Date of Award

Spring 5-22-2017

Degree Type


Degree Name

PhD Nursing




Eileen Toughill, Ph.D

Committee Member

Marie Foley, Ph.D

Committee Member

Donna Mesler, Ph.D


health literacy, health literacy knowledge, health literacy experience, emergency nurses, teaching methods


Health literacy (HL) is the ability one has to understand health information and navigate within the health system. Health literacy is linked to health knowledge and acute and chronic health outcomes. The conceptual model of health literacy outlines the contextual factors related to individual health literacy throughout the health system and the mitigating influence on outcomes. Education is a key factor to health knowledge and behavior changes. Nurses are the primary educators for providing patient teaching and yet research indicates nurses are lacking in knowledge regarding this. One area in the health system where health literacy has a strong effect on patient outcomes is the emergency department (ED). Identifying the association between emergency department nurses knowledge of, and experience with health literacy, and their use of patient education strategies is important for future patient outcomes. This descriptive, exploratory, correlational study examined the HL knowledge, experience and most frequently used teaching methods of ED nurses as well as relationships between and among emergency department nurses’ health literacy knowledge, health literacy experience and their patient teaching methods.

Results of this study indicated that ED nurse participants knew less basic facts about HL than about evaluating HL interventions and the consequences associated with low HL. Overall the participants answered 62% of the knowledge questions correctly. There were correlations found between HL knowledge and age, years as a licensed registered nurse (RN) and years worked in the ED with the strongest predictor of HL knowledge being nurses level of education (β = .21, p = .012). A number of ED nurses (49.8%) indicated they never participated in HL strategies such as HL screening, evaluating reading level of written materials or illustrations and very few (4.6%) indicated they always participate. The participants indicated the most frequently used teaching methods in the ED were providing written materials, avoiding medical jargon and encouraging questions.

Further research is needed to explore methods to increase health literacy knowledge of ED nurses and strategies to facilitate experiences with health literacy in the ED. Communication is an important component of the relationship between nurses and low health literate patients in the ED. Methods to enhance communication and facilitate patient understanding and retention of patient teaching should also be explored.

Included in

Nursing Commons