A comparison of the influence of hospital-trained, ad hoc, and telephone interpreters on perceived satisfaction of limited English-proficient parents presenting to a pediatric emergency department.

BACKGROUND: Latinos are the fastest growing minority group in the United States with a significant percentage of this population having limited English proficiency. OBJECTIVE: To determine whether mode of interpretation influences satisfaction of limited English-proficient parents presenting to a tertiary care pediatric emergency department. DESIGN: One hundred eighty parents of patients presenting to a pediatric emergency department were surveyed after receiving services from one of the following interpreters: hospital-trained, ad hoc, or telephone. An English-proficient comparison group of 60 parents of any ethnicity was also surveyed (total N = 240). RESULTS: Parents were significantly more satisfied (P < 0.001) with hospital-trained interpreters. While no significant difference was found in overall visit satisfaction, there were significant differences in several other outcome variables. When hospital-trained interpreters were used, parents were significantly more satisfied (P < 0.001) with their physicians and nurses. With regard to the ability to communicate with pediatric emergency department personnel, parents using hospital-trained interpreters averaged significantly higher scores (P < 0.001) than the telephone group. Quality-of-care scores were significantly higher (P < 0.001) for parents assigned to hospital-trained interpreters than for the other forms of interpretation. English-proficient parents scored highest in the following categories: ability to communicate, quality of care, and overall visit satisfaction. Parents using hospital-trained interpreters scored higher than English-proficient parents when questioned about physician and nursing satisfaction. CONCLUSION: Hospital-trained interpreters are a valuable and needed resource to facilitate communication with limited English-proficient patients and families. Other interpretation services are useful but have limitations.

Tap water for irrigation of lacerations.

This study was designed to compare the infection rates of simple lacerations irrigated with tap water versus sterile normal saline before repair. Patients with simple lacerations to an extremity that were less than 8 hours from injury were prospectively enrolled. Exclusions from the study were: dog bites, hand lacerations, immunocompromised patients, and those on antibiotics at the time of injury. Patients who qualified were randomized to receive tap water or normal saline for wound irrigation. Before and after irrigation, wound cultures were obtained. After the procedure was complete, patients were scheduled for a 48 hour follow-up wound check. A total of 46 patients were enrolled in the study. Twenty-four patients were randomized to the normal saline group and 21 were assigned to receive tap water irrigation. There were 2 infected lacerations in both the tap water and normal saline groups. The organisms cultured from the wounds in both groups were similar and there was no difference in colony counts when tap water was used. The use of tap water for the irrigation of lacerations does not result in the growth of unusual organisms or increase the colony counts of organisms. Wound infection rates were the same in both groups. This pilot study suggests that the use of tap water for irrigation of wounds may be safe. Further validation is necessary.