The acquisition and effectiveness of "IDEAL" standards in discharge planning and education with simulation method

Basically, although all members of the health care team are responsible for the education of the patient and his/her family, discharge planning to provide self-care skills is the responsibility of the nurse. However, unfortunately, the satisfaction of patients with discharge education is not at the desired level. This study aims to examine the improvement of nursing students' discharge education competencies through simulation method aligned with the IDEAL discharge planning model-Include, Discuss, Educate, Assess, and Listen-developed by the Agency for Healthcare Research and Quality (AHRQ).

A mixed-method design was used in the study. Nineteen second-year nursing students enrolled in surgical nursing courses during the 2023-2024 academic year participated in a five-session simulation, with each session lasting approximately one hour. General Self-Efficacy Scale and Simulation Design Scale were used to obtain quantitative data, and semi-structured individual in-depth interview form was used to obtain qualitative data. Mean, standard deviation, and paired t-test were used to evaluate quantitative data; descriptive content analysis was used to analyze qualitative data, and participants were selected through purposive sampling based on their involvement in all simulation activities.

Quantitative results showed an increase in post-test scores across all discharge education sessions (General total pretest = 55.86 ± 6.59, posttest = 57.63 ± 6.70). The most significant improvement was observed in the "continuation effort and persistence" sub-dimension of the General Self-Efficacy Scale during the fourth session (p <.05). Among the Simulation Design Scale components, support sub-dimension received the lowest (X ± sd = 4.24 ± 0.56) and fidelity the highest (X ± sd = 4.58 ± 0.52) scores. Qualitative findings indicated that as simulation sessions progressed, students reported greater confidence and communication skills; however, challenges remained in applying some IDEAL components, particularly discussing patient goals and involving families in the process.

As a result, it was determined that the simulation intervention improved the discharge education skills of nursing students and increased their self-confidence. Incorporating the "IDEAL" framework can foster more patient-centered care by emphasizing the inclusion of patients and their families in the discharge planning process. By supporting patients' understanding of post-discharge instructions, this approach can promote greater adherence to treatment plans and contribute to improved long-term health outcomes.