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Bridging the Gap: Enhancing Medical Interpreter Utilization for Patients with Limited English Proficiency in Healthcare Settings
Get PDFThe Impact of Utilizing Medical Interpreters and Associated Patient Outcomes
Abstract
Background: In the United States, approximately 21% of households speak a language other than English, emphasizing the need for accessible language services for patients with limited English proficiency (LEP).
Problem: Despite legal mandates, medical interpreters remain underutilized, leading to adverse health outcomes, such as misunderstanding discharge instructions, medication use, and disease processes.
Methods: This DNP student-led evidence-based project explored barriers to medical interpreter utilization among healthcare professionals.
Intervention: A continuing education module was implemented by a DNP student at the University of San Francisco’s School of Nursing and Health Professions to educate graduate nursing students about interpreter laws, the significance of medical interpreter utilization, and their effects on patient care.
Results: Survey responses revealed increased familiarity with medical interpreter modalities and greater clarity regarding appropriate interpreter use. While knowledge gains were evident, dependent t-test analysis of the results did not yield statistically significant differences in overall pre- and post-survey scores, likely due to sample size limitations.
Conclusions: This educational module emphasized the ethical and legal consequences of failing to utilize qualified medical interpreters.
Keywords: medical interpreters, language barriers, health literacy, nurse practitioners, patient outcomes, health equit
From Silence to Clarity: Enhancing Surgical ICU Communication Through Personalized Whiteboards
Get PDFObjective: Critically ill patients in the intensive care unit (ICU) are at heightened risk of dehumanization due to sedation, mechanical ventilation, and prolonged hospitalization. This quality improvement (QI) initiative aimed to enhance patient-centered communication in the Surgical Intensive Care Unit (SICU) at a Northern California academic quaternary care hospital through the implementation of personalized communication whiteboards. Aim: To develop a personalized communication board that, once implemented, would achieve at least 75% utilization in patient rooms by May 2025. Methods: Guided by a Plan-Do-Study-Act (PDSA) framework, surveys were conducted with SICU patients, families, and staff to gather stakeholder input and inform the design of a new personalized whiteboard model. Due to budget constraints, the initial pilot was limited to three patient rooms. Results: A two-week pilot in three patient rooms yielded a 60% whiteboard utilization rate across four observed shifts, reflecting strong early engagement and demonstrating the intervention’s potential for broader unit adoption. Conclusions: While barriers such as unclear maintenance roles, workflow integration, and sustainability planning remain, the use of personalized whiteboards proved to be a practical, low-cost strategy to humanize care in the ICU. Future efforts will aim to scale implementation across the unit, embed whiteboard use into daily routines, and strengthen interdisciplinary collaboration to ensure long-term success
Climate Shocks, Crop Yields, and School Enrollment in Rural Ethiopia
Get PDFThis study investigates how climate-induced shocks to agricultural productivity affect school enrollment in rural Ethiopia. Using five waves of panel data from the Ethiopia Living Standards Measurement Study (LSMS) and satellite-derived weather indicators, I estimate the causal effects of crop yields, specifically Teff, Sorghum, and Maize, on children’s school attendance. To address the endogeneity of agricultural output, I instrument crop yields with agro-climatic measures such as growing degree days (GDD), harmful degree days (HDD), and soil moisture during the Meher growing season. The main empirical strategy uses a two-stage instrumental variable approach with region and wave fixed effects. Results suggest that crop yields do influence school enrollment, though the effects are heterogeneous across crops and gender. Maize yields show no consistent relationship with schooling outcomes. In contrast, Teff and Sorghum yields have more promising effects, particularly for girls. The largest and most robust result appears for Sorghum yields and girls’ enrollment, a finding further supported by nonlinear regression plots. These large but imprecise coefficients may suggest the impacts are concentrated among the most vulnerable, credit-constrained households. While overall school enrollment rates are relatively high in the sample, these results highlight that agricultural shocks can still influence the schooling decisions of specific subgroups. The findings underscore the importance of designing policies that reduce the opportunity cost of schooling and protect human capital accumulation in the face of increasing climate variability
Contributions of Adverse Childhood Experiences, Racism, Therapy and Health Habits to Cardiovascular Health in African American Adults
