Standardizing Best Practices

Why isn’t the wound healing? Consider health literacy.

Health Literacy

Wound care requires a lot of patient education, particularly for patients who struggle with health literacy. That includes those who don’t speak fluent English, can’t read well or have poor vision, says Ottamissiah “Missy” Moore, BS, RN, WCC, DWC, CSD-LTC, Clinical Liaison, Bridgepoint Hospital, Washington, DC.

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“Patients must understand what you are asking them to do,” states Moore, who currently serves as Board President of National Alliance of Wound Care and Ostomy (NAWCO). She recommends that providers:

  • Review your patient education information. Ask yourself: If you weren’t a healthcare professional, would you understand and be able to implement the instructions at home?

  • Keep instructions simple. Go over instructions step by step with patients.

  • Maintain a diverse care team in terms of age and ethnicity.

  • Keep instructions as patient-specific as possible. Tweak instructions over time.
  • Ask community members to help you. Moore said that when she needed help communicating with veterans, she turned to other veterans for assistance.
  • Use language and concepts that the patient is sure to understand. Moore once compared a pacemaker to a carburetor to help a patient understand what it was.
  • Assess patients’ literacy level. Literacy assessment tools are available at https://www.cdc.gov/healthliteracy/learn/index.html

  • Limit the amount of information provided at any given time. Break down instructions, perhaps day by day.
  • Verify understanding of information. Ask patients to explain the wound care in their own words.
  • Understand patients’ payment or treatment issues. Listen to patients. Is the treatment too expensive or complicated for them? Are they able to follow the doctor’s orders independently at home?

“Health literacy directly affects patients’ participation in their care. Active communication is important. Patients and their caregivers must understand what they need to do to regain health.”

“Health literacy directly affects patients’ participation in their care. Active communication is important. Patients and their caregivers must understand what they need to do to regain health.”

Health literacy by the numbers

  1. 12% of adults have proficient health literacy
  2. Nearly nine of 10 adults may lack the skills needed to manage their health and prevent disease.
  3. 14% of adults (30 million people) have below basic health literacy.  These adults were more likely to report their health as poor (42%) and are more likely to lack health insurance (28%) than adults with proficient health literacy.

REFERENCE

  1. Kirsch IS, Jungeblut A, Jenkins L, Kolstad A. 1993. Adult Literacy in America: A First Look at the Results of the National Adult Literacy Survey (NALS). Washington, DC: National Center for Education Statistics, U.S. Department of Education. Available at: https://health.gov/communication/literacy/quickguide/factsbasic.htm. Accessed November 18, 2018.

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