Muir Kathryn Jane, Sliwinski Kathy S, Ang Lee, Amenyedor Kelvin, Villarruel Antonia M, Kutney-Lee Ann, Brooks Carthon Jacqueline Margo
Center for Health Outcomes and Policy Research, University of Pennsylvania School of Nursing, Philadelphia, PA, USA.
Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Inquiry. 2025 Jan-Dec;62:469580251370934. doi: 10.1177/00469580251370934. Epub 2025 Sep 1.
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).
英语水平有限（LEP）的患者更有可能经历不理想的医疗保健结果，包括不必要的急诊科就诊和医院再入院。尽管美国有法律要求在护理过程中为LEP患者提供语言服务，如认证口译员，但这些必要护理流程仍存在差距。护士在医院为LEP患者提供大部分直接护理，并监督必要语言服务的实施。这项定性研究的目的是描述护士在医院为LEP患者提供护理的经历，为针对这一人群的高质量患者护理提供可行策略。在社会生态模型的指导下，对医院护士RN4CAST-NY/IL调查的1295条开放式文本回复进行了定向内容和主题分析。确定了四个主题：（1）充足且专业的护士配备；（2）社区整合团队和项目；（3）语言服务可用性和方式的差异；（4）量身定制的语言服务。根据这些主题，护士认可的改善LEP患者护理的策略包括：提高护士配备的充足性和专业性，纳入多语言工作人员；根据LEP患者的实际生活经历，建立社区整合团队和项目；制定医院标准，规定患者在护理过程中接受的语言服务类型；制定协议，确保根据患者的独特护理需求（如视力或听力障碍）为其提供量身定制的服务。
