Master’s prepared nurses have the key role of leading practice across the entire system of healthcare settings. They can adapt professionally to the dynamic and constantly changing healthcare system and offer valuable contributions which will advance the profession. They can also assume advanced nursing roles in various specialty areas. Moreover, they can use their leadership skills in proposing and enforcing healthcare changes at the national, local, and regional levels. Master’s prepared nurses often put research and theory into practice with communities, individuals, and families. Furthermore, the can formulate, implement, and evaluate various nursing strategies that will ensure the quality of care ( Landry, 2015) . One of the issues that should be addressed by master’s prepared nurses is health literacy. Health literacy describes the level at which patients or individual can acquire, process, and understand fundamental health information. The research paper will evaluate the role of master’s prepared nurses in improving health literacy in the country.
Current Nursing Practices and Stakeholders in Health Literacy
The National Assessment of Adult Literacy stated that about 12% of Americans have the necessary competency in health literacy ( Johnson, 2014) . It is apparent that there is a greater need for health literacy in the country. The Center for Disease Control and Prevention (CDC) explained that when people understand the fundamental concepts of well-being and health such as treatment, illnesses, care, and bodily functions, they have adequate health literacy skills. It is evident that some stakeholders take for granted the knowledge that patients have about their health issues. Most nurses may overestimate the health literacy levels of the populations, therefore, slowing their road to recovery ( Johnson, 2014) . Inadequate health literacy translates to higher healthcare costs, poor patient outcomes, increased numbers of manageable chronic conditions, higher hospitalizations rates, and increased readmission rates. Therefore, nurses have a crucial role in improving health literacy.
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Stakeholders play significant roles in increasing health literacy in both communities and individuals. Some of the stakeholders include public health organizations:
Health consumers: consumers have a role in demanding quality care and information about medication and quality lifestyles.
Caregiver organizations: the organizations should improve the national health status by offering quality care and educating patients and communities.
Healthcare students: they should ensure they have the necessary skills to not only treat but also educate patients about their health conditions.
Professional and practitioners: they should increase cost savings and efficiency of the entire health system.
Healthcare organizations: they should increase cost savings and efficiency of the entire health system. Also, they should improve public access to adequate preventive care.
Tribal, state, and local employees: they should improve communication by educating and assisting communities to understand the importance of health literacy.
Patient support and advocacy organizations: they should improve communication by educating and assisting communities to understand the importance of health literacy. They can also advocate for improved patient education strategies.
Public health doctors, nurses, and dentists: they should ensure they have the necessary skills to not only treat but also educate patients about their health conditions. Furthermore, they should improve the health status of the country by implementing patient education strategies.
Evidence Critique Table
Table 1 showing the evidence critique
| Citations | Evidence Strength (1-7) and Evidence Hierarchy |
| Davis, A. (2014). Core Communication Competencies in health literacy. | Level III |
| 2. Masters, K. (2015). Role development in professional nursing practice . Jones & Bartlett Publishers. | Level III |
| 3. Schmidt, A., Ernstmann, N., Wesselmann, S., Pfaff, H., Wirtz, M., & Kowalski, C. (2016). After initial treatment for primary breast cancer: information needs, health literacy, and the role of healthcare workers. Supportive Care in Cancer , 24 (2), 563-571. | Level IV |
| 4. Landry, K. E. (2015). Using e-Health to improve health literacy among the patient population. Creative nursing , 21 (1), 53. | Level II |
| 5. Johnson, A. (2014). Health literacy, does it make a difference? Australian Journal of Advanced Nursing, The , 31 (3), 39. | Level IV |
Evidenced Based Summary of Sources
All the definitions from the sources indicate that people are believed to possess health literacy skills when they can analyze and understand basic instructions and information regarding healthcare and implement it to stay healthy. Furthermore, the sources indicate that when individuals have poor health literacy skills, they are at risk of various problems. They may require treatment and other healthcare related services to a higher level than individuals with proficient health literacy skills ( Landry, 2015) . They may also not receive adequate treatment or receive it when their health condition is fatal. Also, patients with poor health literacy may take medication incorrectly. Besides, they may experience poorer health outcomes than individuals with proficient health literacy skills.
