Minimizing Language Barriers in Nursing

This research aims to evaluate scholarly literature on minimizing language barriers between nurses and patients to improve patient outcome. It discusses the impact of language barriers, proposes interventions, and emphasizes the importance of effective communication.

Running head: NURSING ASSIGNMENT
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Name of the Student:
Name of the University:
Author Note:

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Background:
According to Moore (2014), pressure ulcers or bed sores are skin injuries that are
caused on account of prolong pressure exerted on the skin surface. It should be noted in this
context that pressure ulcers develop on the areas of skin that cover bony surfaces such as the
heels, ankles, tailbone and the hip. As stated by Efteli and Gunes (2013), patients who remain
restricted to bed or chair on account of a limiting illness are most susceptible to develop
pressure ulcers. With proper management of symptoms and use of appropriate intervention
strategies, bedsores can be managed effectively. Research studies indicate that 22% of the
patients within the hospital are affected with pressure ulcers (Cooper et al., 2013). This
assignment intends to scan the available scholarly literatures to access the risk factors that
cause pressure ulcer and present a discussion on the treatment measures available.
Research Rationale:
The rationale for conducting the research can be explained as the evaluation of the
scholarly literatures to discuss measures that could help in the treatment of pressure ulcers. In
addition to this, the research would also help in the implementation of best evidence based
practice in order to prevent the risk factors that trigger the manifestation of pressure ulcers in
hospitalized patients.
Research Hypothesis:
The research hypothesis for this research study can be mentioned as;
“Evaluation of the risk factors that trigger the formation of pressure ulcer and the available
evidence based practice measures can help in the prevention of the cause and progression of
the pressure ulcer in the patients.”
Research Objectives:

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On the basis of the research hypothesis, the following research objectives can be
summarized:
 To evaluate the risk factors that lead to the formation of pressure ulcer
 To analyse the evidence base to identify the best treatment available for the treatment
of pressure ulcer
Identification of other discipline connected to the research activity:
It should be critically noted in this context that formation of pressure ulcers within the
heel or the ankle region limits the mobilising ability of the patient to move from one place to
another. In order to assist with movement, the inclusion of a physiotherapist and an
occupational therapist can be extremely useful. The rationale for the same being assistance
with mild physical exercises and energy saving technique which would help the patient with
movement and localization.
Search Strategy:
In order to scan the evidence base, a thorough search was conducted across the
electronic databases that included the Google Scholar and Cochrane Library database. A
number of research papers were retrieved that were filtered on the basis of the inclusion and
exclusion criteria and were considered for the research.
Resource Links:
 Cochrane Library
 Google scholar

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Methodology:
Data collection process:
The methodology that would be followed to retrieve information from the scholarly
evidences would include, conducting a literature review based on the use of appropriate key
words and conducting an exhaustive systematic review of the retrieved literatures. The
rationale for the selection of the methods can be mentioned as less time consuming. Further,
building on the available evidence base would help in developing a clear idea about the
research done so far and would help in identifying the existing research gaps so as to work on
those areas.
Discussion and evaluation of collected data:
According to Moore (2014), use of an appropriate pressure ulcer risk assessment tool
or a scale could help in identifying individuals that are at a high risk of developing pressure
ulcers. In addition to this, the use of a pressure risk assessment is also recommended by a
number of pressure ulcer prevention International guidelines. The researchers conducted a
review to evaluate the patient outcome associated with risk assessment of pressure ulcers
within clinical setting. The overall findings revealed no statistically significant results in the
quality of patient outcome for nurses who used the Braden risk assessment tool. However,
results showed improved patient outcome in nurses who made use of unstructured risk
assessment. The limitation can however be mentioned in terms of the studies considered for
the review. According to Cooper et al. (2013), the use of Norden, Braden, Waterlow and
Jackson-Cubbin scales would help in determining the risks of developing pressure ulcers
within the critical care unit. Further, the paper also mentioned that the use of device-related
pressure ulcers could help in prevention of pressure ulcers in patient. However,Efteli and
Gunes (2013) mentioned that the consideration of the patient’s gender and serum albumin

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levels could be considered as potential risk factors that could lead to the formation of
pressure ulcers in ICU patients. This paper was a primary research article which comprised of
a sample size of 22 women and 48 men and therefore, the results can be validated. However,
the paper did not offer valuable treatment recommendation which could help in treating the
pressure ulcers. According to Langer and Fink (2013), a relationship exists between poor
nutritional intake and patients affected with pressure ulcer. The researchers conducted
randomised controlled trails to test the effect of parenteral nutrition on the treatment outcome
of patients suffering from pressure ulcer. The findings revealed that use of nutritional
supplements could help in treating pressure ulcers however, more research is required to
generalize the findings.
Analysis:
Upon analysing the results it can be mentioned that, the use of risk assessment scales
could help in the identification of pressure ulcers. Also, the evaluation of the BGL level and
the serum level could help in assessing risks that could lead to the formation of pressure ulcer
in patients (Efteli&Gunes, 2013). Also, it was found that the use of diet supplements could
help in improving patient outcome.
Relevance of findings:
Upon analysing the evidences, it can be said that risk evaluation of the pressure ulcers
using risk assessment scales could help in identifying patients who are placed at a high risk of
developing pressure ulcers (Moore, 2014; Cooper et al., 2013). The use of the risk assessment
scales could easily be incorporated in the organization after conducting a training workshop.
Validity and reliability:

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On the basis of the retrieved information from the evidence base it can be said that the
findings are valid and reliable and are aligned to the research hypothesis. Also, the evidence
base includes a large sample size which promotes the generalization of the findings.
Summary:
Therefore, to summarize it can be said that the research articles included in the review
helped in understanding the importance of risk assessment in detecting pressure ulcers at an
early stage (Cooper et al., 2013). Also the research studies explained that the consideration of
patient gender and BGL and Serum levels could help in assessing the risks pressure ulcers
(Efteli&Gunes, 2013). Also, the use of nutritional supplements was reported to improve
positive patient outcome in patients.

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Prioritising findings:
The priority research articles can be identified as the research articles dealing with
risk assessment and clinical examination of laboratory results so as to assess risks leading to
the formation of pressure ulcers.
Identification of evidence based practice:
In order to identify patients placed at a high risk of acquiring pressure ulcer, nurses
must make use of the risk assessment scale such as the Norden scale. This would help in
devising early intervention to prevent the progression of the pressure ulcer.
Implementation in workplace:
A training session could be conducted in the workplace where the nurses would be
trained on how to use the risk assessment scales to evaluate the risk of a pressure ulcer and
make use of appropriate interventions to devise care.
Reflection:
Upon reflecting on the findings I have realized that the use of risk assessment could
help in devising early intervention to prevent pressure ulcer formation in patients.
Recommendation:
Research studies on the effect of nutritional supplements and specialized footwear
could help in gaining more knowledge about nursing intervention strategies that could help in
promoting positive patient outcome.
Conclusion:

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Therefore, to conclude, it can be mentioned that early assessment of potential risk
factors that lead to the formation of pressure ulcers could help in the treatment and
management of pressure ulcers in an improved manner.

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Background:
According to the NSQHS standard 2, nurses are expected to partner with consumers
and deliver effective care delivery so as to promote positive patient outcome
(Safetyandquality.gov.au, 2019). Nurses must effectively communicate with patients and
endeavour to deliver a culturally safe and an effective care delivery to the patients. However,
research studies mention that more than 21% of the Australian Indigenous population based
in the rural and remote areas do not access healthcare facilities on account of linguistic and
cultural barriers (JM, 2019).
Research Rationale:
The rationale for the research is to evaluate the scholarly literatures in order to devise
methods in which language barriers could be minimised between nurses and patients so to
promote effective care delivery.
Research Hypothesis:
The research hypothesis can thus be mentioned as;
“Evaluation of scholarly literature helps in devising methods that could minimise language
barriers between nurses and patients in order to improve patient outcome.”
Research Objectives:
The research objectives can therefore be summarized as the following:
 To identify the existing language barriers between the nurses and patient
 To analyse the impact of the challenges in the form of language barriers

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 To scan the evidence base and propose interventions that could help in minimising the
barriers and promote effective communication
Identification of other discipline connected to the research activity:
The other discipline connected to the research activity can be mentioned as
psychology. A psychologist could help in explaining the importance of maintaining a certain
body posture and tone while communicating with the patient so as to improve the flow of
communication.
Search Strategy:
In order to address the research objectives, a thorough search was conducted on
Google scholar and Cochrane Library databaseusing specific inclusion and exclusion criteria
to yield relevant results that were aligned to the objectives enlisted.
Resource Links:
 Google scholar
 Cochrane Library
Methodology of data collection process:
The methodology considered in this case included identifying relevant literature to
conduct a literature review, followed by conducting a systematic review of the retrieved
literatures. This was done to save time and build knowledge on the available research
findings.
Data collection and evaluation:
According to O’Hagan et al. (2013), approach to patients and patient care, manner
towards patients, techniques used for interacting with patients and the generic aspects of

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patients formed essential components that determined the quality of communication that
nurses shared with patients. According to Bramhall (2014),effective communication skills
along with compassion and empathy can help in acquiring positive patient outcome.
Considering the cultural belief of the patient, making use of soothing verbal and non-verbal
gestures and collaborating with bilingual nurses as and when required helps in the process of
maintaining effective communication. In the words of Kourkouta and Papathanasiou(2014),
maintenance of good communication using elements of courtesy, kindness and sincerity is
important in order to effectively deal with language barriers. Norouzinia et al. (2016), in their
research mentioned that differences in colloquial languages, gender differences and hectic
environment at the ward served as barriers and increased the level of anxiety and physical
discomfort among the patients. Allocation of nurses based on the cultural background of the
patient can help in the promotion of effective patient outcome. Also, Ammouri et al. (2014)
in their research paper mentioned that patient safety increased with effective communication.
Analysis:
Hence, the findings of the research studies suggest that effective communication helps
in improving the quality of therapeutic relationship between the patient and the nurses
(Ammouri et al. 2014; Norouzinia et al., 2016; Kourkouta&Papathanasiou, 2014) . In
addition to this, consideration of the culture and religious specific preferences of the patient
along with collaborating with a bilingual nursing professional sharing the similar cultural
background of the patient can help in improving the patient outcome to a significant extent
and at the same time also reduce barriers pertaining to linguistic and cultural background
(Bramhall, 2014; O'H’gan et al. 2013).
Relevance of findings:

