Health-Literate Healthcare Organization Attributes and Perceived Workload Among Nurses and Nursing Coordinators

Health-literate healthcare organizations (HLHOs) have been associated with improved clinical outcomes and quality of care for both patients and healthcare services, through the implementation of the "Ten Attributes of HLHOs" which support individuals in navigating, understanding, and using health information and services. Nurses, in both clinical and managerial roles, are crucial in supporting HLHO initiatives. However, a high level of perceived workload may influence their engagement with health literacy-related initiatives.

To assess nurses' and nursing coordinators' perceptions of the implementation of measures aimed at achieving HLHO status and the relationship between HLHO, sociodemographic factors, and participants' perceived workload.

A multicenter, cross-sectional study was conducted among nurses and nursing coordinators employed in four Italian facilities. An online questionnaire was used to collect participants' sociodemographic data, perceived workload, and perceptions of the implementation of the ten HLHO attributes using the HLHO-10 instrument.

A total of 386 participants were included. The HLHO-10 final scores revealed moderate perceptions of the implementation of health literacy measures across participating centers (mean = 4.73 out of 7; SD = 1.93). Higher HLHO levels were significantly associated with lower perceptions of workload. Female nurses and nurses employed in critical care and emergency departments were less likely to report lower workload (all p < 0.001).

Higher HLHO levels were associated with lower perceived workload, while differences were observed according to gender and working area. These findings suggest that organizational and contextual factors may be related to workload perceptions and highlight areas for further investigation and potential organizational improvement.

Healthcare organizations should consider integrating HLHO principles into organizational policies and practices while supporting staff education and organizational development. Stronger implementation of HLHO principles may be associated with more favorable workload perceptions and staff well-being. Nurse managers and nursing coordinators can play an important role in promoting OHL initiatives and fostering organizational environments that support both healthcare professionals and high-quality patient care.