Label Me Spanish: Spanish Directions for Use

(1)

ACPE Expiration Date

11/17/2014

Credits

1 Contact Hour

Target Audience

Nurses, Pharmacists, Pharmacy Technicians

Program Overview

One of the most important functions of a pharmacy is to be sure its patients fully understand

their prescription directions to increase the likelihood that they will follow them and to

decrease the instance of misuse or overdose. This is a tall enough order with English

speaker. When we consider that even those Spanish speakers who understand some English

may not be able to read it, this task becomes daunting to those pharmacy professionals who

don't have a working knowledge of Spanish. "Label Me Spanish" is a sequel to "An Introduction

to Pharmacy Spanish". This program will focus on putting together directions for medication

use in Spanish.

Nurse Educational Objectives



Identify the correct pronunciation for each vowel in Spanish



Explain why the order of a Spanish speaker's full name can cause labeling and filing errors



Describe general consumer habits of Spanish speakers



Identify common errors in labeling made by computer-generated Spanish translations



Give accurate and complete directions for use in Spanish

Pharmacist Educational Objectives



Identify and practice the correct pronunciation for each vowel in Spanish



Explain why the order of a Spanish speaker's full name can cause labeling and filing errors



Describe general consumer habits of Spanish speakers



Identify common errors in labeling made by computer-generated Spanish translations

(2)

Activity Type

Knowledge

Accreditation

Nurse

Pharmacist

Pharmacy Technician

N-685

0798-0000-11-055-L04-P

0798-0000-11-055-L04-T

PharmCon, Inc. is accredited by the Accreditation Council for Pharmacy Education as a

provider of continuing pharmacy education.

PharmCon, Inc. has been approved as a provider of continuing education for nurses by the

Maryland Nurses Association which is accredited as an approver of continuing education in

nursing by the American Nurses Credentialing Center’s Commission on Accreditation.

Faculty

Stephanie Langston , MFLE

Owner, Hands on Spanish

Financial Support Received From

Pharmaceutical Education Consultants, Inc.

Disclaimer

PharmCon, Inc. does not view the existence of relationships as an implication of bias or that the

value of the material is decreased. The content of the activity was planned to be balanced and

objective. Occasionally, authors may express opinions that represent their own viewpoint.

Participants have an implied responsibility to use the newly acquired information to enhance

patient outcomes and their own professional development. The information presented in this

activity is not meant to serve as a guideline for patient or pharmacy management. Conclusions

drawn by participants should be derived from objective analysis of scientific data presented

from this activity and other unrelated sources.

(3)

presented by:

Stephanie Langston

Hands on Spanish, Inc.

"Label Me Spanish"

Spanish Directions

for Use

PharmCon is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education

Legal Disclaimer: The material presented here does not necessarily reflect the views of Pharmaceutical Education Consultants (PharmCon) or the companies that support educational programming. A qualified healthcare professional should always be consulted before using any therap eutic product discussed. Participants should verify all information and data before treating patients or employing any therapies described in this educational activity.

This program has been supported by PharmCon

“

Label Me Spanish”

Spanish Directions for Use

Accreditation:

Pharmacists: 0798-0000-11-055-L04-P Pharmacy Technicians: 0798-0000-11-055-L04-T Nurses: N-685

CE Credits: 1 contact hour

Target Audience: Pharmacists Technicians & Nurses

Program Overview:

One of the most important functions of a pharmacy is to be sure its patients fully understand their prescription directions to increase the likelihood that they will follow them and to decrease the instance of misuse or overdose. This is a tall enough order with an English speaker. When we consider that even those Spanish speakers who understand some English may not be able to read it, this task becomes daunting to those pharmacy professionals who don’t have a working knowledge of Spanish. “Label Me Spanish” is a sequel to “An Introduction to Pharmacy Spanish”. This program will focus on putting together directions for medication use in Spanish

Objectives:

