The Importance Of Patient Education

Appropriate patient education upon discharge from the emergency department (ED) is essential for effective patient care (Engel et al., 2009; Waisman et al., 2003). Patients are treated and released from the ED, often with complicated instructions they are expected to remember and comply with. The type of discharge education varies widely including verbal, non-verbal, written, illustrated and video information given to patients depending on the health professional and hospital policies. Inadequate discharge instructions can result in poor health outcomes and higher healthcare costs due to re-presentations to the hospital (Han, Barnard & Chapman, 2009; McCarthy et al., 2012; Palonen, Kaunonen, Helminen, & Åstedt-Kurki, 2015; Samuels-Kalow,

6) as the “…written and oral language people use in their everyday life and work; it includes reading, writing, speaking and listening.” Whilst health literacy is defineed as “…the degree to which individuals have the capacity to obtain, process and understand basic health information and services needed to make appropriate health decisions” (Kickbusch, Walt & Maog, 2005, pg. 4). Patients with low health literacy are more likely to have a lower level of knowledge of their illness, treatment and medicines, higher rates of hospitalisation, are less likely to use prevention services and have a higher probability of using emergency services (Ministry of Health, 2010). Low health literacy in patients contributes significantly to patient comprehension and adherence to discharge instructions (Gozdzialski, Schlutow, & Pittiglio, 2012). The Ministry of Health has determined this is a major issue throughout New Zealand as well as across the world. An analysis conducted by the Ministry of Health (2010) identified that New Zealanders as a whole scored low in health literacy skills. However, within this, there was a particular issue with four out of five Māori males and three out of four Māori females having below average literacy skills. Yet if patients are given discharge instructions that they are able to comprehend, then they are more likely to adhere to the instructions (Zavala & Shaffer,

Irrespective of the form of communication, it has been established that effective healthcare worker to patient communication is vital to ensure necessary instructions will be followed (DV & Rajavel, 2008). The manner by which information is shared has changed over recent years, moving from non-existent or hand written notes to now pre-printed instructions or electronic discharge summaries.

McCarthy et al. (2012) conducted a study in the United States (US) gaining patient feedback to help develop educational materials they received upon discharge from the ED. Focus groups were used with 60 people to ensure appropriate literacy and patient centred education is received. They concluded that to be able to use plain language with patients on a daily basis is difficult as it requires great skill to ensure patients from all backgrounds comprehend information (McCarthy et al., 2012). McCarthy et al. (2012) also reported that removing unnecessary words and distractions, this increased the likelihood of retaining key information. Readily understood language that engaged the audience and was displayed in an organised manner aided in the probability of patients remembering information. “Written communication is in plain language if its wording, structure,