Date on Paper

8-2025

Document Type

Doctoral Paper

Degree Name

D.N.P.

Department

Nursing

Committee Chair

Schirmer, Sarah

Committee Member

Williams, Kennetha

Author's Keywords

Teach-back method; discharge education; medication adherence; nurse self-efficacy; quality improvement; pediatric mental health

Abstract

Medication nonadherence in pediatric psychiatric care contributes to worsening symptoms, delayed developmental progress, and increased hospitalizations. Adherence rates remain as low as 30–60%, accounting for up to $300 billion in avoidable healthcare costs annually. Low health literacy and inconsistent education strategies further complicate adherence. This quality improvement project took place on the child and adolescent psychiatric units at the project site, a large teaching hospital in a metropolitan area in the south-central United States, which serves patients aged 5–17 with complex mental health needs. The initiative aimed to improve nurses’ competence, self-efficacy, and time efficiency in delivering medication discharge education using the teach-back method and existing handouts. The overall goal was to enhance patient and family understanding and support adherence. Using the Plan-Do-Study-Act (PDSA) framework, a six-week intervention was implemented through a KNOW module focused on evidence-based medication teaching strategies. Nurses completed pre- and post-intervention surveys assessing self-efficacy, knowledge competence, and time efficiency. A follow-up satisfaction survey and optional qualitative feedback were also collected to evaluate sustainability and impact. QR codes linking to quick-reference resources were provided to support application in practice. Results showed improvements in nurse self-efficacy, knowledge, and efficiency in delivering discharge education. This project supports the value of structured, evidence-based training to address nonadherence and strengthen discharge education practices in pediatric psychiatric care.

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