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April 2013

Julia Yao, BSN, RN
4 East Obstetrics
Registered Nurse 2, VPNPP

Type of project: Quality Improvement
Title of project: Pain Management Communication with Non-English Speaking Postpartum Patients
Co-workers involved in this project: Michelle Browning, MSN, RN
Description of project: There were 4,165 obstetrical postpartum patients in VUMC between July 2011 and June 2012. 19% of these postpartum patients were non-English speaking and represented nearly 30 different languages. Language barriers make communication between the nurse and the patient difficult. The purpose of this study was to determine if a visual chart could improve communication about pain management. The study collected data from 26 non-English speaking patients receiving analgesic pain medication and compared the amount of pain medications patients received before and after the visual chart was implemented. A survey was conducted with the 30 non-English speaking patients in their native language to determine how satisfied they were with the pain management efforts after using the visual chart during their hospital stay. 100% of the patients reported being satisfied or very satisfied with pain management after using the visual chart.

References used during this project:

1.Elizabeth A. Jacobs, M.D., M.P.P.; Niels Agger-Gupta, Ph.D.; Alice Hm Chen, M.D. M.P.H.; Adam Piotrowski; Eric J. Hardt, M.D. (2003 ): Language Barriers in Health Care Settings: An Annotated Bibliography of the Research Literature.

2.Anita Wikkbeerg, Terese Bondas. A Patient Perspective in Research on Intercultural Caring in Maternity care: a meta –ethnography 2010. JQSHWB 2010, 5: 4648-DOI: 10-3402/ qhw.v 5i1-4648

3.Lynn Clark Callister, Inaam K balaf, Sonia Semenic, Robin Kartchner, Katri Vebvilainen-Julkunen. The Pain of Childbirth: Perceptions of Culturally Diverse Women. Pain Management Nursing, 4(4) ( December) 2003 PP 145-154.

4.Narayan, Mary. Culture’s Effects on Pain Assessment and Management (2010). AJN, American Journal of Nursing; 110(4). 38-47.

5. Sandy E. Weber, (1996 ). Cultural Aspects of Pain in Childbearing Women. JOGNN 25, 67-72.

Why you chose this project: The growing patient cultural and language diversity found at VUMC has proved to be a health care challenge for our staff. Managing a patient’s pain levels are especially challenging for the staff when the patients do not speak or understand English. My goal was to develop a tool that would help provide more comfortable, quality care and increase patient satisfaction.

Poster presentations:

1.) Pain Management Communication with Non-English Speaking Postpartum Patients - VUMC Nursing Research Day, Nashville, TN. October 17, 2012.

2.) Pain Management Communication with Non-English Speaking Postpartum Patients - VUMC Postpartum Unit Board Meeting. July 2012.

Future plans: Julia is in the process of writing a manuscript on the results that were collected during her study, and plans to submit it for publication in 2013. In addition, Julia will submit an abstract to AWHONN in hopes of presenting her poster at the AWHONN National Conference in 2014.

If you have any questions about Julia's project she can be reached via email at