Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2024


Doctor of Nursing Practice (DNP)

Primary Advisor

Dr. Cara Pandovano


Background: Patient education is an essential part of caring for patients. Failure to properly educate our patients can result in negative outcomes. To confirm patients have understood their treatment plan healthcare providers use the Teach-Back Method (TBM) to have patients state back in their own words what they need to know or do to take care of themselves.

Aims/Objectives: The purpose of this quality improvement (QI) project is to provide education for the Same Day Surgery nurses on the TBM to increase confidence and conviction when using the TBM to improve patients’ understanding of discharge instructions. Outcomes for evaluation consisted of the following three components: 1) conviction; 2) confidence; and 3) how often nurses are using the TBM. These variables were compared before and after the intervention.

Methods: The design of this DNP project is a quantitative QI analysis. A descriptive before and- after-design was used for data collection and analysis. Participating nurses working in the Same Day Surgery unit took the Agency for Healthcare Research and Quality (AHRQ) Conviction and Confidence Scale survey before and after watching the AHRQ educational videos on TBM.

Results: Thirty nurses completed the AHRQ Conviction and Confidence Scale survey prior to the intervention. Significantly higher results were observed for TBM at post-implementation. Specifically, questions 1(Q1): how convinced they are of TBM, questions 2 (Q2): how confident they are to use TBM, and question 3 (Q3): frequency of TBM use. Q1 (t= -1.75, df=58, CI -1.14, 0.08, p=0.04), Cohen’s d=1.78, Q2 (t= -2.02, df=58, CI -1.19, -0.01, p=0.02), Cohen’s d=1.15, and Q3 (t= -6.67, df=58, CI-1.56, -0.84), p=0.00, Cohen’s d=0.70. A significant increase was also observed in the number of elements of teach-back used post-implementation. (X2 = 6.16, df=2, p=0.046), Cramer's V=0.320, p=0.046).

Conclusions: The results have identified that nurses felt more conviction and confidence when using the TBM to educate patients on discharge information after surgery. Nurses reported that they utilized the TBM and found it to be effective.

Open Access




To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.