• Identify and practice the correct pronunciation for each vowel in Spanish • Explain why the order of a Spanish speaker’s full name can cause labeling and filing errors • Describe general consumer habits of Spanish speakers

• Identify common errors in labeling made by computer-generated Spanish translations • Give accurate and complete directions for use in Spanish

This program has been supported by PharmCon

“

Label Me Spanish”

Spanish Directions for Use

PharmCon is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education

Legal Disclaimer: The material presented here does not necessarily reflect the views of Pharmaceutical Education Consultants (PharmCon) or the companies that support educational programming. A qualified healthcare professional should always be consulted before using any therapeutic product discussed. Participants should verify all information and data before treating patients or employing any therapies described in this educational activity.

This program has been supported by PharmCon

Speaker: Stephanie Langston, MFLE, is a Spanish teaching professional and entrepreneur. She is the President, Curriculum Director and Lead Instructor of Hands on Spanish, Inc. (www.handsonspanish.com) and is a College Spanish Instructor. Her company’s programs include “Pharmacy Spanish” (approved for 12 hours of ACPE credit), “Court Spanish” (a CE course for legal professionals), “Webspanol” (an online conversational tutorial) and “Uno, Dos, Tres” (A Spanish program for children). All of the programs except “Court Spanish” are offered online at www.handsonspanish.com in multi-media format with video instruction, mp3 audio files, audio CDs and DVDs. She also led the development of 400 hours of Spanish curriculum customized for the Immigration and Customs Enforcements Agents for the Department of Homeland Security. New agents must take and pass the Spanish course in order to proceed with their training.

She lives in Monroe, GA with her husband Chris, and her son, Emery. They are active in their church, are avid travelers and are looking forward to a return journey to Colombia to adopt their second child.

Speaker Disclosure: Mrs. Langston has no conflict of interest with any of the corporations providing financial support for this continuing education activity.

Learning Objectives

1. Identify and practice the correct pronunciation for each vowel in Spanish.

2. Explain why the order of a Spanish speaker's full name can cause labeling and filing errors.

3. Describe general consumer habits of Spanish speakers. 4. Identify common errors in labeling made by

computer-generated Spanish translations.

5. Give accurate and complete directions for use in Spanish.

(4)

Hispanic Demographic Statistics

How much do you know about the U.S. Hispanic Growth?

You can find these and more statistics at www.census.gov.

Hispanic Demographic Statistics

•

About 45 million Hispanics currently live in the

U.S.

•

Hispanics are the nation’s largest minority group.

•

The estimated annual buying power of the U.S.

Hispanic market is 600 billion.

•

The U.S. has the third largest Hispanic

population in the world.

•

There are more Spanish speakers in the U.S. than

in Spain.

Better Serve Your Pharmacy and Your

Patients with Job-Specific Spanish

•

Decrease errors in labeling and filing.

•

Improve customer relations.

•

Increase customer base.

General Consumer Habits of Spanish

Speakers

–Hispanic customers are more loyal to merchants and spend 46% more than the general population. *

–They are more likely to generate word-of-mouth referrals and to persuade others away from stores where they are not treated well and are more passionate in their relationships with brands.**

* Food Marketing Institute Nonprofit Organization www.fmi.org

**Ipsos Study Compares Differences in Opinions about Customer Service and Word of Mouth Between Hispanic and Non-Hispanic Households www.ipsos-na.com

(5)

Filing Errors

•

Let's first focus on filing errors. These occur

frequently with Hispanics because they typically

have two surnames ("last" names).

“¿Cómo se llama usted?

The Spanish naming system

Ella se llama María Teresa Álvarez González.

María Teresa Álvarez González

primer

nombre segundo nombre apellido paterno apellido materno OR apellido del esposo

“¿Cómo se llama usted?

“¿Cuál es su...(fill in with name needed)?” “What is your...”

“¿Cuál es su nombre completo?”

“What is your full name?”

“¿Cómo se llama usted?

•

According to tradition, her name would

become...

María Teresa Álvarez Montalvo.

