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Out-the-Door, Dinosaur: Assessing Health Literacy to Improve Discharge Education
Emily Garcia de la Vega1, Maureen Hokama2, Jennifer Newcombe3
1Emily Garcia de la Vega is a pediatric critical care nurse, Loma Linda Children's Hospital, California.
Critical Care Nurse
|March 31, 2026
Summary
Nurses can improve caregiver understanding and confidence by screening health literacy and tailoring discharge education. This quality improvement initiative successfully boosted caregiver satisfaction and reduced hospital readmissions in a pediatric cardiovascular intensive care unit.
Area of Science:
- Healthcare Quality Improvement
- Patient Education
- Health Literacy Assessment
Background:
- Identifying caregivers with limited health literacy is a critical organizational challenge.
- Healthcare organizations must equip nurses to identify and support low-literacy caregivers.
- Effective tools are needed to empower caregivers in making informed decisions.
Purpose of the Study:
- To improve caregiver satisfaction with nursing education and reduce 30-day readmission rates in a pediatric cardiovascular intensive care unit.
- To address below-benchmark caregiver satisfaction (80%) and above-benchmark readmission rates (>10%).
Main Methods:
- A quality improvement project involved screening caregiver health literacy within 24 hours of admission.
- Nurses provided tailored discharge education using the teach-back method, focusing on 5 key areas.
- Data collected via surveys and readmission rates analyzed for care management trends.
Main Results:
- Over 12 months, 150 caregivers were screened; 13% had low health literacy.
- Caregiver satisfaction with discharge education increased to 100%, with enhanced posthospitalization task confidence.
- Thirty-day readmission rates decreased by 1.8%.
Conclusions:
- Enhancing health literacy awareness is vital for improving patient outcomes and caregiver decision-making.
- Utilizing literacy tools empowers nurses to effectively educate caregivers with limited health literacy.
- Improved postdischarge care and patient outcomes are achievable through targeted health literacy interventions.
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