Doctor of Nursing Practice (DNP) Projects

Access Control

Open Access

Embargo Period


Degree Program

Doctor of Nursing Practice

Degree Track

Adult Gerontological Primary Care Nurse Practitioner (AGPCNP)

Year Degree Awarded


Month Degree Awarded



health literacy, screening tools, universal precautions


Dr. Cynthia Jacelon, PhD, RN-BC, CRRN, FGSA, FAAN

DNP Project Chair

Dr. Cynthia Jacelon, PhD, RN-BC, CRRN, FGSA, FAAN


Background/Purpose: Understanding the dynamics involved for patients to truly comprehend their health care needs for optimal self-care management are complex. The ways patients interact within the healthcare system can be stressful, overwhelming, and confusing. Failing to grasp even basic instructions can make patients prone to poor health outcomes. Evidence indicates that 36% of adults in the United States have basic or below basic health literacy levels and only 12% of adults are considered health literate. The purpose of this project was to implement clear, plain language communications, or health literacy universal precautions, within a primary care office. Methods: The DNP student used The Health Literacy Universal Precautions Toolkit, designed by The Agency for Healthcare Research and Quality (AHRQ) in conjunction with Lewin’s Theory of Planned Change, to implement: 1) a one-hour health literacy education session for healthcare staff and 2) a health literacy readability assessment and replacement of current patient forms and education materials to achieve the desired fifth to sixth grade literacy level. Results/Interpretation: Education session results revealed an average score increase from 76.2% on the pre-quiz to 97.6% on the post-quiz. The readability of office forms increased from only 12.5% of forms being at a fifth to sixth grade reading level initially to 50% of the forms meeting this criterion at the conclusion of the readability intervention. The results highlighted that the AHRQ Toolkit was beneficial in increasing healthcare staff knowledge of health literacy and improving the readability of office forms being provided to patients. Discussion/Conclusion: This quality improvement project provided an opportunity for the healthcare staff to become more aware of, and align their efforts in support of, health literacy universal precautions, which has the potential to impact positive change in patient care outcomes.

Creative Commons License

Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 3.0 License.

Included in

Nursing Commons