Date Approved


Graduate Degree Type


Degree Name

Nursing (D.N.P.)

Degree Program

College of Nursing

First Advisor

Patricia Schafer

Second Advisor

Cynthia Coviak

Third Advisor

Joan M. Borst

Fourth Advisor

Gustav K. Barkett


Despite the recent advances in health care related to the patient-centered medical home, meaningful use, and the Affordable Care Act, the health care system has failed the vast number of patients who do not understand basic health information providers or educational materials designed to communicate to them. For the purpose of this project, low health literacy is framed as a barrier to patient and provider communication. Unfortunately, low health literacy often leads to adverse outcomes. These poor outcomes make improving health literacy a priority by acknowledging and evaluating health literacy interventions. The purpose of this project is to evaluate the effectiveness of implementation of The National Patient Safety Foundation’s Ask Me 3 program in increasing high-risk prenatal patients’ satisfaction and self-efficacy with communication experiences. By encouraging question-asking behavior of the high-risk prenatal participants, satisfaction and self-efficacy were hypothesized to improve. Using Donabedian’s conceptual framework about quality of care and Bandura’s Self-Efficacy Theory, the implementation and evaluation processes of this project were determined. Educational sessions with community health workers and medical residents and physicians were the first steps in implementing this quality improvement project. Participants were informed, educated about Ask Me 3, and then given time to practice using this approach at their office visits during the implementation period. With 11 pre-survey participants and 5 post-survey participants, there were no statistically significant findings after implementation for change in satisfaction or self-efficacy, yet strengths and limitations of this project contribute to the impetus to improve patient-provider communication. Health care providers must be sensitive to patient’s health literacy levels and encourage an environment in which patients are able to ask for clarification to enhance understanding. A doctorally-prepared advanced practice nurse can have a vital role in leading and encouraging initiatives related to improving patient-provider communication.

Included in

Nursing Commons