Culturally Sensitive Nursing and Patient Safety

The assignment is a literature review that examines the relationship between culturally sensitive care provided by nurses and patient safety. It analyzes studies that highlight the skills and knowledge nurses need to deliver culturally competent care, addressing communication barriers and the emotional labor involved. The review also discusses the importance of self-assessment for cultural competency, competence training, and ongoing professional development for nurses in this area.

Running head: NURSING ASSIGNMENT
Nursing assignment
Name of the student:
Name of the University:
Author’s note

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Introduction:
Patient safety can be defined as the maintenance of the procedure by which hospitals as
well as other healthcare centers protect the lives of their patients from errors, accidents, injuries,
infections and others. Some of the important activities that accounts for patient safety are the
delivery of proper service by the healthcare professionals, proper management of the
administrative body of the centers, right amount of resource allocation by the boards of directors
and the account system and others (Ammouri et al., 2015). The activities of the healthcare
professionals also play a very vital role. Researchers over the decades have stated that proper
cultural competency and adequate amount of nursing skills, competency and training ensure
patient safety. The following assignment will mainly depict journal articles which will help to
prove the claim made and thereby help to decrease the chances of patient harm in hospitals and
increasing patient safety.
Literature review:
Theme A: Handling cultural sensitive situations in health care
a. Self-assessment of cultural competency-
i. Study 1- (A mixed method study of nurse’s self assessment of cultural competency)-
The research by Alpers & Hanssen, (2014) aimed to investigate how nurse assessed
their culturally competency to deal with patients from different background. As
majority of nurses tend to lack cultural competency, the study findings showed that
knowledge about illness and treatment philosophies does not enhance cultural

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competency in nurses, it is dependent on knowledge of intercultural systems and
culturally competent care.
b. Engaging in emotional labor to handle culturally sensitive patient-
i. Study 1: (Dispensing emotions- Norwegian community nurse’s handling of diversity
in organizational context)- The qualitative research by Debesay et al., (2014) utilized
the concept of emotional labour to identify whether nurse can handle ethnic minority
patients in the context of pressures. The findings gave the indication that language
barriers and unfamiliar cultural traditions challenges nurses in dealing with minority
patients. The demand for efficiency in professional work and time constraints also
affects the nurse ability to deal with minority patients. Hence, organizational changes
is required to develop the confidence of nurses in handling culturally sensitive
situations.
c. Implementation of cultural competence skills program to handle culturally sensitive
patient:
i. Study 1: (The effectiveness of cultural competence program on ethnic minority
patient-centered health care- a systematic review)- The systematic review by Renzah
et al., (2013) gave the idea that effect of patient-centered care model on improving
cultural competence in health care staffs. It was found to have positive effects on
staffs as the program increased their knowledge about cultural sensitivity.
ii. Study 2: (Cultural and language difference as a barrier to provisions of quality care by
workforce in Saudi Arabia)- The research by Almutairi, (2015) aimed to identify the
challenges in faced by workforce due cultural and language difference in Saudi

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Arabia. The main findings of the research was that lack of cultural competency, was
the main reason for difficulties and cultural shock.
Theme B: Inadequate competency in nursing hampers patient safety
a. Failure in certain competencies like social skills, expertise, experience as well as priority
setting:
i. Study 1: According to Kieft et al. (2013), social skills of the nurses are very important
in developing a trustful care relationship. Social skills like proper behavior and
attitude, composure, allocating proper time for patients, having empathy and listening
to patients attentively develop a sense of commitment to patients which help in
meeting expectations of patients. In domain of expertise and experience
communicative capabilities, technical skills and nursing knowledge are believed to
develop expertise and also earn them experience. These will help them to provide
state of art interventions or activities. Failure in them will lead the nurses to take
wrong treatment plan and will not make them critically analyze the situation. This
will hamper patient safety. Moreover nurses who also fail to set their priorities among
the various roles and responsibilities that have to maintain every day, also becomes a
reason for patient quality deterioration.
b. Lack of proper training of the nurses lead to harm in patient safety
i. Study 1: Often patients admitted to emergency departments require the collaborative
activity of a number of health professionals to make a rapid and proper treatment of the
patients and thereby help him recover from any sort of adverse situation. However,
inadequate teamwork may lead to miscommunication and issue in role clarity o each of
the nurses and professionals, which might hamper the patient safety. Therefore,

