Abstract
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.