Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Diana Beckmann-Mendez


Ralph Grinnell


The purpose of this project was to increase provider awareness of health literacy needs for recommended dental screenings among patients with diabetes in a rural clinic setting. Over 35% of adults in the United States are considered to have low literacy levels (Agency for Healthcare Research and Quality, 2015). Low health literacy levels have an impact on patient outcomes due to decrease compliance with recommended treatment plans and preventive health screenings. Patients with diabetes have a trifold increase of developing oral infections such as periodontal disease, fungal infections, and xerostomia (Kudiyirickal & Pappachan, 2015). Healthcare providers acknowledging a patient’s health literacy level can provide appropriate educational material concerning recommended health screenings for diabetes including an annual dental exam and cleaning (Agency for Healthcare Research and Quality, 2015; Hummel, Phillips, Holt, & Hayes, 2015). This was a descriptive statistical quality improvement project conducted on a non-profit rural health clinic offering medical and dental services. Retrospective chart reviews concluded that patient’s health literacy and diabetic referrals to dental are not being conducted. Clinical staff was educated on health literacy assessments and patients with diabetes were administered the Short Assessment of Health Literacy-English/Spanish. A stamp was place on the patient face sheet to prompt the provider of the patient’s health literacy level and the need for a referral to dental. The intervention did increase provider awareness of patients’ health literacy and affected the interaction between the provider and patient. This project has increased referrals for dental screenings among patients with diabetes.