Training for Nurses Caring for Simulated Limited English Proficient Patients in Post-Operative Pain

Abstract

Introduction. 46.8 million people in the United States identify themselves as speaking another language beside English in the home. The Office of Minority Health identified improper language access as a potential cause of minority related healthcare disparities (Office of Minority Health, 2001). The objective of this study was to compare hospital-based training using case study or simulation teaching methods. Simulation training may be an effective means to train healthcare providers on communicating with LEP patients, to address language access within the context of post-operative pain management.

Methods. This study used a post-test only randomized design to test the feasibility of simulation as an intervention to improve nurses' self efficacy and planned use of pain management strategies with an interpreter for registered nurses communicating with Limited English Proficient patients. A power analysis based on moderate ES, power .80, assuming .05 level of significance yielded a necessary N= 67. Eighty-eight registered nurses were recruited.

Results. A total sample of 72 registered nurses participated in the study. Randomization to group occurred with 35 nurses in case study and 37 in simulation. The mean age was 39 years, 97% female, 46% BSN, 51% had 5 or more years experience and 71% were not certified in any specialty area. Checks for randomization to condition resulted in no significant differences between the groups using Chi square for categorical variables and t-test for continuous variables. ANOVA for self-efficacy when communicating with LEP patients and intended pain management yielded no statistically significant results.

Discussion/Conclusion. Increased self-efficacy of the healthcare team could reduce the communication gap by changing the human factor for intended interpreter use, in caring for patients in acute post-operative pain. Simulation offers an innovative approach to staff development related to linguistically competent care and pain management. The promotion of positive patient outcomes for communicating with LEP patients and improvement of intended pain management strategies with nurses was not statistically significant however had improved from previous research (McDonald et al., 2007). Proper language access for LEP patients promotes communication with the nurse and can potentially improve pain management through a better pain assessment.