Interventions to Improve Cultural Competency †MyAssignmenthelp

Question: Discuss about the Interventions to Improve Cultural Competency. Answer: Introduction The aim of this assignment is to point out the factors that influence the type of care provided to the aboriginal individuals. The paper also aims to cover the strategies that would improve the care to the patient coming from diverse cultural and ethnic backgrounds. Global immigration has augmented with times. According to Renzahoet al. (2013), immigration in the past decade has increased from 150 million migrants to 214 million immigrants during the tenure of 2000 to 2010. Such immigration has affected mainly the public sectors like health care since the culture and the ethnicity of the clients and workforce are becoming multifactorious (Markey et al. 2012). This demographical change has its own problems. High differences in the public health status are posing effects on the cultural minority groups negatively and primarily ethnic group (Betancourt et al. 2016). In a multicultural setting, successful delivery of health care is hampered numerous factors, for example, non-verbal commu nication and language gap between care givers and patient, lack of awareness or respect of cultural traditions and institutional as well interpersonal stereotyping and prejudice (Degniet al. 2012). Accordingly, numerous health-care models have been projected for shifting from paternalistic type of health-care system to a self-care approach and involving the patient in the decision making process. Some of the models in this context are the patient-centered care (PCC) models and cultural competence models (CC) (Renzahoet al. 2013). Cultural competence may be considered as the act of being respectful and responsive towards the health care beliefs of a culturally diverse population groups. (Renzaho et al 2013; Barksdale 2009). According to Renzahoet al. (2013), lack of awareness in the domain of cultural differences and lack of knowledge among patients, belonging to culturally different background, bring about adverse health outcomes. These include compromised patientcare giver relation ships and health belief, behaviors and practices of patients. Hence it becomes difficult for both caregivers and patients to achieve the comprehensive health outcome care (Betancourt et al. 2016). The following paragraphs aims to discuss the factors that influence the care provided to the patients belonging to diversified cultural background. In doing this the essay will begin via throwing a brief light on significance of cultural competence in nursing and midwifery practice. Upon discussing the same, the essay will critically discuss the opportunities, barriers and challenges in implementing cultural competence in healthcare. The essay also plans to explore, personal, professional organizational and societal factors that influence the cultural competence care while highlighting the important approaches that can be adopted for improving the cultural competence in health care field. National Center for cultural competence (CC) in the USA has recommended a framework for cultural competence highlighting its requirements of health-care systems. According to Renzahoet al. (2013), CC helps in dodging cultural obstacles between health-care provider and the healthcare consumers and thereby improving the quality of healthcare with patient centered approach. Cultural competence also vouches for effective development of effective communication. It also helps in the growth of the clinical capabilities among the healthcare professionals. This helps in the promotion of the cross-cultural communication among the nurses and midwifery professionals (Douglas et al. 2014). According to Douglas et al. (2014), a nurse uses its cross-cultural communication skills for identifying the values, beliefs, traditions and the unique health care needs of the client and thereby helping to frame person-centered care. Moreover, Betancourt et al. (2016) further highlighted the consequence of cul turally competent nursing care in the domain of hospital setup. Betancourt et al. (2016) is of the opinion that the hospitalized patients and their family members are subjected to numerous stresses. The scenario is extremely evident in critical care, palliative care and emergency unit of the hospital as here the patients suffer from life-threatening situations. Under these circumstances, culturally competent care is strikingly evident. In addition, Betancourt et al. (2016) stated that the absence of cultural awareness and failure to convey culturally proficient care could augment the anxiety level of seriously ill patents and thereby resulting in derisory care or adverse health outcomes. In the domain of providing care to the Muslim-American, Ezenkwele and Roodsari (2013) highlighted important cultural factors that manipulate the delivery of care in the emergency unit. These factors include modesty, role of gender the concept of will of god, the role of the family members, structure of the family, prohibition towards extramarital and premarital sex, special dietary codes, religious cleanliness and praying. Thus, practicing in a culturally competent manner will help to generate cultural awareness among the nurses and thereby helping them to deliver optimal care to the minority population. However, it is imperative to take into consideration the heterogeneity and diversity of the minority inhabitants while employing culturally competent care on an individual basis (Ezenkwele and Roodsari 2013). According to Betancourt et al. (2014) people who belong under the ethnic minority are more susceptible towards developing communicable disease or chronic condition. Patients who are suffering from chronic conditions demand more person-oriented health services and hence increasing their amount of interaction with the healthcare system. If the nursing or other healthcare professionals are not working together to deliver culturally competent care, the patients who are