Baylor Nurse Uses Images to Improve Health Literacy

Jessica Saucier
Jessica Saucier

Jessica Saucier, clinical transplant research nurse at Baylor Research Institute, has developed a low-health-literacy education module aimed at helping cirrhosis-diagnosed patients better understand their disease.

The primary barometer of success was a pair of surveys completed by the patients – at both the onset and conclusion of the project. Saucier designed the surveys to assess the patients’ understanding of their disease before and after the modules. More than 40 percent of patients showed improved health literacy.

Health literacy is the capacity to obtain, process and understand basic health information and services to make appropriate health decisions. Reading comprehension and understanding numbers are key components.

However, Saucier found that visual cues, or pictures, had a more lasting impact for those with low health literacy. For example, a diuretic was represented by a faucet with running water. Rather than a list of written instructions, discharged patients would receive a grid of pictures that included a saltshaker next to a down arrow and wine bottle with an “x” over time to indicate they should be limited or avoided. They also received a video that mixed a Power Point presentation with real-life scenarios that discusses medications and diet restrictions in easy-to-understand terminology.

She said, “Liver disease is difficult to understand even for intelligent people.”

Saucier presented her findings at last year’s International Transplant Nurse Society Symposium in Sweden.

The National Work Group on Literacy and Health recommends that providers rely less on written communication and that health-care material be written at a fifth-grade reading level or lower.

Saucier recently began a second phase of the research. Her low-literacy education model will be part of a one-year experimental protocol to lower readmissions for cirrhosis patients at Baylor Fort Worth. The prevalence of the disease has doubled over the last decade. One in five hospitalized patients with liver disease is readmitted within a month of discharge.

Saucier plans to use social workers, dieticians and chaplains during inpatient care. Upon discharge, patients already get a call from a nurse practitioner within 48 hours to go over medications and verify there is a follow-up appointment with a physician. Saucier will act as a nurse navigator to call weekly thereafter to ensure there are no complications, answer questions and talk to caregivers.

A review of 96 studies found that low health literacy was associated with poor health outcomes. They include more hospitalizations, greater emergency-room use, fewer flu vaccinations, fewer mammogram screenings and poor medication compliance.

“I am hoping to an inpatient multidisciplinary approach and a nurse navigator model will reduce admissions,” she said.

Saucier’s research is among more than 100 nurse-led studies at Baylor Health Care System, many of which have outside funding, according to Baylor Director of Nursing Research Susan Houston. Nurses who participate in research projects are eligible for bonuses.

“Nurses play a critical role in research,” Saucier said. “Nurses take everything into consideration when caring for a patient, and are great detectives when it comes to finding root causes of problems.”

Steve Jacob is editor of D Healthcare Daily and author of Health Care in 2020: Where Uncertain Reform, Bad Habits, Too Few Doctors and Skyrocketing Costs Are Taking Us. He can be reached at

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