(6)

“¿Cómo se llama usted?

•

If they have a child...

Hija: Isabel Carolina Montalvo Álvarez. Madre: María Teresa Álvarez Montalvo.

Padre: Juan Carlos Montalvo Garzón.

Hispanic Names

English Spanish

What is your full name? ¿Cuál es su nombre completo? Write it down, please. Escríbalo, por favor. What name do you go by? ¿Qué nombre usa diariamente? What are your last names (if you

want both – the one they say first is the one you will file them under)?

¿Cuáles son sus apellidos?

Is your name spelled correctly here? ¿Es correcto el deletreo de su nombre y sus apellidos aquí? Is this how you’d like your name to

appear? ¿Es como quiere usted que su nombre completo aparezca?

Is this correct? ¿Es correcto?

Here are some phrases in Spanish that will assist you in obtaining the patient's correct name, whether for a new patient or for the purposes of cross-checking an existing patient in the system. Repeat each after me.

Example:

•

Your patient's complete name (as given to you

by her) is:

Elena

Teresa

Camarillo

Ochoa

•

She would be filed under...

Problems Encountered by Spanish Speakers in

Taking Prescription Medications

 One of the most important functions of a pharmacy is to be sure its patients fully understand their prescription directions to increase the likelihood that they will follow them and to decrease the instance of misuse or overdose. This is a tall enough order with English speakers. When we consider that even those Spanish speakers who understand some English may not be able to read it, this task becomes daunting to those pharmacy professionals who don't have a working knowledge of Spanish.

(7)

Problems Encountered by Spanish Speakers in

• In a recent survey, over half of the Spanish-speaking respondents found it "impossible" to fully understand their prescription drugs because of language difficulties.

• 44% of Spanish-speaking participants said they have at one time taken the wrong dosage because they had trouble translating the instructions into Spanish.

• Overall, 17% have performed an activity that they shouldn't have while on their medication.

http://www.transperfect.com

Problems Encountered by Spanish Speakers in

• 28% of those overall surveyed have guessed at the proper dosage to take because they weren't sure what it said.

• 33% of all respondents surveyed have left the doctor's office without being fully clear about their medication.

http://www.transperfect.com

Common Errors in Labeling

• Some pharmacy professionals may utilize an English-Spanish

dictionary to assist in translations. A dictionary is helpful for intermediate to advanced speakers of a language, but it can be quite dangerous for a beginner due to lack of understanding of parts of speech and verb conjugations.

–Example: "I work at CVS." can yield "Yo obra de arte a CVS." Literal translation: I work of art at CVS.

OR "Yo funciono a CVS." Translation: "I operate/function at CVS."

• Translation websites (like Babblefish) cannot take into account the context of a sentence and can sometimes yield highly awkward and sometimes incomprehensible translations.

–Example: "until gone" yields "hasta el pasado" (literal translation: until the past)

Common Errors in Labeling

• Many pharmacy professionals make use of computer-generated

Spanish label translation software.

• Half of computer-generated Spanish prescription labels are either inaccurate or incomplete, according to a study published by the American Academy of Pediatrics. These lead to errors made by patients in following directions for use.

http://pediatrics.aappublications.org/content/early/2010/04/05/peds .2009-2530.abstract

Title of Study "Accuracy of Computer-Generated, Spanish-Language Medicine Labels"Authors: Iman Sharif, MD, MPH, Julia Tse, BAPublication: Official Journal of the American Academy of PediatricsDate: Published online April 5, 2010

(8)

Common Errors in Labeling

• Methods: A survey of all pharmacies in the Bronx, New York, was performed. Selected pharmacies were visited to learn about the computer software being used to generate Spanish medicine labels. Outcomes included the proportion of pharmacies providing Spanish medicine labels, frequency of computerized translation, and description of Spanish medicine labels produced.

