Cultural care needs of Spanish speaking parents with limited English proficiency whose children are hospitalized: An ethnonursing study.

PURPOSE: Parents' inability to speak English proficiently is associated with communication barriers in the care process of their children, social determinants of health, and poor child health outcomes. Research exploring perspectives of Spanish speaking parents with limited English proficiency (SSP-LEP) whose children are hospitalized in the context of culture is lacking in the literature. The purpose of this study was to explore the cultural experiences, values, and beliefs of SSP-LEP, of Mexican origin, whose children were hospitalized and to understand nurses' roles in providing culturally congruent care. DESIGN AND METHODS: Leininger's qualitative, ethnonursing method was used for this study. The Theory of Culture Care Diversity and Universality provided a guiding framework. Eleven SSP-LEP, of Mexican origin, participated in interviews conducted in-person and via Zoom. Data was analyzed using Leininger's four phases of qualitative analysis. RESULTS: Three themes emerged: 1. role of the mother as an ever-present manager of care for the hospitalized child and family, 2. parents' difficult, fearful, stressful, and unknowing experiences in the presence of a language barrier, and 3. expected nursing care that was kind, respectful, compassionate, and attentive. CONCLUSIONS: Lack of knowledge creates hardships for parents who desire to be involved, informed caregivers. Communication in Spanish language is integral to parents' understanding and expected nursing care. SSP-LEP may have negative feelings; yet describe a positive care experience. PRACTICE IMPLICATIONS: Culturally congruent care should incorporate language services for information sharing that facilitates parent participation and decision-making; be kind, respectful, compassionate, and attentive; and promote maternal role maintenance.

Pediatric Nurses' Experiences in Caring for Non-English Speaking Patients and Families.

INTRODUCTION: Language barriers challenge patient- and family-centered care. Literature guiding pediatric nurses caring for patients and families with limited English proficiency in the inpatient setting is nonexistent. The purposes of this phenomenological study were to understand pediatric nurses' experiences in caring for patients and families with limited English proficiency and to explore how nurses navigate the communication gap. METHOD: A purposive sample of 15 pediatric Registered Nurses at a large urban children's medical center participated in face-to-face semistructured interviews. Verbatim transcribed interviews were analyzed line-by-line and categorized into themes. RESULTS: Themes included personal framework of care, consequences of caring, starting off right, nurse sensing, verbal/nonverbal methods, and interpreters. DISCUSSION: Nurses did not perceive differences in task-oriented care; they described compromised personal paradigms, held negative feelings, and utilized verbal/nonverbal communication methods. Future research is needed exploring patients' and families' perceptions regarding care by other language-speaking nurses.

A Call for Nurse Leader Action: Ethical Nursing Care of Latinx Unauthorized Immigrant Children and Families.

Latinx unauthorized immigrant children and children of unauthorized immigrant parents are at risk for care disparities and negative health outcomes. Unauthorized immigration from South and Central America to the United States has elevated to crisis level, exposing many children to poor health conditions, human rights violations, and risk of death. Unauthorized status greatly influences care access and delivery in the hospital setting. Restricted nursing care creates ethical dilemmas. Nurse leaders are in key positions to influence and advocate care. This article explores issues surrounding nursing care using the Theory of Bureaucratic Caring and identifies opportunities for nurse leader action.

Spanish Speaking, Limited English Proficient Parents whose Children are Hospitalized: An Integrative Review.

PROBLEM: Children of non-English speakers are at risk for health disparities. Little is known about the experiences of Spanish speaking parents with limited English proficiency (LEP) whose children are hospitalized. The purposes of this integrative review were to explore what is known and to identify gaps in the literature about the experiences of Spanish speaking parents with LEP whose children are hospitalized. ELIGIBILITY CRITERIA: Whittemore and Knafl's (2005) integrative review method guided the process. Studies addressed Spanish speaking parents of hospitalized children in the United States. SAMPLE: A final sample consisted of 36 quantitative and qualitative research studies published from 1994 to 2018; located through a search of CINAHL, Pubmed, and Scopus. RESULTS: Language services were inconsistent although mandated by standards and laws. Parents experienced mixed emotions related to care. Emergency departments in large, urban cities were the most common care settings. Differences in care outcomes and safety risks for children of Spanish speaking parents existed; however, findings were inconsistent. Only three of the 36 studies addressed nursing care. CONCLUSIONS: Research design and quality varied. Parents valued communication in their language. Nurses are the primary healthcare provider in the hospital setting but few studies explored parents' experiences associated with nursing care. No studies explored parents' experiences with their child's hospitalization in the context of culture. IMPLICATIONS: Future research is needed to explore the cultural values, beliefs, and experiences of Spanish speaking parents with LEP and the role of nurses and to inform culturally congruent nursing care, research, and policy.

