Improving Hospital Care for Patients Experiencing Communication Barriers Through Nurse-Endorsed Strategies.

Abstract

Patients with limited English proficiency (LEP) are more likely to experience suboptimal health care outcomes, including avoidable emergency department visits and hospital readmissions. Despite legal requirements in the United States to provide patients with LEP language access services such as certified interpreters during care encounters, gaps in these necessary care processes persist. Nurses provide the majority of direct care to patients with LEP in hospitals and oversee the implementation of necessary language access services. The objective of this qualitative study was to describe nurses' experiences providing care to patients with LEP in hospitals to inform actionable strategies for high-quality patient care for this population. A directed content and thematic analysis of 1295 open text responses from the RN4CAST-NY/IL survey of hospital nurses was conducted, informed by the Social Ecological Model. Four themes were identified: (1) Sufficient and Expert Nurse Staffing ; (2) Community-Integrated Teams and Programs; (3) Variation in Language Access Availability and Modalities; and (4) Tailored Language Access. Nurse-endorsed strategies to improve LEP patient care, informed by the themes, include: improving the adequacy and expertise of nurse staffing to include a multilingual workforce; developing community-integrated teams and programs informed by the lived experiences of LEP patients; developing hospital standards for the type of language access services patients receive in care encounters; and developing protocols to ensure that tailored services are delivered to patients depending on their unique care needs (eg, visual or hearing impairment).