Teach-Back Discharge Education to Improve Self-Care and Reduce 30-Day Readmissions in Heart Failure Patients

Heart failure is a chronic and progressive condition affecting millions of adults in the United States. Despite advances in treatment, nearly one in four patients are readmitted to the hospital within 30 days of discharge, often due to poor understanding of discharge instructions and inadequate self-care. These readmissions contribute to worse health outcomes and increased healthcare costs.

This study evaluated the effectiveness of a structured discharge education intervention using the teach-back method. The teach-back method is a communication technique in which patients are asked to repeat discharge instructions in their own words. This approach helps confirm understanding, reinforce learning, and promote active engagement in self-care.

The study used a quasi-experimental, pre-test/post-test design to assess changes in patients' knowledge and self-care behaviors before and after the intervention. Participants were adults hospitalized with systolic heart failure (LVEF ≤ 40%) who meet specific clinical criteria. Each participant received a 30-minute individualized education session at discharge, covering key self-care topics such as medication adherence, symptom monitoring, fluid restriction, and dietary modifications. Printed educational materials from the American Heart Association were also provided.

To measure outcomes, participants completed the European Heart Failure Self-care Behavior Scale (EHFScB-9) before and after the intervention. Thirty-day readmission data was collected through a retrospective review of hospital records. The study aimed to determine whether teach-back education improved self-care behaviors and reduced 30-day readmission rates.

This project was reviewed and exempted by the Nova Southeastern University Institutional Review Board under Exempt Category 2. It aligned with national goals to improve patient education, reduce preventable readmissions, and enhance the quality of care for individuals with heart failure.

Inclusion criteria

• Adults aged 18 years and older
• Diagnosed with systolic heart failure with a left ventricular ejection fraction (LVEF) ≤ 40%
• Classified as New York Heart Association (NYHA) Class II, III, or IV
• Categorized as American College of Cardiology/American Heart Association (ACC/AHA) Stage C or D
• Currently hospitalized at the project site
• Able to read and understand English at an 8th grade reading level
• Have access to a smartphone or tablet capable of scanning QR codes and connecting to the internet
• Provide voluntary informed consent via the REDCap platform

Exclusion criteria

• Cognitive impairment
• Non-English speaking
• Unwilling to participate