Teach-Back Discharge Education to Improve Self-Care and Reduce 30-Day Readmissions in Heart Failure Patients

February 23, 2026 updated by: Sara Bierschenk, Nova Southeastern University

Impact of Discharge Teach-Back Education on Heart Failure Patients' Knowledge/Self-Care Behaviors and 30-Day Readmissions

This study aimed to improve how patients with heart failure understand and manage their condition after leaving the hospital. Many heart failure patients are readmitted within 30 days due to confusion about their discharge instructions and difficulty following self-care routines. The study tested whether a structured discharge education session using the "teach-back" method-where patients repeated instructions in their own words-could help improve their knowledge and self-care behaviors. The goal was to reduce hospital readmissions and help patients feel more confident managing their heart failure at home.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

Heart failure is a chronic and progressive condition affecting millions of adults in the United States. Despite advances in treatment, nearly one in four patients are readmitted to the hospital within 30 days of discharge, often due to poor understanding of discharge instructions and inadequate self-care. These readmissions contribute to worse health outcomes and increased healthcare costs.

This study evaluated the effectiveness of a structured discharge education intervention using the teach-back method. The teach-back method is a communication technique in which patients are asked to repeat discharge instructions in their own words. This approach helps confirm understanding, reinforce learning, and promote active engagement in self-care.

The study used a quasi-experimental, pre-test/post-test design to assess changes in patients' knowledge and self-care behaviors before and after the intervention. Participants were adults hospitalized with systolic heart failure (LVEF ≤ 40%) who meet specific clinical criteria. Each participant received a 30-minute individualized education session at discharge, covering key self-care topics such as medication adherence, symptom monitoring, fluid restriction, and dietary modifications. Printed educational materials from the American Heart Association were also provided.

To measure outcomes, participants completed the European Heart Failure Self-care Behavior Scale (EHFScB-9) before and after the intervention. Thirty-day readmission data was collected through a retrospective review of hospital records. The study aimed to determine whether teach-back education improved self-care behaviors and reduced 30-day readmission rates.

This project was reviewed and exempted by the Nova Southeastern University Institutional Review Board under Exempt Category 2. It aligned with national goals to improve patient education, reduce preventable readmissions, and enhance the quality of care for individuals with heart failure.

Study Type

Interventional

Enrollment (Actual)

57

Phase

  • Not Applicable

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • United States
    • Florida
      • Atlantis, Florida, United States, 33462
        • HCA Florida JFK Hospital

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Adult
  • Older Adult

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • Adults aged 18 years and older
  • Diagnosed with systolic heart failure with a left ventricular ejection fraction (LVEF) ≤ 40%
  • Classified as New York Heart Association (NYHA) Class II, III, or IV
  • Categorized as American College of Cardiology/American Heart Association (ACC/AHA) Stage C or D
  • Currently hospitalized at the project site
  • Able to read and understand English at an 8th grade reading level
  • Have access to a smartphone or tablet capable of scanning QR codes and connecting to the internet
  • Provide voluntary informed consent via the REDCap platform

Exclusion Criteria:

  • Cognitive impairment
  • Non-English speaking
  • Unwilling to participate

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Health Services Research
  • Allocation: N/A
  • Interventional Model: Single Group Assignment
  • Masking: None (Open Label)

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Experimental: Teach-Back Education Intervention
Participants in this arm received a structured discharge education session using the teach-back method. The session was delivered in person at hospital discharge and covered key heart failure self-care behaviors, including medication adherence, symptom monitoring, fluid restriction, and dietary modifications. Participants were asked to restate instructions in their own words to confirm understanding. Printed educational materials from the American Heart Association were also provided.
Behavioral: Teach-Back Discharge Education
A structured, 30-minute discharge education session delivered in person using the teach-back method. Participants are asked to restate instructions in their own words to confirm understanding. The session covers key heart failure self-care behaviors including medication adherence, symptom monitoring, fluid restriction, and dietary modifications. Printed educational materials from the American Heart Association are also provided.

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Change in Heart Failure Self-Care Behaviors (EHFScB-9 Total Score)
Time Frame: Baseline (pre-intervention) and immediately post-intervention on the same day, up to 35 minutes after the start of the education session.
The 9-item European Heart Failure Self-Care Behavior Scale (EHFScB-9) was used to assess self-care behaviors. Each item is scored on a 5-point Likert scale ranging from 1 ("completely agree") to 5 ("do not agree at all"), producing a total score range of 9 to 45. The outcome represents the change in total EHFScB-9 score from baseline (pre-intervention) to immediately post-intervention following the discharge education session. Lower total scores indicate better self-care performance (more consistent adherence to recommended behaviors), while higher total scores indicate poorer self-care performance (less consistent adherence).
Baseline (pre-intervention) and immediately post-intervention on the same day, up to 35 minutes after the start of the education session.

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Number of Participants With 30-Day Heart Failure Readmission
Time Frame: Assessed during the 30-day period following hospital discharge.
Readmission status was determined from hospital records and participants were classified as readmitted (Yes) or not readmitted (No) within 30 days of discharge. Data are displayed as counts in the results table.
Assessed during the 30-day period following hospital discharge.

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Nova Southeastern University

Investigators

  • Study Chair: Virginia Waters, Ph.D., MSN, MBA, RN, CNE-BC, Nova Southeastern University, Ron and Kathy Assaf College of Nursing

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

September 11, 2025

Primary Completion (Actual)

October 11, 2025

Study Completion (Actual)

November 10, 2025

Study Registration Dates

First Submitted

November 29, 2025

First Submitted That Met QC Criteria

December 10, 2025

First Posted (Actual)

December 12, 2025

Study Record Updates

Last Update Posted (Actual)

February 25, 2026

Last Update Submitted That Met QC Criteria

February 23, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Additional Relevant MeSH Terms

Other Study ID Numbers

  • 2025-398

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

IPD Plan Description

Individual participant data (IPD) will not be shared for this study. The data collected will be used solely for the purposes of evaluating the effectiveness of the discharge teach-back education intervention on heart failure self-care behaviors and 30-day readmissions. All data will be stored securely and managed in compliance with HIPAA and IRB regulations. Due to the sensitive nature of health information and the limited scope of the study, there is no plan to make IPD publicly available.

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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