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researchers like Klipfel et al. (2014) are of the opinion that effective team based training
of nurses in application of care in a collaborative approach is very much necessary in
attending the adverse situations. They have suggested that education strategy of in situ
simulation training is found to be extremely helpful for building interdisciplinary
teamwork as well as nursing staff confidence in managing emergency situations. They
have also explained that for the proper implementation of effective teamwork would
require not only team training but also training which is instituted interdependently with
proper fair and just culture as well as visible engaged leadership.
c. Inadequate nursing skills lead to hamper in patient safety:
i. Study 1: A research paper was published by researchers Aiken et al. (2016) explaining
the importance of nursing skill for marinating patient safety. They had conducted a
quantitative study where they have shown that richer nurse skill mix that were composed
of mostly nursing professionals with adequate training, expertise and experience was
associated mostly with lower rates of mortality, low hospital ratings of patients in their
feedback form, lower reports of poorer quality, poor safety grades and poor outcomes. On
the other hand poor nurse skill mix which complained mainly of low paid untrained
nursing associates and healthcare staffs who had low knowledge, expertise, training and
experience were related to high mortality rates in preventable deaths and poor ratings in
quality care, low quality and patient harm. Therefore this study proves that nurses should
undergo professional development and completing of their training procedures for being
fully skilled and hospitals hold appoint nurses with proper degrees and do not settle with
nursing individuals with low or incomplete qualification to meet their resource restraints
as that might harm lives of patients.

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Conclusion:
The review of literature on the theme of culturally sensitive care and impact of low
competencies on patient safety gave many important implications for nursing practice
development. The key strength of the study is that it informs about the skills and knowledge that
is necessary for nurse to handle culturally sensitive patients and enhance their safety. The
element of regular self-assessment for cultural competency, implementation of competence skills
training and providing emotional labors was found as a factor to satisfy patient and enhance
patient safety. However, there are certain limitations of the literature review too. For instance
Almutairi, (2015) did not covered all communications barriers that affect patient safety and
delivery of culturally sensitive care. In some studies, the generalization of findings became
difficult because of low sample size and difference between years of experience and competency
level of nursing staffs. Hence, year of experience can significantly affect the outcome of research
and considering this factor was important. Therefore, to develop the clinical skills of nurse in
providing quality care, more studies is needed to investigate improvements needed in nursing
education as well as training needs during clinical practice.
Reference
Almutairi, K. M. (2015). Culture and language differences as a barrier to provision of quality
care by the health workforce in Saudi Arabia. Saudi medical journal, 36(4), 425.

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Alpers, L. M., & Hanssen, I. (2014). Caring for ethnic minority patients: A mixed method study
of nurses' self-assessment of cultural competency. Nurse education today, 34(6), 999-
1004.
Ammouri, A. A., Tailakh, A. K., Muliira, J. K., Geethakrishnan, R., & Al Kindi, S. N. (2015).
Patient safety culture among nurses. International nursing review, 62(1), 102-110.
Debesay, J., Harsløf, I., Rechel, B., & Vike, H. (2014). Dispensing emotions: Norwegian
community nurses' handling of diversity in a changing organizational context. Social
science & medicine, 119, 74-80.
Griffiths, P., Ball, J., Drennan, J., James, L., Jones, J., Recio, A., & Simon, M. (2014). The
association between patient safety outcomes and nurse/healthcare assistant skill mix and
staffing levels and factors that may influence staffing requirements.
Kieft, R. A., de Brouwer, B. B., Francke, A. L., & Delnoij, D. M. (2014). How nurses and their
work environment affect patient experiences of the quality of care: a qualitative
study. BMC health services research, 14(1), 249.
Klipfel, J. M., Carolan, B. J., Brytowski, N., Mitchell, C. A., Gettman, M. T., & Jacobson, T. M.
(2014). Patient safety improvement through in situ simulation interdisciplinary team
training. Urologic nursing, 34(1), 39.
Renzaho, A. M. N., Romios, P., Crock, C., & Sønderlund, A. L. (2013). The effectiveness of
cultural competence programs in ethnic minority patient-centered health care—a
systematic review of the literature. International Journal for Quality in Health
Care, 25(3), 261-269.