Document Type

DNP Project

Date of Degree

Spring 2024


Doctor of Nursing Practice (DNP)

Primary Advisor

Quiping Zhou, PhD, RN


Background: Patients must perform self-care after discharge to manage their heart failure. In the project setting, usual care includes a handout for patients with or without verbal teaching. Multimedia education gives patients the ability to learn with a combination of methods - video, verbal and written.

Objective: The purpose of this quality improvement project was to determine if patients with heart failure have a greater increase in self-care knowledge before discharge with the use of multimedia patient education consisting of video, verbal teaching and written materials, compared to the usual care of verbal teaching and written materials.

Methods: This project used a quasi-experimental, pre-test/post-test two group design. Knowledge was measured with the use of the Atlanta Heart Failure Knowledge Test (v3). During the first phase (1.5 months), patients received usual care. During the second phase (1.5 months), patients received a multimedia intervention (written materials, verbal teaching and a video). Baseline (pre-test) knowledge was measured before the usual care or the intervention, and post-test knowledge was measured after usual care or the intervention. Repeated measures ANOVA was used to analyze the data.

Results: We recruited 15 participants for each group. For the usual care group, knowledge scores increased from 80.98 to 84.00; while for the multimedia group, knowledge scores increased from 72.01 to 81.05. The multimedia group showed a significantly greater increase in knowledge scores (3.02% vs. 9.04%) F=18.706, p<0.001. The Cohen’s d effect size was 0.788, which is highly meaningful for clinical practice.

Conclusion and Implications: A nurse-led multimedia intervention for patients with heart failure improved self-care patient knowledge by 9.04% before discharge. Self-care knowledge is necessary for successful heart failure management after discharge and could lead to fewer readmissions, decreased healthcare costs and increased patient satisfaction.

Open Access


Available for download on Wednesday, May 21, 2025