Abstract Delivering a preterm baby who is admitted to a neonatal intensive care unit can be an enormous hardship for parents and families, and especially for mothers. The consequences of prematurity alter the parental role, affect their confidence in caring for the baby, and subsequently may impact infant outcomes. Adequately educating mothers of premature babies using an evidence-based practice approach may help them gain the confidence and skills needed to care for their infants. The purpose of this project was to create a tool kit to educate mothers of premature babies about the essential components of caring for their babies, establish content validity of the tool kit among clinical experts, and make recommendations about the use of the tool kit in the neonatal intensive care unit. Polit, Beck, and Owen’s framework was used to establish content validity. Neonatal intensive care nurses who were considered “experts” using Benner’s novice-to-expert theory (n = 7 reviewed the tools which were quantitatively computed and yielded an Item Content Validity Index value range of 0.86 to 1.00, and a Scale Content Validity Index of 0.97, reflecting that the content met the objectives of the toolbox. Positive social change can be realized through use of the tool kit in the neonatal intensive care unit to educate mothers in the care of their preterm babies, thus improving both maternal and infant outcomes.

Health literacy (HL) skills are necessary to understand the context of medical information provided to patients in all settings including the emergency room. People with low health literacy (LHL) have difficulty comprehending and implementing basic tasks such as understanding medication administration. The purpose of this quasi-experimental study guided by Orem’s self-care theory was to determine the effect of using the teach-back method for discharge instructions compared to standard written instructions based on parents’ learning style and HL skills assessed during their visit to the emergency room. The Newest Vital Sign (NVS) tool was reworded to assess the parents’ HL. A panel of experts reviewed the tool independently, judged appropriateness and accuracy of the questions, and suggested minor changes. Interrater reliability was assessed in a pilot study with 14 participants, and the strength of the agreement was classified as good (κ = 0.61–0.80) to very good (κ = 0.81–1.00). The NVS was used to determine the literacy levels of 16 participants. The data were analyzed using the Mann-Whitney U test to compare the median scores in comprehension, adherence, and recall. Results revealed no statistically significant increase in comprehension adherence and recall when using the teach-back method (n = 9) compared to the standard written instructions (n = 7). The small sample size was a limitation. Modifying teaching methods for those with LHL to assure complete understanding of important health information will affect positive social change. Further research addressing low health literacy in parents who speak languages other than English is necessary to assure the results are applicable to the general population.