Seventy-eight percent of emergency department (ED) patients do not thoroughly understand their discharge instructions prior to leaving the hospital (Engel, Heisler, Smith, Robinson, Forman, & Ubel, 2009). The chaotic nature of the emergency department and the necessity of discharging patients in a rapid manner create significant challenges in the communication process between health care providers and the patient. The aim of this quality assessment study was to evaluate the patient's understanding of the emergency department discharge instructions and motivation to use an online health information website. This was a descriptive cross-sectional quantitative study, conducted from March-June, 2012, in a 52-bed emergency department facility in an urban setting which randomly surveyed 100 adult patients at the time of discharge from the emergency department. The majority of the participants did not or was not completely sure if they understood the discharge instructions. The Pearson chi-square r = 0.43,p < .001 was statistically significant and indicated a reasonable difference between the preferred method of learning and understanding of the ED discharge instructions. Cramer's V was 0.302 with a significance of .01 and indicated a reasonable association between the preferred method of learning and understanding the ED discharge instructions. Motivation to use a health information website, indicated a central tendency mean of 3.02, and a standard deviation of 1.56, (0 is not motivated and 5 is very motivated). There was a relationship between motivation and the use of the online website and a quantitative prediction could be made for anticipatory guidance in clinical practice. A five question survey was completed by 45 ED staff members in October, 2012. Thirty-five or 76.1% of the ED staff was motivated to discuss the online website with the patient and family and make a change in their practice. The results indicated that when patients are discharged from the ED having care instructions and other information available electronically or online could provide a better understanding of their condition. The ability for patients to understand their medical condition through a visual or audio learning process could increase their level of understanding and adherence to the discharge instructions.
|Advisor:||Kiresuk, Teresa A., McLeod, Renee P.|
|Department:||Nursing and Health Professions|
|School Location:||United States -- California|
|Source:||DAI-B 75/09(E), Dissertation Abstracts International|
|Subjects:||Medicine, Nursing, Health care management|
|Keywords:||Communication, Discharge instructions, Emergency departments, Health literacy, Kaiser Permanente, Online health information|
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