NR-224 Fundamentals: Skills RUA Speak Up Brochure Critique and Patient Safety Goals

Course: NR-224: Fundamentals – Skills
Assignment: RUA: Safety Goals – Speak Up Brochure Critique
Point value: 50 points
Length: Maximum 3 pages excluding title page, reference page, and brochure copy
Format: Short paper with required section headers, APA 7th edition
Sources: One Speak Up brochure from The Joint Commission and one current nursing or healthcare journal article
Submission: Canvas RUA dropbox with the brochure attached

Context

Chamberlain University anchors the NR-224 Fundamentals RUA in the National Patient Safety Goals and the Joint Commission’s Speak Up initiatives. The assignment asks students to select a Speak Up brochure, critique it against current nursing literature, and evaluate whether the brochure would work as patient education in a real care setting. The public NR224 guidelines from the September 2023 revision establish a 50-point, three-page paper with mandatory section headers, a required journal article no older than five years, and a rubric that scores brochure introduction, summary, communication analysis, personal reflection, evaluation, evidence integration, conclusion, and APA mechanics (Chamberlain University, 2023). The earlier November 2022 version carried a similar structure at 50 points, which confirms the assessment has held a stable architecture across recent course cycles. The assignment is small in page count and large in evidence discipline. A student who summarizes the brochure without critiquing it will satisfy the summary criterion and lose points on the 28 percent evaluation section.

Task

Select one Speak Up brochure from The Joint Commission website. Write a short paper reviewing and critiquing the brochure. Use the required section headers: Summary of Brochure, Patient Communication, Personal Reflection, Evaluation of Brochure, Evidence Review and Application, and Conclusion. Integrate one current nursing or healthcare journal article to support your critique. Attach a copy of the brochure to the submission. Submit the paper and brochure to the RUA dropbox.

Requirements and Instructions

1. Select a Speak Up brochure from The Joint Commission website. Do not use a brochure from another source, a hospital handout, or a manufacturer’s patient education sheet. The Speak Up series includes titles on preventing medication errors, preventing infections, preventing falls, understanding your discharge instructions, and speaking up about pain. Choose a brochure that aligns with a patient population you have encountered or expect to encounter in clinical. The brochure title and publication date must appear in the introduction.
2. Attach a copy of the brochure to the submission. The rubric requires the brochure to be cited, included on the reference list, and submitted with the assignment. A paper without the attached brochure loses the citation and submission points in the introduction section. Save the brochure as a PDF and upload it with the paper.
3. Write no more than three pages excluding title page, references, and brochure. The page limit is strict. Extra pages will not be read and will not contribute to the grade. A three-page paper with tight paragraphs is the target. Students who write four pages because they summarized the brochure at length have misread the assignment. The summary section is 10 percent of the grade. The evaluation section is 28 percent. Spend the page space accordingly.
4. Use the required section headers. The guidelines specify six headers: Summary of Brochure, Patient Communication, Personal Reflection, Evaluation of Brochure, Evidence Review and Application, and Conclusion. An introduction without a header is acceptable, but the six body sections must carry the exact header wording. Instructors check headers against the rubric. A paper with creative headers such as “Why This Brochure Matters” does not satisfy the header requirement.
5. Include one current nursing or healthcare journal article. The article must be no older than five years and must come from a peer-reviewed nursing or healthcare journal. The article supports the critique, not the summary. A student who cites an article in the introduction and never uses it again has not integrated the evidence. The article should appear in the Evaluation of Brochure section and the Evidence Review and Application section, where it supports specific claims about readability, patient comprehension, or the brochure’s recommendations.
6. Evaluate the brochure against seven criteria. The Evaluation of Brochure section carries 28 percent of the grade and asks seven questions: whether the information was beneficial and could be incorporated into patient education, what was done well and what could be improved, whether the information was presented clearly, whether current research supports the brochure’s information, which population benefits most, who else can use the information, and whether the information will increase patient safety. Answer each question in the section. A single paragraph that addresses three of the seven questions leaves four criteria unaddressed and loses points accordingly.
7. Include a personal reflection that explains why the topic interested you. The reflection is short, two points out of fifty, but it is a required section. A sentence such as “I chose this brochure because I watched a patient with limited English proficiency misunderstand discharge instructions during my clinical rotation” satisfies the requirement. A reflection that restates the brochure’s topic without explaining the personal connection does not.
8. Format in APA 7 with a title page, in-text citations, and a reference page. The brochure and the journal article both appear on the reference page. In-text citations for the brochure include the Joint Commission as author and the publication year. In-text citations for the journal article follow standard APA author-date format. The paper uses double spacing, one-inch margins, and a running head if your section requires one.