Salmonella bloodstream infections: report from the SENTRY Antimicrobial Surveillance Program (1997-2001).

Salmonella spp. are significant bloodstream pathogens and are routinely monitored for antimicrobial resistance by the SENTRY Antimicrobial Surveillance Program. Six hundred and one bloodstream infection (BSI) isolates of Salmonella spp., collected over a 5-year period (1997-2001) were tested for their susceptibility against 20 antimicrobial agents, comparing year and geographical region. Salmonella enterica serotype Typhi was the most frequently identified 'species' (43% of identified strains), although 'unspeciated' strains predominated overall (54.2%). The rank order for six selected drugs tested by their MIC(90) values and percentage susceptibility was: ceftriaxone (< or =0.25 mg/l; 99.5% susceptible)>ciprofloxacin (0.12 mg/l; 99.3%)> trimethoprim/sulphamethoxazole (< or =0.5 mg/l; 92.7%)>amoxycillin/clavulanate (16 mg/l; 89.7%)>ampicillin (>16 mg/l; 81.0%)>tetracycline (>8 mg/l; 79.4%). Most isolates remained highly susceptible to all 20 agents examined, with the exception of Salmonella Typhimurium (only 35.3% susceptible to tetracycline, 41.2% to ampicillin, and 61.8% to amoxycillin/clavulanate). DT104 resistance phenotypes were noted in 3.4 and nearly 60.0% of unspeciated Salmonella and S. Typhimurium, respectively. Unexpectedly, the highest overall susceptibility rates were recorded in Latin America. Fluoroquinolone resistance was observed and nalidixic acid screening MICs (< or =8 mg/l) predicted full susceptibility to ciprofloxacin. Five-year results from the SENTRY Program show no clear trend toward greater resistances in Salmonella spp. BSIs for the commonly used antimicrobial classes. With the exception of S. Typhimurium DT104, most Salmonella spp. remain highly susceptible to the tested antimicrobials that maybe utilized for Salmonella BSI.

Antimicrobial susceptibility profile among beta-haemolytic Streptococcus spp. collected in the SENTRY Antimicrobial Surveillance Program--North America, 2001.

The surveillance of antimicrobial resistance among beta-hemolytic Streptococcus spp. is an important health care concern due to the serious nature of the diseases that are caused by these pathogens and the emerging antimicrobial resistances. National and international studies have documented diverse rates of resistance to macrolide and lincosamide agents. The SENTRY Antimicrobial Surveillance Program evaluated the resistance rates of beta-hemolytic Streptococcus spp. to several drug classes including erythromycin and clindamycin during the 2001 study year. Twenty-five medical centers in North America contributed 787 isolates from serogroups A (SGA; 397 strains), B (SGB; 318 strains), G (SGG; 45 strains), C (SGC; 19 strains), and F (SGF; eight strains). Isolates were tested at a reference center by broth microdilution using NCCLS methods. A subset of isolates were characterized by molecular methods to determine the presence of erm and mef resistance mechanisms. All isolates were susceptible to beta-lactams, linezolid, vancomycin, chloramphenicol, quinupristin/dalfopristin, and fluoroquinolones. Garenoxacin (MIC(90,) 0.06 microg/ml) was the most potent fluoroquinolone tested. Tetracycline was inactive against SGB (14.8% susceptible) compared to SGC, SGG, SGF and SGA (48.9-85.6% susceptible). Resistance to erythromycin and clindamycin was highest among SGB isolates with M-phenotypes (mef) representing the majority (59.1%) of strains. Among isolates randomly selected for genotypic characterization, eight strains had mef (A), 16 had erm (A) [subclass erm (TR)], seven had erm (B) and one strain had erm (A) [subclass erm (TR)] and mef (A) present. These data when compared to previous SENTRY Program analysis showed macrolide resistance has remained stable over the last five years and M-phenotypes are the most prevalent expression of MLS(B) resistance in North America.