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June 2012, Volume 42 Number 6 , p 65 - 66


  • Leigh Miranda Ashton MA, BSN, RN


MORE THAN 50 million people, or about one in five U.S. residents, speak a language other than English at home.1 Many patients need language assistance to communicate effectively in a healthcare setting. Studies show us that patients with no or significantly limited English proficiency (LEP) are far more likely to omit or delay medical care, misunderstand instructions and advice, be confused about test results or a diagnosis, skip follow-up appointments, revisit the ED, and experience adverse drug reactions.2-4This article discusses current legislation and regulations about caring for patients with LEP, best practices to keep these patients safe, and new requirements for nursing practice. But first, consider the patient-safety risks presented by patients with LEP.In 2003, the Institute of Medicine published Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.4 This report clearly documented an increase of poorer quality care and also a dramatically higher incidence of medical errors among patients who may face barriers to speaking, hearing, or understanding the English language.5,6To foster excellence in patient safety and quality of care, The Joint Commission (TJC) became involved in evaluating the language access services provided for patients. With the close of the pilot phase, the recommendations of TJC have now evolved into firm criteria for accreditation. Healthcare facilities treating both inpatients and outpatients are now required to take the following steps:7 * Identify patients' preferred language for discussing healthcare. * Inform patients of their right to access a trained medical interpreter at no charge. * Provide documented qualifications of training and competence for medical interpreters. * Document each patient's individual and specific communication needs. * Provide written policies for patients' rights, especially the right to receive information in a manner that can be understood. * Provide translations of patients' rights

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