Evidence-based project to improve stroke unit outcomes: Assessment of health literacy to individualize stroke education

Saturday, 16 November 2013: 3:35 PM

Lynne M Massaro, DNP, RN, ANP-BC, FNP
School of Nursing, University of Rochester, Rochester, NY

Learning Objective 1: Identify an effective tool to assess a patientís health literacy status.

Learning Objective 2: Discuss one stroke unitís approach to influence patientsí stroke knowledge acquisition to improve outcomes.

Background: Stroke affects almost one million people annually. Comprehensive stroke centers use evidence-based treatment guidelines and mandated secondary stroke risk reduction education to reduce disability and decrease morbidity and mortality from neurovascular disease. Multiple barriers affect the delivery of stroke education and patients’ stroke knowledge acquisition. The Newest Vital Sign (NVS) health literacy assessment tool is effective in identifying patients with low health literacy enabling the provision of individualized educational formats.

Aim: To provide individualized secondary stroke risk reduction education for patients in a primary certified, adult inpatient stroke unit in a Magnet designated, academic, tertiary care medical center thereby influencing stroke knowledge acquisition and improving outcomes.

Methods: Integration of the Health Promotion Model with The Model for Evidence-Based Practice Change provided the theoretical framework used to guide project design and development. Patients’ health literacy assessments were completed using the Newest Vital Sign Tool, baseline assessments of secondary stroke risk knowledge were completed, and individualized stroke risk reduction education was provided.  Stroke risk knowledge was then reassessed at the outpatient stroke follow-up appointment with comparison between baseline and follow up questionnaire scores.

Results: The NVS health literacy assessment tool identified 53% of participants with low health literacy. Secondary stroke risk reduction education was individualized and 92% of participants demonstrated stroke knowledge acquisition and overall improved scores between baseline and follow-up stroke knowledge questionnaires. 

Conclusions: Results indicate that stroke unit patients with low health literacy benefit from individualized secondary stroke risk reduction education.  Stroke units using best evidence to address individual education barriers increase a patient’s potential for healthy outcomes. Including health literacy assessments to tailor mandated education may result in positive consequences that surpass the efficacy of traditional education formats currently being used.