Language barrier as it relates to patient safety

[rgverian]

This question is being posted as a probable critical issue for nursing education and practice: Is language barrier an important factor for patient safety? Do any of our colleagues who have done work or research on this topic like to share their opinion about this? Thank you.

[philipyuxu]

Our research team has completed a two study on communication competence of international nurses. Communication competence certainly affects quality of care. Although the design of this study did not directly link communication competence with clinical outcomes (including patient safety indicators), it documents the linguistic deficit of the sampled international nurses and suggests that there could well be a direct link. Currently, we are conducting further studies on the linkage. This study is published in Journal of Nursing Regulation (issue 2) in 2010. Send me a message if you want a pdf copy of the article since this system does not allow attachments in pdf format.

Yu (Philip) Xu, PhD, RN
Professor
University of Nevada Las Vegas
School of Nursing
yu.xu@unlv.edu

[VirginiaAllum]

My presumption is that you are speaking of the language barrier between international nurse and local patient:
Patient safety issues can be subdivided into two main groups: Firstly, planned patient safety procedures or activities and secondly, emergency patient safety procedures activities. Planned patient safety measures include routine Risk Assessment e.g. Waterlow Scale, VTE Risk Assessment, MRSA screening and so on. In these cases, language barriers caused by lack of knowledge of relevant vocab or medical terminology can be minimised by pre-teaching and practice off-site. This is especially important where Risk Management tools are unfamiliar.

Emergency Patient safety procedures are not as easy to prepare for and are especially difficult as there is often limited time to think of correct responses and, in addition, stress levels are high. Because of this, practice (e.g. rehearsal of simulated situations) of possible scenarios is very important. Patients who are unable to understand instructions in a crisis situation because of a language barrier are likely to become more distressed and less compliant. In these cases ,patient safety may be compromised.

[rgverian]

Hi Virginia,

Thank you for your reply.

Had you had any research studies conducted related to the two-point classification you mentioned in your post? If yes, where can I find them?


Sincerely,

Ronaldo

[VirginiaAllum]

Dear Ronaldo,
No, I haven't done any research on this, however, I co-wrote two English for Nursing books which covered some of these situations and am currently producing online materials in EMP (specicifically English for Nursing) which will also cover patient safety situations. I have also recently spoken at two conferences for teachers of medical/nursing english where my brief was to give tips to language teachers who teach in the ESP area. I used to teach international students in the Diploma of Nursing in Australia and always advised students to prepare for situations by 'rehearsing' possible scenarios. Many students , particularly from countries where more traditional forms of education still exist, are hesitant to use role plays as a way of rehearsing authentic situations. I am a great believer in practising potentially difficult scenarios (difficult e.g. because they are emergency situations ) and was often pleased with the feed back from students who tried this method.
best wishes,
Virginia

[emmamike28]

Yup; language barrier can affect patient safety.
Apart from 'Communication Competence'..Tons of things that can be discussed.
It's all about medical facilities, universal language, effective practices and all.
Yes, there is no one liner solution..hands on experience & skill level assure care level.

[treysmith01]

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[marie joseph]

Here in Miami, the language barrier has become out of control. In some areas, if you "must" go to a hospital, you would rather die trying to go to one that you know you will not have to take Spanish or French 101 to communicate. Unfortunately, I have had this experience with both a Spanish speaking RN as well as a Creole speaking RN. This barrier extends further than just being able to communicate ailments; it is exalted to post treatment as well. If one is unable to speak to someone in "fluent" English then they should not be working in an environment as critical as ER. If you do not understand what is being said and vice versa then we both can and will be at risk. This also goes a little further with those Doctors and some Nurses whom speak technical and expect the patient to understand the diagnosis or the solution.

All in all communication plays an immense part in treatment, diagnosis, and safety. If communication is not properly used the results can be hazardous and/or fatal.

[KBreitkreuz]

In the USA - JCAHO (our accrediting body) requires the use of interpreters. I know in my personal practice if I am not fluent in another language I will get an interpreter. Is this a consideration outside the US?

[umajeff21]

Emma is right. Some case studies revealed intense results due to language barrier. It is strongly recommended to develop a concrete framework that must have ability to negotiate every language barrier. Hey people, we all should contribute to this noble cause in terms of suggestions.