CoreCHI cheat sheet

Universal precautions treat all blood, body fluids, secretions, excretions (except sweat), non-intact skin, and mucous membranes as potentially infectious; standard precautions apply them to every patient regardless of known diagnosis.

Personal protective equipment sequence: don gloves last and remove gloves first; perform hand hygiene before donning and immediately after removing PPE; never touch the face or clean surfaces with contaminated gloves.

Hand hygiene with soap and water is required when hands are visibly soiled or after contact with spore-forming organisms such as Clostridioides difficile; alcohol-based rub is acceptable otherwise.

Needlestick or sharps exposure: wash the site with soap and water, do not squeeze or scrub, report immediately, and follow the facility's post-exposure prophylaxis protocol; source-patient testing requires consent or permitted exception.

Airborne precautions (e.g., tuberculosis, measles) require an N95 or higher respirator and a negative-pressure room; droplet precautions require a surgical mask plus eye protection within about 3-6 feet.

HIPAA permits disclosure of protected health information for treatment, payment, and health care operations; interpreters function under treatment and are bound by the minimum-necessary standard.

The interpreter's role is a communication conduit: relaying clinical information to the care team is permitted, but sharing patient information with family, friends, or the community without authorization is a reportable breach.

Protected health information includes any individually identifiable health data transmitted or maintained in any form; incidental disclosure that cannot reasonably be prevented is not a violation.

Interpreters may not be compelled to disclose PHI in legal proceedings without a court order, patient authorization, or valid legal process; refer requests to the privacy officer.

Message analysis sequence: identify the speaker's intent, the propositional content, and the register before rendering; accuracy of meaning outranks word-for-word equivalence.

Manage segments by requesting pauses at meaning boundaries rather than mid-clause; longer segments increase omission risk, so chunking protects completeness.

Detect and resolve ambiguity by asking the speaker a clarifying question in the first person, never by guessing or by asking the patient what the provider meant.

Track numbers, dosages, units, frequencies, and negations as high-risk elements; a dropped negation or a unit error (mg vs. mcg) is a critical error, not a minor one.

Use memory-support strategies legally permitted by the setting (note-taking in consecutive interpreting); notes must be destroyed or secured as they may contain PHI.

Distinguish linguistic competence from clinical knowledge: the interpreter conveys the message faithfully but does not add, omit, explain, or substitute medical advice.

Recognize paralinguistic and pragmatic cues (hesitation, euphemism, politeness forms) and render their function, since tone can carry clinically relevant meaning such as reluctance or nondisclosure.

When the speaker uses an idiom or culturally bound concept with no target equivalent, use a descriptive rendering plus a brief transparent clarification of the term rather than an unexplained literal translation.

Core ethical tenets: confidentiality, accuracy and completeness, impartiality, role boundaries, respect, and professional conduct; conflicts are resolved by weighing which tenet is most at risk.

The interpreter does not act as advocate, counselor, or medical decision-maker; advocacy is limited to voicing communication barriers (e.g., requesting a qualified interpreter or clarifying role).

Conflicts of interest (family relationship, financial interest, prior personal involvement) require disclosure and, where feasible, withdrawal from the assignment.

Accepting gifts or favors that could influence impartiality is discouraged; small culturally motivated tokens may be declined politely with explanation per institutional policy.

If asked to perform a non-interpreting task (transporting a patient, obtaining consent, giving instructions), decline and redirect to the appropriate staff member.

When a provider requests that the interpreter withhold information from the patient, the interpreter states the ethical obligation to interpret completely and escalates if the omission would harm the patient.

Errors must be disclosed promptly to the parties affected and corrected; concealing a mistranslation is an ethical violation regardless of outcome.

Scope-of-practice limits: the interpreter does not certify competence, does not simplify clinical information independently, and does not answer clinical questions directed at the provider.

Ethical decision framework: identify the dilemma, list affected parties, consult the code of ethics and institutional policy, seek supervision, act, and document.

Cultural humility is a lifelong process of self-reflection and redressing power imbalances, distinct from cultural competence framed as a finite body of knowledge.

Explanatory models (Kleinman's questions: what do you call the problem, what do you think caused it, how severe is it, what do you fear) elicit the patient's illness beliefs without stereotyping.

Health disparities arise from structural and social determinants (access, language, insurance, racism); limited English proficiency itself is an independent risk factor for adverse events.

Avoid treating culture as deterministic: within-group variation exceeds between-group variation, so assess each patient individually rather than applying group generalizations.

Use qualified interpreters rather than family members or children; ad hoc interpreting raises error rates, breaches confidentiality, and distorts sensitive information.

Cultural factors can shape symptom expression, decision-making authority (family-centered vs. individual autonomy), and attitudes toward medication, disclosure, and mental health.

Address taboos and modesty norms (eye contact, touch, gender of provider) by asking the patient's preference rather than assuming a rule from group membership.

Title VI of the Civil Rights Act and related guidance require meaningful access for limited-English-proficient patients, including qualified language services at no cost to the patient.