Description
This section of your change project paper should include:
A reference to the project’s benefits in terms of cost, time, and/or quality that address needs or changes, results, impacts, or consequences that the project has on people, programs, or institutions.
Goals and objectives that are measurable, shared, and hypothetically agreed on by all key stakeholders. They are directly linked to the concept of project success factors.
What variables need to be considered and and whether or not you have control over them.
For example, if you were to implement a clinic-wide practice change, would budget be an issue and how would you address that variable?
If you were to implement your study, consider how would you gather data. Would you choose the qualitative or quantitative method?
An explanation of what your research will provide to the community, or to social change.
A description of the desired outcomes: Specifically, state the purpose, focus, and viewpoint of the project as well as its expected accomplishments.
While you may not be implementing your project, you should have a goal in mind that relates to solving your problem.
Establish a timeline for accomplishing your project goal(s).
This section should be 3–4 pages in length, not including the cover or reference page, and should address the intended outcomes of your project. You must reference a minimum of 3 scholarly articles.
Use current APA format to style your paper and to cite your sources. Review the rubric for more information on how the assignment will be graded.
Rubric
NURS_691A_DE – NURS 691-A Rubric Week 4: Project Aims, Values, and Desired Outcomes
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeContent
60 to >49.2 pts
Meets Expectations
The project, aims, values, and desired outcomes are well developed and clear and thorough. Aims include detailed examples of projected features and functions. Values include implementation benefits for specific stakeholders. Desired outcomes expertly state the purpose, have a quality focus, and clearly describe the benefits that are expected to occur as a result of implementation.
49.2 to >45.0 pts
Approaches Expectations
The project, aims, values, and desired outcomes are somewhat clear but may be vague in places. Aims include somewhat vague examples of projected features and functions. Values include only general implementation benefits. Desired outcomes state the purpose, have a general focus, and generally describe the benefits that will occur as a result of implementation.
45 to >35.4 pts
Falls Below Expectations
The project, aims, values, and desired outcomes are somewhat clear, but lack many key details.
35.4 to >0 pts
Does Not Meet Expectations
The content is generally unclear. There is no clear evidence of what the project, aims, values, or desired outcomes are, or there might just be a list of project objectives.
60 pts
This criterion is linked to a Learning OutcomeOrganization
7.5 to >6.15 pts
Meets Expectations
Content is well written throughout. Information is well organized and clearly communicated.
6.15 to >5.63 pts
Approaches Expectations
Content is overly wordy or lacking in specific language. Information is reasonably organized and communicated.
5.63 to >4.43 pts
Falls Below Expectations
Content is disorganized in many places and it lacks clarity.
4.43 to >0 pts
Does Not Meet Expectations
Content lacks clarity and information is disorganized, or may be an outline or a list.
7.5 pts
This criterion is linked to a Learning OutcomeAPA Format/Mechanics
7.5 to >6.15 pts
Meets Expectations
Follows all the requirements related to format, length, source citations, and layout. Assignment is free of spelling and grammatical errors.
6.15 to >5.63 pts
Approaches Expectations
Follows length requirement and most of the requirements related to format, source citations, and layout. Assignment is mostly free of spelling and grammatical errors.
5.63 to >4.43 pts
Falls Below Expectations
Follows most of the requirements related to format, length, source citations, and layout. Assignment contains some spelling and grammatical errors.
4.43 to >0 pts
Does Not Meet Expectations
Does not follow format, length, source citations, and layout requirements. Assignment contains many spelling and grammatical errors.
7.5 pts
Total Points: 75
Unformatted Attachment Preview
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Language Barrier Among the Hispanic Population in Miami, FL: The Integrative
Literature Review
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Language Barrier Among the Hispanic Population in Miami, FL: The Integrative
Literature Review
Literature Review
To guarantee patient safety, care quality, and the satisfaction of both healthcare providers
and patients, good and effective communication between these two parties is crucial. Whitaker et
al. (2022) outline that excellent communication between healthcare providers and patients is
associated with effective care management and the provision of accurate diagnosis. Generally,
good communication, which is not hampered by language limitations, is very important at every
phase of the medical care process, from recognizing the health issue of a patient and delivering
patient-focused treatment and care through patient engagement and involvement.
