Cultural Barriers and How to Overcome ThemMichelle GalvinPurdue University Northwest The National Cultural and Linguistically Appropriate Services (CLAS) standards is a guide to improve health equality for health care organizations. This design plan helps provide ways to achieve safe, accurate care for those with diverse cultural beliefs, religions, literacy and other communication needs. While CLAS helps to reduce disparities in healthcare, it is not without barriers for implementation. Some barriers in CLAS standards are educating and training the workforce in culturally appropriate policies and practices on an ongoing basis, and promoting a workforce that is responsive to the population it is serving; ensuring that competent individuals are providing language assistance and the use of family, minors or untrained individuals is avoided, and making sure there is ongoing assessments and monitoring of the CLAS for quality improvements. These barriers can be a challenging obstacle for healthcare. Educating and training the workforce can be a challenging undertaking. We must have buy-in from the staff in order to be successful in implementing the importance of cultural diversity in the healthcare setting and the first step is to educate ourselves by acknowledging our own values, beliefs and bias’s. “The key to successful transcultural communication is to recognize the uniqueness of every culture, every relationship, and every individual-including yourself” (Munoz and Luckmann, 2005, p. 147). Once education has been completed, recruiting and promoting cultural standards can begin. Competent interpreters must be used in communicating with those having language deficits. “Multiple studies have demonstrated that the error rate for professional interpreters is considerably lower than that of ad hoc interpreters (untrained family, friends, or staff), and when errors are made, they are less likely to be clinically significant. Clinicians can also help reduce the chance of errors by learning and practicing the skills needed for successful patient encounters when using professional medical interpreters” (Karliner, 2018). Ongoing assessments and measures for quality are vital to ensure patients are receiving the cultural needs they require. Staff may have push back on assessments of their ability to communicate within the cultural environment of the community. It may be challenging to obtain buy-in from staff that cannot put their stereotypes and bias’s aside. Clinical staff that have prejudice have no place in healthcare. “The nurse who commits subtle intentional or unintentional racism, reinforces prejudice that leads to disparities in care. Many would say nurses exhibit less racism than other groups. But any racism is still racism and strikes at the core of our professional obligation to protect and care for patients” (Confronting racism, 2013). As a nurse executive, I play an integral role in influencing and creating policies for cultural standards of care. My first step is to research the evidence as to why educating our staff on cultural awareness in healthcare is important. This evidence will be presented to administration and finance for approval on educational time for staff, translators, and education materials for both staff and patients. Once I have the approval to move forward, I would then reach out to the employee education department. I would work with them to develop an assessment tool to see staff’s current knowledge on cultural competence before we begin an educational roll out. After the assessment, we will be better prepared to develop an educational plan. Having a meeting with advanced practice nurses, nurse managers and the nursing governance board will help promote and carry out this endeavor, as I will need their support to have buy-in from all clinical staff. Competent translators are a vital necessity in communication with those who we cannot communicate with. Staff must understand we cannot use family, minors or other non-clinical individuals when trying to translate with our patients. “The Joint Commission requires hospitals to provide professional interpretation services to every patient who needs it. It also requires written materials be tailored to patients’ age, language and ability to understand” (Rice, 2014) Continuous monitoring of the cultural competence is a barrier to overcome by providing ongoing education and assessments of our nursing staff, patient feedback and satisfaction scores (pre-printed surveys given in the patient’s language for accurate feedback), and keeping the staff engaged. Engagement and ownership of this initiative is what will keep it alive and in the forefront. Having the buy-in and letting staff run with it once it takes of will ensure the success of the initiative but will gain something more important…safe care for the patient. ReferencesAmerican Nurse Today. (2013, August 11). Confronting racism in health care. Retrieved November 2, 2019, from https://www.americannursetoday.com/confronting-racism-in-health-care/.Karliner, L. S. (2018, March). When Patients and Providers Speak Different Languages. Retrieved November 2, 2019, from https://psnet.ahrq.gov/web-mm/when-patients-and-providers-speak-different-languages.Munoz, C., & Luckmann, J. (2015). Transcultural Communication in Nursing (2nd ed.). Clifton Park, NY: Delmar Learning.Rice, S. (2014, August 30). Hospitals often ignore policies on using qualified medical interpreters. Retrieved November 1, 2019, from https://www.modernhealthcare.com/article/20140830/MAGAZINE/308309945/hospitals-often-ignore-policies-on-using-qualified-medical-interpreters.
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