Our hospital system has had us nurses trained to use the Teachback
method. I don't know if that is a copyrighted term or not. When we
were being trained, a video was shown of all manner of pts not
understanding many things about their discharge. For example, a pt
thought he was hyper (active, anxious) when he was actually
hypertensive. He was taking his medicine for anxiety, as I recall.

Basically, any time during your education of a patient, and especially
when you are discharging a pt, you ask questions of them. This lets
you know if they have learned the important information you have
shared, or if they know where to find the information (in the written
hard copy that you give them). So my discharge Teachback session might
go something like this:

Mrs. Jones, this might seem obvious, but your breasts ought to go
through some changes over the next couple of days. What changes will
let you know that milk production is progressing well? (Answer might
be "they'll get fuller, they'll leak") and then you reinforce this.
Next question might be Now, with the babies poops: they're black and
tarry at first, but at 4 or 5 days old what would we like the babies
poops to look like? Mom may be able to tell you or she may go to the
Diaper Diary handout and see for herself and show you. As long as she
knows what hard copies she has and where to find info.
Another question I ask: Let's say that 2 wks from now you have a very
sore throat, swollen glands, and a fever. What will you do about
breastfeeding? or Would this affect your breastfeeding? (answer: it's
ok to bf; nurse reinforces handwashing, call your doctor etc).
Another question tangential to this: What if you go to an
ear-nose-throat doctor for your sore throat and he wants to prescribe
an antibiotic, but he doesn't know which ones you can bf with? How
could you find that answer? (most abx safe, call me, call the wic bf
counselor, infant risk center ph number in her packet).

You get the idea. You can ask questions about feeding cues, followup
appts, who to call, etc.  The idea is not to make it seem like a test,
not to seem threatening, but to sort of give scenarios. I think it's a
pretty good improvement over our old rote method of dc teaching.
Laurie Wheeler RN MN IBCLC
Mississippi USA

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