GUIDELINES FOR THE PRACTICE OF

CULTURALLY COMPETENT NURSING CARE

 A SET OF GUIDELINES FOR IMPLEMENTING CULTURALLY COMPETENT NURSING
CARE WAS RECENTLY DEVELOPED BY A TASK FORCE CONSISTING OF MEMBERS
OF THE AMERICAN ACADEMY OF NURSING (AAN) EXPERT PANEL ON GLOBAL
NURSING AND HEALTH AND THE TRANCULTURAL NURSING SOCIETY (TCNS)
 KNOWLEDGE OF CULTURES
 EDUCATION AND TRAINING IN CULTURALLY COMPETENT CARE
 CRITICAL REFLECTION
 CROSS- CULTURAL COMMUNICATION
 CULTURALLY COMPETENT PRACTICE
 CULTURAL COMPETENCE IN HEALTH CARE SYSTEMS AND ORGANIZATIONS
 PATIENT ADVOCACY AND EMPOWERMENT
 MULTICULTURAL WORKFORCE
 CROS- CULTURAL LEADERHIPS
 EVIDENCE-BASED PRACTICE AND RESEACH
CULTURAL COMPETENCE

CATEGORIES OF CULTURAL COMPETENCE

 INDIVIDUAL CULTURAL COMPETENCE
REFERS TO THE CARE PROVIDED FOR SN INDIVIDUAL CLIENT BY ONE OR MORE
NURSES , PHYSICIAN, SOCIAL WORKERS, AND OTHER HEALTH CARE , EDUCATION
OR SOCIAL SERVICES PROFESSIONALS.
 ORGANIZATIONAL CULTURAL COMPETENCE
FOCUSES ON THE COLLECTIVE COMPETENCIES OF THE MEMBERS OF AN
ORGANIZATION AND THEIR EFFECTIVENESS IN MEETING THE DIVERSE NEEDS OF
THEIR CLIENT, PATIENTS, STAFF AND COMMUNITY.
 CULTURAL BAGGAGE- REFERS TO THE TENDENCY OF PERSON’S OWN CULTURE
TO BE FOREMOST IN HIS /HER ASSUMPTIONS, THOUGHTS, WORDS AND
BEHAVIOR.
CULTURAL SELF-ASSESSMENT

 THE PURPOSE OF CULTURAL SELF-ASSESSMENT IS FOR NURSES TO CRITICALLY REFLECT ON

THEIR OWN CULTURALLY BASED ATTITUDES, VALUES, BELIEFS AND PRACTICES AND GAIN
INSIGHTS INTO AND AWARENESS OF THE WAYS IN WHICH THEIR BACKGROUND AND LIVED
EXPERIENCES HAVE SHAPED AND INFORMED THE PERSON THE NURSE HAS BECOME TODAY.
BARRIERS
 BIAS
 ETHNOCENTRISM
 RACISM
 CULTURAL IMPOSITION
 CULTURAL STEREOTYPE
 PREJUDICE
 DISCRIMINATION
EXAMPLES OF “-ISMS” BASED ON
PRECONCEPTIONS
CHARACTERISTICS TYPE OF –ISM
RACE RACISM
ETHNICITY ETHNOCENRISM
NATIONAL ORIGINNATIONALISM
SOCIOECONOMIC CLASS CLASSISM
GENDER SEXISM, FEMENISM
SEXUAL ORIENTATION HOMOPHOBISM
DISABILITY ABLEISM
RELIGION ISLAMISM, ANTI-SEMITISM(ANTI-JEWISH)
POLITICAL OPINION ANTI-(NAME OF IDEOLOGY) ANTI- COMMUNISM, ANTI-CAPITALISM
SIZE SIZEISM
CULTURAL ASSESSMENT OF CLIENTS

 CULTURAL ASSESSMENT- A TERM THAT REFERS TO THE COLLECTION OF DATA

ABOUT THE CLIENTS HEALTH STATE.
TWO MAJOR CATEGORIES
1. SUBJECTIVE DATA
2. OBJECTIVE DATA
 EMIC
 ETIC
CROSS CULTURAL COMMUNICATION