suffering from chronic conditions are more likely to become victim of negative health consequences. This results in complete dissatisfaction in care. For instance, African-American population are reported to undertaking less partnership with the healthcare professionals, less participation in medical decision-making a nd lower level of satisfaction under the care plan (Betancourt et al. 2014). Furthermore, reports published by Betancourt et al. (2014) highlighted that Asian Americans, Latinos and African-Americans are more likely to generate nurture a thought that they could have enjoyed a better care support had been of a different race or ethnicity. Nevertheless, according to Barksdale (2009), there is a major problem that, there is not adequate provides in the health care domain to procure culturally competent care to the ethnic minority group and thus creating controversy towards culturally competent care. Dauvrin and Lorant (2015) have recommended that culturally competent care model can be implemented among the healthcare professionals via strong leadership characteristics. Because,proper leadership models affect the social relationships, and this helps in implementing and developing care (Dauvrin and Lorant 2015). Approaches that focus on expand in knowledge about numerous groups, especially through a list of common health behaviors and beliefs and principal dos and donts provide the main starting point for the healthcare professionals to know more about the nature of health practices of a particular ethnic group (Truong et al. 2014). This approach leads to the generation of stereotypes and may ignore the variation that exists within the groups. To illustrate, Barksdale (2009) highlighted that the African Americans are taught never to disclose their personal or health related matters or their weak points to the white people and this create a societal challenge in procuring culturally competent care. Correspondingly, personal challenges, which are highlighted by Barksdale et al. (2009) under the domain of culturally competent care, include fear or unwillingness to learn new culturally competent care model and to provide a new approach and bias approach of providers, as they are unmotivated towa rds providing culturally competent care. Likewise, In the domain of organizational challenges, there occurs certain sort of miscommunication between the administrative authority and patient family members towards providing competent care (Barksdale et al. 2009). Here comes the importance of the opportunity of cultural competence as it allows generating an approach that is capable to addressing the cultural needs of diverse ethnic communities. For example, skills such as effective communication and procedure to recording medical history can be applied to a wide variety of clientele and thereby enabling them to participate within the decision-making process (Truong et al. 2014). According to Markey et al. (2012), in Ireland, there is no necessity for addressing the lack of cultural awareness that results out of unintended prejudices, which occurs as insensitivity and unawareness. It stems in socialized behaviors and attitudes enacted through systemic practice. Learned behavior and rooted morals should be challenged for addressing the stereotyping and unwitting prejudices. Noticeably, the study conducted by Suk et al. (2018) showed that the culturally competent care model is also crucial for the visiting nurses. In their study conducted in Korea, it showed that the culturally competent care approach is deficient among the visiting nurses. Since Korea nurture multicultural population, more qualified and culturally competent nurse is crucial for procuring effective care. They recommended regular organized instruction on culturally sensitive care that would be supportive for the visiting nurses for procuring culturally sensitive nursing care (Suk et al. 2018). On the contrary, there is constant refutation inside Irish healthcare setting for acknowledging the insensitive practices as racist. Markey et al. (2012) suggested that defiance of racist practice is a worldwide issue, and this is the major challenge in the domain of comprehensive implementation of cultural competence in healthcare. Racing in nursing is however, denied or avoided as nursing is euphemized as debated construct that conceptualize nurses as caring professionals. Nonetheless, under the Irish context, fighting against denial of racism is difficult because the Irish population mostly feels boastful about themselves for having a welcoming culture, which might curb the acknowledgement and confrontation of racism (Markey et al. 2012). Irish political and social debates have been unenthusiastic for employing the term racism for describing the fanaticism and prejudices experienced by the ethnic minorities in Ireland and this impose a challenge towards culturally competent nursin g care. Additionally, Irish population has a fascination towards the term xenophobia or fear form the strangers in order to describe the minority class and their intolerance and prejudice. Markey et al. (2012) have further opined that this tendency of the Irish population towards describing the term racism in a new way is actually protecting the concept of discrimination and thus creating challenge to focus on culturally competent care. Factors influencing culturally competent care Personal factors are the attributes that contributes to the cultural competence among the individual nurses. (Arieliet al. 2012). Firstly,ethnocentricityis one of the main factor which influence the cultural competent care. Ethnocentricity among the health care professionals can be defined as the belief of his/ her own culture and ethnic group being superior and the other cultures are just reference to them (Oelkeet al. 2013). This concept had been found to be responsible for patient alienation, misdiagnosis and inadequate treatment. According to Renzahoet al. (2013) there had been a strong inverse relationship between cultural