Health Literacy Education Evidence-Based

[rvzohfeld, BSN, MSN, RN]

The Issue

Low literacy is a complex issue that has been linked to several negative health outcomes. Poor understanding of medications and how they work can lead to errors, which can lead to delay in recovery or even death. Nurses have the professional responsibility to provide effective patient teaching to their patients. Providing information to the patient is simply not sufficient. Nurses must also know how to use health promotion and teaching methods according to the patient's level of understanding, learning needs, readiness, ability to understand, culture, and language preference. According to Scott 2016, many nurses poorly understand the concept of health literacy and its impact.

The likelihood of nurse faculty that has not received proper or formal training on health literacy is a reality. Therefore, the topic of health literacy must and should be included in all basic nursing programs. At this point, it is hard to imagine the extent to which Health Literacy Education (HLE) is included within the nursing programs in the U.S. (Scott, 2016).

A lot of the health literacy has focused on the skills or deficits of the patients, however; other variables can affect the patient's ability to utilize and understand health information.

Those variables are the quality of the information taught, the methods used to teach, and the context of the situations, and the ability of the healthcare professional to communicate and teach effectively. Furthermore, the improvement in sharing health information requires the implementation of HLE within the academic programs and health care professionals (Scott, 2016).

Solutions

The question remains: what can nurses, as healthcare educators, do to make a difference in dealing with health literacy? According to Kennard (2016), it is only recently that studies have introduced the notion of health literacy education among healthcare providers. Regrettably, nurses, who comprise the largest segment of healthcare workers, reported having the highest rate of no prior health literacy knowledge. Fortunately, there are tools and techniques at the disposition of nurses such as The Quality and Safety Education for Nurses program that includes health literacy assessments. These assessments provide instructions on patient education and the importance for nursing faculty to emphasize to nursing students the potential of low health literacy in certain vulnerable populations (Kennard, 2016). Another tool designed to provide support and assist healthcare providers in removing health literacy barriers is The Health Literacy Universal Precautions Toolkit, which was developed by the Agency for Healthcare Research and Quality (AHRQ).

Nursing schools should introduce these tools to assist students in their new role as patient educators. Commonly used tools to administer to patients include the Test for Functional Health Literacy (TOFHLA), which measures reading and comprehension. The Rapid Estimate of Adult Literacy in Medicine (REALM) is a pronunciation and word recognition tool that can be administered quickly. The Newest Vital Sign (NVS) measures numeracy, which is an important skill

for patients to calculate medication dosage. The tools should be introduced to the nursing students prior to graduation so they can become familiar in how to appropriately administer them to patients (Kennard, 2016).

Techniques to understand if the patient has been able to understand the information taught are also being developed. One case Is the "Teach Back Method" which allows the healthcare provider to identify what the patient took from the teaching and if there is any confusion or lack of clarity. A simple question such, as "How would you explain the information I just gave you to a family member when you get home?" or "What are the highlights of our conversation/teaching today?" will help the nurse to understand how well the information has been presented and/or understood. It will also give a chance for further clarification if needed (Kennard, 2016).

Another way to teach our nursing students at the undergraduate level is through interactive teaching and learning modalities such as roleplaying, literacy assessment, readability testing, revision, demonstration, and practice. This can significantly enhance the undergraduate learning experience. Furthermore, this will result in well-educated and articulate nurses who are better prepared to address health literacy issues in their professional practices (Smith & Zsohar, 2011).

Conclusion

All in all, research evidence has shown that nursing is a discipline that needs cultural competency and skills to handle patients with low health literacy levels. The evidence also shows that the profession of nursing remains unaware of the prevalence and tools available to them to help with the issue of health literacy. It is imperative that nursing students be presented early on with the tools and means to educate their future patients with the information they will need for their health care. In short, Health Literacy Education must be provided to nursing students' curricula to ensure all new nurses can have a greater impact on their patients' health.