Evidence-Based Health Literacy Strategies for Perianesthesia Nurses: Empowering Nurses with Knowledge and Tools for Better Patient Outcomes
- Arizona AzPANA
- Jun 27
- 4 min read
Bethany Biardi, MSN, RN, CPN, CPAN
Understanding Health Literacy
If you are anything like me, the concept of health literacy can seem a bit abstract. Until recently, I didn’t appreciate the scope or impact of health literacy on my work as a perianesthesia nurse.
Healthy People 2030 defines health literacy as “the degree to which individuals are able to find, understand, and use information and services to inform health-related decisions and actions for themselves and others.”1 This highlights the importance of clear and effective communication in healthcare settings. Unfortunately, according to the CDC, only 12% of literate Americans are proficient in health literacy.2 This is a significant concern as limited health literacy can lead to more hospital visits, longer stays, trouble managing chronic conditions, medication errors, increased emergency room visits, and higher morbidity and mortality.3 For these reasons, Healthy People 2030 has set a goal to improve health literacy for everyone
Impact on Surgical and Procedural Patients
What does poor health literacy mean for our surgical and procedural patients? According to a 2018 systematic review with meta-analysis, approximately one-third of surgical patients may have limited health literacy.4 In a 2018 randomized control trial of 704 patients undergoing same-day surgery, researchers found a statistically significant association between decreased health literacy and poor post-op recovery.5 Similarly, a 2023 systematic review of 25 cross-sectional and cohort studies found a correlation between surgical outcomes and health literacy.6
Role of Perianesthesia Nurses
The Perianesthesia Nursing Professional Practice Model from ASPAN exemplifies that the patient is central to perianesthesia nursing.7 Everything we do should be driven by an ever-present drive to meet our patients’ safety and health promotion needs. Before surgery, patients need to understand essential details to ensure a safe and beneficial outcome. They need to know the procedure's ins and outs, the risks, alternatives, preoperative medications, dietary restrictions, and logistical details. Communicating effectively during this phase will significantly affect patient preparedness. Successful preprocedural education will help to ensure not only readiness but also throughput. After surgery, patients and their caregivers must understand the critical elements of their wound care, mobility, infection prevention, pain management, and follow-up plan.
Evidence-Based Strategies to Improve Health Literacy
Knowing that an estimated one-third of surgical patients may have limited health literacy, perianesthesia nurses can employ simple evidence-based strategies when communicating with patients.4 Evidence-based strategies include the universal precautions approach, plain language, and teach-back.
Universal Precautions Approach
The universal precautions approach, a key evidence-based strategy, assumes everyone may have low health literacy.8 It accounts for the fluidity of health literacy. For example, you may be a perianesthesia nurse with high health literacy skills. Still, when faced with finding, understanding, and using health information to make decisions for a sick child, an ailing parent, or yourself after a new medical diagnosis, your immediate health literacy may become limited. This approach encourages clear and simple communication, regardless of the patient's perceived health literacy.
Plain Language
Plain language is a strategy for removing medical jargon from communication with patients. Nurses should create a list of medical terms used routinely in their practice and replace them with plain-language equivalents. For example, many of our patients have been diagnosed with hypertension, but patients may be more familiar with the term high blood pressure. Similarly, instead of using 'myocardial infarction', you can use 'heart attack' to ensure better patient understanding.
Teach-back
Teach-back is a method where healthcare providers ask patients to repeat the information provided in their own words. This ensures that the patient has understood the message correctly and allows the nurse to clarify any misunderstandings.9 For instance, after explaining a post-operative care plan, the nurse can ask, “Can you tell me how you will care for your wound at home?” This technique is particularly effective in ensuring patient comprehension and adherence to medical instructions.
Conclusion
I call on all perianesthesia nurses to implement health literacy strategies in all patient interactions. As perianesthesia nurses, we can foster clearer communication, enhance learning, and empower our patients to make informed health decisions by employing simple evidence-based strategies such as the universal precautions approach, plain language, and teach-back. These easy-to-implement, high-impact strategies will significantly affect patient safety, recovery, and overall well-being.
References
2. Rasu, R. S., Bawa, W. A., Suminski, R., Snella, K., & Warady, B. (2015). Health Literacy Impact on National Healthcare Utilization and Expenditure. International Journal of Health Policy and Management, 4(11), 747–755.
3. Coughlin, S. S., Vernon, M., Hatzigeorgiou, C., & George, V. (2020). Health Literacy, Social Determinants of Health, and Disease Prevention and Control. Journal of Environment and Health Sciences, 6(1), 3061.
4. Roy, M., Corkum, J. P., Urbach, D. R., Novak, C. B., von Schroeder, H. P., McCabe, S. J., & Okrainec, K. (2019). Health Literacy Among Surgical Patients: A Systematic Review and Meta-analysis. World Journal of Surgery, 43(1), 96–106.
5. Hälleberg Nyman, M., Nilsson, U., Dahlberg, K., & Jaensson, M. (2018). Association Between Functional Health Literacy and Postoperative Recovery, Health Care Contacts, and Health-Related Quality of Life Among Patients Undergoing Day Surgery: Secondary Analysis of a Randomized Clinical Trial. JAMA Surgery, 153(8), 738–745.
6. Trutner, Z. D., Furlough, K., Martinez, A., Vetter, I., Uhler, L. M., Haynes, A., & Jayakumar, P. (2023). Is Health Literacy Associated With Surgical Outcomes? A Systematic Review. Journal of Surgical Research, 291, 720–733.
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