A study conducted by Bombard et al. (2018) indicates that patient care experiences and
outcomes may be negatively influenced by the capability of healthcare providers to listen,
demonstrate, and understand the complaints presented by the patient. However, the presence of a
language barrier makes it challenging for healthcare providers, including nurses among other
healthcare professionals to communicate. This is because, problems associated with language
barriers in one way or another may impact persons from minority populations in terms of the
level of healthcare quality delivered (De Moissac & Bowen, 2019). As a result, effective
communication and appropriate patient interactions are required to address some of the health
disparities in healthcare access and the level of care delivered among minority populations as
well as to improve the patient’s understanding of treatment approaches. At present, healthcare
systems are heavily investing in the utilization of interpreter resources and other forms of
language access services as well as advancing cultural competency and establishing meaningful
relationships with patients and healthcare providers to eliminate some of the negative
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consequences linked to language issues (Al Shamsi et al., 2020). Apart from the use of
interpreter resources, health systems are utilizing digital technologies, signage, and translated
health information to provide essential services.
Given that every human being has the right to receive the best probable form of
healthcare regardless of ethnicity or socioeconomic status, healthcare providers must deliver
optimal medical care that aligns with human rights as well as equity to all patients (Al Shamsi et
al., 2020). Taking into account that language barriers in one way or another hinder minority
populations from accessing and utilizing healthcare services leading to various health disparities
and poor health outcomes, language differences pose a significant problem to healthcare
delivery. For example, a study by De Moissac & Bowen (2019), outlines that patients who do not
speak the common dialect tend to be disadvantaged when it comes to healthcare services access
and availability. Also, results from research performed by Al Shamsi et al. (2020) highlight that
patients who face language obstacles have worse health outcomes in comparison to those who
communicate and interact using the common dialect. As a result, persons who experience
language limitations tend to utilize more healthcare services to address their health issues and
have more adverse events due to a lack of healthcare comprehension and fear of receiving lowquality care and discrimination.
Taking a look at the Hispanic population in Miami, FL, some of the individuals from this
minority group face various issues associated with language barriers. Since most persons from
this population do not speak fluent English, healthcare providers must adapt to their needs and
initiate strategies to minimize these language obstacles to prevent or reduce health disparities.
This is because, the inability of healthcare providers to mitigate language differences among the
Hispanic population can lead to health inequality (Velasco-Mondragon et al., 2016). In addition
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to that, these language differences can put the safety of persons from this population at risk in
terms of increased prevalence of medical errors and providing care that does not align with their
health needs. Within the Hispanic population, according to CMS (2022), healthcare providers
need to implement strategies to overcome language barriers, particularly when it comes to
offering language assistance services, to avoid discriminating against non-English-speaking
patients.
Key Findings of the Research
Research indicates that language barriers among the Hispanic population are associated
with various impacts, especially when the level of healthcare provided does not meet their needs
or is inaccurate. According to Kelson et al. (2022), language limitations within the Hispanic
population significantly contribute to the increased prevalence of medical errors. In all healthcare
settings, the medical history and information of a patient should be considered when providing
medical care. However, several studies outline that language differences can make healthcare
delivery challenging, particularly when it comes to engaging with patients to receive their
medical history and other healthcare-related information. If the patient does not entirely
understand the information that is needed from them, language limitations could be an issue
because they could contribute to numerous adverse events. As a result, research indicates that
when language proficiency and understanding pose a significant problem to healthcare delivery,
professional interpreters must be involved in the process. This is because the use of interpreter
resources advances patient teaching and in turn, promotes their safety as well as ensures the
efficacy of the suggested treatment approaches.
Also, research outlines inaccurate assessment as an impact of language barriers among
minority groups, including the Hispanic population. Hollingshead et al. (2016) outline that
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patients from the Hispanic population who experience language difficulties tend to undergo
inaccurate assessment in all aspects of care, especially when it comes to pain management.
