Health Literacy in Nursing

Health literacy concerns how people obtain, interpret and use information and services to make health decisions. In nursing, the useful question is whether a person can use the information and support available for the task in front of them.

CDC distinguishes personal health literacy from organizational health literacy. The first concerns an individual's abilities; the second concerns how equitably an organization helps people find, understand and use information and services. This distinction places responsibilities on the healthcare system as well as on the person receiving care.

A universal approach

AHRQ's health literacy universal precautions approach recommends simplifying communication, checking understanding and making services easier to navigate for everyone. Clear explanations need not wait for a patient to receive a literacy label or disclose difficulty reading. The approach includes supportive systems as well as spoken and written information.

For a nursing team, a useful starting point is one recurring task: arranging a follow-up visit, explaining a care plan or helping someone find the right service. Identify what the person must understand, what they must do and what assistance the organization should provide.

Separate an explanation problem from an access problem

Consider this fictional example: a patient correctly explains that a follow-up visit is needed but cannot reach the scheduling service during its opening hours. Repeating the importance of follow-up does not answer the scheduling problem. A practical response is to establish who can help arrange the appointment and how the patient will receive confirmation.

Use questions that make the task concrete:

What is the patient trying to accomplish?
Which words, numbers or steps need clarification?
Can the patient reach the service and use the communication format offered?
Who is responsible for resolving a barrier?
How will the team learn whether the next step happened?

These questions are a suggested workflow, not a diagnostic test of literacy. Avoid turning a difficulty with one form or instruction into a permanent judgment about the person.

Record what would help the next clinician

Prefer a specific account of communication and support needs over an unexplained label such as “poor understanding.” Record the topic discussed, the patient's questions, the explanation or resource provided and any unresolved next step, using the organization's documentation standards.

For example, “Patient described the purpose of follow-up; requested help arranging transportation; referral sent to the designated team” tells the next clinician what remains to be done. This is an illustrative note, not a required documentation formula.

Improve the service as well as the conversation

A team can review an entire patient task from beginning to end: the letter, telephone menu, portal message, directions and final confirmation. Ask patients where the process became unclear. Assign responsibility for the identified problem and review whether the revised process works.

Related methods include teach-back and plain-language communication. Health literacy is the broader organizing concept; those pages describe individual communication techniques.

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