1. 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

2. 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.

3. 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

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

5. 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

6. 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.

7. 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.

8. 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.

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

10. 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.

11. 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.

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

13. 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

14. 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

15. 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.

16. 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.

17. 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.

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

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

20. 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?

21. Reference Douglas, M.K., et al. 2009. Commentary.
Journal of Transcultural Nursing, (20 )3,
Publications.
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