Reducing disparities: Bilingual nurses caring for patients with limited-English proficiency

Background: In light of increasing diversity in the patient population, the purpose of this analysis is to examine hospital use of bilingual nurses to care for patients with language needs.

Methods: The primary datasource was 899 completed telephone surveys of hospital human resources directors fielded in 2008, representing nearly 20 percent of hospitals in the U.S., with supporting data from interviews with provider associations. The nationwide sample was adjusted by ownership, teaching status, urban/rural market, and geography to reflect the national hospital industry. Using descriptive statistics, we examined how many hospitals train staff to access language services, the requirement of this training for nurses compared to other staff, and collection of information on nurses' language abilities.

Results: The majority of hospitals require language services training for some staff (69 percent of the 83 percent offering training). Training was most frequently mandatory for nurses (96 percent); compared to 50 percent for doctors, 32 percent for medical residents, and 92 percent for registration staff. Hospitals also collect information on language abilities of nurses (61 percent) more frequently than of doctors (48 percent). Interview data revealed multiple challenges related to using bilingual nurses to provide language services, including the need for training and assessment, and the burden of additional responsibilities on top of busy workloads.

Conclusions: Hospitals rely heavily on nursing staff with bilingual ability to care for patients with language needs. Special attention should be paid to the support needed to sustain the use of bilingual nurses as providers of language services.