There are various reasons for the poor health literacy in the country. Particular demographics have higher risks of inadequate health literacy such as high school dropouts, people with low incomes, older adults, people living in underserved areas, and racial minorities. However, the most common barrier to adequate health literacy is the level of access to information. Some of the reasons some individuals cannot access information include education levels, age, lack of access to the necessary online materials, lack of transportation, cultural differences, and language ( Schmidt et al., 2016) . Therefore, most of the people with poor health literacy often have the inadequate education necessary to improve their health literacy. Despite the fact that some individuals with poor health literacy skills may have access to information, either from healthcare professional or online sources, they may fail to understand the information because of poor reading and writing skills, or mistrust that may increase the level or risks of miscommunications.
Specific Best Practice and Change Model
Due to the importance of health literacy, it is significant for all healthcare professionals including nurse managers and nurses to lead the efforts regarding patient education. The patient education strategies should focus on understanding information and preventative health care techniques. It should also involve strategies that will treat particular health care issues. Communication is quite important not only when giving instructions but also when evaluating whether the patient understands the medical instructions ( Davis, 2014) . When communicating, nurses should put aside medical jargon and use plain language that is easily understood by most people.
The change model should be communicating the importance of health literacy to all stakeholders. The next step should be involving the stakeholders in formulating a strategy that will improve health literacy. The next stage should involve implementing the strategy and evaluate the results. On the other hand, nurses may use some strategies to encourage health literacy. Nurses should create a welcoming environment so that patients can trust the providers and communicate their health-related issues. Moreover, nurses can make use of printed information by relaying crucial information to patients in the most common languages among their patients ( Masters, 2015) . Besides, nurses should use basic language when explaining health issues. Also, they should speak at a measured pace. Patients may fail to understand important information if the information is relayed quickly. Furthermore, nurses should ask and encourage questions to evaluate whether individuals understand the basic instructions. It also provides gaps that the healthcare organizations can address.
Possible Barriers to Change Model
There are various challenges when implementing the change model. One of the challenges includes limited knowledge of cultural differences such as the differences in word meanings and language. The other barrier includes the use of medical or technical terminology that may be misinterpreted by patients. The other barrier is the focus on information instead of actions. In most cases, nurses focus on what the patients need to know but not how they should do it ( Johnson, 2014) . Also, the overreliance on print communication may be inadequate to improve health literacy because some patients do not have writing and reading skills.
Ethical issues in Proposed Model
As the healthcare system becomes more complex due to evidence-based practices, the poor health literacy level issue has become more problematic. Furthermore, patient involvement in particular healthcare choices has become more important. The National Committee for Quality Assurance (NAQA) and the Joint Commission adopted some guidelines to improve patient education through care instructions, consent forms, and other medical instructions ( Masters, 2015) . Medical professionals who will adhere to the change model are likely to have less litigation, have more favorable patient outcomes than professionals who will not comply with health literacy guidelines. Lack of compliance with health literacy guidelines may lead to malpractice lawsuits, medication errors, adverse medical appointments, and missed appointments.
Conclusion
The research paper evaluates the role of master’s prepared nurses in improving health literacy in the country. Health literacy describes the level at which patients or individual can acquire, process, and understand fundamental health information. However, only 12% of Americans have the necessary competency in health literacy. Inadequate health literacy translates to higher healthcare costs, poor patient outcomes, increased numbers of manageable chronic conditions, higher hospitalizations rates, and increased readmission rates. Increasing patient knowledge about side effects, treatment and medication are essential to boosting favorable patient outcomes. Nurses have a critical role in effectively communicating with patients regarding their prognosis and illness. Health literacy has a significant role in recovery. In most cases, physicians get in and out of patients' rooms, and nurses are supposed to implement the orders ( Davis, 2014) . Through professional design, nurses spend ample time with patients and they have a role in implementing and addressing health literacy issues.
References
Davis, A. (2014). Core Communication Competencies in health literacy.
Johnson, A. (2014). Health literacy, does it make a difference? Australian Journal of Advanced Nursing, the , 31 (3), 39.
Landry, K. E. (2015). Using e-Health to improve health literacy among the patient population: Creative nursing , 21 (1), 53
Masters, K. (2015). Role development in professional nursing practice : Jones & Bartlett Publishers.
Schmidt, A., Ernstmann, N., Wesselmann, S., Pfaff, H., Wirtz, M., & Kowalski, C. (2016). After initial treatment for primary breast cancer: information needs, health literacy, and the role of healthcare workers. Supportive Care in Cancer , 24 (2), 563-571.
