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Effect of an RN-Led Medication Teaching Initiative on Psychiatric Recidivism
Jeffrey Kessler1, Pamela Bjorklund1
1Department of Graduate Nursing, The College of St. Scholastica, Duluth, MN, USA.
Issues in Mental Health Nursing
|September 25, 2019
Summary
Registered nurse-led medication teaching did not reduce psychiatric patient readmissions. Future interventions should target high-risk patients to improve recidivism rates.
Area of Science:
- Healthcare Quality Improvement
- Psychiatric Nursing
- Patient Readmission Studies
Background:
- Readmissions pose a significant challenge in psychiatric care, impacting patient outcomes and healthcare costs.
- Medication adherence is crucial for preventing relapse and readmission in psychiatric populations.
- Understanding the effectiveness of nursing interventions in improving medication adherence and reducing readmissions is vital.
Purpose of the Study:
- To evaluate the impact of registered nurse (RN)-led medication teaching on 30-day readmission rates for adult psychiatric patients.
- To assess patient medication adherence following discharge after receiving RN-led teaching.
- To identify factors influencing readmission rates in a psychiatric veterans' hospital setting.
Main Methods:
- A quality improvement project analyzing data from 2017-2018 at a Midwest psychiatric veterans' hospital.
- Data collection included electronic medical records (EMR) and patient discharge logs.
- Analysis focused on RN participation, patient medication teaching rates, self-reported adherence, and 30-day readmission rates.
Main Results:
- Only 43% of RNs participated in the medication teaching initiative, with patient teaching rates ranging from 27% to 40%.
- Self-reported medication adherence was high (73-85%), yet the initiative did not impact recidivism, which increased compared to previous years.
- Fifty-three percent of readmitted patients reported adherence, suggesting potential over-reporting or limited impact of teaching on preventing readmissions.
Conclusions:
- The RN-led medication teaching initiative showed no significant impact on reducing psychiatric patient readmissions.
- Low staff engagement and patient participation rates may have limited the initiative's effectiveness.
- Future quality improvement efforts should focus on identifying and targeting high-risk, chronically readmitting patients with tailored interventions.
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