Reducing disparities in emergency department outcomes for individuals with limited English proficiency: The nurse work environment

Background: Patients with limited English proficiency (LEP) experience worse emergency department (ED) outcomes. Purpose: To evaluate the association between nurses' work environments and ED outcomes among individuals with and without LEP. Methods: Cross-sectional study of 1,358,802 patients seen in 64 New Jersey hospital EDs. Nurse work environment was measured by the Practice Environment Scale of the Nursing Work Index. Outcomes included 72-hr ED revisits, and departures against medical advice (AMA). Discussion: Individuals with LEP experienced higher odds of a 72-hr ED revisit (aOR 1.12, 95% CI 1.04-1.21, p < .001) and lower odds of AMA departure (aOR 0.67, 95% CI, 0.61-0.74, p < .001). An interaction was found between LEP status and the nurse work environment: individuals with LEP experienced lower odds of a 72-hr ED revisit in better vs. poor nurse work environments, compared those without LEP. Conclusion: Disparities in LEP outcomes might be ameliorated by targeted improvements to nurses' work environments. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.