(793) Interpreter Use and Communication With Spanish-Speaking Families in the PICU

Introduction: Communication in a pediatric ICU is fraught with difficulties. When a patient and their caregivers identify as non-English language preferred (NELP), the difficulties with communication are further increased. Language barriers have been shown to result in poorer quality of care. Interpreters and culturally appropriate communication are an invaluable resource for NELP families as a way to understand medical care and to prevent medical errors. In the ICU, caregivers rely on frequent updates to stay informed, and these updates may be lacking amongst NELP families. Our study’s primary aim is to assess and compare provider and NELP family perceptions of interpreter use and communication quality in a pediatric ICU with primarily video interpreter access. The goal is to utilize this information to inform providers’ effectiveness at addressing language barriers with virtual modalities in the fast-paced environment of the PICU.

Methods: The study took place at an urban, stand-alone tertiary care children’s hospital, with a 26-bed pediatric ICU. This prospective study included structured interviews utilizing new survey tools developed with an iterative process for providers and Spanish-language preferred families.

Results: In the study period December 2022 through March 2024, 30 families and 75 providers were recruited to complete the surveys. In regards to frequency of interpreter use, 53.3% of families said “always”, compared to 60% of physicians and 8.6% of nurses. Regarding the family’s understanding of the daily plan of care, 56.7% of families said “always”, compared to 55.0% of physicians’ and 22.9% of nurses’ perceptions. For the quality of care, 80% of families reported “very good” or “excellent”, physicians 30%, and nurses 25.7%. Overall quality of interpreter services was reported as “very good” or “excellent” by 66.6% of families, 36.2% of physicians, and 57.5% of nurses.

Conclusions: This study points to the overall effectiveness of frequent interpreter use on positive NELP family perceptions of care quality and communication in the PICU, even with resource limitations. Our nurses and physicians were less positive in this perception. This is likely multifactorial in etiology, including the ease of building rapport with English-speaking families from frequent informal bedside interactions.