Date of Award

Summer 2023

Project Type


College or School




Departments (Collect)


Program or Major

Direct Entry Masters in Nursing

Degree Name

Master of Science

First Advisor

Pamela Kallmerten

Second Advisor

Kathleen Sherman



Background: An infusion center in a critical access hospital provides education to patients and their families to address health literacy which supports shared decision-making and patient centered care. This education includes medication knowledge to support self-care. The goal of this project was to create printed drug education rack cards (DERC) for patients to review prior to their first treatment to increase their perceived confidence in drug knowledge. There are many different aspects to consider for each drug treatment given within the microsystem including side effects, administration schedules, and lab and diagnostic procedures. Many of these aspects are unknown to the patient prior to arriving to the microsystem for their first treatment. Patients may seek drug information on the Internet, most likely written at a reading level higher than 8th grade and contain information that does not fit their needs pertaining to their drug and the microsystems process for drug administration.

Local Problem: If aspects of drug administration are unknown to the patient, it can lead to missed appointments, knowledge deficit about the side effects of the drugs, and many questions from the patient to the nurse about how this drug treatment works. There were no educational information sheets to provide patients upon their first or reoccurring treatments.

Methods: To conduct this quality improvement project, the DERCs were inputted into the Flesch-Kincaid tool that calculates the grade level required to understand the text of the DERCs (Readable, 2023). The Patient Education Materials Assessment Tool for Printed materials (PEMAT-P) instrument was also used to screen the materials for content, language, visual aids, and engagement of the reader and if there were directions for action to be taken (Agency for Healthcare, 2020). To measure the patients perceived knowledge change, the project lead employed a third measurement, a retrospective and post-intervention survey.

Results: According to the Flesch-Kincaid tool, the average reading grade level a patient must be able to read at in order to read and understand the DERCs was between an 8th and 9th grade reading level, with the lowest score at 7.5 and the highest score at 10.2. The average PEMAT-P score overall was a 96%, indicating a high level of readability and understandability.

According to the patient survey, the participants overall confidence in knowledge about their prescribed drug increased by 15.38%. The change in perceived confidence in knowledge about each drug information category varied greatly ranging from 0% to 28.57%. 66% of participants found the DERC to be extremely easy to read and understand.

Conclusions: The DERCs were created to enhance readability and actionability for the target population. Overall perceived confidence in knowledge increased suggesting that the use of the DERCs improved knowledge.