Screening for literacy and readability: implications for the advanced practice nurse

The National Adult Literacy Survey reported that 44 million adult Americans could not read or write well enough to meet the needs of everyday living and working. Low literacy is more prevalent than the average nurse is aware, and often the written materials given to patients are above their reading level and therefore are misunderstood. This article defines literacy and describes literacy screening tools and readability formulas. Recommendations for including assessment of literacy and readability as essential activities of the advanced practice nurse (APN) are presented. The APN can be instrumental in providing leadership and directing education, thus ameliorating the effects of low literacy.