Lack of Cultural Competence Creates Barriers

Wk4 Instructions:

Go to the link https://www.thinkculturalhealth hhs gov/clas/standards (Links to an external site.).

View the National Culturally and Linguistically Appropriate Services Standards (CLAS) categories aimed at equity and quality care (HHS, n.d.). Notice how these standards overlap with many of the expectations and standards in professional nursing practice!

• In what ways are you and your peers using these standards in your areas of nursing practice?


• Discuss one nursing action you might incorporate to improve cultural competence in your organization.

REQUIREMENTS:

Integrates evidence from assigned reading OR lesson,
Integrates evidence from at least one outside scholarly source,
All sources are credited within the body of the post,
Evidence supports the discussion

Lesson:

Reference:

https://chamberlain.instructure com/courses/81919/pages/week-4-lesson-foundational-concepts?module_item_id=11602093

Nurses as Patient Advocates

Nurses advocate for the health and safety of patient populations from direct patient care to supporting legislation. Advocacy is defined as "using one's position to support, protect, or speak out for the rights and interests of another" (Zolnieriek, 2012, para 1). Many aspects of the ANA Nursing Code of Ethics (ANA 2015b) and Standards of Practice (ANA, 2015a) contain advocacy statements related to this definition. Individual state nurse practice acts also contain language related to our responsibilities as patient advocates. Many state practice standards include statements regarding patient safety.

Look up South Carolina state practice act to review specifics related to patient advocacy!    

Nurses as Advocates for Self and Colleagues

Nurses have often worked in environments with rotating shifts and long hours. Job associated stress leaves nurses vulnerable if the organization is not aware and supportive of areas such as working extended hours (AHRQ, Patient Safety Primer, n.d.). Today, there is evidence that nurses and physicians have work stress "consistently linked to patient safety risks, and some studies show that higher numbers of patients per nurse is correlated with increased risk of burnout among nurses" (AHRQ, Patient Safety Primer, n.d., para. 5).

How can nurses support one another in a work setting to maximize their health and provide exceptional patient care? Some organizations have developed governance councils or committees in an effort to gain input from direct caregivers and managers. This input is often used to improve patient care and work environments (Tomajan, 2012). Participating in surveys or governance groups is an important part of advocating for ourselves and colleagues.

Another method of advocating for colleagues is role modeling professional behaviors. Novice nurses often need experienced guidance when initially practicing. "Modeling positive professional behaviors and helping those new to the profession to acquire these behaviors is a form of advocacy" (Tomajan, 2012, p.4).

Cultural Competence

The founder of transcultural nursing, Madeleine Leininger, is a nurse theorist who developed the Theory of Culture Care Diversity and Universality (Transcultural Nursing Society (TNS), n.d.). Dr. Leininger founded The Transcultural Nursing Society in 1974 (TNS, n.d.). She defined transcultural nursing as "a formal area of study and practice focused on comparative human care (caring) differences and similarity of the beliefs, values, and patterned lifeways of cultures to provide culturally congruent, meaningful, and beneficial health care to people" (TNS, n.d., para.3). Nursing research now includes attention to holism and cultural diversity in healthcare and provides the evidence to support consistent care for all populations, known as cultural competence.

The U.S. Department of Health and Human Services (HHS, 2018) now has a division entitled, Think Cultural Health. This division is devoted to important standards for all healthcare professionals when working with our diverse patient population.

 Book:

Reference:

Association, A. N. (2015). Nursing. [VitalSource Bookshelf]. Retrieved from https://online.vitalsource com/#/books/9781558106215/

 Standard 8. Culturally Congruent Practice

The registered nurse practices in a manner that is congruent with cultural diversity and inclusion principles.

Competencies 

The registered nurse:

► Demonstrates respect, equity, and empathy in actions and interactions with all healthcare consumers.

► Participates in life-long learning to understand cultural preferences, worldview, choices, and decision-making processes of diverse consumers.

► Creates an inventory of one’s own values, beliefs, and cultural heritage.

► Applies knowledge of variations in health beliefs, practices, and communication patterns in all nursing practice activities.

► Identifies the stage of the consumer’s acculturation and accompanying patterns of needs and engagement.

► Considers the effects and impact of discrimination and oppression on practice within and among vulnerable cultural groups.

► Uses skills and tools that are appropriately vetted for the culture, literacy, and language of the population served.

► Communicates with appropriate language and behaviors, including the use of medical interpreters and translators in accordance with consumer preferences.

► Identifies the cultural-specific meaning of interactions, terms, and content.

► Respects consumer decisions based on age, tradition, belief and family influence, and stage of acculturation.

► Advocates for policies that promote health and prevent harm among culturally diverse, under-served, or under-represented consumers.

