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Language barriers The ethical and legal issues surrounding translation

John Sok Boston College Connell School of Nursing Keys to Inclusive Leadership in Nursing . Language barriers The ethical and legal issues surrounding translation .

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Language barriers The ethical and legal issues surrounding translation

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  1. John Sok Boston College Connell School of Nursing Keys to Inclusive Leadership in Nursing Language barriersThe ethical and legal issues surrounding translation

  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 Purpose Statement & Objectives

  3. Joseph M. Smith Community Health center • Serves Brighton, Allston, Waltham • Diverse patient populations • Offers medical, dental, counseling, vision, and pharmacy services

  4. Demographics –Allston/Brighton2000 u.s. census

  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 Mentoring Experience

  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 Language barrier, a problem?

  7. Advocate for patient autonomy Accurate translation Facilitate communication Maintain Confidentiality Culturally competent directed care Legal and Ethical responsibility

  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? Language Interpreting as Social Justice (Messias et al., 2009)

  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 Language Interpreting as Social Justice

  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 Do we Really need Translators?

  11. Interpreter Phone on a Pole (IPOP) • 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 Clinical Case Example

  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 Creating Change

  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=geoSelect&_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. References

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