Grading Rubric

Criteria	Points	Weight	Outstanding	Competent	Needs Improvement
Introduction of brochure	3	6%	Names the brochure title, identifies the publication date, describes the intended audience, cites the brochure, and attaches the brochure to the submission	Includes most elements; one element is missing or the brochure is cited but not attached	Missing title, date, audience description, citation, or attached brochure
Summary of brochure	5	10%	Reviews the main topics accurately and concisely; citation is present; summary stays within a proportionate share of the page limit	Summary is accurate but overlong or uneven; citation is present	Summary is missing, inaccurate, or consumes most of the paper
Patient communication	5	10%	Reviews the brochure’s guidance on communication between patients and providers; citation is present; connects the guidance to a realistic clinical interaction	Reviews the communication guidance but the clinical connection is thin	Communication section is missing or merely repeats the summary
Personal reflection	2	4%	Explains why the topic interested the writer with a specific clinical or personal connection	Reflection is present but generic	Reflection is missing or restates the brochure topic without a personal connection
Evaluation of brochure	14	28%	Answers all seven evaluation questions with specific evidence; cites the brochure and the journal article where required; distinguishes strengths from weaknesses	Answers five or six of the seven questions; evidence is present but uneven	Answers fewer than five questions or evaluates the brochure without evidence
Evidence review and application	5	10%	Integrates a current peer-reviewed article to support the critique; explains how the evidence applies to the brochure’s recommendations	Article is present and relevant; application is brief	Article is missing, outdated, non-scholarly, or cited but not applied
Conclusion	5	10%	Restates the main ideas, summarizes the benefits of following the brochure’s advice for a person at risk, and avoids introducing new claims	Conclusion summarizes the paper but remains descriptive	Conclusion is missing, repeats earlier content verbatim, or introduces new material
APA style and structure	2	4%	APA 7 is accurate for title page, margins, in-text citations, reference page, and required headers; paper stays within three pages	One or two minor APA errors; headers are present; page limit is met	Multiple APA errors; headers are missing or altered; page limit is exceeded
Clarity of writing	9	18%	Standard English, original thought, no spelling or grammar errors, logical progression	Writing is clear with minor errors that do not interfere with meaning	Errors interfere with readability or the progression of ideas is unclear
Total	50	100%

Sample Answer: Critique of the Speak Up Medication Safety Brochure

The brochure I selected is Speak Up: Prevent Medication Errors, published by The Joint Commission in 2023. The brochure addresses patients and family caregivers who manage medications at home and who receive new prescriptions during a hospital stay or clinic visit. Its central message is that patients should ask questions about every medication, keep an updated list, and speak up when a dose or instruction does not match what they expected. The audience is broad, which is both the brochure’s strength and its limitation. A patient with limited health literacy may struggle with the phrase “adverse drug event,” while a caregiver managing twelve prescriptions may find the checklist too general. The Joint Commission designed the Speak Up series to help patients take charge of their own safety, and the medication brochure carries that purpose into a high-risk domain (The Joint Commission, 2023). The brochure works best as a conversation starter during discharge teaching rather than as a standalone handout. A nurse who hands it to a patient without reviewing it aloud has not used the brochure as intended.

