Standards of Practice for

Culturally Congruent Nursing Care

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Larry Purnell, PhD, RN, FAANEmeritus Professor: University of DelawareFunded Professor: Universita di Modena, ItalyAdjunct Professor: Florida International UniversityConsulting 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.

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Committee Members

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Marilyn K. Douglas, DNSc, RN, FAAN: University of California, San FranciscoJoan Uhl Pierce, PhD, RN, FAAN: Pierce & Associates Nursing ConsultantsMarlene Rosenkoetter, PhD, RN, FAAN: Medical College of GeorgiaLynn Clark Callister, PhD, RN, FAAN: Brigham Young UniversityMarianne Hattar-Pollara, DNSc, RN, FAAN: Azusa Pacific UniversityJana Lauderdale, PhD, RN: Vanderbilt UniversityJeri Milstead, PhD, RN, FAAN: University of ToledoDeena A. Nardi, PhD, PMHCNS-BC, FAAN: University of St. FrancisDula Pacquiao, EdD, RN, CTN: University of Medicine and Dentistry of New JerseyLarry 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

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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

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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.

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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.

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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.

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Cross Cultural Practice

Nurses shall use Cross-cultural theories, knowledge, and

culturally-competent skills in order to implement culturally congruent nursing care.

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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.

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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.

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Multicultural Workforce

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

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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

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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

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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.

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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.

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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.

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

General

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Culturally Competent

Is this term an accurate or “appropriate” description of this concept?

Culturally competent, culturally congruent, culturally appropriate, culturally safe, etc.

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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?

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ReferenceDouglas, 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

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