Several studies state that there is a lot of patient teaching and instruction that is needed when
describing the scale of pain to patients. This is because the described level of pain may be wrong
if the patient cannot rate their pain level as a result of language differences. In all healthcare
settings, different cultural groups have varying ways of explaining their health conditions and as
a result, miscommunication can lead to inaccurate diagnosis as well as undermedication or
overmedication, which could lead to poorer health outcomes. Taking that into account,
individuals need to understand that when providing medical care to persons from the Hispanic
population with language problems, inaccurate assessments can significantly influence their
treatment plans and this can result in the aggravation of existing health conditions.
Another key finding of the research is that patients with language problems may be
psychologically stressed and this can to severe consequences. According to Funk and Lopez
(2022), members of the Hispanic population facing language barriers are likely to miss medical
appointments, which makes follow-up and treatment difficult. Besides that, these persons have
an increased chance of misunderstanding their treatment plan and this minimizes their potential
for medical adherence. Considering that, we need to know that medical decisions within the
Hispanic population could be dangerous if the patient does not understand the diagnosis or if the
healthcare provider cannot comprehensively explain the risk factors that are linked to the
diagnosis. Many persons do not know that understanding medical information presents a
significant issue for any patient, regardless of their ethnicity. Therefore, all persons, especially,
healthcare providers need to know that language obstacles influence the level of health literacy
of a patient, making it more difficult for the patient to comprehend sophisticated medical
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treatments and diagnoses. Moreover, language barriers among the Hispanic population are
associated with health inequity. For this reason, some members of this population have a higher
chance of not obtaining the level of patient care that aligns with their health needs.
There are two things that we do not know regarding addressing the care needs of the
Hispanic group. One of the things is the influence of interpreting services in healthcare delivery.
According to Whitaker et al. (2022), interpreter resources do not substitute direct communication
and may lead to various safety risks. This is because, in one way or another, the use of interpreter
services limits the capacity of patients to be involved in their own care, pushing them to play a
passive part. Generally, this leads to a disconnect between patients and their healthcare providers
as various interactions may not be interpreted appropriately. The second thing that we do not
know concerning addressing the care needs of persons from the Hispanic group is the impact of
the current health policies. These policies need to be reviewed to promote the health and safety
of persons from the Hispanic population with language problems.
Gaps in Knowledge
The issue of language barriers in care delivery poses more threat than it appears. For
instance, healthcare policies are designed to guarantee there is no discrimination towards persons
from minority groups, according to Yearby et al. (2022). However, there are no well-established
guidelines on how to utilize the policies to minimize health disparities faced by minority groups.
Given the ineffectiveness of some of the implemented health policies on language differences,
healthcare institutions need to hire qualified medical interpreters and provide language assistance
services. This is because, research indicates that the use of interpreter services is associated with
various healthcare delivery benefits such as better patient health results, low rates of
readmission, and increased healthcare utilization. Also, in all healthcare settings, patient
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involvement is associated with culturally consistent care as this facilitates trust development and
provides patients from minority groups with a chance to communicate their health needs directly
and effectively to healthcare providers. As a result, health systems need to implement programs
that bridge the gap in the Hispanic population and healthcare provider communication.
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References
Al Shamsi, H., Almutairi, A. G., Al Mashrafi, S., & Al Kalbani, T. (2020). Implications of
language barriers for healthcare: a systematic review. Oman Medical Journal, 35(2),
e122. https://doi.org/10.5001%2Fomj.2020.40
Bombard, Y., Baker, G. R., Orlando, E., Fancott, C., Bhatia, P., Casalino, S., … & Pomey, M. P.
(2018). Engaging patients to improve quality of care: a systematic
review. Implementation Science, 13, 1-22. https://doi.org/10.1186/s13012-018-0784-z
CMS. (2022). Providing language services to diverse populations: Lessons from … – CMS.
