Nurses Must Be Involved in Patient Health Literacy Support

The American Academy of Nursing is calling on nurses to better support patient education and patient health literacy as a part of the organization’s annual policy brief.

“Health literacy is a precursor to health and achievement of a culture of health,” the group wrote in the brief. “Patient empowerment, engagement, activation, and maximized health outcomes will not be achieved unless assurance of health literacy is applied universally for every patient, every time, in every health care encounter, and across all environments of care.”

Patient health literacy is loosely defined as the ability for patients to understand and use health terminology and concepts to become more activated in their own health. Touted as a key social determinant of health, patient health literacy could be the difference between a patient who is able to manage their own chronic illness and one who cannot.

However, according to AAN, pushes for better patient health literacy often fall by the wayside. Only 12 percent of adults have at least proficient health literacy, per HHS statistics. Patients with low health literacy are known to be in poorer health, HHS says. Additionally, patients with low health literacy are less likely to use key patient engagement tools and technologies.

This should not be the case, the group wrote. As such, the push for better patient health literacy will play a key role in the AAN’s most recent policy brief.

“Health literacy is not well understood by clinicians, rarely approached as a health care system issue, and is not universally executed across health care domains,” AAN explained. “Strategies and initiatives must be implemented to prepare nurses and other health care providers to embrace the importance of health literacy and to use available resources to enhance health literacy skills. In health-care systems and community health care settings, leaders must provide resources that enable all health-care providers to minimize the gap between patient skills and abilities and the demands and complexities of health care systems.”

Medical professionals, including and especially nurses, must uncover how to effectively improve health literacy among patients. This includes efforts to emphasize health literacy with every patient during very healthcare encounter, the group wrote. Nurses have an important part to play in supporting better patient health literacy, which is why AAN has integrated it as a part of its strategic goals.

“The timing is right for a call to action to increase nurses' knowledge, attitudes, behaviors, practice resources, and system capabilities to lessen the health literacy-related burden on patients and costs for health care,” AAN wrote. “Implementation of a nursing-specific health literacy policy will result in patient empowerment, engagement, and activation; increased health care equity; and improved patient, population, organization, and system outcomes.”

AAN has split its efforts into three key domains: practice, systems of care, and partnerships.

“A nursing focus on health literacy as an essential component of all patient care will enhance the provision of person-centered care, patient safety, and patient, population, and system outcomes,” the organization wrote.

Nurses and their care partners must use a universal standard for assessing patient health literacy, and initially work under the assumption that all patients are at risk for not understanding health information or terminology, the policy brief states. Nurses must address patient health literacy at each stage of the care encounter, including diagnoses, treatment, and discharge.

Nurses must also integrate patient health literacy efforts seamlessly into patient-provider interactions, create a judgement-free environment for reviewing medication terminology, and use non-clinical terms and patient teach-back to reinforce literacy reviews.

Organizations may consider consulting patient health literacy checks across the entire health system, as well. Industry-leading tools such as Health Literacy Universal Precautions Toolkit, Building Health Literate Organizations: A Guidebook to Achieving Organizational Change, Ten Attributes of Health Literate Health Care Organizations, and The Health Literacy Environment of Hospitals and Health Centers may be of assistance.

Health systems can reinforce efforts through financial incentives and universal success measures, as well. Additionally, hospitals and health systems that illustrate a business case for supporting better patient health literacy may be more successful, the report authors explained.

Finally, efforts to support partnership across different healthcare entities and specialties will better reinforce the need for increased patient health literacy. Health system nurses must partner with counterparts in other areas of the hospital and the health industry writ large to instate health literacy goals and measures.

Joining groups such as the Joint Commission can help establish best practices within an individual organization, the brief authors wrote. Nurses can also influence organizations to integrate efforts for patient health literacy in their quality measures, the authors noted.

Ultimately, this policy brief tapped into nurses’ unique positions to drive better health literacy in their patients, according to Lori A. Loan, PhD, RN, FAAN.

“Research into consequences of, and solutions to mitigate, low health literacy are widely available, but seriously underutilized,” Loan, who is also a member of the Academy’s Expert Panel on Quality Health Care, said in a statement. “Nurses as leaders are uniquely positioned to minimize the gap that often exists between patient skills and abilities and the increasingly complex demands of health care systems by implementing a health literacy universal precautions approach with every patient, every time and in every health care encounter.”

AAN President Karen Cox, PhD, RN, FAAN, echoed those sentiments, saying that nursing policy on patient health literacy is timely and appropriate for the organization’s industry goals.

“The Academy publishes this timely policy brief to call on nurses to engage in health literacy activities for patient empowerment,” Cox pointed out. “Health literacy activities are well-aligned with the Academy’s mission and strategic plan, and aids in our work with the Robert Wood Johnson Foundation and others on creating a Culture of Health”.