Evidence on Speaking Up and Patient Safety

Research on nursing students and speaking up about safety concerns shows that the behavior depends on more than patient instruction. Hoffmann et al. (2022) found that nursing students who observed unsafe practice often hesitated to speak up because they feared the response from senior staff, and that structured communication training improved their confidence without fully removing the hierarchy barrier. That finding matters for evaluating the Speak Up brochure because the brochure places the burden of speaking up on the patient. Patients face an even steeper hierarchy than students do. A brochure that tells patients to ask “what is this medication for” does not change the power dynamic that makes the question difficult to ask. The brochure can support a patient who already feels entitled to ask, but it may not reach the patient who most needs permission. A stronger patient education approach pairs the brochure with a nurse-led rehearsal of the questions before discharge. The evidence suggests that rehearsal and role-play do more for speaking-up behavior than written materials alone (Hoffmann et al., 2022).

What Students Get Wrong About the Evaluation Section

The evaluation section carries fourteen of the fifty points, which is more than the summary, the communication section, and the personal reflection combined. Students who treat it as a closing paragraph lose the largest single block of points. A defensible evaluation answers each of the seven questions in order, even if the answer is brief. For example, on the question of whether the information was presented clearly, a student can point to a specific page and note that the medication list template is legible but the instructions for what to do with the list are printed in six-point type at the bottom. That level of specificity demonstrates that the student read the brochure rather than skimmed it. On the question of whether current research supports the brochure, the student can cite Hoffmann et al. (2022) and explain that the research supports the brochure’s communication goal but not its assumption that written instruction alone changes behavior. The evaluation is not a place for opinion unsupported by the brochure or the article. Every claim about clarity, benefit, or safety should point to a page in the brochure or a finding in the article.

Choosing a Brochure That Supports the Paper

Brochure selection shapes the entire paper. A brochure with dense text and few images gives the student more to critique on clarity, but it also risks producing a negative paper that never acknowledges strengths. A brochure with strong visual design but vague recommendations gives the student evidence for a balanced critique. The medication safety brochure works well because it includes a checklist, which is a concrete feature to evaluate, and because medication errors are a well-documented safety problem with a substantial research literature. A student who selects the falls prevention brochure can use the same structure, but the evaluation questions about population and secondary users require different evidence. The safest choice is a brochure the student has already seen in a clinical setting, because the personal reflection then has a real anchor and the evaluation can reference what patients actually did with the handout. The guidelines do not require a specific brochure, which means the student’s choice is part of the assessment. A brochure chosen at random produces a generic paper.

Integrating the Journal Article Without Overloading the Page Limit

One journal article is required, and one is enough. Students sometimes add three or four articles and then run out of space before the evaluation section is complete. The article should appear in two places: the evaluation section, where it supports or challenges a specific brochure claim, and the evidence review section, where it is applied to the brochure’s overall recommendation. A single well-integrated article earns more points than four articles that are cited once each and never connected to a criterion. The Hoffmann et al. (2022) study works for the medication brochure because it addresses speaking up, which is the brochure’s central action. A student writing about infection prevention might use a different article on patient hand hygiene education. The article does not need to study the brochure itself. It needs to study the behavior the brochure asks patients to perform. That distinction keeps the paper focused and keeps the page count under control.

Conclusion

The NR-224 RUA asks for a short paper with a narrow structure, and the rubric rewards students who respect the structure rather than fight it. The brochure must come from The Joint Commission and must be attached. The six section headers must appear exactly as written. The evaluation section must answer all seven questions, because that section alone carries more weight than any other. One current peer-reviewed article must support the critique, and it should do real work in the evaluation and evidence sections rather than sitting in the introduction. The page limit is three pages, which means the summary must be brief and the evaluation must be specific. Students who write the evaluation first and then fit the summary around it tend to produce stronger papers than students who summarize first and run out of room for the critique.

References

Chamberlain University. (2023). Fundamental skills: RUA safety goals guidelines. Chamberlain University.