Common Errors in Labeling

• Results: Pharmacies that provided Spanish labels mostly commonly (86%) used computer programs to do so; 11% used lay staff members, and 3% used a professional interpreter. We identified 14 different computer programs used to generate Spanish labels, with 70% of pharmacies using 1 of 3 major programs.

• (43%) included incomplete translations (a mixture of English and Spanish) and additional labels contained misspellings or grammar errors, which resulted in an overall error rate of 50%.

Common Errors in Labeling

• Phrases that were not translated included “dropperfuls,” “apply

topically,” “for 7 days,” “for 30 days,” “apply to affected areas,” “with juice,” “take with food,” and “once a day.”

• Deviations included errors such as “by the little” for the translation of the misspelled Spanish word poca (for boca, meaning “mouth”), “two kisses” for the translation of the Spanish phrase dos veces (meaning “two times”), and “eleven times a day” for the translation of the phrase “once a day.”

poca = a little boca = mouth

veces = times besos = kisses

once = eleven

http://pediatrics.aappublications.org/content/early/2010/04/05/peds. 2009-2530.abstract

Common Errors in Labeling

• Conclusions: Although pharmacies were likely to provide medicine labels translated into Spanish, the quality of the translations was inconsistent and potentially hazardous. Unless regulations and funding support the technological advances needed to ensure the safety of such labeling, we risk perpetuating health disparities for populations with limited English proficiency.

http://pediatrics.aappublications.org/content/early/2010/04/05/peds. 2009-2530.abstract

(9)

How to Solve the Problem

• Obviously, there is still a need to serve Hispanic patients with

directions in their first language even though the risk of error is high with translation software.

• An knowledge of job-specific Spanish on the part of pharmacy professionals will help them to proof such translations for errors and to develop a better rapport with their patients.

• Learning how to state some of the most common directions for use in Spanish is a fantastic start. First, we'll do a brief pronunciation overview and then we'll learn components of directions for use in Spanish. It is important that from here until the end of the presentation that you repeat aloud the sounds, words and phrases after me for practice.

Las Vocales - Vowels

Letter: Sound: Example:

a ah mañana (tomorrow) e ay mes (month) i ee libro (book) o oh dolor (pain) u oo computadora (computer) * y ee muy (very)

There is only one way to pronounce each vowel in Spanish. None are silent. Each is always pronounced as follows:

Do not draw out the vowels. Keep them short.

The Pronunciation of Spanish Vowels

•

Practice Activity

How would you pronounce the following?

pulmones medicina

garganta dificultad

diabetes embarazada

La Cantidad / Quantity

English Spanish Pronunciation

one ounce una onza oo-nah own-sah

two ounces, etc. dos onzas dohs own-sahs

...and a half ...y media …ee may-dee-ah

a fourth of... un cuarto de... oon k'warr-toe day…

a third of... una tercera de... oo-nah tare-say-rah day…

a half of... la mitad de... la me-todd day

one tablespoon una cucharada oo-nah koo-cha-rah-dah

two tablespoons dos cucharadas dohs koo-chah-rah-dahs

(10)

