How Language Barriers Affect The Patient Safety And Overall Quality Of Care

Establishing effective communication with the patient is a critical factor in promoting patient quality care. Good communication is fundamental when providing safe and effective care at the beside in order to increase the quality of patient care. One of the many communicative barriers that exists between patients and the healthcare team are language barriers. Language barriers are considered an initial problem of translation or code-switching. Individuals who speak different languages require a certain code breaker in order to facilitate effective communication (Gregg & Saha, 2007). Furthermore, language barriers may hinder the quality of patient care and interfere with optimal clinical outcomes. According to Happ et al., 2011, nurses have the unique responsibility to engage in communication with patients and have control over the timing and method of communication. Evidenced based interventions such as communication boards are needed to improve nurses’ communication skills in order to achieve effective communication.

Communicate is essential in health and social care settings because without a good communication to patients, families, colleagues and management is very difficult to deliver good service of care.

Non-English speaking citizens and immigrants are receiving improper medical care because of the miscommunication. The people who cannot speak English well are misunderstood, when they go to free clinics or hospital emergency rooms and attempt to explain their symptoms and illness or cannot understand the doctors or medical profession that are trying to help them. ” Interpreters are omitting questions about drug allergies. Patients are not telling nurses the correct symptoms. A mother misunderstood by putting oral antibiotic into the ears of the child instead of the mouth. The Puerto Rican word for mumps is not the same in Central America, so a child was mistreated. A doctor mistakenly told a parent to put a steroid crème on entire child instead of just the face” (Yolanda Prtida, 2005). Language barriers in the medical field are dangerous and some times even fatal. There is definitely a need for more translators in hospitals and doctors office. Clear communication is essential for safe quality healthcare. Poor communication can lead to disastrous outcomes, especially for patients with limited or no English ability.

In 2004 my grandmother and I moved from Haiti to United States without a speck of English in our language. After few years living in the states, my grandma started to get ill and she had to seek monthly medical assistance. At the time, my mother was working multiple jobs and I was a full time undergrad student that lived on college campus. Our busy schedule posed a challenge for us to bring grandma to her medical appointments. Most times it was hard for us to find someone to go with her and assist her with language translation. When it was time for her to go by herself, the health providers would have trouble finding a professional translator on the spot to assist my grandma. This became a repetitive problem and my grandma’s case was not getting any better. If she had the ability to communicate with her provider using her own language, she would have been able to be more expressive about her symptoms and the doctors would have assisted her to her needs. Just like my grandma, many people that speaks little to no English, are having trouble interpreting their medical diagnosis and communicating with their healthcare providers.

In the state of Massachusetts the state law states that the emergency department patients with limited English proficiency have the right to a medical interpreter (Ginde, Clark, & Camargo, 2009). Having a medical interpreter for patients that have limited English proficiency will increase the quality of health care they receive; it also increases patient compliance and increases patient satisfaction. The use of professional interpreters is shown to decrease revisiting the emergency department, and increase this population’s use of outpatient clinics for follow up care (Ginde et al., 2009).

Can you imagine the how the healthcare industry would be without language, what seems to be impossible to imagine is the everyday reality of some patients because of their native language. Language is a major contribution to the health disparities that some populations face, because it makes it difficult for some patients to communicate their problems as well as understand the care they provided. Language contributes to the health disparities that some populations face because it creates a barrier between the patient and the care provider, making it difficult for a patient to receive proper care. Language barriers create a communication gap between a patient and a provider, forcing the patient to feel misunderstood and unable to trust his/her provider to properly care for them. I come from a family that speaks more than one language, so I have seen the impact language barriers can have on someone who doesn’t speak fluent English.

(Jayne Crow 2010) stated that just the way you laugh can influence the way a patient reacts with you. For example laughing at someone compared with someone can help “to equalize the power relationship in a situation and empower the service user.” Laughing can help to lighten a situation and can be a way of bonding with a patient. The patient feels as though they can trust the nurse and are more likely to open up about their feelings or if anything is wrong. Communication comes in many forms. (Barbara Scammel 1990) has outlined many different types of communication such as direct and indirect verbal communication, writing, body language, kinesics, touch, gestures. A patient may be in a coma but that doesn’t mean they cannot hear you. The power of the voice can do many things, ie, to comfort them, to know that someone is with them and that there not alone. A patient’s life can be in danger with the inability of a doctor and patient to communicate with each other. (Saha, S and Fernandez, A 2007) stated that the efficiency and provision on basic health care services are interfered with language barriers and being unable to understand. As a nurse it is vital to make sure all the information is necessary to give out the best patient centred care. This cannot be done if there is no communication line with the patient. (Saha, S and Fernandez, A 2007) translating one word in other languages may be

