2.50
Hdl Handle:
http://hdl.handle.net/10755/162886
Type:
Presentation
Title:
Reading Levels of ED Patients Compared to the Level of Discharge Instructions
Abstract:
Reading Levels of ED Patients Compared to the Level of Discharge Instructions
Conference Sponsor:Emergency Nurses Association
Conference Year:2003
Author:Somes, Joan, RN, MSN, PhD, CEN
P.I. Institution Name:St. Joseph's Hospital
Contact Address:5718 Upper 136th Street Court, Apple Valley, MN, 55124, USA
Contact Telephone:651/232-3348
Purpose: Patients discharged from the emergency department (ED) are given written instructions explaining how to care for themselves. Yet, many return stating they did not understand the instructions. The purpose of this study was to determine the patient's reading level compared to the level of discharge instruction. Design: This study had three parts. The first part tested ED patients to determine at what grade level they were able to read. The second part calculated at what grade reading level the discharge instruction were written. Finally, the two sets of data were compared to determine if the patients' reading abilities matched, or were less than, what was required to read the instructions. Methodology: A convenience sample of 340 patients in an upper Midwest inner-city ED that treats primarily internal medicine and psychiatric patients with some pediatric and trauma patients. Patients range in age from neonate to geriatric. A nurse did all the testing during the 7-3 or 3-11 shifts over a two-month period. Psychiatric and unstable cardiovascular or respiratory patients and non-English speaking were excluded. The patients' reading level ability was determined by using the REALM (Rapid Estimate of Adult Literacy in Medicine) test. The REALM test is sixty-six words long and has demonstrated a high correlation between the patient's ability to correctly "pronounce" words out loud with ability to "read" words. The nurse marked incorrectly pronounced and "skipped" words. The number of correctly pronounced words was counted for each patient and then matched to the REALM table, which assigns grade levels. The second part of the study applied the Fry Formula to discharge instructions to determine grade level the patient would need to read at in order to read the instructions. The Fry test counts the number of syllables in each sentence over several paragraphs. The more syllables there are and/or the longer the sentence is, requires a higher reading ability. The Fry Formula was used with a computer generated and a loose-leaf set of instructions in the study emergency department. To ensure consistent data, instructions for five diagnoses were obtained from each company and were tested using the Fry Formula. The last step of this study was to compare the patients' ability to read to the reading ability required by the instructions. This was simply done by graphing the grade reading levels required by the 25 sets of instructions, graphing the grade reading abilities of the patients, and superimposing the two graphs. Results: There were 211 patients who read at the ninth grade level or above. Five admitted they could not read at all, eight patients could only read up to the 3rd grade level, 18 were reading at 4th through 6th grade reading level, and 98 could read at the 7th to 8th grade level. The discharge instructions were written at the 7th through 16th grade level, with most of them requiring a 10th to 11th grade reading ability to read the instructions. Conclusions: Many of the instructions required at least a 10th grade reading level to read. Only 211 of the patients could read at the ninth grade reading level or above. By looking at the graphs it was clear that one-third (129) of the patients were only reading up to an eighth grade reading level and would have trouble reading many of the instructions. Over one-third of the patients sent home from this ED could not read the instructions because the instructions were written at a reading level higher than what they could read. A set of instructions written at the 3rd grade reading level is currently being evaluated. [Research Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleReading Levels of ED Patients Compared to the Level of Discharge Instructionsen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162886-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Reading Levels of ED Patients Compared to the Level of Discharge Instructions</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2003</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Somes, Joan, RN, MSN, PhD, CEN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">St. Joseph's Hospital</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">5718 Upper 136th Street Court, Apple Valley, MN, 55124, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">651/232-3348</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Somes@Blacl-hole.com</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Patients discharged from the emergency department (ED) are given written instructions explaining how to care for themselves. Yet, many return stating they did not understand the instructions. The purpose of this study was to determine the patient's reading level compared to the level of discharge instruction. Design: This study had three parts. The first part tested ED patients to determine at what grade level they were able to read. The second part calculated at what grade reading level the discharge instruction were written. Finally, the two sets of data were compared to determine if the patients' reading abilities matched, or were less than, what was required to read the instructions. Methodology: A convenience sample of 340 patients in an upper Midwest inner-city ED that treats primarily internal medicine and psychiatric patients with some pediatric and trauma patients. Patients range in age from neonate to geriatric. A nurse did all the testing during the 7-3 or 3-11 shifts over a two-month period. Psychiatric and unstable cardiovascular or respiratory patients and non-English speaking were excluded. The patients' reading level ability was determined by using the REALM (Rapid Estimate of Adult Literacy in Medicine) test. The REALM test is sixty-six words long and has demonstrated a high correlation between the patient's ability to correctly &quot;pronounce&quot; words out loud with ability to &quot;read&quot; words. The nurse marked incorrectly pronounced and &quot;skipped&quot; words. The number of correctly pronounced words was counted for each patient and then matched to the REALM table, which assigns grade levels. The second part of the study applied the Fry Formula to discharge instructions to determine grade level the patient would need to read at in order to read the instructions. The Fry test counts the number of syllables in each sentence over several paragraphs. The more syllables there are and/or the longer the sentence is, requires a higher reading ability. The Fry Formula was used with a computer generated and a loose-leaf set of instructions in the study emergency department. To ensure consistent data, instructions for five diagnoses were obtained from each company and were tested using the Fry Formula. The last step of this study was to compare the patients' ability to read to the reading ability required by the instructions. This was simply done by graphing the grade reading levels required by the 25 sets of instructions, graphing the grade reading abilities of the patients, and superimposing the two graphs. Results: There were 211 patients who read at the ninth grade level or above. Five admitted they could not read at all, eight patients could only read up to the 3rd grade level, 18 were reading at 4th through 6th grade reading level, and 98 could read at the 7th to 8th grade level. The discharge instructions were written at the 7th through 16th grade level, with most of them requiring a 10th to 11th grade reading ability to read the instructions. Conclusions: Many of the instructions required at least a 10th grade reading level to read. Only 211 of the patients could read at the ninth grade reading level or above. By looking at the graphs it was clear that one-third (129) of the patients were only reading up to an eighth grade reading level and would have trouble reading many of the instructions. Over one-third of the patients sent home from this ED could not read the instructions because the instructions were written at a reading level higher than what they could read. A set of instructions written at the 3rd grade reading level is currently being evaluated. [Research Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:35:50Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:35:50Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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