John Sok Boston College Connell School of Nursing Keys to Inclusive Leadership in Nursing.
-
Upload
prudence-bryan -
Category
Documents
-
view
214 -
download
0
Transcript of John Sok Boston College Connell School of Nursing Keys to Inclusive Leadership in Nursing.
LANGUAGE BARRIERSTHE ETHICAL AND LEGAL ISSUES SURROUNDING
TRANSLATION
John SokBoston College Connell School of NursingKeys to Inclusive Leadership in Nursing
PURPOSE STATEMENT & OBJECTIVES
The purpose of this presentation is to inform and educate fellow nursing peers and faculty about language barriers and cultural competency
Objectives: Identify current issues regarding language
barriers Evaluate the importance of certified interpretation Highlight intervention to facilitate communication
JOSEPH M. SMITH COMMUNITY HEALTH CENTER
Serves Brighton, Allston, Waltham
Diverse patient populations
Offers medical, dental, counseling, vision, and pharmacy services
DEMOGRAPHICS –ALLSTON/BRIGHTON2000 U.S. CENSUS
Total Population 43,887
Caucasian 33,768 75.1%
Black/ African American
1,965 12.3%
Hispanic/Latino 3,260 7.4%
American India/Alaska Native
91 0.9%
Asian 5,218 3.6%
Native Hawaiian/ Other Pacific Islander
31 0.1%
Other races 1,485 5.5%
Two or more races 1,329 2.4%
MENTORING EXPERIENCE
June & Olga Monthly Meetings
Medication adherence (Merk Tool) Language Interpreter Service
Nursing Staff Meetings Every second Thursday
staffing, clinical/ethical problems, changes and implementations, feedback
LANGUAGE BARRIER, A PROBLEM?
Increase number of diverse patient population
Limited English Proficient Patients = Communication issue
Discrepancy in language translation Need for more medically certified
interpreter usage Current practice utilizes family members
and/or other health care personnel
LEGAL AND ETHICAL RESPONSIBILITY
Advocate for patient autonomy
Accurate translation
Facilitate communication
Maintain Confidentiality
Culturally competent directed care
LANGUAGE INTERPRETING AS SOCIAL JUSTICE (MESSIAS ET AL., 2009)
Purpose: Exploring how informal and formal interpreters conceptualize and implement their role
Methods: interviewed 27 interpreters (13 formal) U.S., Puerto Rico, Mexico, Columbia, Brazil,
Venezuela, Panama Could you describe your work as an interpreter to me? Please tell me your relationship and interaction with
patients What is the most difficult part of the job is for you?
LANGUAGE INTERPRETING AS SOCIAL JUSTICE
Results: Informal: lack of preparation, inadequate cultural
competent care, inconsistent felt that it was their personal responsibility to ensure
understanding on the part of the patient and to advocate on behalf of the patient with the physicians
Formal: supportive, more trusted, confident “… professional interpreters viewed their role as one of
information transfer while maintaining professional boundaries”
Implications: A need for improve language access and qualified
interpreting service
DO WE REALLY NEED TRANSLATORS?
ADVOCATORS OPPOSITION
Legal and ethical issues Certified
Understands medical concepts/terminology
Reduces biases 24hours/7 days
Available as needed via IPOP
Continuity of care
Convenience Live Interpreters
Cost effective? Demoralizing Difficult to use/
confusing
INTERPRETER PHONE ON A POLE (IPOP) System similar to speaker
phone system Providers dial the
Language Line, input authorization code (specific to floor/unit), ask for specific language, connected
Reference numbers for interpreter and event interaction
CLINICAL CASE EXAMPLE
http://www.youtube.com/watch?v=hzOP7Ee-x7Q
CREATING CHANGE
Increase in IPOP and Language Line usage
Hiring full time certified translators (Thai)
Patients are asking more questions Increase in medical adherence Proactive disease management
Diabetes Mellitus, Hyperlipidemia, STDs
REFERENCES
02135 - Fact Sheet - American FactFinder. American FactFinder. Retrieved April 11, 2011, from http://factfinder.census.gov/servlet/SAFFFacts?_event=Search&geo_id=01000US&_geoContext=01000US&_street=&_county=&_cityTown=&_state=&_zip=02135&_lang=en&_sse=on&ActiveGeoDiv=geoSelect&_useEV=&pctxt=fph&pgsl=010&_submenuId=factsheet_1&ds_name=ACS_2009_5YR_
lynnekelly2000. YouTube - A Few Minutes In The Life Of A Sign Language Interpreter. YouTube- Broadcast Yourself. Retrieved April 11, 2011, from http://www.youtube.com/watch?v=hzOP7Ee-x7Q
Messias, DeAnne K, Liz McDowell, and Robin D Estrada. "Language interpreting as social justice work perspective of formal and informal healthcare interpreters." Advances in Nursing
Science 32.2 (2009): 128-143.