Health literacy is a national problem with more than 77 million people in the United States having low health literacy (U.S. Department of Health and Human Services, 2008). Health literacy is linked to more readmissions, higher mortality, and an increase in adverse effects (Mitchell, Sadikova, Jack, & Paasche-Orlow, 2012). Factors that contribute to a low health literacy are language barriers, age, education level, and culture (Osborne, 2006).
Learning styles or how a person receives and processes information also affects comprehension (Russell, 2006). There are three learning styles: auditory, visual, and kinesthetic. To address all three learning styles, Fredricks, Ibrahim, and Puri (2009) suggest presenting information in a multi media approach in multiple sessions.
A patient's self efficacy can be addressed utilizing the adult learning theory. Adult learning theory as described by Merriam (2001) combines andragogy and self directed learning. Adult learning theory describes the basic assumptions of an adult learner. The traits of an adult learner include having a life time of knowledge that directs their learning, is internally motivated to learn, expects the knowledge to be immediately applicable and to benefit them, as well as being in control of when the learning occurs.
This newly designed tool is a free standing, laminated patient educational tool provided in English and Spanish. This tool integrates adult learning theory, health literacy, and patient involvement and focuses on daily activity and discharge teaching for a hospitalized patient. This tool consists of a mnemonic alliteration, pictures, different colors, and clock faces. The mnemonic alliteration corresponds to the three most important discharge educational needs to prevent readmission for a specific patient population. For example, the most common reasons for readmission with a patient who has undergone open heart surgery are heart failure and wound infections (AlWaqfi, Khader, Ibrahim, & Eqab, 2012; Fox et al., 2013; Hannan et al., 2003; Hannan et al., 2011; Li et al., 2012). Therefore, the mnemonic alliteration would be weigh (to prevent heart failure), wash (to prevent infection), and walk (to strengthen the heart to aid in preventing heart failure).
Each discharge need has a corresponding picture and color to address the visual learners needs and those patients with low literacy as well as the color aiding in memory recall. In addition, the educational tool has clock faces that encourage goal setting and mobilization of the hospitalized patient. In compliance with the adult learning theory, this educational tool permits the adult learner to review the information at his/her own pace, allows for repetition as well as provides information that is basic and necessary to know (Rigdon, 2010). This educational tool allows the healthcare professional to repeat and test acquired knowledge throughout the day in short sessions.
In addition to addressing the patient's learning style and educational needs, the tool focuses on movement and/or ambulation with hospitalized patients. This education tool provides a method to visualize the patient's mobility goals and expectations while at the same time communicating these goals between clinicians, caregivers, and patients. This visualization allows coordination in care among caregivers as well as promotes families and patients to be actively involved in achieving those goals. This tool promotes ownership in a patient's care, allows for a continuum of care between healthcare professionals, and helps to standardize common discharge teaching instructions while at the same time allowing for individualized teaching instructions.
This educational tool was implemented with open heart surgery patients in February 2014. This study is complete and data has been collected and analyzed. The hypothesis was by implementing this tool, a patient’s self-care will improve thereby leading to an increase in the frequency of mobility/ambulation while hospitalized and a decrease in length of hospitalization and readmission. The educational tool addresses patient educational needs including: individuality, health literacy, adult learning theory, and learning styles.
This presentation will provide an overview of the concepts within the educational tool. Suggestions and recommendations for implementing the concept into different settings will be provided as a means for addressing discharge planning options, increasing patient satisfaction, and decreasing 30 day readmission challenges.
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