Health literacy (HL) refers to a person’s ability to receive, process, and comprehend fundamental health information and services in order to make informed health decisions. The skills related to HL are grouped under three main categories of functional (basic numeracy, skills to read, write and gather health-related information in health care milieu), interactive (higher cognitive skills to gather, comprehend and apply the necessary information to changing contexts to make effective decisions), and critical HL (skills to analyze and make use of the information to improve health) (Asharani et al., 2021). In order to establish optimal glycemic control, patients must have adequate health literacy in order to monitor their caloric and carbohydrate consumption as well as their blood glucose levels (Mann et al., 2019). According to Mann et al., 2019, more than 34.2 million Americans have diabetes, and an additional 88 million adults have prediabetes, a condition that puts them at risk for type 2 diabetes. Heart disease, renal failure, and blindness are among the major complications of diabetes. In 2017, the entire projected cost of diagnosed diabetes in medical bills and lost productivity was $327 billion (Mann et al., 2017). At the practicum site, the issue is that the length of stay for patients admitted with the diabetes diagnostic related grouping (DRG), is greater than the national benchmark average. Diabetic patients are coming to the clinic with uncontrolled glucose levels.
In order to address the difficulties related to a local unit as well as the global concerns that affect certain care service lines or patient groups, quality improvement work in health care involves various components (Agency for Healthcare Research and Quality, 2017). These different components work together to provide the essential synergy in order to improve care and patient outcomes. Within the practicum site, there are six diabetes educators. The educators primarily educate in the outpatient setting however they are utilized in the inpatient setting for newly diagnosed diabetic patients and when consulted by the endocrine team. According to the diabetes educator’s nursing manager, currently, the diabetes educators do not utilize a health literacy screening tool prior to teaching diabetic patients. The manager was very interested in collaborating with the learner to educate the educators on health literacy and explore the idea of incorporating a health literacy screening tool into practice. Low health literacy, which is primarily defined as health-related reading and numeracy abilities (i.e., functional health literacy), is increasingly linked to negative health outcomes, including early death (Friis et al., 2020). The practice focus question would be exploring if educating diabetes educators on health literacy would enhance diabetes management compliance in patients. Proper diabetes management would decrease readmissions and decrease the length of stay in patients with diabetes. The practice project for this course would focus on educating the diabetes educators on health literacy and explore the use of implementing an evidence-based screening tool. According to Stannard (2021), once an issue has been identified, it is necessary to establish if all five steps of evidence-based practice will be implicated to address the problem. It is unknown at this time if other organizations assess health literacy levels prior to educating diabetic patients. Low HL has been associated with extended hospital admissions, medication mistakes, and poor chronic illness management (Vellar et al., 2017). Consumers are in danger if health organizations do not invest in a coordinated approach to addressing HL. The learner will conduct a literature search to gather information on common practices prior to teaching a diabetic patient within healthcare organizations.
Patients are becoming more involved in health care, with the ultimate goal of patients being able to better manage their own health. This necessitates an understanding of the health-related abilities that patients require in order to manage information and actively participate in their health. It is vital for diabetes educators to understand the health-related competencies that an individual diabetic patient needs prior to teaching. A variety of teaching methods can be utilized to meet the health literacy level of diabetic patients. Organizations should have a process in place to assess for health literacy prior to teaching on health information.
Agency for Healthcare Research and Quality. (2017). Action plan for translating research into practice: Gap analysis and tests of change: Facilitator guide. https://www.ahrq.gov/hai/tools/mvp/modules/cusp/action-plan-trip-fac-guide.html