Nurse's Role in Health Literacy Improvement among Patients

Jordan Nacalaban, BSN, RN

Every interaction you have with your patient is an opportunity for addressing health literacy. Taking in the role of an educator, nurses can make a significant difference by engaging with the patients who seek their help.

The understanding that holistic patient care isn't only for the physical ailment that your patient presents but also helping them understand spoken and written health information that's readily accessible, clear, and understandable.

The definition of health literacy was updated and expanded last August 2020 concerning the community's initiative on improving health literacy.

Most importantly, what are personal health literacy and organizational health literacy?

According to Health.gov¹:

"Personal health literacy is the degree to which individuals can find, understand, and use information and services to inform health-related decisions and actions for themselves and others".

"Organizational health literacy is the degree to which organizations equitably enable individuals to find, understand, and use information and services to inform health-related decisions and actions for themselves and others".

Patients' challenges with limited health literacy can contribute to poor health outcomes, difficulty managing their health conditions, poor compliance to their medication regimen, and reduced ability to make well-informed healthcare decisions.

As a direct health educator for your patients in your area, the need to accept the challenge in supporting health literacy falls on the numerous efforts to inform and educate your patients accordingly, with the resources that you can tap from your facility and beyond its walls.

What are the factors that affect health literacy?

Socioeconomic status - limited access to health
Age
Race and Ethnicity
Education levels of each patient
Limited Proficiency of the English language
Healthcare professionals use words that patients don't understand

The first five factors - we don't have any control over. For this reason, it shouldn't stop us from getting through them.

Therefore, it all boils down to recognizing these factors exist and then tailoring your approach to educating your patients the best and helping them have the information they require to make educated healthcare decisions and take action.

How can you help improve a patient's health literacy?

Your Role

You've been assigned the task of educating patients in a short period between admission and discharge. You own that role with a sense of pride that you can make a difference in your patient's health and life under your care.

Take the opportunity to address what each patient needs to act on any health information provided.

As a nurse, you are the driving force in the frontline of health communications. You are a proponent of change in improving your patient's health literacy.

Providing clear, understandable, and actionable information to patients is critical to achieving progress in health literacy in the community.

Educating all patients is a fundamental skill in nursing. When you provide your patients' health information, they can either better grasp their condition, develop a fear of it or become more confused than ever.

That's why nurses are held to a high standard for providing effective patient education.

Not to mention being able to demonstrate skills relevant to patient teaching on managing their conditions at home and using medical technology and devices.

Nurses can enhance their personal and professional growth through pursuing specialty certification and continuing education:

Health literacy
Specialty area-related class
Updated medical technology use
Effective health communication

Addressing the sixth factor

Patients have a hard time understanding the phrases and words that nurses use.

These patients become more unsettled with every health detail received. When health literacy is low, they are more baffled and lost.

As the nurse assigned in your area with direct patient communication -

How often have you encountered a patient that felt overwhelmed by all the healthcare information provided to them in a given time?

Most certainly in every area of healthcare services.

However, there are ways in which you can contribute to helping your patient improve understanding and take action for their health.

Strategies That Aid in Providing Clear Health Information are as follows:

Recognize every patient who has a limited literacy level² in general
Determine the best way for the patient to learn about their condition and assess their learning ability.
Use plain language in short sentences that the patient can easily understand and take action based on their health information.
Have a clear discussion about their health conditions and have them teach back for confirmation: evidence-based teaching back practice³ for patient education.
Simplify directions about their newly prescribed medications and have them repeat the regimen, including common side effects.
Accurate, direct to the point instructions at admission, during a hospital stay, and at discharge with emphasis on critical health information
Use visual communication resources:⁴
- visual aids
- hospital-approved health videos
- picture graphics
- other resources to enhance health information understanding
Encourage patients to ask questions throughout their hospital stay/clinic visit and take the time to answer questions.
Take the time to listen to what they say about their health and how they manage their conditions at home.
When patients have limited English Proficiency, use your facility resources to provide appropriate language aids.⁵
Involve a patient's family member/caregiver in the teaching process in your area; also encourage a question/answer round-up.
Do step-by-step care instructions for patients going home with a medical device; urinary catheter, ostomy, insulin pump, On-Q pain pump, PEG tube, and others. You are also performing a hands-on approach with patient teaching.
Offer to assist them in filling out health forms - this task becomes tedious for patients with limited health literacy (med-Surg history, consent, pre-anesthesia, and other medical forms)
Provide other educational materials for patients to read and point to an expert resource within your facility or even outside entities.
Collaborate with your Disease Education Management (e.g., Diabetic Educator, Wound Care Specialist) and Pharmacy Patient Safety - to provide evidence-based and understandable health information.

Takeaway

Let your role as a health educator for your patients shine through.

Improve your understanding of health literacy among health consumers
Provide patient education in a clear and easily digestible outline emphasizing the critical information they need to know
Assess your patient's understanding of health information provided through an open discussion and encouraged questions.
Get them connected with additional resources to help them navigate new diagnoses, support current health management and acquire information for needed medical devices.

What the patient needs is for the nurse to take the time to explain in ways the patient can understand; for the nurse to answer questions related to their health care needs.

By improving health literacy among patients, we empower them to make informed decisions based on their health information and healthcare plans.

Take charge as the nurse who promotes health literacy.

How can you help improve patient health literacy in the hospital or community?

How did you overcome the challenge of caring for a patient with limited English Proficiency during their hospital stay or short clinic visit?

In what ways can you mobilize change in the culture of health literacy in your facility or other health-related work that impacts direct patient care and education?

References

¹Health.gov - Healthy People Initiative (HP2030)

²National Assessment of Adult Literacy (NAAL)

³Use and Effectiveness of the Teach-Back Method in Patient Education and Health Outcomes

⁴Visual Communication Resources: CDC

⁵When Patients and Providers Speak Different Languages