Impact of language concordant care on comprehension and adherence to infection prevention protocols among hospitalized patients: A multicentre survey.

BACKGROUND

Language concordant care can influence patient outcomes. The level of language concordant care and its impact on adherence to infection prevention protocols has not been well described.

OBJECTIVE

To assess whether patients' preferred language impacts their ability to follow infection prevention protocols.

METHODS

A multicentre survey was performed to assess understanding and self-reported adherence to two different sets of infection prevention instructions: preoperative chlorhexidine bathing before cardiac surgery and central line care during chemotherapy for hematologic malignancy. Standardized interviews were conducted following cardiac surgery or central vascular catheter insertion. Preferred language was defined by patient's stated preference, with professional hospital-based interpretation used for patients with non-English language preference.

RESULTS

Among 238 eligible patients, 222 (93%) completed the interview across both sites, including 179 (81%) with English preference and 43 (19%) with non-English preference. Comprehension of infection prevention instructions among English-preferred and non-English-preferred groups was no different (97.2% vs 93.0%; p=0.19), and similar for reported adherence (97.8% vs 97.7%; p=0.97). Among 26 (65%) non-English-preferred patients, instructions were reported to be interpreted by family rather than by hospital-based interpretation services. Qualitative themes included reliance on family for interpretation or other informal solutions, patient frustration with language barrier and expressed desire for improved language services.

CONCLUSION

No significant difference was identified in comprehension or adherence to infection prevention protocols based on language preference; however, closing this gap relied on family members or other informal solutions. Given the risks and inequity of such workarounds, improved use of hospital-based interpretation services is needed.