Date of Conferral



Doctor of Nursing Practice (DNP)




Patrick Palmieri


Health literacy is demonstrated when individuals can obtain, process, and understand basic health information and services needed to make appropriate health decisions. Veteran health literacy is believed to be lower than the general population due to the aging and culturally diverse population. Veterans require adequate health literacy to manage their diverse high acuity physical injuries, psychological conditions, and chronic diseases. Clear communication between the clinician and veteran patient is essential to provide high quality health services. The objective of this quality-improvement project was to evaluate the ability of nurses in the ambulatory environment to identify low health literacy patients and to deliver an educational intervention focused on health literacy awareness and communication strategies. A pre-intervention Clear Communications Questionnaire (CCQ), a validated instrument, was delivered to 299 ambulatory nurses with a 20% response rate. The results from this questionnaire informed the development of a 40-minute educational program, multimedia and discussion format, provided to 200 nurses. Following the education program, the post-intervention CCQ was sent to the nurses, with a 30% response rate. Survey Monkey was utilized to collect the CCQ data and Minitab for the statistical analysis, including a pre- and post-intervention data analysis with a t test. While this project was unable to show a significant difference between the pre- and post-intervention CCQ, the individual survey items indicated increased awareness about the importance of health literacy and the ability to locate patient health literacy level in the medical record. Further work needs to be undertaken to assure veteran patients can actively engage in clear communication with clinicians, discern between treatment options, adhere to treatment recommendations, and develop health-seeking behaviors across their lifespans.

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Nursing Commons