 BASED ON KNOWLEDGE OF MANY FACTORS, SUCH AS THE OTHER PERSON‘S

VALUES, PERCEPTIONS, ATTITUDES, MANNERS, SOCIAL STRUCTURE, DECISION
MAKING PRACTICES, AND UNDERSTANDING OF HOW MEMBERS OF GROUPS
COMMUNICATE BOTH VERBALLY AND NON VERBALLY.
 INDIVIDUAL CULTURAL COMPETENCE
 CULTURAL DIVERSITY
REFERS TO THE CLIENT’S UNIQUENESS IN THE DIMENSIONS OF RACE , ETHNICITY,
NATIONAL ORIGIN, SOCIO ECONOMIC BACKGROUND, AGE, GENDER, SEXUAL
ORIENTATION, PHILOSOPHICAL AND RELIGIOUS IDEOLOGY, LIFESTYLE, LEVEL OF
EDUCATION, LITERACY, MARITAL STATUS, PHYSICAL, EMOTIONAL, AND PSYCHOLOGIGAL
ABILITY, POLITAC IDEOLOGY, SIZE, OR OTHER CHARACTERISTICS USED TO COMPARE OR
CATEGORIZE PEOPLE.
1. ASSESSMENT 2.MUTUAL GOAL SETTING 5. EVALUATION OF CARE PLAN
CULTURAL SELF ASSESSMENT 3. CARE PLANNING AND OBJECTIVES BY CLIENT
 SELF REFLECTION (BIASES, CULTURAL 4. IMPLEMENTATION AND TEAM
 STEROTYPES,PREJUDICE,DISCRIMINATION) ( IN COLLABORATION WITH SAFE?
 SELF LOCATION( CULTURAL, GENDER, CLASS CLIENT AND TEAM OF ACCEPTABLE ?
AND OTHER SELF IDENTITIES) CREDENTIALED FOLK CULTURALLY CONGRUENT?
 PSYCHOMOTOR SKILLS TRADITIONAL, RELIGIOUS, CULTURALLY COMPETENT?
CLIENT CULTURAL ASSESSMENT AND SPIRITUAL HEALERS) AFFORDABLE?
 HEALTH HISTORY (SUBJECTIVE DATA) ACCESSIBLE?
 PHYSICAL EXAMINATION QUALITY?
(OBJECTIVE DATA) EVIDENCE BASED?
BEST PRACTICES
ORGANIZATIONAL CULTURAL
COMPETENCE
A DEFINE SET OF VALUES AND PRINCIPLES AND DEMONSTRATION OF BEHAVIORS,
ATTITUDES, POLICIES, AND STRUCTURES THAT ENABLE THEM TO WORK
EFFECTIVELY, CROSS CULTURALLY
 THE CAPACITY TO:
1. VALUE DIVERSITY
2. CONDUCT SELF ASSESSMENT
3. MANAGE THE DYNAMICS OF DIFFERENCE
4. ACQUIRE AND INSTITUTIONALIZE CULTURAL KNOWLEDGE
5. ADAPT TO THE DIVERSITY AND THE CULURAL CONTEXT OF THE COMMUNITIES
THEY SERVE
TRANSCULTURAL NURSING ASSESSMENT GUIDE FOR
HEALTH CARE ORGANIZATIONS AND FACILITIES

 CLIENTS WITH SPECIAL NEEDS

 HEALTH DISPARITIES
 CULTURE OF THE DEAF
 COMMUNICATION AND LANGUAGE ASSISSTANCE
CULTURAL COMPETENCE IN THE HEALTH
HISTORY AND PHYSICAL EXAMINATION
 TRANSCULTURAL PERSPECTIVE ON THE HEALTH HISTORY
 BIOGRAPHIC DATA
 GENETIC DATA
 PHARMACOGENOMICS
 REVIEW OF MEDICATIONS AND ALLERGY
 REASONS FOR SEEKING CARE
 PRESENT HEALTH AND HISTORY OF PRESENT ILLNESS
 CULTURE BOUND SYNDROME
 PAST HEALTH
 FAMILY AND SOCIAL HISTORY
 REVIEW OF THE SYSTEM
TRANSCULTURAL PERSPECTIVE ON THE
PHYSICAL EXAMINATION
 BIOCULTURAL VARIATION IN MEASUREMENT
 HEIGHT
 BODY PROPORTIONS
 WEIGHT
 VITAL SIGNS
 BIOCULTURAL VARIATIONS IN THE ASSESSMENT OF PAIN
 BIOCULTURAL VARIATIONS IN GENERAL APPEARANCE
 PHYSICAL APPEARANCE
 BODY STRUCTURE
 MOBILITY
 BEHAVIOR
 BIOCULTURAL VARIATIONS IN SKIN
 MONGOLIAN SPOTS
 VITILIGO
 HYPERPIGMENTATION
 CYANOSIS
 JAUNDICE
 PALLOR
 ERYTHEMA, PETECHIAE AND ECCHYMOSES
 ADDISSON’S DISEASE
 UREMIA
 ALBINISM
 NORMAL AGE RELATED SKIN CHANGES
 BIOCULTURAL VARIATIONS IN SWEAT GLANDS
 BIOCULTURAL VARIATIONS IN THE HEAD
 HAIR
 EYES
 EARS
 MOUTH
 TEETH
 BIOCULTURAL VARIATIONS IN THE MAMMARY VENOUS PLEXUS
 BIOCULTURAL VARIATIONS IN THE MUSCULO SKELETAL SYSTEM
 BIOCULTURAL VARIATIONS IN ILLNESS
 BIOCULTURAL VARIATIONS IN LABORATORY TEST
THE INFLUENCE OF CULTURAL AND HEALTH BELIEF
SYSTEM ON HEALTH CARE PRACTICE

 CULTURAL BELIEF SYSTEM

 METAPHOR
 WORLD VIEW
 PARADIGM
 HEALTH BELIEF SYSTEM
 MAGICO-RELIGIOUS HEALTH PARADIGM
 SCIENTIFIC OR BIOMEDICAL HEALTH PARADIGM
 HOLISTIC HEALTH PARADIGM
HEALTH AND ILLNESS BEHAVIORS

 TYPES OF HEALING SYSTEM

 SELF CARE
 PROFFESSIONAL CARE SYSTEMS
 FOLK HEALING SYSTEM
 COMPLEMENTARY, INTEGRATIVE AND ALTERNATIVE HEALTH SYSTEM