Standards of Practice for Culturally Congruent Nursing Care Larry Purnell, PhD, RN, FAAN Emeritus Professor: University of Delaware Funded Professor: Universita di Modena, Italy Adjunct Professor: Florida International University Consulting Faculty: Excelsior College

Committee Members American Academy of Nursing *Expert Panel on Global Nursing *Expert Panel on Cultural Competence *Transcultural Nursing Society *All members of the committee have extensive global health care experiences.

Committee Members Marilyn K. Douglas, DNSc, RN, FAAN: University of California, San Francisco Joan Uhl Pierce, PhD, RN, FAAN: Pierce & Associates Nursing Consultants Marlene Rosenkoetter, PhD, RN, FAAN: Medical College of Georgia Lynn Clark Callister, PhD, RN, FAAN: Brigham Young University Marianne Hattar-Pollara, DNSc, RN, FAAN: Azusa Pacific University Jana Lauderdale, PhD, RN: Vanderbilt University Jeri Milstead, PhD, RN, FAAN: University of Toledo Deena A. Nardi, PhD, PMHCNS-BC, FAAN: University of St. Francis Dula Pacquiao, EdD, RN, CTN: University of Medicine and Dentistry of New Jersey Larry Purnell, PhD, RN, FAAN

Purpose Establish a set of guidelines to initiate global discussion for the practice of culturally competent nursing care in Clinical Practice Education Administration Research

Review of the Literature ~ 50 documents of International origins Examples International Council of Nurses Hospital Accreditation Agencies Government Agencies National Nursing Organizations, ex. New Zealand, Australia, UK, & others

Social Justice Professional nurses shall promote social justice to attain racial and ethnic equality for all. The applied principles of social justice guide nurses’ decisions related to the patient, family, community, as well as to other health care professionals. Nurses will develop leadership skills to advocate for socially just policies.

Critical Reflection Nurses shall engage in critical reflection of their own values, beliefs, and cultural heritage in order to have an awareness of how these qualities and issues can impact culturally congruent nursing care. Use of self-reflection.

Transcultural Nursing Knowledge Nurses shall gain an understanding of the perspectives, traditions, values, practices, and family systems of culturally diverse individuals, families, and communities for whom they care. Nurses shall gain a knowledge of the complex variables that affect the achievement of health and well being.

Cross Cultural Practice Nurses shall use Cross-cultural theories, knowledge, and culturally-competent skills in order to implement culturally congruent nursing care.

Health Care Systems & Organizations Health care organizations shall Provide the structure and resources necessary to evaluate and meet the cultural and language needs of their ethnically diverse clients.

Patient Advocacy and Empowerment Nurses shall recognize the effect of healthcare policies, delivery systems, and resources on their patients.. Nurses shall empower and advocate for their patients. Nurses shall advocate for the inclusion of patients’ cultural beliefs and practices in all dimensions of their healthcare.

Multicultural Workforce Nurses shall be activists in the global effort to ensure a representative multicultural workforce in health care settings.

Education and Training Nurses shall be educationally prepared to deliver culturally congruent health care through use of Standards of practice that guide knowledge and skills necessary for the inclusion of culturally congruent care that are mandated in global heath care agendas through: formal education clinical training continuing education

Communication Nurses shall use effective, culturally competent communication that takes into consideration each client’s verbal language non-verbal (del cuerpo) language cultural values perceptions

Cross Cultural Leadership Nurses shall have the knowledge and ability to influence individuals, groups and systems to achieve satisfactory outcomes of cultural competent care for diverse populations.

Policy Development Nurses shall have the knowledge and skills to work with government and non-government organizations, professional associations, and local communities in order to establish policies and standards for comprehensive implementation and evaluation of cultural competent care.

Evidence-Based Practice & Research Nurses shall base their practice on interventions that have been systematically tested and shown to be the most effective for the culturally diverse populations that they serve. In areas where there is a lack of evidence of efficacy, nurse researchers shall investigate and test interventions that may be the most effective in reducing the racial and ethnic inequalities in health outcomes.

Kofi Annan former UN Secretary-General “Borders can no longer be boundaries” Kofi Annan former UN Secretary-General

Culturally Competent Is this term an accurate or “appropriate” description of this concept? Culturally competent, culturally congruent, culturally appropriate, culturally safe, etc.

The Standards Are they relevant to your nursing practice? Could you implement them as currently presented? Challenges? What resources would you need to implement these standards?

Reference Douglas, M.K., et al. 2009. Commentary. Journal of Transcultural Nursing, (20 )3,257-269. Publications. http://icn.sagepub.com hosted at: http://online.sagepub.com