Date of Paper/Work


Type of Paper/Work

Doctor of Nursing Practice Project

Degree Name

Doctor of Nursing Practice



First Advisor

Gay Varecka


Doctor of Nursing Practice


Background: Hospital readmissions affect patients’ health status, healthcare experience, and healthcare costs. A large urban Midwest teaching hospital found an association between readmission rates and medication understanding by patients. Therefore, improvement efforts focused on increasing medication understanding to reduce readmissions.

Purpose: The purpose of this quality improvement (QI) project was to improve medication understanding using a structured patient education in order to reduce potentially preventable readmission (PPR) rates, increase Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores, and improve nursing attitudes and behaviors around patient education.

Methods: A Plan-Do-Study-Act design was used. Patient education was structured using the Ask Me 3 questions, developed by the Institute for Healthcare Improvement.

Results: Structured patient education with the Ask Me 3 questions yielded positive results. A consistent decline and less variation was noted in readmission rates after project implementation, suggesting a possible association between structured patient education and readmissions. Regarding patient satisfaction, there was an increase in patients who responded “strongly agree” to understanding how to manage their health (from 40% to 51%) and the purpose of their medications (from 60% to 68%). Among nurses, there was an overall increase in the belief that educating patients is important, an increase in the frequency of patient education, and an increasein confidence patients understood their medications and health after education. Finally, qualitative feedback interviews with the nurses revealed four themes about the project: Simplicity, Ease of Implementation, and Improved Communication despite Patient Learning Barriers (i.e., cognitive impairment, language barriers, and visual or hearing deficits which affect the ability to learn).

Conclusion: Structuring patient education with the Ask Me 3 questions had positive results. Improvements in PPR rates, HCAHPS scores, and nursing attitudes and behaviors surveys were observed. Additionally, themes of Simplicity, Ease of Implementation, and Improved Communication were identified despite the theme of Patient Learning Barriers and other barriers to implementation.