A patient’s understanding of and compliance with medication treatment regimens post-myocardial infarction is key to reducing 30-day hospital readmission rates, according to research presented at the American College of Cardiology Quality Summit held in New Orleans.

Tara See, RN, BSN, of Olathe Medical Center, and colleagues developed an interdisciplinary team-based approach to patient education. The team included the bedside nurse, a cardiology nurse navigator, the floor pharmacists, and the outpatient cardiac rehabilitation staff. These stakeholders participated in a 5-step plan aimed at improving patient education regarding their medication use and adherence:

  • First, the bedside nurse reviews medications with the patient and any family members or caregivers. The nurse should specify what the medication is used for and any side effects the patient may experience.
  • Then, the cardiology nurse navigator uses a medication log visual aid to have the patient write out discharge medication information. The medication log will contain the name of the medication along with its use, dose, frequency, and the time of day it should be taken.
  • The floor pharmacist then provides the patient with a more in-depth explanation of the medications, including side effects, administration routes, missed doses, and possible drug interactions.
  • Within 48 hours of discharge, a care coordinator or nurse navigator will call the patient to provide medication teach back.
  • Finally, at the first outpatient cardiac rehabilitation appointment, patients are asked to check off their medications from a list of common cardiac medications to ensure that patients understand their medication regimen.

The researchers used the Hospital Consumer Assessment of Healthcare Providers and Systems survey tool to assess any improvements in scores. They found that within the study group, medication understanding increased by 10% in 2018. In addition, 30-day hospital readmission rates decreased from 8.2% in the first quarter of 2018 to 3.4% and 3.6% in the second and third quarters, respectively.

“When patients leave a hospital, they often feel that there has been little preparation for the discharge plan of care,” said Ms See in an American College of Cardiology press release. “We realize improving medication understanding is only part of what hospitals need to do to help reduce readmissions.”

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She concluded, “We are also continuing to focus on other goals, such as increasing risk assessment and appropriate interventions placed on high risk patients. We believe this will optimize our process and further decrease readmissions.”

References

  1. American College of Cardiology. Interdisciplinary Education Helps Hospital Patients Better Understand Their Medication [news release]. Published March 13, 2019. Accessed March 13, 2019.
  2. See T. Improving medication communication. Presented at: American College of Cardiology Quality Summit; March 13-15, 2019; New Orleans, Louisiana.