Nurses Can Help Improve Health Literacy in Patient Care

A health professional explains a prescription label to a patient.Extensive research shows that people who have low health literacy have poorer health outcomes and higher medical costs. Carolyn Dickens, a nurse practitioner at the University of Illinois–Chicago and a member of the Northwestern CERT, is challenging nurses to help reverse this trend.

Dickens and her colleague Mariann Piano recently published a review in the American Journal of Nursing that examines health literacy prevalence, definitions, and strategies nurses can use to assess and improve health literacy among their patients. In another study, she and her colleagues found that nurses often overestimate their patients’ health literacy levels. For this reason, Dickens believes it is important to raise awareness of the pervasiveness of low health literacy in certain patient groups among staff nurses who are directly involved in patient care.

Dickens notes that nurses in many community hospitals are often in charge of patient education materials because of their role as educators. Dickens recommends that they join together to produce materials that address low health literacy and improve patient comprehension. She also stresses the importance of training nurses to use proven verbal methods to communicate with patients. Finally, she advocates a rule of thumb—treat every patient as if he or she has low health literacy.

Read our feature article about Carolyn Dickens’s work.   

Download the Health Literacy Universal Precautions Toolkit (PDF, 6.75 MB) developed by the Agency for Healthcare Research and Quality.


  1. Dickens C, Piano MR. Health literacy and nursing: an update. Am J Nurs. 2013 Jun;113(6):52-7. PMID: 23702767.
  2. Dickens C, Lambert BL, Cromwell T, et al. Nurse overestimation of patients’ health literacy. J Health Commun. 2013;18 Suppl 1:62-9. PMID: 24093346.
  3. Agency for Healthcare Research and Quality. Health Literacy Universal Precautions Toolkit. Accessed November 22, 2013.
Page last reviewed March 2017
Page originally created March 2017
Internet Citation: Nurses Can Help Improve Health Literacy in Patient Care. Content last reviewed March 2017. Agency for Healthcare Research and Quality, Rockville, MD.
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