Get PDFThis dissertation explores the impact of Adverse Childhood Experiences (ACEs), racism, health habits, and therapy engagement on cardiovascular disease (CVD) among Black adults. This study builds on the Biopsychosocial Model and Allostatic Load Theory to examine how trauma, racism, and health habits influence cardiovascular health outcomes in the African American population. Through a quantitative analysis, this study investigates whether ACEs, experiences of racism, engagement in health habits, and participation in therapy contribute to the development or mitigation of CVD in Black adults. A total of 83 participants were included in the study, with data collected on ACEs, the frequency of racial discrimination, health behaviors, and therapeutic interventions. Due to the exclusion criteria, the ACE analysis involved 28 total participants. The findings revealed no significant associations between ACE scores, experiences of racism, or therapy engagement with CVD. However, this research demonstrates the importance of further research to explore these factors, particularly in larger, longitudinal studies that account for protective factors, health measures, and the unique experiences of Black individuals in cardiovascular health research
Sociocultural Contexts of HIV Transmission for Newcomer Black Gay, Bisexual Men (GBM) Who Have Sex with Men: Implications for Sexual Health Education and Human Rights in Ontario, Canada
Get PDFThis article examines the sociocultural and structural conditions that shape HIV vulnerability among newcomer Black gay, bisexual, and other men who have sex with men (GBM) in Ontario, Canada. Based on qualitative data from focus groups with 22 newcomer Black GBM, the study explores how intersecting experiences of anti-Black racism, homophobia, trauma, and precarity during migration and resettlement impact access to sexual health education and care. Participants shared accounts of violence in their countries of origin, challenges navigating Canada’s housing and healthcare systems, and the ongoing mental health impacts of displacement and marginalization. Using a community-based participatory research framework, and in partnership with the Black Coalition for AIDS Prevention (Black CAP), the article argues for a culturally responsive and rights-based approach to sexual health education—one that centres the lived realities of Black GBM newcomers. The findings underscore the urgency of trauma-informed, anti-racist, and inclusive services to support HIV prevention, mental health, and human rights for this underserved population
Inferior to Who?
Get PDFThis poem confronts the enduring impact of systemic racism and the internalized notions of inferiority imposed on Black folks in education and beyond. It reflects the lived experience of navigating microaggressions, stereotypes, and assumptions in academic spaces where Black excellence is often questioned or undermined. The speaker challenges perceptions of worth and rejects biases cloaked in white saviorism. The poem critiques historical and contemporary narratives that equate intelligence or achievement with whiteness and calls for self-recognition and pride, urging Black youth to reject internalized oppression and societal constraints. The poem culminates in a powerful reclamation of agency, asking the pointed question: Inferior to who? This poem is meant to be heard, we recommend you click the audio link while reading
untitled, unmastered.
Get PDFFrom one writer to another:
Writing is often a therapeutic release for me. Being able to encounter my own words, as well as the words of others, has helped form the contours of my thinking and my ability to name. When I write, I am able to describe my experiences and my truths, but these words alone cannot help me live my convictions. In this sense, as a writer, the act of writing fails me. When we write, we dis-embody our beliefs. That is, we must take our beliefs from our body and bind them to the page. No longer fluid and adaptable, but immutable symbols fixed in time. Symbols to be summoned upon when needed in the future—much like we summon upon our gadgets to tell us where to go. Many of us in the industrial world have lost our sense of direction and ability to navigate, preferring to surrender our spatial and geographic awareness to technology. We offload our sense of belonging, our sense of place, and, in doing so, we literally outsource our ancestral ability to read the land, the sea, the weather. Similarly, writing externalizes our innate and experiential sense of being and knowing. When we release words onto the page—without continuing to embody and practice—we lose our internal compass. Without care, writing creates windows of forgetting because we no longer need to live our beliefs. Our ancestors knew that the power of the word lives in the call, not the page. When we call out, we speak our life, our breath, into the life of another. In this exchange, our life energies blend and create a synergy of movements that give form to our collective futures. I submit this ‘blank’ page as an offering. May this blank page blanket us as we continue to breathe life in ways ink cannot capture.
