Care CEUs

LEP Guide for Improving Patient Safety

Executive Summary

1. Which of the following is a liability exposure when providing care to LEP populations?

A. Patient comprehension of medical condition, treatment plan, discharge instructions, complications, and followup. B. Improper preparation for tests and procedures. C. Poor or inadequate informed consent. D. All of the above.

2. An immediate strategy that can be implemented to prevent medical errors among LEP patients is which of the following?

A. Improving access to interpreters B. Changing check-in procedures C. Increasing the number of rounds D. All of the above

3. While the benefits may reduce medical errors, challenges to interpreters serving as cultural brokers include all of the following, except:

A. Confusion of role boundaries among care team during medical interaction. B. Interpreters not following confidentiality rules. C. Challenges associated with interpreters acting as patient advocates and retaining impartiality and objectivity required of professional interpretation. D. Institutional culture and resistance of interpreters stepping outside of traditional role.

4. Research has shown that TeamSTEPPS is effective in multiple settings at improving care outcomes, team communication, and team attitudes. Unlike other team-based trainings, TeamSTEPPS is evidence based, field tested, comprehensive, and customizable. It is publicly available at no cost.

A. True B. False

5. Patients may not feel comfortable revealing that they have trouble communicating in English. Thus, it is important to offer professional interpretation services, even when patients seem to speak enough English to "get by."

A. True B. False

6. The Department of Justice and the Department of Health and Human Services have stated that failure to provide appropriate interpreter services can be considered discrimination based on national origin.

A. True B. False

7. Interpreter services benefit the patient, but cause staff members to struggle to ensure the provisions of high-quality care due to always having someone "looking over their shoulder."

A. True B. False

8. All of the following are risks associated with using non-qualified interpreters, including family members, friends, or untrained staff, except for:

A. "Ad hoc" interpreters must be financially compensated for their services which cost nursing homes substantial amounts of money. B. "Ad hoc" interpreters are not trained or skilled in the interpretation process, such as the need to interpret everything the clinician and patient say, to interpret manageable chunks of information, and to avoid paraphrasing long explanations. C. Family members are not neutral parties to the medical encounter; they may withhold information from the clinical care team or from the patient, or may add their own perspectives. D. "Ad hoc" interpreters have been shown to commit more communication errors of clinical significance than trained interpreters.

Chapter 1: Background on Patient Safety and LEP Populations

9. The Institute of Medicine Report, Crossing the Quality Chasm, states that quality means that patients are not harmed by the care that is intended to help them, and they remain free from inappropriate treatment, although accidental injuries and misdiagnoses are expected to occur occasionally.

A. True B. False

10. All of the following have been identified as causes of errors, or potential errors, for LEP and culturally diverse patients, except for:

A. Use of family members, friends, or non-qualified staff as interpreters. B. Provider use of basic language skills to "get by." C. Telephonic interpreting. D. Cultural beliefs and traditions that affect care delivery.

11. LEP patients may have cultural beliefs and traditions that can influence the medical encounter and subsequent health outcomes in subtle and often invisible ways. These include all of the following, except for:

A. Minimizing reports of pain B. Not being honest about health conditions C. Respecting authority D. Class biases

Chapter 2: Five Key Recommendations To Improve Patient Safety for LEP Patients

12. Which of the following is the most important key condition for the predicted effectiveness of patient safety reporting systems?

A. User-friendly tools that facilitate reporting. B. Staff who are educated about the issue of safety and the reporting process. C. Organizational culture that makes staff members feel comfortable making reports when events arise. D. All of the above are equally important.

Chapter 3: Improving Team Communication To Foster Safety for LEP Patients: TeamSTEPPS LEP Module

13. The care team should call a qualified medical interpreter to the encounter for LEP patients by which of the following methods?

A. Telephone B. Video C. Web-based D. Any of the above

14. All of the following are CUS words, an agreed-upon communication tool that any team member can use to stop the action at any time when there is any concern for miscommunication or risk to patient safety, except for:

A. Concern B. Caution C. Uncomfortable D. Safety

Appendix A: Recommendations for Staff Training

15. With regard to patient safety training for nurses, interpreters, and other staff, roles and responsibilities should be clarified for all clinical and nonclinical staff pertaining to reporting safety events and emphasis should be placed on reporting as the responsibility of all staff.

A. True B. False


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