Direct Practice Improvement Project Proposal

One’s engagement requires health literacy skills, which are the ability to “read, comprehend, and analyze information; decode instructions, symbols, charts, and diagrams; weigh risk and benefits” (Schulz & Nakamoto, 2013). To encourage patients and their caregivers to comprehend their disease and achieve greater outcomes, providers are understanding limited health literacy may weaken treatments and the processes expected of them (Labson, 2015). This can cause a patient to become disengaged with their care (Labson, 2015). The problem becomes more pronounced during the hospital discharge process, which typically last six to eight minutes (Bickmore, Pfeifer, & Jack, 2009). Engaging the patients in the process of treatment to understand their needs is the building block of patient-centered care. However, healthcare professionals have a problem of overestimating the level of health literacy of patients.

The outcomes are serious. For instance, the healthcare professionals can provide patients with education that is not matched to the needs of the patient. The overestimation can be due to the weakness of the screening tools used to assess patient literacy and patient characteristics (Goggins et al. Various studies have revealed that majority of nurses rarely or never assess the health literacy of patients using validated tools. When nurses and physicians overestimate the literacy skills of patients, the key outcome is the readmission of patients into care within the first thirty days of discharge (Mitchel et al. An Australian study found that there is high readmission of patients categorized as frequent utilizers of healthcare services compared to the patients who have chronic illnesses but with a sufficient self-management support (Kirby, Dennis, Bazeley, & Harris, 2013).

This shows that patient activation plays a key role in readmissions. It is important for nurses to have adequate knowledge required for the assessment of health literacy to ensure that they provide patients with the education required for effective management of a disease after a discharge. Overestimating literacy when there is inadequacy can result in the worsening of illnesses such as diabetes, HIV/AIDS, and hypertension. Patient engagement a. Patient-Centered Care: This is a type of care that focuses on three factors. The first one is ensuring that the needs of patients come first. The second one is ensuring that patients are involved in the decision making process. The final one is treating a patient as if he or she is the only patient that needs care (Southwick, 2013) b.

Financial Research has shown that the overestimation of health literacy of patients results in increased costs to patients and healthcare systems due to its poor health outcomes. The patients have to incur costs of readmission while healthcare facilities have to incur space costs related to housing the readmitted patients (Johnson, 2014). Health literacy a. Three Sequential Levels: I. Functional literacy is the first level. c. Educating nursing staff regarding their previous knowledge of HL Gap/problem: There is a need to examine health literacy knowledge of nursing staff in relation to greater patient engagement decreasing negative patient outcomes associated with low HL. This is based on the ongoing efforts to reform healthcare systems in improving efficiency, quality, and safety of care. Quantitative, cross-sectional, pre and posttest design: • The Newest Vital Sign (NVS) health literacy screening instrument for patients • Nurses: Health literacy tool kit, questionnaire, and PowerPoint • Demographic Survey (seven questions Significance: The study will provide a broader understanding to see if there is a correlation between the staff nurse’s knowledge of their patient’s health literacy skills and the patient’s engagement during the hospital discharge process.

Problem Statement Problem statement Research shows that patient engagement levels vary by one’s race and ethnicity, particularly African-Americans and Hispanics compared to Whites (Hibbard, Greene, & Overton, 2013). The pre and posttest literacy scores of participants will be used to determine their knowledge levels related to patient’s health literacy. A G-Power analysis will be used to determine the sample size. Excel 2016 will be used to develop a codebook that shows the meaning of each response by assigning names and values to responses. This codebook will be inserted in SPSS 26 for analysis References Bass III, P. F. nlm. nih. gov/pubmed/12377684. Bickmore, T. W. VirtualNurse. pdf. Dickens, C. , Lambert, B. L. , Cromwell, T. , & Piano, M (2013). Nurses’ overestimation of patients’ health literacy. Journal of Health Communication 18(Supplement 1), 62-69.

Doi: 10. , & Kripalani, S. What patient characteristics influence nurses’ assessment of health literacy?.  Journal of health communication, 21(sup2), 105-108. doi. 1193919 Johnson, A.  Patient education and counseling, 66(1), 119-122. DOI: 10. 1016/j. pec. Khodyakov, D. 1111/hex. Kirby, S. E. , Dennis, S. M. Home Healthcare Now 33(3), 143-146. Retrieved from https://www. ncbi. nlm. nih. Mistiaen, P. , Duijnhouwer, E. , Wijkel, D. , Bont, M. D. , Sadikova, E. , Martin, J. M. , Jack, B. W. U. Patient satisfaction in healthcare delivery–a review of current approaches and methods.  European Scientific Journal, ESJ, 10(25). Retrieved September 27, 2018 from https://pdfs. semanticscholar. The care transitions intervention: a patient-centered approach to ensuring effective transfers between sites of geriatric care.  Home health care services quarterly, 22(3), 1-17. Retrieved September 27, 2018 from https://www. researchgate. net/profile/Carly_Parry/publication/6793630_The_Care_Transition_Intervention/links/00b7d5214ebf744592000000/The-Care-Transition-Intervention.