Patient and Caregiver Teaching

Teaching patients and their caregivers is increasingly important, especially in home care. Patients must care for themselves, or be assisted by volunteer or paid caregivers in between visits from professional staff members in order to receive home care services. The effectiveness of teaching matters because it impacts the quality of care patients receive, which is, of course, the primary concern of providers. It also matters from the point of view of risk management. Home care providers need to provide effective teaching in order to avoid potential legal liability for adverse consequences to patients.

Although home care providers generally recognize the importance of teaching, it may be less clear how to provide it. Studies have shown that a majority of patients remain confused about their plans of care (POCs). Most patients and caregivers do not recognize their lack of comprehension. A substantial proportion of medical information is forgotten immediately after discharge. Studies also show that when larger amounts of information are presented, less information was recalled and almost half of recalled information was incorrect.

Historically, using the so-called “teach-back method” with patients has, at least anecdotally, seemed to be effective. When the teach-back method is used, patients and/or their caregivers explain information about their care that has been provided to them in their own words. This method may also involve so-called “return demonstrations” in which patients and/or their caregivers successfully perform the activities related to care that they have been taught. This method allows providers to verify patients’ and caregivers’ understanding of health information provided to them.

A recent article entitled “Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes (Fed Pract. 2019 June; 36(6), 284-289)” by Peggy Yen supports the conclusion that the teach-back method of patient and caregiver education is effective. Use of the teach-back method was evaluated based on:
• Patient satisfaction
• Post-discharge readmission
• Patient perception of each-back method effectiveness
• Disease knowledge and disease management improvements
• Intervention effects on health-related quality of life
Results showed that use of the teach-back method had positive effects on all of the above.

Needless to say, it is important for staff members to document their use of the teach-back method in individual patients’ medical records.

In addition, when patients and their caregivers cannot explain information about their care or perform the care taught to them, it is clear that more teaching is needed. Repeated education, including use of the teach-back method, must, of course, also be documented.

Patients’ and caregivers’ knowledge of needed care is crucial to the provision of home care services. Staff members should use the teach-back method in their efforts to improve such knowledge.

©2019 Elizabeth E. Hogue, Esq. All rights reserved.

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