Hoffmann, M., Schwarz, C. M., Schwappach, D., Banfi, C., Palli, C., & Sendlhofer, G. (2022). Speaking up about patient safety concerns: View of nursing students. BMC Health Services Research, 22(1), 1547. https://doi.org/10.1186/s12913-022-0893-5

The Joint Commission. (2023). Speak Up: Prevent medication errors. https://www.jointcommission.org/resources/patient-safety-topics/speak-up-campaigns/

The Joint Commission. (2025). National Patient Safety Goals. https://www.jointcommission.org/standards/national-patient-safety-goals/

Kim, S., Lee, E., & De Gagne, J. C. (2023). Patient safety over power hierarchy: A scoping review of healthcare professionals’ speaking-up skills training. Journal for Healthcare Quality, 45(3), 143–155. https://doi.org/10.1097/JHQ.0000000000000379

Example of a Critique of the Speak Up About Your Medications Brochure

The brochure selected is Speak Up™ About Your Medications, published by The Joint Commission in 2024. The material targets patients, family caregivers, and anyone who manages medications at home or receives new prescriptions in hospital or clinic settings. Its core message stresses that medication safety requires active participation: patients must maintain an updated list of all medicines, vitamins, and supplements, ask specific questions about new prescriptions, confirm identity before receiving any dose, and speak up immediately if something appears incorrect. The intended audience is broad and includes people with varying levels of health literacy. The Joint Commission designed the Speak Up series to encourage patients to become informed members of their care team, and this brochure applies that principle to one of the highest-risk areas of daily care (The Joint Commission, 2024).

Summary of Brochure

The brochure opens by stating that medication safety is a team effort involving the patient, physician, pharmacist, and other caregivers. It directs readers to keep a current medication list that includes prescription drugs, over-the-counter products, vitamins, herbs, and natural remedies, and to carry that list at all times. Essential questions for physicians appear next: how the medication will help, what side effects may occur and how long they last, which other medicines or foods to avoid, and what to do if a dose is missed. Parallel questions for pharmacists focus on filling accuracy, label clarity, and storage. Practical tips address safe storage away from children and pets, proper disposal of unused medicines, and the need to report unexpected reactions promptly. Visual elements and short bullet lists reinforce the written guidance so that the material remains usable even for readers who skim. The brochure ends by urging patients to speak up without hesitation whenever doubts arise (The Joint Commission, 2024).

Patient Communication

The brochure places clear responsibility on patients to initiate conversations with providers. It supplies ready-made questions that patients can ask during a visit or at the pharmacy counter, thereby lowering the barrier to speaking up. In a realistic clinical interaction, a nurse preparing a patient for discharge can review the list of questions aloud, invite the patient to practice one or two of them, and confirm that the patient understands how to update the medication list after leaving the facility. This approach converts a passive handout into an active teaching tool. Patients who already feel comfortable asking questions gain a structured checklist; those who hesitate receive explicit permission and language they can use. The guidance therefore supports two-way communication rather than one-way instruction (The Joint Commission, 2024).

Personal Reflection

The topic of medication safety drew interest because of direct observation during clinical rotations. Several patients with limited English proficiency or low health literacy left the hospital with new prescriptions they could not fully explain. One older adult later returned with symptoms consistent with an adverse reaction after combining an over-the-counter product with a newly prescribed medicine. Watching the confusion and preventable harm made the value of clear, actionable patient education materials immediately apparent. The brochure addresses exactly the gaps witnessed in those encounters.

Evaluation of Brochure

The information is beneficial and can be incorporated into routine patient education, particularly at discharge and during medication reconciliation. Strengths include the concrete medication-list template, the specific questions supplied for both physicians and pharmacists, and the emphasis on carrying the list at all times. These features give patients tangible actions rather than vague advice. Clarity is generally high because of short sentences, bullet formatting, and visual hierarchy, yet some patients with limited literacy may still need the material read aloud and reinforced with teach-back. Current research supports the brochure’s focus on patient engagement and speaking up, although the same research indicates that written materials alone rarely overcome hierarchical barriers or fear of negative reactions (Hoffmann et al., 2022). Older adults managing multiple chronic conditions and their unpaid caregivers stand to benefit most, because polypharmacy is common in this group. Secondary users include nurses, pharmacists, and medical assistants who can distribute the brochure and model the recommended questions during teaching sessions. When patients follow the guidance, the likelihood of medication errors decreases and overall patient safety improves, provided the brochure is used as a conversation aid rather than a stand-alone handout.