competence and ethnocentricity. In order to overcome the ethnocentrism, it is necessary to have an open mind, engage himself in society- integrated activities and absorb new information from different cultures. Secondly, Cultural awareness: People of different cultures have different health beliefs, practices and values. One of the cultural issues that can arise in the nurses involves religious beliefs and faith (Galanti 2014). Certain religious groups may refuse prescribed medications and depend more on bush medicines. Cultural awareness also helps the nurses to give treatment regardless of the gender differences, although the nurses have to remain aware of the gender differences as different cultures have different needs (Loftin et al. 2013). Cultural awareness in nursing can be increased by building up the cultural knowledge, encouraging discussions and by celebrating the diversity. Thirdly,assessment of the cultural heritage is important to give a patient centered care. It provides the nurses an in-depth knowledge of the patients belief about diseases and sicknesses (Kirmayer 2012). A nurse trying to preserve her own cultural heritage may be unsuccessful in delivering care to a patient of complete different cultures. The study of the cultural heritage helps the nurses to study the patient as a whole, how the family clings to their cultural beliefs, and the extent of their superstitions. To exemplify, in a certain tribe, the woman in the post-partum period is provided with roots and herbs for the contraction of the uterus for delivering the baby. Similarly, many tribes believed in the effectiveness of the complementary therapies like acupuncture and aromatherapies (Kirmayer 2012). Moreover, Nurses having an understanding of the cultures can prepare treatment plans using their traditional methods. The nurses can preserve cultural heritage by acts such as sharing of different cultural information and tradition for better understanding. Besides nurses should be committed to the patients irrespective of their race, ethnicity, cultural beliefs, traditions and gender differences (Galanti 2014). This can be achieved by practicing different course of ethics, self-reflective practices and clinical reasoning. Finally, Courage is one of the fundamental values of the nurses and the midwives in giving a culturally competent care. Courage is important in nursing practice for safeguarding the people who are vulnerable or raising concerns about the concerns of care such as those with mental health problems, women, children, LGBTQ community (Peiyinget al. 2012). To exemplify, people with psychotic disorders are often stigmatized in the society and the health care professionals often have to become the victims of violence, still their focus always remains to provide a comprehensive and rational care to the patients (Oelkeet al. 2013). Loftin et al. (2013) have argued for the requirement to foster courage in nurses such that the nurses are ready for making any change. The LGBTQ community has always been the victim of social stigma and shame. Hence, nurses should be courageous enough to move beyond the society and provide them care (Fredriksen-Goldsen et al. 2013). Personal risk-taking practices ca n help out the nurses to develop the sense of courage among the nurses. Education:The nurse educators face several challenges in teaching cultural competence in nursing. A nurse without a proper education would not develop the sense of cultural sensitivity or awareness towards other ethnic groups. This thought would jeopardize the care provided to the patients. Education helps a nurse to avoid all the cultural and the gender differences. It provides them with the ethics of beneficence, maleficence and to understand that, it is the patient that come above all interests.Therefore, it is necessary to develop a sound educational foundation regarding the diverse ethnic and the cultural groups(Delgado et al. 2013). Professional regulatory bodies:The Nursing and the midwifery board of Ireland is the regulatory body for the nurses for setting out standards for the education and the professional conduct of the nurses. The codes of conduct published by this organization contain the instructions that ever nurse should withheld in order to enhance the professional career in nursing and to gather skills of cultural safety practices. It is of no doubt that autonomy and accountability is the main ingredient of nursing (Zamanzadehet al. 2013). The different organizational factors that affect the nursing are the workload. Excess workload in nursing can bring burn out and fatigue among the nurses. Secondly, in an organization the professional nurses should be in a position to perceive all the resources to meet the work demands. Proper distribution of the workloads, financial management of the hospital resources and motivation from the managers can help the nurses to cope up with the organizational factors (Barksdale et al. 2009). Leadership:Health care delivery often requires a multidisciplinary care approach where the patient safety depends on each members of the team. For the nurse, being culturally competent is not sufficient. The nurses need to use their own expertise in order to provide a culturally competent care (Delgado et al. 2013). Leadership in the nurses can be based upon positive norms and negative norms. Positive norms in the nurses helps to integrate the concept of cultural competence into their daily practice, whereas the negative norms help the nurses to provide develop a negative perception of intercultural care. A leader nurse fostered with the concept of cultural competence can describe the cultural competence among the health care leaders and the staffs (Galanti 2014). Mission, vision and values:The values of the nurses help them to deliver culturally competent care. A nurse is imbibed with the knowledge of cultural care if the patient treats others with dignity by recognizing and valuing diversity. Delgado et al.