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The findings published by Norouzinia et al. (2016) can be considered relevant as it
indicated that an improvement in the level of communication between the nurses and patients
helped in improving patient outcome. Also, the finding published by Kourkouta and
Papathanasiou (2014) helped to develop an understanding about the fact that effective
communication considerably improved the quality of communication between nurses and the
patients and helped in dealing with communication barriers.
Relevance and Validity:
Therefore on the basis of the evaluation of findings retrieved from the evidence base,
it can be said that implementation of effective communication strategies and consideration of
cultural safety principles can help in minimising the language barrier between patients and
care professionals.
Summary:
Therefore, to summarize the findings it can be mentioned that effective
communication helps in improving patient outcome. In addition to this, referral to bilingual
nursing professionals who are able to understand the cultural, linguistic and religious beliefs
of the patients could help in acquiring positive patient outcome and at the same time
contribute to effective care delivery.
Prioritising findings:
On the basis of the exhaustive literature review, the findings published by Kourkouta
andPapathanasiou (2014)can be deemed appropriate. Also, the findings published by
Norouzinia et al. (2016) presented an effective understanding about the barriers that disrupted
the flow of effective communication between patient and the nurses within a care
environment.

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Identification of evidence based practice:
It can therefore be mentioned here that the effective use of training to train nurses to
make use of effective verbal and non-verbal gestures can help in the process of reducing
communication barriers and effectively communicate with the patients.
Implementation in workplace:
A training workshop could be organized within the organization where nurses could
be trained to pay attention to the critical areas of maintaining body gesture and body language
while treating patients belonging to diverse cultural and religious beliefs.
Reflection:
Upon reflecting on the review of literatures conducted, I have realized the importance
of paying attention to the critical intricacies of effective communication so as to acquire
positive patient outcome.
Recommendation:
Research studies about special courses which could assist nurses in caring for
immigrant patients could help in developing a better understanding about the special skills
required to promote positive patient outcome.
Conclusion:
Therefore, to conclude it can be mentioned that the consideration of the religious and
the cultural beliefs of the patients could help in communicating effectively with the patient
and at the same time help in acquiring positive patient outcome.

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References:
Ammouri, A.A., Tailakh, A.K., Muliira, J.K., Geethakrishnan, R. & Al Kindi, S.N., (2015).
Patient safety culture among nurses. International nursing review, 62(1), pp.102-110.
Bramhall, E., (2014). Effective communication skills in nursing practice. Nursing Standard
(2014+), 29(14), p.53.
Cooper, K.L., (2013). Evidence-based prevention of pressure ulcers in the intensive care
unit. Critical care nurse, 33(6), pp.57-66.
Efteli, E.U. &Gunes, U.Y., (2013). A prospective, descriptive study of risk factors related to
pressure ulcer development among patients in intensive care units. Ostomy Wound
Manage, 59(7), pp.22-7.
J, M. (2019). Australia's Health System: Some Issuesand Challenges. [online] Health-
medical-economics.imedpub.com. Available at: https://health-medical-
economics.imedpub.com/australias-health-system-some-issuesand-challenges.php?
aid=8344 [Accessed 18 Apr. 2019].
Kourkouta, L. &Papathanasiou, I.V., (2014). Communication in nursing practice. Materia
socio-medica, 26(1), p.65.
Langer, G. & Fink, A., (2014). Nutritional interventions for preventing and treating pressure
ulcers. Cochrane database of systematic reviews, (6).
Moore, Z.E. & Cowman, S., (2014). Risk assessment tools for the prevention of pressure
ulcers. Cochrane Database of Systematic Reviews, (2).
Norouzinia, R., Aghabarari, M., Shiri, M., Karimi, M. &Samami, E., (2016). Communication
barriers perceived by nurses and patients. Global journal of health science, 8(6), p.65.

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O'hagan, S., Manias, E., Elder, C., Pill, J., Woodward‐Kron, R., McNamara, T., Webb, G.
&McColl, G., (2014). What counts as effective communication in nursing? Evidence
from nurse educators' and clinicians' feedback on nurse interactions with simulated
patients. Journal of advanced nursing, 70(6), pp.1344-1355.
Safetyandquality.gov.au (2019). [online] Safetyandquality.gov.au. Available at:
https://www.safetyandquality.gov.au/wp-content/uploads/2011/09/NSQHS-
Standards-Sept-2012.pdf [Accessed 18 Apr. 2019].

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Appendix A:
Conclusions: Awareness and education in relation to pressure ulcer risk assessment and
improved knowledge about clinical evaluation results can help care professionals in
preventing pressure injuries among high risk patients.

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Conclusions: Effective communication and cultural consideration can help in minimising
language barriers between patients and nurses and improve patient outcome.