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Background: Parents and caregivers’ understanding of how to provide safe and effective care at home is vital. However, elevated levels of stress and limited health literacy face significant challenges in understanding discharge instructions.
For parents of pediatric patients seen in an acute perioperative setting, how will the use of the Ask Me 3® health literacy tool impact understanding of medical information and communication with healthcare providers?
Literature Evidence: Patients who understand heath instructions make fewer mistakes when they take their medicine, follow treatment plans, and prepare for medical appointments (Six-Means, Amy, et al, May 2012). Patients have reported higher satisfaction and found that the use of Ask Me 3® was helpful in learning more about their medical condition (Vaillancourt & Cameron, May 2021).
Practice Changes: Multidisciplinary team lead initiative, including Unit coordinator, patient care techs, and unit nurses. Unit printed The Ask Me 3® handout in both Spanish and English and provided to caregivers during the preoperative phase. Postoperative nurses reviewed discharge instructions and Project leader assessed if the Ask Me 3® tool was reviewed with them, if they found it useful, and if they felt confident in caring for their child at home.
Implementation: The Ask Me 3® handout was introduced by nursing staff during the preoperative phase using a standardized script. Caregivers of pediatric patients were asked after preoperative check in was completed and postoperatively if the tool had been reviewed. If not reviewed, it was introduced at that time. Discharge instructions were reviewed during the post-operative phase and included Did I explain things in a way you can understand? This question is a National Research Corporation (NRC) Health® Nurse Sensitive indicator. The introduction of the Ask Me 3® tool was tracked, and NRC scores were compared across quarters using the NRC Health benchmarks from 2025 Quarter1 (2025Q1) as baseline and 2025 Quarter2 (2025Q2) post-intervention.
Results: The intervention led to marked improvements and outperformed the benchmarks set by the NRC Health® in Care Coordination, Careful listening, Patient Education, Responsiveness Communication, and Service Recovery. Caregivers who felt that communication between the different doctors and nurses improved from hospital score of 25.0 in 2025Q1 to 100.0 in 2025Q2. Similarly, caregivers reported that discharge instructions clear and surpassed the set benchmark and 2025Q1 hospital score of 50.0 to 100.0 in 2025Q2. Comfort in talking to nurses about their worries or concerns as well as their perception of the nurse listening carefully to them also outperformed the 2025Q1 hospital scores and set benchmarks from 50.0 to 100.0, respectively.
Conclusions: Ask Me 3® tool was effective in improving communication, clarity, and caregiver confidence in understanding postoperative discharge instructions. Challenges in implementation including caregivers’ recollection about the introduction of the Ask Me 3® tool when interviewed, information overload, and or child distress during interviews. Recommendations include revaluating the format and delivery of written materials to reduce redundancy, improve clarity, and caregiver engagement. Next steps include fostering team involvement, ongoing evaluation of the Ask Me 3® tool and how written materials presented to caregivers ensure long-term sustainability and adoption.
Publication Date
9-22-2025
Keywords
Pediatric nursing
Disciplines
Pediatric Nursing
Recommended Citation
Medina, Yaseming, "Ask Me 3® in Action Advancing Health Literacy in Pediatric Acute Care" (2025). TCU EBP Fellowship. 15.
https://scholarlycollection.childrens.com/nursing-posters-tcuebp/15
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This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