(2013) have stated that it is the core values of nursing that helps the nurses to take decisions while caring for the patients with diverse cultural background. The mission of encouraging others to contribute to their full potential for providing support and training to the nurses provides the base for the cultural competency (Galanti 2014). Some of the other missions include engagement in the ongoing learning activity in order to increase the professional effectiveness regarding inclusion and diversity (Harding 2013). Nowadays a nurse is an educator, manager and client advocate. Society knows that a caring nurse can provide solace and comfort to someone in need. Loftin et al. (2013) have identified four categories of patient perception about the nursing care that is supervising individual patient, explaining, responding and watching over. In most cases, the public image of nursing involves low social status, and is experts in doing domestic activities, but the perspectives of the public are changing (Flodgrenet al. 2012). They are found to be honest and ethical. They are a professional with 24x7 involvements. These changed perceptions create a pressure upon the nurses for meeting their standards. Nurses thrive more for their interpersonal development. Interventions regarding the improvement of the cultural competency involve the improvement of the accessibility and effectiveness of appropriate health care for the people from different ethical and racial minority by augmenting knowledge, awareness and the skills of the health care providers as well as altering the policies. The interventions can be taken at the patient- client level or the organizational levels. Galanti(2014) have found that culturally relevant strategies have brought about glycemic control amongst the African- American woman having type 2 diabetes. According to Kratzke and Bertolo (2013) there are some major factors, which should be focused on for example, language. Gender matched, culturally and linguistically appropriate interpretation should be provided for avoiding any miscommunication between the patient and the caregiver. There are professional interpreters that provide hand on supports and personal aids (Holland 2017). Another factor is the availability of proper insurances for the people, particularly for the vulnerable groups having low literacy level, or those living in the remote areas and cannot afford transportation needs (Hernandez and Kose 2012). Some culture supports care to be provided by the same gender as the patient. Hence, if possible the caregivers should be gender matched. Respect of modesty is another step towards providing culturally safe care. Touching of the private parts may be termed as disrespectful for a woman patient (Galanti 2014). Significantly, provision of a chaperon in the examination room is essential regardless of the gender. It is necessary to be cognizant of the traditions of a culture as they may influence pregnancy, antenatal care (Varaeiet al. 2012). It is necessary to be aware of the autonomy of the women against any religious practices. Anticipatory care and guidance, counseling and education should be provided to patient. Provision of multidisciplinary team i s required for supporting the women health, in particular, the provision of caseload midwifery during pregnancy (Hernandez and Kose 2012). Develop attitudes allied with exceptional transcultural care: By developing certain fundamental attitudes such as empathy, openness, caring and flexibility will aid to deliver culturally sensitive care Create an awareness of the impact culture has on the beliefs, values, and practices of the patient and the nurses Acquire general knowledge about patients cultures Complete cultural assessment on admission: Assess patients medical history, physical status, and activity level, as it is essential to develop personalized care plan for the patient. Perform nutrition assessment, medication assessment, pain assessment and psychosocial assessment which indeed helps the nurses to deliver patient centred care (McCalmanet al. 2017). Moreover, audit and quality improvement approaches play a crucial role in developing culturally competent care. These approaches were applied across various healthcare facilities and resulted in better-quality relationships with local peoples, improved health service availability and occurrence of hospital visits, and the improved participation of clients and their relatives in their own healthcare and eventually enhanced CC care. Besides, introducing Cultural Competency Assessment Tool for Hospitals (CCATH) is an option to evaluate hospital performance in cultural competency and recognize enhancements. Additionally, an organization can develop culturally competent care by identifying social factors, recruting aboriginal staff, making a friendly service, supporting access through transport and assimilating cultural practice (McCalmanet al. 2017). To Conclude, cultural competency is a popular approach for providing a culturally safe care to the patients. Cultural safety had always been an essential tool while dealing with patients with different cultural background and respond to them accordingly. The report has focused on the role of cultural safety in the nursing and the midwifery practice. It had also focused on the opportunities and the challenges in implementing cultural competence in health care. The essay had focused on the concepts such as racism and discrimination in nursing practice. Cultural awareness nurses help them to understand the culture, help the patients form making accommodations and may be work around with traditional treatment plans. There are several barriers in maintaining cultural safety such as the social perception and the stigma. The credit lies in abandoning all the stigma and step beyond the conventional practices. The report could also describe about the role of different personal, professional a nd organizational factors that can influence the nursing actions. 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