7 Ways to Increase Your Patient's Health Literacy

Melissa Mills, BSN

Nurses rattle off acronyms and big words like it's their job - well, actually it is! But, when those big words get in the way of your patient understanding what's going on with their health, it's a problem. The Patient Protection and Affordable Care Act of 2010 defined health literacy as the degree to which an individual has the capacity to obtain, communicate, process, and understand basic health information and services to make appropriate decisions.

You understand the critical position literacy plays in the care of patients. But, when you're up to your eyeballs with your patient assignment, it's probably not the first thing on your mind. Here are 7 quick ways you can meet your patient's unique health literacy needs.

Assess Patients Skills and Needs

Assessing literacy can be a bit tricky. You can ask the patient about their education levels or even directly ask if they can read. However, some patients might try to hide the fact they can't read for many reasons. It's your job to dig a bit deeper to assess their skills and needs.

For example, I had a home care patient that was being labeled as non-compliant. No matter what we did, he wouldn't take his medications and required multiple readmissions to the hospital. My manager at the time gave the directive to figure out the issue or discharge for non-compliance. As the RN on the case, I took the lead and went out to assess the problem again, since nothing was apparent during the start of care visit.

During our appointment, I set his meds in front of him and asked him to read each label, tell me when he took the medication, and what condition the pill treated. He sat quietly and looked away. After a few moments - it hit me - he couldn't do this because he couldn't read.

His literacy issues were creating barriers that were exhibited as non-compliance. I worked with the LPN who saw him a few times each week to devise a system of color coding for his drugs. After a week or so, he was doing much better, and compliance was no longer an issue.

It took a bit of investigation to identify the issue, but it was worth it to be able to discharge this gentleman and know that he was now independent in med and disease management.

Make a Human Connection

No matter what a patient's disability might be, you have to remember that they are human. Take time to connect with them and create a relationship. Once this connection is set, it should be easier for them to trust you and confide in you if they don't understand.

Use Teach-back

If you need to assess the patient's understanding, you can use the teach-back method. This method allows you to check the patient's understanding by asking them to state what they need to know or do about their health in their own words.

Use an Interpreter

According to an August 2017 article in The American Journal of Psychiatry Residents' Journal, communication barriers can lead to a variety of problems, such as lack of informed consent, aggression, and avoidance of the health care system. The use of professional medical interpreters can increase outcomes, improve adherence to care and decrease adverse outcomes.

Mix the Modes

Do you remember sitting in a lecture and wishing that there were more visuals or hands-on teaching methods used? The same is true for those who may have communication barriers. Here are a few ways to mix the modes of communication:

Provide demonstration for care
Allow the patient to demonstrate competency
Give written instructions for reference
Provide an opportunity for questions to be asked before they must be independent
Use videos and other technology
Be sure all videos have captioning

Tap into Tech

Have you ever considered the use of technology or apps when teaching self-care? Apps can put critical health information at the patient's fingertips. They can also deliver information using video, text, and images. For newly diagnosed diabetics, try MySugr Diabetes Logbook. Or, if you're looking for a med management app, look into Mango Health.

Record Teaching

Our society is video recording happy. We record everything from a baby's first steps to crimes happening in our neighborhoods. So, why wouldn't we consider allowing a patient to video record teaching or demonstration of care?

Well, there are many legal issues for sure, but there is evidence that it is an effective method for instruction. One study found that 72% of patients listened to recordings, 68% shared them with caregivers, and those with these recordings reported a better understanding and recall of healthcare information.

Before you allow a patient to record any teaching, be sure to check with your manager and read your facility's policy on patients recording staff.

By using these methods to increase health literacy, you're not only improving understanding, but you are impacting the patient's overall ability to care for themselves. Enhanced self-care behaviors increase well-being and outcomes.

Have you ever used any of these methods with success? Let us know in the comments below.