Abstract TP37: Teach-back Method And Hospital Readmission

Abstract

Introduction: The transitions of care can be stressful and challenging to the AIS survivors and their families as each adjusts to unfamiliar roles. During care transitions, patients are faced with self-care challenges that can often lead to unplanned readmission. Patient education is an essential component of supporting the patient and family in preventing secondary stroke and promoting self-management. However, 40-80% of the medical information during education sessions is forgotten immediately, and can be misunderstood. Hypothesis: The researcher hypothesized that age of ≥ 75 years old; LOS ≥ 5 days; the presence of multiple modifiable risk factors; a NIHSS score ≥ 5; discharge destination to a SNF; and/or a high LACE score are the characteristics that will be seen most often among AIS patients with a 30-day readmission. The researcher also hypothesized that patient education using the teach-back method will decrease all-cause 30-day hospital readmission rates of patients with AIS. Method: A chart review of 955 medical records over 2 years was collected using a researcher-designed spreadsheet. Data were analyzed through descriptive and inferential statistics using measures of central tendency, Mann-Whitney, and Chi-Square Comparison. Results: The research study showed a high readmission rate on patients with a LOS ≥ six days (p=.006), discharge destination to SNF (p=.008), NIHSS score of ≥ 6 points (p=.03), and high LACE score (p=.008). However, there is a weak correlation between each variable and readmission. There was no significant difference in readmission rate between the pre-intervention group (3.3%) and the post-intervention group (4.35%) (p = .40). Conclusion: The researcher concluded that patient characteristics such as a higher length of stay, discharge to a SNF, high NIHSS score, and high LACE score can influence the risk of readmission. Since the contributing factors to 30-day hospital readmission are complex and multifactorial, identification of high-risk patients may allow opportunities for specific interventions such as patient education using the teach-back method. However, interventions must be patient, and family-centered, and targeted at the transitions of care.