Patient satisfaction with discharge teaching by nurses affects patient health outcomes as well as hospital reimbursement by the Centers for Medicare and Medicaid Services. A review of Penn State Hershey Medical Center (HMC) Press Ganey data showed a wide range of scores for nursing units in the area of “Instructions for care at home.” For other indicators showing low performance, the hospital-wide integrated council requires a unit action plan. Scores for patient satisfaction with “Instructions for care at home” have yet to receive this attention. In addition, research correlating nurse practices and patient satisfaction between units is limited. Satisfaction with patient teaching has been studied from the nurse’s perspective. In a multi-state study, nurse practice environments were related to patient satisfaction with discharge teaching (Kutney et al., 2009).