1. John Sok Boston College Connell School of Nursing Keys to Inclusive Leadership in Nursing

2.  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

3.  Serves Brighton, Allston, Waltham  Diverse patient populations  Offers medical, dental, counseling, vision, and pharmacy services

4. Total Population43,887 Caucasian33,76875.1% Black/ African American1,96512.3% Hispanic/Latino3,2607.4% American India/Alaska Native 910.9% Asian5,2183.6% Native Hawaiian/ Other Pacific Islander 310.1% Other races1,4855.5% Two or more races1,3292.4%

5.  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

6.  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

7.  Advocate for patient autonomy  Accurate translation  Facilitate communication  Maintain Confidentiality  Culturally competent directed care

8.  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?

9.  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

10. 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

11.  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

12.  http://www.youtube.com/watch?v=hzOP7Ee- x7Q http://www.youtube.com/watch?v=hzOP7Ee- x7Q

13.  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

14.  02135 - Fact Sheet - American FactFinder. American FactFinder. Retrieved April 11, 2011, from http://factfinder.census.gov/servlet/SAFFFacts?_ev ent=Search&geo_id=01000US&_geoContext=0100 0US&_street=&_county=&_cityTown=&_state=&_zip =02135&_lang=en&_sse=on&ActiveGeoDiv=geoSel ect&_useEV=&pctxt=fph&pgsl=010&_submenuId=f actsheet_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.