Terri Ann Parnell, DNP, RN, is principal and founder of Health Literacy Partners, LLC, and an adjunct assistant professor at the Hofstra North Shore-LIJ School of Graduate Nursing and Physician Assistant Studies, Hempstead, N.Y. In the first installment of a two-part Q&A, Parnell talks about the importance of health literacy and its essential principles for nurses in practice and education.
Please explain what you mean by health literacy and why it is essential for nurses to integrate it in their practice and in education.
A common definition of health literacy is the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions. Health literacy is a field that is still fairly young. Early on, many felt health literacy was mostly dependent upon an individual’s skills and abilities. That placed the bulk of the responsibility and burden upon the person receiving healthcare and treatment. I am happy to say the field of health literacy has advanced to a shared responsibility, between the person receiving healthcare or treatment and the professionals and systems providing the care and treatment.
Health literacy is a crosscutting priority, and it is essential for all nurses to embrace health literacy. Nurses are uniquely positioned to provide care that enhances effective communication and is culturally and linguistically respectful of each patient. When nursing faculty appropriately educate their students about the implications of low health literacy and provide opportunities for the students to integrate health literacy principles, the students will have the agility to provide patient-centered care that will enhance the patient experience, patient safety and ultimately, patient outcomes.
When educating healthcare professionals, particularly nurses, what are the three main points you emphasize to support their efforts?
There are so many opportunities to integrate health literacy principles into patient care and patient education. I would begin with educating nurses about using a universal precaution approach. Never assume a person’s health literacy level based on how they look, their occupation or how many years of education they have completed. Each person’s health literacy skills are fluid and context-dependent, and everyone may experience low health literacy at certain times.
Second, always use plain language when speaking with patients. Nurses should use plain, jargon-free words when discussing medical information. Individualizing the teaching by using words the patient is familiar with will enhance a patient’s understanding. All patients benefit from the use of plain language.
Third, assess your patients’ understanding of the information you provided by using teach-back. The nurse should explain the information, then respectfully ask the patient to repeat the information in his or her own words. The nurse can then re-explain any information if needed and again check for understanding until the patient is able to state it correctly. This should not feel like a quiz to the patient.
The nurse could say something like, “I would like to be sure I was clear when going over your discharge instructions; since your wife was not here today, can you tell me how you will explain to her what foods you will be eating when you are at home?”
Next week, Parnell shares health literacy resources and discusses how she became involved in the field.