions to watch for and who to call-1-800 number. Then I ask the patient or the caregiver if he/she can identify the meds we just talked about.
ReplyDeleteI use the teach back method when teaching patients about side effects they may encounter with chemotherapy that they are receiving and the medications they can use if the symptom should arise. I test their knowledge by asking them to tell me what the would do if they felt nauseous or has diarrhea etc... Also making sure they understand that if they have questions, care management is only a phone call away. :)
ReplyDeleteThe Teach-Back Method is a great way in teaching patients in the Return Patient Clinic. The biggest barrier for the patients in the clinic are the new patients who are so overwhelmed at their first visit with all of the information that they are receiving so quickly that it is not always an ideal time to try the teach back method. Their second visit is a much more effective time to teach the teach back method and have the patient do a return demonstartion or repeat information and show understanding. For the first visits I always write everything down for them and highlight important points so they have a reference to look at. This has been helpful for many patients as well.
ReplyDeleteThe Teach Back method is great tool in patient education. We use it in SIU daily with discharge,very very helpful.Written instruction regarding wound care and JP drain care is given to patient but nothing helps patient and family as much as demonstration with returned demonstration.
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ReplyDeleteFirst of all, anytime we teach a patient or give them instructions on what to do We have to remember to use plain language so that it is easy for them to understand. Talking slow and taking the time to pause and allowing them time to ask any questions that they might have can help ensure that patient understands the given instructions. When i have a return patient in the infusion center, i ask them right away if they are familier with their discharge instructions, and if they say yes, i ask them to tell me what they are. This allows me to see how much they know and what i need to clarify for them.
ReplyDeleteIn the Infusion Center I reinforce chemo teaching and the chemo precautions that should be followed 48 hours after. When I am done with my teaching I ask them questions that I have taught them earlier. One example is that I ask them how many times they should flush the toilet, or what a fever is considered for them. Also, I ask the patient when they are coming back to ensure that they remember their neulasta injection and to also schedule their return visit.
ReplyDeleteThe Teach-Back Method that we can use in the Return Patient Clinic on every visit. From the first visit on the patients can be taught by this method. In the the beginning there is a problem with information over load, but each visit your use this method until you know the patient understands show you that they understand or can teach back what ever you have told them. I do give my patients on the first visit written information that I have taught them so that they can always go back refer to the information if they for get.
ReplyDeleteUtilizing the Teach-Back Method will be useful in the Radiation Oncology area or any area and truly enlightened me as to just how prevelent health care illiteracy is. Also, how just changing and rewording a few key phrases will have a significant impact upon evaluating the patients/families comprehention of the information we provide. I love the whole aspect of creating a safe and shame free environment to providing care with dignity and respect.
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