The purpose of this Ruth L. Kirschstein National Research Service Award (NRSA) Individual Pre-Doctoral Fellowship in Nursing Research (F31) application is to provide research training for Ms. Ahrens, a third-year doctoral student at the University of Washington School of Nursing. The long-term goal of this training is for Ms. Ahrens to develop into an influential independent researcher in a research-intensive academic setting with a research focus on improving Intensive Care Unit (ICU) delirium prevention and management for patients who speak a language other than English (LOE) to improve health equity for LOE patients in critical care. ICU delirium is a consequential sequela of critical illness that affects up to 70% of ICU patients and is associated with increased length of stay, hospital costs, and risk of death. The primary preventative and mitigation strategy for ICU delirium is the ABCDEF bundle, which includes: Assess and treat pain; Both spontaneous awakening trial and breathing trial; Choice of sedation; Delirium assessment; Early mobility; and Family engagement. Due to a language barrier, LOE critically ill patients may be at increased risk of not receiving full ABCDEF bundle components, as four out of the six bundle components are reliant on effective communication for task completion and accurate assessments. Previous literature finds that professional medical interpreters are used less than 20% of the time when they are necessary in medical settings. Critically ill patients have additional barriers to professional medical interpreter use, and additional tools to facilitate cross-language communication are needed. The contributors to health disparities for LOE patients in ICU delirium care have not been previously studied. To address this gap, the proposed study will use qualitative and mixed-methods implementation science design to investigate determinants of fidelity to the ABCDEF bundle for LOE critically ill patients, guided by the health equity implementation framework and the implementation fidelity framework. Aim 1 of the study will qualitatively assess the facilitators and barriers to ABCDEF bundle fidelity for LOE patients from 32-48 key stakeholders in ICU delirium prevention, including healthcare workers who implement the ABCDEF bundle in the ICU at the University of Washington Medical Center and LOE ICU survivors who received ICU delirium prevention care. Aim 2 of the study will assess the feasibility, acceptability, and appropriateness of the VidaTalkTM application as a method to enhance communication between healthcare workers and linguistically diverse patients while performing ABCDEF bundle tasks. The findings from this study and associated training will provide foundational knowledge to generate a program of independent research for Ms. Ahrens with the goal of improving health equity for LOE patients in critical care.