Best Practices in

Providing Health Care to

Deaf Populations

Christine Walsh
 Outline
• Chapter 1: Background & Significance
• Chapter 2: Review of Literature
• Chapter 3: Recommendations
• Chapter 4: Implementation & Evaluation
 Background

Americans with Long wait time for Higher likelihood

Disabilities Act interpreters of ED use
(McKee et al., 2015)
(1990)

Background Purpose Trust Training Communication Recommends Implementation Evaluation

 Purpose
To determine effective methods in overcoming communication
barriers with deaf patients

For deaf and hard of hearing adults, does providing nursing

students and nurses with cultural competence training,
simulations, and appropriate visual aids enhance this
population’s social determinants of health?

Background Purpose Trust Training Communication Recommends Implementation Evaluation

 Establishing Patient Trust

Law enforcement 68% of deaf Disclosing sexual Perinatal care among

officer cultural patients have a orientation to five deaf women
competency training behavior health dx interpreters (Hubbard, D’Andrea, & Carman,
2018)
(Pertz et. al, 2018) (Miller et. al, 2019)
(Engelman & Deardorff, 2016)

Background Purpose Trust Training Communication Recommends Implementation Evaluation

 Assessing Current Provider Training

Nursing student Deaf medical student Deaf Strong

simulations in in emergency Hospital
(Mathews et. al, 2011)
Turkey medicine
(Yuksel & Unver, 2016) (Meeks et. al, 2018)

Background Purpose Trust Training Communication Recommends Implementation Evaluation

 Ensuring Effective Communication

98.6% of pharmacists use Deaf patients prefer Iowa

written communication temperature pain scale
(Ferguson & Shaw, 2016) (McKee et. al, (Palese et. al, 2011)
2015)

Background Purpose Trust Training Communication Recommends Implementation Evaluation

 Recommendations

• Advocate • Adhere to laws • Implement • Visual aids

• Patient-centered • Provide CC simulation • Iowa pain
• Cultural training thermometer (IPT)
competency scale

Background Purpose Trust Training Communication Recommends Implementation Evaluation

 Plan-Do-Study-Act:
Implementation

Decision tree Cultural Annual in-person

for deaf competency trainings with
nurse educator &
patients modules ASL interpreter

Background Purpose Trust Training Communication Recommends Implementation Evaluation

 Plan-Do-Study-Act:
Evaluation

Evaluate Make changes

surveys and and prepare for
observations next cycle

Background Purpose Trust Training Communication Recommends Implementation Evaluation

 References
Bae J. M. (2014). The clinical decision analysis using decision tree. Epidemiology and health, 36, e2014025.
https://doi.org/10.4178/epih/e2014025
Engelman, A., & Deardorff, J. (2016). Cultural Competence Training for Law Enforcement Responding to Domestic
Violence Emergencies With the Deaf and Hard of Hearing: A Mixed-Methods Evaluation. Health promotion
Ferguson, M., & Shan, L. (2016). Survey evaluation of pharmacy practice involving deaf patients. Journal of Pharmacy
Practice, 29(5), 461-466. doi: 10.1177/0897190014568379
Gallaudet University (2020c). Formation of a community. Retrieved from: https://www.gallaudet.edu/history-through-
deaf-eyes/online-exhibition/formation-of-a-community
Hemberger, L. & Morrow, K. (n.d.) Respecting the deaf community. Retrieved from
https://sites.trinity.edu/sensoryimpariment/respecting-deaf-community
Hubbard, L., D’Andrea, E. & Carman, L. (2018). Promoting best practice for perinatal care of deaf women. Nursing for
Women’s Health, 22(2), 126-136. https://doi.org/10.1016/
j.nwh.2018.02.002
 References
Institute for Healthcare Improvement. (2020). Science of improvement: Testing chances. Retrieved from:
http://www.ihi.org/resources/Pages/HowtoImprove/ScienceofImprovementTestingChanges.aspx
Mathews, J. L., Parkhill, A. L., Schlehofer, D. A., Starr, M. J., & Barnett, S. (2011). Role-Reversal Exercise with Deaf
Strong Hospital to Teach Communication Competency and Cultural Awareness. American Journal of
Pharmaceutical Education, 75(3), 1—10.
McKee, M. M., Paasche-Orlow, M. K., Winters, P. C., Fiscella, K., Zazove, P., Sen, A., & Pearson, T. (2015). Assessing
Health Literacy in Deaf American Sign Language Users. Journal of health communication, 20 Suppl 2(0 2), 92–100.
https://doi.org/10.1080/10810730.2015.1066468
McKee, M., Winter, P., Sen, A., Zazove, P., & Fiscella, K. (2015). Emergency department utilization among deaf
American sign language users. Disability and Health Journal, 8(4), 573-578.
https://doi.org/10.1016/j.dhjo.2015.05.004
Meeks, L. M., Engelman, A., Booth, A., & Argenyi, M. (2018). Deaf and hard-of-hearing learners in emergency
medicine. The western journal of emergency medicine, 19(6), 1014–1018.
https://doi.org/10.5811/westjem.2018.8.38550
 References
Miller, C. A., Biskupiak, A., & Kushalnagar, P. (2019). Deaf LGBTQ Patients' disclosure of sexual orientation and
gender
identity to health care providers. Psychology of sexual orientation and gender diversity, 62(2), 194–203.
https://doi.org/10.1037/sgd0000319
Palese, A., Salvador, L., and Cozzi, D. (2011). One-dimensional scales for pain evaluation adopted in italian nursing
practice: Giving preference to deaf patients. Journal of Nursing Measurement, 19(2), 91-104.
doi:http://dx.doi.org.ezproxy4.library.arizona.edu/10.1891/1061-3749.19.2.91
Pertz, L., Plegue, M., Diehl, K., Zazove, P. & McKee, M. (2018). Addressing mental health needs for deaf patients
through
an integrated health care model. The Journal of Deaf Studies and Deaf Education, 23(3), 240-248.
https://doiorg.ezproxy4.library.arizona.edu/ 10.1093/deafed/eny002
Yuksel, C. & Unver, V. (2016). Use of simulated patient method to teach communication with deaf patients in the
emergency department. Clinical Simulation in Nursing, 12(7), 281-289. https://doi-
org.ezproxy4.library.arizona.edu/10.1016/j.ecns.2016.03.007