► Promotes equal access to services, tests, interventions, health promotion programs, enrollment in research, education, and other opportunities.

► Educates nurse colleagues and other professionals about cultural similarities and differences of healthcare consumers, families, groups, communities, and populations.

Additional competencies for the graduate-level prepared registered nurse 

In addition to the competencies of the registered nurse, the graduate-level prepared registered nurse:

► Evaluates tools, instruments, and services provided to culturally diverse populations.

► Advances organizational policies, programs, services, and practice that reflect respect, equity, and values for diversity and inclusion.

► Engages consumers, key stakeholders, and others in designing and establishing internal and external cross-cultural partnerships.

► Conducts research to improve health care and healthcare outcomes for culturally diverse consumers.

► Develops recruitment and retention strategies to achieve a multicultural workforce.

Additional competencies for the advanced practice registered nurse 

In addition to the competencies of the registered nurse and graduate-level prepared registered nurse, the advanced practice registered nurse:

► Promotes shared decision-making solutions in planning, prescribing, and evaluating processes when the healthcare consumer’s cultural preferences and norms may create incompatibility with evidence-based practice.

► Leads interprofessional teams to identify the cultural and language needs of the consumer.

 Standard 14. Quality of Practice

The registered nurse contributes to quality nursing practice.

Competencies 

The registered nurse:

► Ensures that nursing practice is safe, effective, efficient, equitable, timely, and patient-centered (IOM, 1999; IOM, 2001).

► Identifies barriers and opportunities to improve healthcare safety, effectiveness, efficiency, equitability, timeliness, and patient-centeredness.

► Recommends strategies to improve nursing quality.

► Uses creativity and innovation to enhance nursing care.

► Participates in quality improvement initiatives.

► Collects data to monitor the quality of nursing practice.

► Contributes in efforts to improve healthcare efficiency.

► Provides critical review and/or evaluation of policies, procedures, and guidelines to improve the quality of health care.

► Engages in formal and informal peer review processes.

► Collaborates with the interprofessional team to implement quality improvement plans and interventions.

► Documents nursing practice in a manner that supports quality and performance improvement initiatives.

► Achieves professional certification, when available.

Additional competencies for the graduate-level prepared registered nurse 

In addition to the competencies for the registered nurse, the graduate-level prepared registered nurse:

► Analyzes trends in healthcare quality data, including examination of cultural influences and factors.

► Incorporates evidence into nursing practice to improve outcomes.

► Designs innovations to improve outcomes.

► Provides leadership in the design and implementation of quality improvement initiatives.

► Promotes a practice environment that supports evidence-based health care.

► Contributes to nursing and interprofessional knowledge through scientific inquiry.

► Encourages professional or specialty certification.

► Engages in development, implementation, evaluation, and/or revision of policies, procedures, and guidelines to improve healthcare quality.

► Uses data and information in system-level decision-making.

► Influences the organizational system to improve outcomes.

Additional competencies for the advanced practice registered nurse 

In addition to the competencies for the registered nurse and graduate-level prepared registered nurse, the advanced practice registered nurse:

► Engages in comparison evaluations of the effectiveness and efficacy of diagnostic tests, clinical procedures and therapies, and treatment plans, in partnership with healthcare consumers, to optimize health and healthcare quality.

► Designs quality improvement studies, research, initiatives, and programs to improve health outcomes in diverse settings.

► Applies knowledge obtained from advanced preparation, as well as current research and evidence-based information, to clinical decision-making at the point of care to achieve optimal health outcomes.

► Uses available benchmarks as a means to evaluate practice at the individual, departmental, or organizational level.

Standard 15. Professional Practice Evaluation 

The registered nurse evaluates one’s own and others’ nursing practice.

Competencies 

The registered nurse:

► Engages in self-reflection and self-evaluation of nursing practice on a regular basis, identifying areas of strength as well as areas in which professional growth would be beneficial.

► Adheres to the guidance about professional practice as specified in the Nursing: Scope and Standards of Practice and the Code of Ethics for Nurses with Interpretive Statements.

► Ensures that nursing practice is consistent with regulatory requirements pertaining to licensure, relevant statutes, rules, and regulations.

► Uses organizational policies and procedures to guide professional practice.

► Influences organizational policies and procedures to promote interprofessional evidence-based practice.

► Provides evidence for practice decisions and actions as part of the formal and informal evaluation processes.

► Seeks formal and informal feedback regarding one’s own practice from healthcare consumers, peers, colleagues, supervisors, and others.

► Provides peers and others with formal and informal constructive feedback regarding their practice or role performance.

► Takes action to achieve goals identified during the evaluation process.