Nurses' experiences of working with healthcare interpreters when caring for patients with limited proficiency in the primary language: a qualitative systematic review

Background: Patients with limited proficiency in the primary language who do not receive a healthcare interpreter have poorer health outcomes. Clinician preference is an important factor in determining whether a healthcare interpreter will be used; yet little is known about their experiences and preferences for working with healthcare interpreters. Aims and Objectives: To review and synthesise the evidence examining nurses' experiences of working with healthcare interpreters when caring for patients with limited proficiency in the primary language. Methods: This review follows the reporting items contained within the ENTREQ statement. A systematic search of the literature was undertaken from inception to August 2024 in the databases CINAHL, Embase, Medline, PsychInfo, PubMed, Scopus, and ProQuest Dissertations and Theses Global. Included studies were assessed using the Critical Appraisal Skills Programme tool for qualitative studies. Thematic synthesis was undertaken on studies meeting the inclusion criteria, including studies undertaken in acute settings. Articles were limited to English-language papers and peer-reviewed. Findings: Eighteen studies representing the experiences of 416 nurses from eight countries were included in the review. Four themes were identified: (1) working with Interpreters, (2) tensions and challenges, (3) making connections, and (4) workarounds. Discussion: Nurses' experiences of working with healthcare interpreters were overwhelmingly positive; however, concerns about interpretation accuracy, unreliable technology, additional time required when working with a healthcare interpreter, and being sidelined were evident. Nurses commonly resorted to using bilingual nurse colleagues and family members when healthcare interpreters were unavailable. Conclusion: This review highlights the need for nurses to be allocated additional time in their patient loads when caring for patients with limited proficiency in the primary language. Healthcare policy that accommodates the use of bilingual healthcare professionals as well as the need for nurses to receive formal training on working collaboratively with healthcare interpreters is needed. Patient or Public Contribution: Not applicable due to systematic review.