Evidence Review and Application

Hoffmann et al. (2022) surveyed nursing students about speaking-up behaviors during clinical internships and found that most students observed safety concerns yet frequently remained silent. Fear of negative reactions, unpredictable responses from senior staff, and a sense that speaking up would be ineffective ranked as the strongest barriers. Hierarchical culture, rather than lack of knowledge, suppressed voice. The brochure’s central recommendation that patients ask questions and challenge discrepancies therefore rests on an assumption that may not hold for every patient. Written permission to speak up is useful, yet the evidence shows that rehearsal, role-play, and a supportive environment produce stronger behavior change. Nurses can apply this finding by pairing the brochure with a brief practice session in which the patient or caregiver rehearses the supplied questions before discharge. The article thus supports the brochure’s communication goals while highlighting the limits of text-only education and pointing toward more effective delivery methods.

Conclusion

The Speak Up About Your Medications brochure supplies practical tools that help patients take an active role in preventing medication errors. Its checklists, sample questions, and emphasis on speaking up align with recognized patient-safety principles. When nurses present the material as a conversation starter and reinforce it with teach-back, the brochure contributes to safer medication use, especially among older adults and caregivers managing complex regimens. Written guidance alone cannot remove every barrier to speaking up, yet the brochure remains a valuable, accessible resource that strengthens patient engagement and supports safer care.

References

Hoffmann, M., Schwarz, C. M., Schwappach, D., Banfi, C., Palli, C., & Sendlhofer, G. (2022). Speaking up about patient safety concerns: View of nursing students. BMC Health Services Research, 22(1), Article 1547. https://doi.org/10.1186/s12913-022-08935-x

The Joint Commission. (2024). Speak Up™ about your medications. https://www.jointcommission.org/en-us/knowledge-library/for-patients/speak-ups/about-your-medications

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Critique of the Speak Up: About Your Medications Brochure

Introduction

Patients managing multiple prescriptions face a daily risk of adverse drug events that written education materials can help reduce. The Joint Commission’s Speak Up: About Your Medications (2024) addresses this risk by targeting patients and family caregivers who administer or coordinate medications across care settings. Older adults on polypharmacy regimens, parents responsible for pediatric dosing, and recently hospitalized individuals receiving new prescriptions all fall within the intended audience. Rather than presenting dense medical explanations, the brochure asks patients to maintain updated medication lists, verify identity before taking drugs, and question providers about side effects or interactions. Evaluating this resource through current health literacy research reveals both its practical utility and its limitations in reaching patients with low literacy skills. A careful critique of the brochure’s communication strategies, evidence base, and clinical applicability appears necessary for understanding its true role in patient education.

Summary of Brochure

Speak Up: About Your Medications offers patients a set of actionable strategies for avoiding medication errors at home and in healthcare facilities. Patients should keep a complete list of all prescriptions, over-the-counter drugs, and supplements, then carry this list to every medical appointment. Specific questions appear for new medications, including how the drug will help, what side effects might occur, and which foods or other medicines to avoid. Before taking any medication, patients should confirm that caregivers have verified their identity and should report unexpected symptoms promptly. Safe storage practices appear as well, such as keeping drugs in cool, dry places away from children and disposing of unused medication through appropriate channels. An infographic format with video supplements accommodates different learning preferences. The Joint Commission (2024) designed these materials to foster a collaborative safety culture among patients, pharmacists, and nurses.

Patient Communication

Clear dialogue between patients and providers determines whether medication regimens succeed or fail, and the brochure structures this dialogue around specific questions that patients should ask. During a typical hospital discharge, a nurse might hand this brochure to a patient who has just received three new prescriptions for heart failure. That patient could use the brochure’s question list to ask whether a new diuretic interacts with an existing potassium supplement. Without such prompting, the patient might remain silent, assuming the provider has already considered every interaction. Passive receipt of information transforms into active negotiation of care when patients carry the brochure into conversations. Furthermore, the brochure encourages patients to speak up when a medication looks different from what they expect, which creates a critical checkpoint against dispensing errors. In clinical practice, this guidance aligns with the National Patient Safety Goals, which emphasize verifying medications with the patient before administration (The Joint Commission, 2025). A nurse who reviews the brochure with the patient during discharge can reinforce these communication behaviors through demonstration and rehearsal. Pairing written material with verbal instruction appears essential for patients who feel intimidated by authority figures in healthcare settings.

