Creating Culturally Competent in Health Care Organizations
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Nursing Culture Wk 9 DQ
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Read chapter 9 of the class textbook and review the attached PowerPoint presentation. Once done present an analysis of the following case study answering the questions below.
Mrs. Li Huan, a 79-year-old Chinese American widow who lives alone in New York City’s Chinatown recently had a cerebrovascular accident (CVA) or stroke. Mrs. Li has right-sided paralysis with partial loss of voluntary movement and sensation in her right arm and leg. Mrs. Li has weak facial muscles, difficulty with speech, and drooling. She experiences numbness and tingling in her arms and legs. Mrs. Li is going to a rehabilitation center known for delivering culturally competent interprofessional care where she is cared for by a team of credentialed health care providers: Dr. Indira Patel, nurse J.J. Johnson, physical therapist Mohammad Abu Said, dietician Maria Gonzalez, and Chinese American herbalist, Chen Minzhe.
(Note: In traditional Chinese culture, a person’s last name or surname is written first, followed by his/her first name. Therefore, the patient’s last name is Li and the herbalist’s last name is Chen. It is proper etiquette to call a person of Chinese background by his/her title, in this case, Mrs. Li and Mr. Chen until the individual gives you permission to use his/her first name. To further confuse matters, many acculturated Chinese Americans are likely to reverse their first and last names in the typical US or Canadian order. Therefore, it is important to ask the patient, “What is your first name? What is your last name?” Note the correct order on the patient’s chart for other members of the team.)
- How do members of the interprofessional team assess Mrs. Li’s literacy, diet, and medications, including herbal medicines being provided by her herbalist, Mr. Chen?
- How do the nurse and other members of the team determine if complementary or integrative treatments, such as medicinal herbs, are helpful, harmful, or neutral to Mrs. Li’s recovery?
- If you were seeking advice or consultation from a traditional Chinese herbalist in your community, how would you locate one?
- Why do patients seek treatment from alternative and integrative healers?
- How can credentialed health care providers work collaboratively with Mr. Chen to ensure that prescription medicines and herbs are compatible and that there are no adverse or harmful interactions between various medicines?
- What strategies would you recommend in promoting Mrs. Li’s optimum functioning and health following her CVA? (Andrews & Boyle, Transcultural Concepts in Nursing Care, 7th Edition).
A minimum of 2 evidence-based references besides the class textbook no older than 5 years must be used (excluding the class textbook). You must post two replies to any of your peers on different dates sustained with the proper references no older than 5 years as well and make sure the references are properly quoted in your assignment. A minimum of 800 words is required. Please make sure to follow the instructions as given and use either spell-check or Grammarly before you post your assignment.
Please check your assignment after the week is due because I either made comments or ask for clarification in some statements.
Due dates: Assignment – Wednesday, March 4, 2020, @ 11:59 PM in the discussion tab of the blackboard, and SafeAssign exercise in the assignment tab of the blackboard.
Chapter 9:
Creating Culturally Competent Health Care Organizations
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6 Wolters Kluwer Health | Lippincott Williams & Wilkins
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Defining a Culturally Competent Health Care Organization #1
A culturally competent organization is an organization that provides services that are respectful of and responsive to the cultural and linguistic needs of the clients they serve.
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Defining a Culturally Competent Health Care Organization #2
Cultural competence includes providing respectful care that is consistent with cultural health beliefs of the clients and family members, with consideration of:
Age, culture, ethnicity, gender, language, race, religion, sexual preference, and socioeconomic status
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Question #1
Is the following statement true or false?
To be culturally competent, an organization should provide respectful care that is consistent with cultural health beliefs of the clients, family members, and staff.
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Answer to Question #1
True
Rationale: Humans need care to survive, thrive, and grow. According to Leininger (1996), organizations need to incorporate universal care constructs, including respect and genuine concern for clients and staff.
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The Need for Culturally Competent Organizations: External Motivations
The need for culturally competent organizations has been recognized by many external agencies, including:
Transcultural Nursing Society (TCNS)
American Nurses Association (ANA)
Sigma Theta Tau International (STTI)
American Organization of Nurse Executives (AONE)
The Joint Commission
The Institute of Medicine (IOM)
National Standards for Culturally and Linguistically Appropriate Services in Health Care (CLAS Standards)
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The Need for Culturally Competent Organizations: Eliminating Health Disparities #1
Racial and ethnic disparities influence unequal health care treatment.
Disparities in health are “differences in the incidence, prevalence, mortality, and burden of diseases and other adverse health conditions that exist among specific population groups in the United States” (National Institutes of Health, 2010).
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The Need for Culturally Competent Organizations: Eliminating Health Disparities #2
Key factors in achieving good health outcomes include:
Access (getting into the health care system)
Quality care (receiving appropriate, safe, and effective health care in a timely manner)
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Question #2
Which of the following would support Access and Quality of Care issues in eliminating health disparities?
Universal health care
Organizational culture
Joining TCNS
External auditing of health care organizations (e.g., Joint Commission)
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Answer to Question #2
B. Organizational culture
Rationale: Organizational culture is one area that may influence both cultural competence and health disparities. Individuals must deliver culturally competent health care that focuses on risk reduction, vulnerability reduction, and promotion and protection of human rights.
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Assessing Organizational Culture #1
Organizational culture: the goals, norms, values, and practices of an organization in which people have goals and try to achieve them in beneficial ways.
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Assessing Organizational Culture #2
An organization’s culture:
Consists of shared beliefs, assumptions, perceptions, and norms leading to specific patterns of behaviors
Results from an interaction among many variables including mission, strategy, structure, leadership, and human resource practices
Is self-reinforcing; once in place, it provides stability and changes are resisted by organizational members
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Assessing Organizational Culture #3
An inclusive workplace is characteristic of a caring organization.
Inclusive workplaces:
Encourage members of the workforce to become active in the community and participate in state and federal programs
Draws staff members who are committed to cultural competence and who value diversity and mutual respect for differences
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Assessing Organizational Culture #4
Assessment tools:
The Magnet Hospital Recognition Program for Excellence in Nursing Services
Evidence-based practice
Leininger’s culture care model
Andrews’ assessment tool
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Building Culturally Competent Organizations #1
Specific areas are critical to fostering culturally competent health care organizations:
Governance and administration
Board members, mission/vision/values, budget
Internal evaluation of adherence to cultural competence standards
Availability, accessibility, affordability, acceptability, and appropriateness
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Building Culturally Competent Organizations #2
Fostering culturally competent health care organizations :
Staff competence
Organizational support, orientation, and ongoing education
Physical environment of care
Assessment of environment and barriers
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Building Culturally Competent Organizations #3
Fostering culturally competent health care organizations (cont.):
Linguistic competence
Complete, accurate, timely, unambiguous, and understood by the patient
Community involvement
Partnerships
Culturally congruent services and programs
Implement effective programs
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Question #3
Is the following statement true or false?
Building culturally competent organizations may result in increased patient satisfaction rates.
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Answer to Question #3
True
Rationale: Research found that inpatients reported higher satisfaction with hospitals that had greater cultural competency.
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Overcoming the Barrier of Institutional Racism in Health Care
Institutional racism is defined as differential access to goods, services, and opportunities based on race, including differential access to health insurance.
More often done unintentionally.
Cultural differences must be acknowledged and celebrated.
The strategies outlined build culturally competent health care organizations.
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