161 - SSI Prevention Using the Teach-Back Method During Discharge Teaching

Description:

Description of team - The facility had a significant increased number of SSI in the first 3 quarters of year 2024. The clinical problem was brought to the Unit Professional Governance Council, which were composed of the unit staff represented in the said council & unit managers. With the guidance of the Quality and Safety Department, Teach-back method for discharge education in the Post-anesthetic unit (PACU) was adopted.

Preparation and planning - Observations on how the discharge education in the PACU were done & noted areas on where to embed the teach-back initiative as well as enhance the scripting of the teaching, video education tool was built for training staff, audit tool was created to measure the accuracy of each teaching component added, and time of implementation was set as well as the period of data collection, and obtaining of result.

Assessment - During the surveillance of the Periop unit, it was identified that there was a gap in the delivery of discharge education in the Post-anesthetic unit (PACU) which could have affected the SSI occurrences. Many of these infections occurred weeks after surgery, which gave the inference that there might have been a lack of understanding of surgical wound care from patients & caregiver's standpoint. Upon observing the PACU discharge education process, it was identified that discharge education could be improved through incorporating teach-back method on surgical patients. Evidence supports that using the teach-back method improves patient comprehension of discharge instructions and wound care management.

Implementation - Enhanced discharge education process by validating patient understanding using the teach-back method, which included standardized teaching script and three guided open-ended questions was incorporated as part of the PACU workflow. Patients charts were reviewed for signs & symptoms of early/developing infections and data was cross-referenced to the SSI report from October - December 2024

Outcome - 50 patients received the intervention, 49 out of 50 (98%) met all the measures for the intervention. 1 patient struggled with recalling the correct contact information, possibly due to post-surgical grogginess. This patient was provided with a reinforced handout containing the necessary information.0 superficial General Surgery SSIs noted in Nov 2024 (month of implementation) and every month thereafter until May 2025. The teach-back method initiative has contributed to the reduction of Superficial SSIs. Patients and caregivers expressed feeling more confident and well-equipped to care for their surgical sites after discharge. And lastly, nurses observed higher engagement levels from patients during education sessions.

Implications for perioperative nursing - These included the following:
a) Adopting, disseminating, and standardizing teach-back method across all surgical service lines
b) Enhancing patient education materials to ensure instruction clarity & accessibility
c) Sustaining best practices by training most if not all nursing staff on effective teach-back techniques
d) Expanding follow-up monitoring to assess ongoing wound care adherence
e) Improving patient access to information for patients' easy-access to resources, such as QR codes linked to wound care guidelines
By integrating the teach-back method into discharge education, patients will be better prepared to care for their surgical sites, reducing the risk of SSIs and improving overall patient safety outcomes.