Personal Reflection

Medication safety became personally relevant after observing a patient in clinical rotation who refused to question a nurse about a pill that looked different from her usual regimen. She later admitted that silence felt safer than speaking up because she did not want to appear disrespectful. That hesitation could have led to a serious adverse event had the medication actually been incorrect. Patients need permission to ask questions, not just instructions about what to ask. This brochure interests me because it addresses the exact barrier that silenced that patient: the power imbalance between consumers and providers. Understanding how written materials can either reinforce or overcome that barrier matters for anyone entering nursing practice.

Evaluation of Brochure

The information in Speak Up: About Your Medications is beneficial for patient education because it converts abstract safety concepts into concrete behaviors that patients can practice immediately. Nurses can incorporate the question lists and medication templates directly into discharge teaching or outpatient counseling sessions. What works particularly well is the structured medication list, which gives patients a tangible tool rather than vague advice about staying organized. The infographic format also presents content clearly through visual hierarchy and short phrases. However, the brochure could improve by addressing health literacy more explicitly; it assumes patients will understand terms like adverse drug event without providing a definition. Font size in some downloadable versions may also challenge older adults with visual impairments. Current research supports the brochure’s emphasis on structured patient education. House (2022) demonstrated that nursing students struggle to create simple patient materials even when instructed to do so, which suggests that professionally designed brochures fill an important gap in clinical practice. Older adults managing multiple chronic conditions represent the population most likely to benefit from this resource, since polypharmacy increases error risk and cognitive load. Patients with limited English proficiency or low health literacy may struggle with some terminology unless a nurse explains key terms during teaching. Pharmacists, home health nurses, and family caregivers can also use this information to reinforce medication safety across care transitions. When a pharmacist reviews the brochure’s question list with a patient at discharge, the handout becomes a shared reference rather than a passive document. Family caregivers particularly need this guidance when managing medications for pediatric or elderly patients who cannot advocate for themselves. Safety will likely increase because the brochure creates multiple checkpoints where patients can catch errors before harm occurs. Patients who carry medication lists reduce the risk of omission or duplication during emergency visits. Similarly, patients who feel empowered to question discrepancies in pill appearance serve as an additional safety layer in high-risk medication administration processes.

Evidence Review and Application

House (2022) emphasized that approximately thirty-six percent of American adults possess basic or below-basic health literacy skills, which means printed materials must use simple language and organized formatting to reach all patients. The Speak Up brochure partially meets this standard through its question-based format and visual design, though it could strengthen alignment with health literacy principles by defining technical terms and adding teach-back prompts. Wilandika et al. (2023) identified nurses as the primary professionals responsible for bridging health literacy gaps, suggesting that the brochure functions best when a nurse tailors it to individual patient needs. In practice, a nurse might review the medication list template with the patient, simplify complex terminology, and ask the patient to repeat back instructions before discharge. That application transforms the brochure from a static handout into an interactive educational tool. Research on patient-centered care indicates that health literacy competencies among nurses significantly influence how well patients understand and use educational materials (Yang, 2022). Consequently, the brochure’s effectiveness depends less on its independent readability and more on how skillfully nurses integrate it into discharge teaching.

Conclusion

Patient education materials such as the Speak Up: About Your Medications brochure offer a structured entry point for reducing medication errors, but their impact depends on nurse facilitation and health literacy awareness. The brochure provides clear, evidence-based guidance that patients can incorporate into daily self-management routines, particularly when they receive support from pharmacists and family caregivers. Its question lists and medication templates create opportunities for patients to participate actively in their own safety rather than remaining passive recipients of care. For an older adult managing multiple prescriptions, following the brochure’s advice could mean the difference between a dangerous drug interaction and a corrected prescription before leaving the hospital. Written resources alone cannot overcome systemic power imbalances or low health literacy; however, when nurses use them as part of deliberate teaching strategies, they become valuable instruments for advancing the National Patient Safety Goals. Future clinical practice should treat patient education handouts not as standalone solutions but as components of larger communication systems that include teach-back, cultural tailoring, and ongoing assessment of patient understanding.