Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2019


Doctor of Nursing Practice (DNP)

Primary Advisor

Karen Kesten, DNP, APRN, CCNS, CNE, CCRN-K, FAAN; Raymond Zarate, DNP, RN, AGACNP-BC, CCNS


Background: Approximately forty to eighty percent of patient education is immediately forgotten, and about fifty percent of retained information is inaccurate; knowledge is an essential bridge between patient teaching, comprehension and knowledge retention by using the teach- back method (Farris, 2015; Rouse et al., 2016; Stamp et al., 2014).

Objectives: The purpose of this study was to compare teach-back education method versus standard education and care, on knowledge of heart failure (HF) self-care management at discharge and retention of knowledge at three to ten days post discharge.

Methods: A non-probability convenience sampling of 22 HF patients, 65 years and older, over a 6-month period was used. The intervention group received HF education using teach-back, plus standard care and HF handbook. The control group received the standard care plus HF handbook. The study intervention was measured using the Dutch HF Knowledge Scale (DHFKS), the European HF Self-care and Behavior scale (EHFScB-9) and teach-back questionnaire, during the hospital stay and follow up telephone calls, three to ten days post discharge.

Results: The pre-discharge teach-back knowledge retention was statistically significant between groups (t (20) = 2.28, p = 0.03). Post teach-back intervention, EHFScB-9 and DHFKS scores were demonstrated as moderate effect size and deemed clinically significant.

Conclusions: The findings from this study were encouraging to support the effect of teach-back technique on knowledge retention and self-care of HF. Further research study with a larger sample will be needed to evaluate teach-back education on HF knowledge and patient outcomes.

Open Access




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