Zimmermann, A., Pilarska, A., Gaworska-Krzemińska, A., Jankau, J., & Cohen, M. N. (2021). Written informed consent—translating into plain language. A pilot study. Healthcare, 9(2), 232. https://doi.org/10.3390/healthcare9020232
This paper presents the plain language revision of an informed consent form in Polish plastic surgery through a stepwise procedure, incorporating a validated readability methodology and an iterative process of sentence writing to make text shorter, simplify words and phrases, and use the first and second person to enhance the comprehension of the information presented (Zimmermann et al., 2021). As illustrated in the article, intentional editing by readability scale can be beneficial to improve patient understanding, reduce confusion that can lead to treatment error, low adherence, and possible lawsuits (Zimmermann et al., 2021). The plain language principles and the study workflow can be used by nurses to review and rephrase test drafts of local consent and discharge materials with patients and match rewritten text with teach back during preprocedure teaching to confirm understanding. One tangible action nurses can spearhead to make the teaching of consent and discharge safer and more patient-centered is adopting plain language and testing documents on real patients.
Holcomb, J., Ferguson, G. M., Thornton, L., & Highfield, L. (2022). Developing, implementing, and evaluating the Teach Back curriculum for community health workers. Frontiers in Medicine, 9(1). https://doi.org/10.3389/fmed.2022.918686
This report outlines how a three-week Teach Back curriculum was designed and evaluated to support community health workers to enhance patient knowledge and retention of discharge information through a combination of brief didactic sessions, plain language practice video demonstrations, role play, and iterative feedback to develop Teach Back competence (Holcomb et al., 2022). The curriculum provides a proven training framework that nurses could implement to ensure better patient knowledge and retention of discharge instructions that support care transitions and reduce avoidable readmissions associated with poor comprehension (Holcomb et al., 2022). As part of orientation, nurses can incorporate short modular Teach Back training and use videos and case-based role play in team huddles. They can also schedule short refresher courses after rollout to remind them of the technique, particularly for high-risk groups at discharge.
Dijkman, E. M., ter Brake, W. W. M., Drossaert, C. H. C., & Doggen, C. J. M. (2024). Assessment tools for measuring health literacy and digital health literacy in a hospital setting: A scoping review. Healthcare, 12(1), 11. https://doi.org/10.3390/healthcare12010011
This scoping review lists 44 instruments applied in hospitals to measure health literacy and digital health literacy and includes features such as domains covered, administration time, and whether instruments are objective or self-reported, with the Newest Vital Sign NVS the Short TOFHLA, the Health Literacy Questionnaire HLQ and the Brief Health Literacy Screener BHLS being the most commonly used by the authors (Dijkman et al., 2024). The review will help nurses pick viable screening tools that can be adapted to clinical needs and measurement goals, leverage the opportunity to tailor communication to patients at risk of misconceptions, reduce readmissions and unfavorable post discharge events (Dijkman et al., 2024). The nurse could use a one-minute screener (e.g., BHLS or NVS) to screen the patient at the bedside rapidly, and a wider screener (e.g., HLQ) could be used when developing education programs or quality initiatives that may need multidomain assessment. Choosing the appropriate tool in the clinical setting provides nurses with an effective means of determining literacy requirements and providing education in areas where it will do the least harm.
Nguyen, Q., Flora, J., Basaviah, P., Bryant, M., Hosamani, P., Westphal, J., Kugler, J., Hom, J., Chi, J., Parker, J., & DiGiammarino, A. (2024). Interpreter and limited-English proficiency patient training helps develop cross-cultural communication skills for medical and physician assistant students. BMC Medical Education, 24(1). https://doi.org/10.1186/s12909-024-05173-z
This quality improvement article describes a curriculum model that includes certified medical interpreters and actual limited English proficiency patients in preclerkship clinical practicums and records the short prebriefing interpreter training, live interpreter-supported patient interactions, and interpreter feedback that students acquired (Nguyen et al., 2024). By showing that guided interpreter presence and actual LEP experiences work to enhance clinician self-confidence and emphasize practical interviewing strategies, the study provides nurses with an evidence based strategy, which in turn significantly reduces the risk of consent errors, medication errors and follow up issues (Nguyen et al., 2024) by offering them a safer means to communicate with patients with limited English proficiency. Nurses may apply the model by conducting short prebriefing with the interpreter before direct-patient direct to patient encounter modeling, and asking the interpreter to provide real-time feedback and debriefing about the complex teaching or consent conversation. The strategy to make interpreters an active teaching partner when communicating with patients on consent and discharge is a scalable strategy that nurses can lead to enhance equity and safety.