Doctoral Project Defense: Lucy Schoemer
Candidate: Lucy Schoemer
Major: Nursing Practice
Advisor: Elke Zschaebitz, D.N.P.
Title: Impact of Education on Perinatal Nurse Knowledge, Attitudes, and Practices with Language Interpreter Services: A Quality Improvement Project
There is overwhelming evidence to support that the use of language interpreter services improves healthcare outcomes for patients with limited English proficiency (LEP). While federal legislation mandates that medical facilities provide free and competent translation services to patients with LEP, providers often view language services as inefficient and avoid them even when readily available. The literature consistently recommends the use of education to increase healthcare provider knowledge and utilization of language interpreter services. This project evaluated the impact of an online educational module focused on culturally and linguistically appropriate services (CLAS) on perinatal nurse knowledge, attitudes, and practices when caring for patients with LEP. Nurses on a single Labor and Delivery unit were evaluated using a pre- and post-test format. There was a statistically significant improvement (p=.014) in perinatal nurse knowledge post completion of the online education. Qualitative analysis was used to gain understanding of why providers underutilize language services and if enhancing nurse-patient therapeutic relationship through intentional conversation can have an impact on language interpreter service use. The results reveal that nurse participants recognize the importance of translation services but find lack of usability and time constraints as barriers to use. After asking a culturally connecting question to a patient with LEP, all participants reported increased likelihood to use language interpreter services with that patient in the future. The outcomes of this study demonstrate that a brief online educational module may increase perinatal nurse knowledge on providing CLAS for patients with LEP. Qualitative outcomes provide deeper insight into the complexities of health systems in the United States. Nurses recognize the need for CLAS and desire to provide high quality care however, they are frequently met with technological challenges, time constraints, and limited systematic support. Despite these struggles, human connection was found have a positive influence on care for patients with LEP. This quality improvement project demonstrates the need for continued education, systemic support, and technological advancements to increase usability of language interpreter services while also serving as a reminder of the value in human connection between healthcare provider and patient.