(2013) discussed the issue of lack of english skills being a primary barrier for patients receiving adequate health care. The article also mentions how studies have shown that Spanish speaking Latinos are less satisfied with the health care that they received in determine whether comparison to their English speaking counterparts. The purpose of the study was to Spanish speaking Latinos have an increased quality of care when provided with an interpreter during their visit. The population for the study was 30 patients in the Washington, DC metropolitan area, whose primary language was spanish. The intervention implied that the use of interpreters will improve the quality of healthcare received by non english speaking patients. The comparison aimed at urging providers to make an effort to provide legally appropriate care to patients who are unable to speak english. The outcome of the study was that miscommunication between healthcare workers can end up causing medical mistakes and liabilities. It was found that when facilities provided patients with interpreter services, the patient perception of quality care was

Effective communication with patients is critical to the safety and quality care. From the last two decades ,number of researches has been conducted on the impact of language barrier on health and healthcare. It is observed that language barriers are the main cause of medical errors, complication and adverse event. But due to data limitations ,limited researches on impacts of language barrier has been conducted in Canadian setting. However, the researches conducted on other countries on the impact of language barrier on quality of care is applicable in the Canadian context. Some researches shows that there are several barrier which affect quality of care and patient safety. Now, researches has begun to know the complexity of language, culture, race, health literacy that may affect patient care. Current approaches are moved towards the knowledge of risk of language barrier rather than implementation of effective, evidence informed strategies.

The purpose of effective communication in healthcare is to provide first-class medical care, minimal to no medical errors and have precision; and without it there is room for medical errors, poor patient care and an ineffective team that produces undesired outcome. In the professional and patient relationship, the lack of good communication causes the patient to be apprehensive in asking questions, to worry about being bothersome because they feel other patients are sicker, and there is an assumption that the patient does not have any concerns. There are barriers to communication that include only one between the sender and receiver of the message understands the message, cultural differences, and lack of education. In sending the message it is essential that the message is received with clarity, it is concise and complete. If the patient has a language barrier, it can be masked by the patient not responding to information and it is detected as a result of poor or no compliance. In literacy concerns, all information should be presented on a 5th grade level to aid in the comprehension of the information. The care of the patient should be patient/family centered which helps in detecting any language, cultural or literacy barriers (Schyve, 2007). For example, a 46 year old single male patient that is functionally literate is admitted with a diagnosis of acute angina. During the

Communication is a basic, root function of living. Communication happens with words, without words, using symbols, gestures, sounds, and drawings. Sometimes getting the idea across to the receiver of the communication is a difficult task when there are communication barriers such as different languages, cognitive ability, and disability. Communication is an essential tool that needs constant use and refinement to be effective for the user and receiver. In this paper, the basic elements of communication, health care communication, consumer communication, and cultural differences in communication will be the topics of discussion.

Tyler, using a translator would be a very good intervention for non-English speaker. In fact, even if they do speak English, some of them are not familiar with medical terms. During nursing school, I volunteered at a free clinic in Philadelphia to be a translator for non-English speaker who came to the clinic. I think everything went smoother that way, and they follow their medical regimen better if they understand them.

Realistically, there are many aspects of culture that impact the care we provide our patients on a daily basis. One of the most important that I see affecting the care I give patient daily in my practice as an emergency nurse is language. This can and is a huge barrier to administering appropriate care to patients. It is very difficult and frustrating for me to care for a patient that does not understand what I am saying. At my facility, we have a language line phone that we are told to use, but it is much more difficult to communicate via these phones versus having a bilingual nurse interpret. When we use the phones, it seems like a lot of the conversation is lost in translation. In the emergency department, we spend a lot of time going in

A key element to overcoming cultural barriers during interacting with the patient is the use of effective communication. A diabetes patient who does not speak English well would be hard to communicate for who speaks English as the first language. Especially, when educating a patient, you would need to speak as simple you can. Since the cultures are different, some of the non-verbal communications also different. Sometimes misunderstanding could happen to each other.

There are multiple different ways to have effective communication in health care facilities, it is just taking the time to do it that tends to be the hardest part. By taking the time to communicate properly with those around you that are caring for the same patient, it could ultimately be the difference between life and death. Enforcing policies to make sure all health care personnel are effectively communicating by checklists, dry-erase boards, providing monthly staff meetings, briefings, debriefings, and using the SBAR will decrease the number of medical and/or surgical errors