Process and Outcomes of Care Provided by Foreign Educated Nurses

Thursday, July 14, 2011

Linda Y. Kim, RN, MSN
School of Nursing, UCLA, Los Angles, CA

Learning Objective 1: The learner will be able to describe the relationship between foreign educated nurses' intercultural communicative competence and their perceived patient outcomes.

Learning Objective 2: The learner will be able to describe the relationship between foreign educated nurses' intercultural communicative competence and nurse-physician communication process.

Background: Recruitment and employment of FENs in response to the nursing shortage raised a key concern by several scholars related to the communicative competence of nurses who speak English as a second language and the possible effects on patient safety. Suggestions by these scholars include an assessment of patient outcomes, addressing the competence that FENs bring to patient care. The purpose of the study is to determine the relationship between the foreign educated nurses’ (FEN) intercultural communicative competence, the FEN-MD communication, and FENs’ perceived patient outcomes. Methods: A descriptive correlational design will be used. The study participants will be recruited from various participating healthcare organizations in the Los Angeles area. Inclusion criteria include FENs who a) are licensed to practice as a registered nurse in the U.S.; b) obtained entry-level nursing education in a country other than the U.S.; c) speak a primary language other than English; d) is at least 18 years old; d) and is currently working in a nursing position that has regular contact with adult patients in an acute care setting. The study instruments will include the Cultural Self-Efficacy Scale (CSES), the Nurses' Assertiveness Inventory (NAI), and the Basic English Skills Test Plus (BEST Plus) to measure the FENs’ intercultural communicative competence; the ICU Nurse-Physician Questionnaire to measure nurse-physician communication; and a self report using a 4-point Likert-type scale to measure the FENs’ perception of patient outcomes. Data will be analyzed using descriptive statistics, a Pearson correlation coefficient, multiple-step hierarchical regression analysis, and ANOVA. Results: We hypothesize that there will be a negative relationship between the FENs’ intercultural communicative competence and FEN-MD communication, with FENs’ perceived patient outcomes. Implications: Findings from the study will fill an important knowledge gap related to the competence that FENs bring to patient care, and its possible effects on patient safety.