Centers for Medicare & Medicaid Services. https://www.cms.gov/About-CMS/AgencyInformation/OMH/Downloads/Lessons-from-the-Field.pdf
De Moissac, D., & Bowen, S. (2019). Impact of language barriers on quality of care and patient
safety for official language minority Francophones in Canada. Journal of Patient
Experience, 6(1), 24-32. https://doi.org/10.1177/2374373518769008
Funk, C., & Lopez, M. H. (2022). Hispanic Americans’ experiences with health care. Pew
Research. https://www.pewresearch.org/science/2022/06/14/hispanic-americansexperiences-with-health-care/
Hollingshead, N. A., Ashburn-Nardo, L., Stewart, J. C., & Hirsh, A. T. (2016). The pain
experience of Hispanic Americans: A critical literature review and conceptual model. The
Journal of Pain, 17(5), 513-528. https://doi.org/10.1016%2Fj.jpain.2015.10.022
Velasco-Mondragon, E., Jimenez, A., Palladino-Davis, A. G., Davis, D., & Escamilla-Cejudo, J.
A. (2016). Hispanic health in the USA: a scoping review of the literature. Public Health
Reviews, 37, 1-27. https://doi.org/10.1186/s40985-016-0043-2
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Whitaker, K. L., Krystallidou, D., Williams, E. D., Black, G., Vindrola-Padros, C., Braun, S., &
Gill, P. (2022). Addressing language as a barrier to healthcare access and quality. British
journal of general practice, 72(714), 4-5. https://doi.org/10.3399/bjgp22X718013
Yearby, R., Clark, B., & Figueroa, J. F. (2022). Structural racism in historical and modern us
health care policy: Study examines structural racism in historical and modern US health
care policy. Health Affairs, 41(2), 187-194. https://doi.org/10.1377/hlthaff.2021.01466
1
Language Barrier Among the Hispanic Population in Miami, FL
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Language Barrier Among the Hispanic Population in Miami, FL
Description of the Problem
Currently, minority populations across the U.S. are continuously growing, and as these
numbers increase so are the healthcare disparities individuals from these groups face. One of the
healthcare disparities is language barriers. As a result of language limitations and the increasing
number of diverse providers, individuals from minority populations, including the Hispanic
population, face several challenges concerning access to medical treatment and healthcare
services. Sohn (2017) outlines that most individuals from minority groups are less likely to have
health coverage and to access preventive care than other Americans. In addition to language
barriers, other aspects such as increased poverty levels, especially among the Hispanic
population, significantly contribute to uneven health outcomes for persons from these groups.
In Miami, FL, a significant number of the residents receive their care from general
hospitals. The hospitals provide numerous and different healthcare services for patients
regardless of their age and disease conditions. This clinical setting encompasses organizations,
health professionals, and ancillary healthcare employees who offer healthcare to those in need. In
Miami, FL, all residents are allowed to access services provided by these hospitals, but the level
of care may differ depending on one’s ethnicity. There are several problems I see in hospitals
within Miami, including disparities in health insurance and care associated with low-income and
poor living conditions, among other elements, inadequate access to mental/behavioral health
services, low health literacy, and increased substance use. According to Buchmueller and Levy
(2020), minority groups still have a difficult time accessing optimal healthcare, despite the
introduction of the Affordable Care Act (ACA), which has played a significant part in lowering
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health disparities. In Miami, these challenges are prevalent in hospitals, and most affected are
those people from minority groups.
Statement of the Problem and Target Population
As previously mentioned, the language barrier is among the challenges that contribute to
poor health outcomes among individuals from the Hispanic population. For this reason, among
others, Hispanic Americans have an elevated chance than White Americans to die from various
health conditions or to get hospitalized. Funk and Lopez (2022) outline that when it comes to
circumnavigating the healthcare system, most Hispanics describe that communication problems
associated with language differences significantly contribute to their poor health outcomes. As a
result of these language differences, Hispanic Americans are less likely to utilize preventive and
clinical services. Also, due to these language limitations, healthcare providers tend to provide
Hispanic persons with low-quality or inferior medical care. All these factors together
demonstrate why individuals from the Hispanic population in Miami have generally worse and
poorer health outcomes when compared to other populations in the area.
To lower health disparities and improve health results, person-centered care is essential.
