Academic journal article Nursing Education Perspectives

Health Literacy Education in Baccalaureate Nursing Programs in the United States

Academic journal article Nursing Education Perspectives

Health Literacy Education in Baccalaureate Nursing Programs in the United States

Article excerpt


AIM This study's aim was to determine the prevalence of health literacy education in nursing programs. Health literacy content and teaching strategies were also explored.

BACKGROUND Over 75 million Americans have low health literacy, a problem that can cause negative health outcomes. Knowledge about health literacy is important for nurses; yet, the extent to which the topic is included within nursing curricula is unknown.

METHOD An online survey was distributed to 150 nursing programs to obtain information about health literacy education in the curricula.

RESULTS Fifty-seven programs responded, with the majority reporting that health literacy is taught in their curricula. The impact of low health literacy and the importance of plain language were noted as common topics.

CONCLUSION The majority of participants reported inclusion of health literacy in their curricula using various teaching strategies. However, a low response rate prevents generalized conclusions.

KEY WORDS Health Literacy Education--Baccalaureate Nursing Education--Nursing Curricula


More than 75 million Americans, 36 percent of the population, have low health literacy as determined by the 2003 National Adult Literacy Survey (Kutner, Greenberg, Jin, &

Paulsen, 2006). Health literacy is defined as "the degree to which individuals can obtain, process, and understand the basic health information and services they need to make appropriate health decisions" (US Department of Health and Human Services Health Resources and Service Administration, n.d.).

Effective communication Is necessary for achieving patient-centered care and a critical factor for positive health outcomes. It is an essential part of the nursing care needed to support patients in meeting their health care goals. Nurses use words to teach, to inform and explain, to support and comfort, and to advocate for their patients and families. For these reasons, nurses must be knowledgeable about the prevalence of low health literacy and its impact on patients and must be well Informed about effective strategies for health care communication. Inclusion of health literacy information in undergraduate nursing education Is a logical approach to addressing this learning need.


Low health literacy is a multifaceted, complex issue that has been linked to multiple negative health outcomes and high health care costs. The financial burden of low health literacy is in the $1 trillion to $3 trillion range (Vernon, Trujillo, Rosenbaum, & DeBuono, 2007), with more frequent hospitalizations and emergency room visits noted among those with low health literacy (Baker et al., 2002; Cho, Lee, Arozullah, & Crittenden, 2008). Poor understanding of medication information can lead to medication errors or unintentional missed medication doses, which can therefore lead to delayed recovery or worsening symptoms (Lindquist et al., 2011).

Low health literacy also leads to greater risk of death (Cavanaugh et al., 2010). During a follow-up period of 1 to 3 years in a study of 480 hemodialysis patients, researchers tracked death rates and found that those with low health literacy had a 54 percent higher risk of death than those with adequate health literacy. For each 10-point decrease in the health literacy screening score, there was a 16 percent higher risk of death.

Nurses have a professional responsibility to provide effective patient teaching, as outlined in professional practice standards (American Nurses Association, 2004, Standard 5B; Ferguson & Pawlak, 2011). The American Nurses Association (2004) states that nurses shall "use health promotion and health teaching methods appropriate to the situation and the patient's developmental level, learning needs, readiness, ability to learn, language preference, and culture." Merely providing information to patients is not sufficient; the nurse has an ethical duty to teach patients effectively and evaluate their understanding and ability to utilize health information. …

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