Reducing disparities in emergency department outcomes for individuals with limited English proficiency: The nurse work environment

IF 4.1 2区医学 Q1 NURSING

Nursing Outlook Pub Date : 2024-11-28 DOI:10.1016/j.outlook.2024.102318

Kathryn Jane Muir PhD, MSHP, RN, FNP-BC , Kathy Sliwinski PhD, MBE, RN , Karen B. Lasater PhD, RN

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引用次数: 0

Abstract

Background

Patients with limited English proficiency (LEP) experience worse emergency department (ED) outcomes.

Purpose

To evaluate the association between nurses’ work environments and ED outcomes among individuals with and without LEP.

Methods

Cross-sectional study of 1,358,802 patients seen in 64 New Jersey hospital EDs. Nurse work environment was measured by the Practice Environment Scale of the Nursing Work Index. Outcomes included 72-hr ED revisits, and departures against medical advice (AMA).

Discussion

Individuals with LEP experienced higher odds of a 72-hr ED revisit (aOR 1.12, 95% CI 1.04–1.21, p < .001) and lower odds of AMA departure (aOR 0.67, 95% CI, 0.61–0.74, p < .001). An interaction was found between LEP status and the nurse work environment: individuals with LEP experienced lower odds of a 72-hr ED revisit in better vs. poor nurse work environments, compared those without LEP.

Conclusion

Disparities in LEP outcomes might be ameliorated by targeted improvements to nurses’ work environments.

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减少英语水平有限的个体在急诊科结果上的差异：护士工作环境

背景英语水平有限（LEP）的患者在急诊科（ED）的预后较差。目的评价护士工作环境与LEP患者和非LEP患者ED结果的关系。方法对新泽西州64家医院急诊科1358802例患者进行横断面研究。采用护理工作指数执业环境量表对护士工作环境进行测评。结果包括72小时急诊科就诊和不遵医嘱离院（AMA）。LEP患者发生72小时ED重访的几率更高(aOR 1.12, 95% CI 1.04-1.21, p <；.001)和较低的AMA偏离几率(aOR 0.67, 95% CI, 0.61-0.74, p <；措施)。LEP状态与护士工作环境之间存在相互作用：与没有LEP的个体相比，LEP个体在较好的护士工作环境中与较差的护士工作环境中经历72小时ED重访的几率较低。结论有针对性地改善护士工作环境可以改善LEP结果的差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nursing Outlook 医学-护理

CiteScore

6.20

自引率

7.00%

发文量

109

审稿时长

25 days

期刊介绍： Nursing Outlook, a bimonthly journal, provides innovative ideas for nursing leaders through peer-reviewed articles and timely reports. Each issue examines current issues and trends in nursing practice, education, and research, offering progressive solutions to the challenges facing the profession. Nursing Outlook is the official journal of the American Academy of Nursing and the Council for the Advancement of Nursing Science and supports their mission to serve the public and the nursing profession by advancing health policy and practice through the generation, synthesis, and dissemination of nursing knowledge. The journal is included in MEDLINE, CINAHL and the Journal Citation Reports published by Clarivate Analytics.