With love,
simple an
Bridging the Gap in Early Mobilization: Implementing the BMAT 2.0 to Enhance Patient Care and Outcomes
Get PDFObjective: Early mobilization of patients is correlated to enhanced functional recovery (Zhang et al., 2019), decreased hospital stays (Zhang et al., 2019), and a reduction in healthcare costs (Liu et al., 2019). Unfortunately, inconsistency in hospital staff training and an absence of mobility assessment standardization have served as barriers to successful implementation. Aim: This quality improvement project aims to increase the percentage of RNs and CNAs who effectively use the BMAT 2.0 to promote early mobilization of medical-surgical endocrine and stroke patients by 20%, from 31.4% to 51.4% by April 22, 2025. The project will occur during a 12-week period from January 27, 2025, to April 22, 2025. Methods: A pre-survey was administered to hospital staff on 2 medical-surgical floors to analyze baseline knowledge and application of the BMAT 2.0. The research team conducted a 2-week in-service training during day and night shifts, utilizing posters, case scenarios, and presentations to increase staff knowledge. Following the in-service training, a post-survey that was identical to the pre-survey was distributed to analyze any changes in responses. Outcome measures included the following: BMAT competency, BMAT knowledge, mobility equipment awareness, documentation consistency, and appropriate responses to case scenarios. Results: The post-survey results revealed an 11.2% increase in hospital staff claiming they are extremely knowledgeable about the BMAT 2.0, a 12.7% increase in having formal training completed, and a 35.2% increase in awareness of equipment location. All case scenario responses showed increased accuracy, with one case scenario increasing from 43.1% to 71.1% appropriate responses. Conclusions: This project illustrated that in-service training successfully enhanced hospital staff competency in the application of the BMAT 2.0. Sustainability endeavors like continuing education are recommended to ensure the long-term success of this project
Association Between Decisional Conflict and Quality of Life Among Parents with a Child Undergoing Hospital-based Treatment for a Recent Cancer Diagnosis
Get PDFHaving a child with a chronic illness, such as cancer, can cause families significant distress. Parents of these children must make frequent decisions relating to their child’s care. Depending on factors such as health literacy and support from medical staff, parents may have varying levels of decisional conflict (DC) throughout the decision-making process. Compounding stress throughout their child’s illness can often contribute to lower levels of health-related quality of life (HRQoL) while their child is receiving hospital-based treatment. Parents with a non-English language preference (NELP) often have greater challenges navigating healthcare systems due to a lack of resources and limited health literacy. The present study investigated the association between parental DC and HRQoL among 35 Latinx and White parents caring for a child with cancer. Differences in DC and HRQoL between three language groups: monolingual English, monolingual Spanish, and bilingual English and Spanish were also examined. Results indicated that higher DC was a statistically significant predictor of lower HRQoL. Additionally, there was no significant difference between language groups on either DC or HRQoL. Results suggest the need for further support for parents making decisions for their children to limit possible impacts on their HRQoL while caring for their child. Future research should include studies in various geographic locations to gain data from more diverse hospital systems and improve the generalizability of results. Furthermore, qualitative research studies could be implemented to provide parents with opportunities to explain their experiences more in-depth, which could help inform directions for additional quantitative studies
The Blinding Lights of (Post)feminist Empowerment in Joyce Carol Oates’s Night, Neon”
Get PDFJuliana, the protagonist of Joyce Carol Oates’s 2018 novella “Night, Neon,” is portrayed as a confident, empowered young woman who appears to embody the postfeminist ideal of “having it all”—autonomy, agency, and adherence to traditional feminine norms like marriage and motherhood. However, as the story unfolds, it becomes evident that Juliana’s sense of empowerment is largely performative, concealing deep-seated vulnerabilities and unresolved traumas. Through a series of flashbacks revealing Juliana’s troubled past, Oates critiques the postfeminist tendency to reinterpret traumatic experiences as tools for self-empowerment and resilience, suggesting that such a framework may obscure the systemic and pervasive nature of violence against women. By drawing parallels between Juliana and earlier Oates heroines, this article argues that Oates challenges the postfeminist narrative, exposing its limitations and the enduring influence of entrenched gender dynamics. Ultimately, the story underscores the complexities of contemporary womanhood, and the dangers of embracing an illusion of empowerment that fails to address underlying issues of gender inequality