Date of Award

Fall 12-16-2022

Document Type

DNP Project

Project Team Faculty Member

Laurie Hopper

Project Team Faculty Member

Melissa Bogle


patient discharge instructions, after-visit summaries, family practice, urgent care, health literacy, adherence



Discharge instructions are an important tool providers use to communicate information to patients about their medical diagnosis after they return to their home environments. When patients understand and follow discharge instructions there are improved outcomes, fewer callbacks, and decreased return visits. The purpose of this quality improvement project were (a) to develop and distribute discharge instructions at or below a sixth-grade reading level, (b) on common diagnoses appropriate for a rural community, (c) decreased the need for subsequent office visits, and (d) decreased call volumes at a rural walk-in clinic. A large-scale literature review was conducted to determine the most appropriate literacy level for patient summaries, to examine the benefits of providing written instructions in conjunction with verbal instructions, and to investigate potential barriers to patient adherence and follow up. Pre and post surveys were conducted with both the practitioners utilizing the summaries and with patients who received the written instructions who had previously been evaluated in the clinic and given verbal instructions only. Results demonstrated patients liked the new summaries, found them easy to read, helpful, and referred to the summaries after going home. Practitioners utilizing the new written discharge instructions felt comfortable using and locating the sheets in the internal hard drive. Providers also felt the summaries were beneficial and easy to read. Limitations included the small sample size and inability to incorporate the summaries into the electronic medical record [EMR].

Keywords patient discharge instructions, after-visit summaries, family practice, ambulatory care, urgent care, health literacy, compliance, adherence

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Nursing Commons



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