Nursing Assignment on Foundations for Cultural Competence Individual and Organizational

This is assignment is to respond to those 2 discussion posts posted below. Each answer should be a minimum of 150 words APA format. All replies must be constructive and use literature where possible by extending, refuting/correcting, or adding additional nuance to your peers with at least 2 sources each. Sources cannot be older than 5 years.
Question 1 (GA)
Purnell’s Model for Cultural Competence and Advanced Practice Nursing
In order to meet the needs of a multicultural society, health care education and practice stress the importance of providing culturally sensitive and competent care to improve patient outcomes. As diversity in the healthcare workforce increases, patients increasingly receive care that is culturally competent and sensitive. Healthcare providers can benefit from a conceptual model of cultural competence that can be used by all health disciplines in all practice settings. The Purnell Model for Cultural Competence is applicable to all health care providers. The model consists of 12 domains that briefly describe the primary and secondary characteristics of culture, which determine variations in values, beliefs, and practices of an individual’s cultural heritage (Larry, 2002). The model provides an overview on culture and heritage and concepts related to the country of origin, current residence, the effects of the topography of the country of origin and current residence, economics, politics, reasons for emigration, educational status, and occupations (National Association of School Nurses, 2013). The model continues to provide overviews on other 11 domains than rather working alone, they affect each other. It talks about communication and concepts related to the dominant language and dialects and the importance of non-verbal forms of communication such as eye contact and facial expressions. The model also analyzes family roles and organization, workforce issues, bicultural ecology, high risk behaviors, nutrition, pregnancy and childbearing, death rituals, spirituality, and health care practices. The model also analyzes the role of the healthcare practitioner and includes concepts such as the status, use, and perceptions of traditional, magic religious, and allopathic biomedical health care providers (National Association of School Nurses, 2013). In addition, the gender of the health care provider may have significance.

This model is of high significance for all healthcare providers including advanced practice nurses, because it is a foundation for understanding the various attributes of a different culture, allowing nurses to adequately view patient attributes, such as incitement, experiences, and notions about healthcare and illness. The model allows advanced practice nurses to deliver high-quality services in a variety of cross-cultural scenarios. Cultural competence is an essential requirement in nursing. Culturally congruent healthcare does not aim to facilitate patient care for ethnic or racial minority groups only; rather, the objective is to improve healthcare delivery by considering differences in age, gender, religion, and socioeconomic status (Albougami, Pounds, & Alotaibi, 2016). Nurses should adapt to different cultures by making modifications to their nursing practices. Th absence of training in cultural diversity, often results in a disconnect between patient and nurse. The main objective of transcultural nursing is to promote the delivery of culturally meaningful, high-quality, and safe healthcare to patients belonging to similar or diverse cultures. Culture affects an individual’s concepts and approaches to health and illness. Because nurses need to care for patients belonging to different cultures, cultural competence is essential for nursing.

References

Albougami, A. S., Pounds, K. G., & Alotaibi, J. S. (2016). Comparison of Four Cultural Competence Models in Transcultural Nursing: A Discussion Paper. Retrieved June 30, 2020, from https://clinmedjournals.org/articles/ianhc/international-archives-of-nursing-and-health-care-ianhc-2-053.php?jid=ianhc

Purnell, L. (2002). A Description of the Purnell Model for Cultural Competence. Retrieved June 30, 2020, from https://pubmed.ncbi.nlm.nih.gov/11982073/

Purnell Model for Cultural Competence by Larry Purnell (2013). Retrieved June 30, 2020, from https://www.nasn.org/nasn-resources/practice-topics/cultural-competency/cultural-competency-purnell-model

Question 2 (RF)
Discussion Week 1 – Purnell Model
Introduction
The Purnell Model for Cultural Competence assists advanced practice nurses (APNs) in understanding patient’s needs through twelve cultural domains (Purnell, 2013). Since the model was created, Purnell (2019) has made changes to include “additional assumptions, variant characteristics of culture, and an extensive assessment guide” that can be used by APNs (p. 98). The patient, their environment, health status, nursing, and caring can be influenced to better meet the cultural needs of the patient when APNs understand what is most important and valuable to them.
Purnell Model for Cultural Competence & Relevance for APNs

It is important for the APN to first ask a patient what their beliefs are and if there are any specific needs relating to these beliefs that they would like met (Purnell, 2013). The patient’s responses will change how the APN cares for the them to ensure their specific cultural needs are being accommodated whenever possible and appropriate. An example of this could be a patient whose beliefs did not allow for them to have blood transfusions.

By identifying a patient’s cultural beliefs, APNs are demonstrating care for the patient which builds a trusting relationship with them. This will also impact how an APN documents patient information as well. A patient that cannot eat after sunset but is being prescribed a medication that needs to be taken with food at that time may need their medication times changed to meet both their cultural beliefs and the APN’s medication orders.

APN’s need to be aware of different cultures within their geographical area. There are several reservations of Seminole Florida Indians throughout Florida that comprise around 5,000 members (The Seminole Tribe of Florida, 2018). Many members still rely on medicine men to communicate with medical staff on their behalf so that they feel comfortable that their cultural and medical needs are being addressed.

A question that an APN can ask that can gain knowledge on a patient’s cultural preferences is if they have any cultural food preferences. Some patients may have some very simple requests when it comes to their diet. When these dietary needs are met, patients are more likely to eat their meals and ultimately improve outcomes. Simply asking a patient if they have food allergies or what foods they prefer does not ascertain the importance of meal planning for the patient. APNs need to determine what foods patients can or cannot it, and what times of the day they can eat.

Wang and Lam (2017) discuss how evidence-based practice (EBP) research has not implemented cultural adaptations. APNs must find a balance between respecting and accommodating a patient’s cultural beliefs while also providing care in line with EBP. Future studies that focused on how to accommodate differing cultural needs based upon specific EBPs would be helpful in improving patient outcomes.

Conclusion
Overall, in order to provide culturally competent care, APNs need to assess their patient’s cultural and religious preferences. The patient, their environment, health status, nursing, and caring can be influenced to better meet the cultural needs of the patient when APNs understand what is most important and valuable to them. Again, APNs must find a balance between respecting and accommodating a patient’s cultural beliefs while also providing care in line with EBP. Building a trusting relationship with the patient and their families can also help ease the anxiety of the patient when aspects of their cultural beliefs are not able to be met.

References
Purnell, L. (2013). Transcultural health care: A culturally competent approach (4th ed.). Philadelphia: F.A. Davis Co.

Purnell, L. (2019). Update: The Purnell Theory and Model for culturally competent health care. Journal of Transcultural Nursing, 30(2), 98–105. doi: 10.1177/1043659618817587

The Seminole Tribe of Florida. (2018). About. Retrieved from https://www.semtribe.com/

Wang, M., & Lam, Y. (2017). Evidence-Based Practice in Special Education and Cultural Adaptations. Research & Practice for Persons with Severe Disabilities, 42(1), 53-61. doi:10.1177/1540796916685872