English Spanish Pronunciation

one teaspoon una cucharita oo-nah koo-cha-ree-tah

two teaspoons dos cucharitas dohs koo-cha-ree-tahs

one drop una gota oo-nah go-tah

two drops dos gotas dohs go-tahs

English Spanish Pronunciation

one dropperful un gotero lleno oon go-tay-rah yay-no

two droppers full dos goteros llenos dohs go-tay-rahs yay-nohs

one applicator full

un aplicador lleno

oon ah-plee-kah-door

yay-no two applicators

full

dos aplicadores llenos

dohs ah-plee-kah-door-ace

yay-nohs

a liter un litro oon lee-troh

a milliliter un mililitro oon me-lee-lee-troh

a gram un gramo oon grah-ma

English Spanish Pronunciation

a milligram un miligramo oon me-lee-grah-moe

¼ tablet un cuarto de tableta

oon k'warr-toe day tah-blay -tah

½ tablet una mitad de tableta

oo-nah me-todd day

tah-blay-tah

one tablet una tableta oo-nah tah-blay-tah

two tablets dos tabletas dohs tah-blay-tahs

one pill una píldora oo-nah peel-door-ah

two pills dos píldoras dohs peel-door-ahs

one capsule una cápsula oo-nah cop-sue-lah

two capsules dos cápsulas dohs cop-sue-lahs

La Frecuencia / Frequency

English Spanish Pronunciation

once daily una vez al día oo-nah base all dee-ah

twice daily dos veces al día dohs bay-sace all dee-ah

3 times daily tres veces al día trace bay-sace all dee-ah

# times a day # veces al día _#_ bay-sace all dee-ah

every other day /every two days

cada dos días kah-dah dohs dee-ahs

once weekly / once a week una vez a la semana oo-nah base ah la say-ma-nah

(11)

English Spanish Pronunciation

twice weekly / twice a week

dos veces a la semana

dohs bay-sace ah la

say-ma-nah

# times a week # veces a la

semana

_#_ bay-sace ah la

say-ma-nah

until gone hasta que no

hay más

ah-stah kay no

eye mahs

every # hours cada _#_ horas kah-dah # oh-rahs

every 4 hours cada cuatro

horas

kah-da k'wah-troh

oh-rahs

every 6 hours cada seis horas kah-da sace oh-rahs

every 4 to 6 hours

cada cuatro a seis horas

kah-dah k’wah-troh ah

sace oh-rahs

¿Cómo? How?

English Spanish Pronunciation

as directed by your doctor

como dirigido por su doctor

ko-mo dee-ree-he-doe

pour sue doke-tore

as needed for pain

si la necesite para el dolor

see la nay-say-see-tay

pa-rah ale doe-lore

when you have...(pain, etc.) cuando tenga...(dolor de, etc.) k'wann-doe tain-gah…(doe-lore day) only when you

need it

sólo cuando lo necesite

so-lo k'wann-doe lo

nay-say-see-tay

Next, you will need to tell the patient

HOW to take the medicine:

English Spanish Pronunciation

in the morning/ afternoon/ evening por la mañana/ tarde/ noche

pour la mahn-ya-nah /

tar-day /

no-chay

before bedtime antes de acostarse

ahn-tace day

ah-ko-star-say

right now ahora mismo ah-oar-ah meece-mo

by mouth por boca pour bow-kah

English Spanish Pronunciation

with meals con las comidas cone lahs ko-me-dahs

with food con un alimento cone oon ah-lee-main-toe

with food con comida cone ko-me-dah

after meals después de las

comidas

dace-p'wace day lahs

ko-me-dahs

before meals antes de las comidas

ahn-tace day lahs

ko-me-dahs

before breakfast

antes del desayuno

ahn-tace dale

day-sah-you-no

after supper después de la

cena

dace-p'wace day la

(12)

English Spanish Pronunciation

with lunch con el almuerzo cone ale all-m'ware-so

between meals

entre las comidas

ain-tray lahs ko-me-dahs

on an empty stomach

en ayunas ain ah-you-nahs

with water con agua cone ah-g'wah

mixed with food

mezclada con un alimento

mace-klah-dah cone

oon ah-lee-main-toe

mixed with liquids

mezclada con líquidos

mace-klah-dah cone

lee-key-dohs

when you take / eat / drink…

cuando tome... k'wann-doe toe-may

To Obtain the Following Free Resources

go to

www.handsonspanish.com/freece

• An enhanced player version of this presentation with audio.

• Video Series:

The Seven Most Common Spanish Pronunciation Errors Made by English Speakers

• PDF download of the Pharmacy Spanish “Behind the Counter Spanish Cheat Sheet” of common Spanish pharmacy words, their English meanings and an easy pronunciation guide

• mp3 of the audio for the cheat sheet

Preguntas - Questions

We will now begin the Q&A session.

www.handsonspanish.com/freece

www.fmi.org