However, person-centered care cannot be achieved if there exist language differences that hinder
the delivery of ideal care. This is because, according to Amirehsani et al. (2017), person-centered
care is based on effective communication and interaction between healthcare providers and
patients. Generally, healthcare delivered in an individual’s primary language has a high
probability of positively influencing the health status of that individual. However, with language
differences and discordance, interaction and understanding between healthcare providers and
patients will be poor and this may lead to patient dissatisfaction and poor health outcomes. This
is the same problem Hispanics located in Miami are facing because most of them are still not
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able to obtain top-notch medical care. This will continue to be a problem not only in Miami, FL
but across the U.S. because the ratio of nurse practitioners and Hispanic nurses does not match
the growth of the Hispanic population.
Significance of the Evidence-Based Project
An example of an evidence-based project that could be introduced in general hospitals
within the Miami area to the nursing profession is the use of interpreter resources. These
resources generally consist of in-person interpreters either employed by the organization or
contracted externally. In the selected setting, the use of interpreter resources is important because
these resources will help bridge the communication gap resulting in effective and interactive
communication. As previously mentioned, most persons from the Hispanic population are less
likely to utilize preventive care and other medical services because of problems associated with
language differences and this, in one way or another, has contributed to worse health outcomes
within this population. With the utilization of interpreter resources, general hospitals in Miami
can improve communication and this will not only increase the number of persons seeking
medical care but also contribute to better health outcomes. This project is important because it
will play a major part in reducing health disparities as well as mitigating challenges faced by
persons from minority groups.
Moreover, due to language barrier among other factors, most Hispanic Americans do not
seek differential treatment because they are likely to obtain low-quality medical care when
compared to their counterparts. Also, this limitation prevents most healthcare providers from
providing people from this population with advanced medical care because of the fear they may
not align the treatment with their preferences and health needs (Funk & Lopez, 2022). However,
with the use of interpreters, these healthcare providers will be confident to provide advanced
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medical care as an interpreter will close the communication gap. This will not only help improve
the communication between the healthcare provider and the patient but will also build trust
between the two parties. With trust and effective communication, healthcare providers can
deliver patient-centered care and in doing so, achieve better health outcomes and decrease the
prevalence of health disparities within the minority populations.
Effective communication is essential in healthcare because communication failures and
misunderstandings can negatively influence patient outcomes. According to Tiwary et al. (2019),
poor communication in healthcare settings is associated with misdiagnoses and other medical
blunders that can result in avoidable health problems as well as the death of patients. Hence,
language differences between healthcare providers and Hispanic patients could contribute to
miscommunication and this could lead to these patients receiving the wrong medical procedure
or treatment, delays in vital tests and treatments, or being given the wrong medication. Hence,
the use of interpreter resources within Miami hospitals would be essential in addressing the
language barrier.
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References
Amirehsani, K. A., Hu, J., Wallace, D. C., Silva, Z. A., Dick, S., West-Livingston, L. N., &
Hussami, C. R. (2017). US healthcare experiences of Hispanic patients with diabetes and
family members: A qualitative analysis. Journal of Community Health Nursing, 34(3),
126-135. https://doi.org/10.1080%2F07370016.2017.1340556
Buchmueller, T. C., & Levy, H. G. (2020). The ACA’s impact on racial and ethnic disparities in
health insurance coverage and access to care: An examination of how the insurance
coverage expansions of the Affordable Care Act have affected disparities related to race
and ethnicity. Health Affairs, 39(3), 395-402. https://doi.org/10.1377/hlthaff.2019.01394
Funk, C., & Lopez, M. H. (2022). Hispanic Americans’ experiences with health care. Pew
Research. https://www.pewresearch.org/science/2022/06/14/hispanic-americansexperiences-with-health-care/
Sohn, H. (2017). Racial and ethnic disparities in health insurance coverage: Dynamics of gaining
and losing coverage over the life-course. Population research and policy review, 36(2),
181-201. https://doi.org/10.1007%2Fs11113-016-9416-y
Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by
health care professionals may lead to life-threatening complications: examples from two
case reports. Wellcome open research, 4.
https://doi.org/10.12688%2Fwellcomeopenres.15042.1
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