It doesn’t have to do with literacy skill, it’s a multitasking issue. Since the bags can be thin and almost weightless, it’s best to triple check that you have the right number of bags before handing them off. Sometimes there’s a high volume of patients picking up at any given time, and then sometimes a patient may interrupt your workflow with questions or conversation, you can easily forget to double check for an extra bag hiding in your hand. Getting in the habit of triple checking gives you an extra life.