Assignment: Expert Panel on Global Nursing

Executive Summary

A task force of the Expert Panel for Global Nursing and Health of the American Academy of Nursing, along with members of the Transcultural Nursing Society, has developed a set of standards for cultural competence in nursing practice. The aim of this project was to define standards that can be universally applied by nurses around the world in the areas of clinical practice, research, education, and administration, especially by nurses involved in direct patient care. The document includes a Preface and 12 Standards: Standard 1. Social Justice Standard 2. Critical Reflection Standard 3. Knowledge of Cultures Standard 4. Culturally Competent Practice.

Standard 5. Cultural Competence in HealthCare Systems and Organizations Standard 6. Patient Advocacy and Empowerment

Standard 7. Multicultural Workforce Standard 8. Education and Training in Culturally Competent Care Standard 9. Cross Cultural Communication Standard 10. Cross Cultural Leadership Standard 11. Policy Development Standard 12. Evidence-Based Practice and Research For each standard, a definition, supporting rationale, and numerous suggestions for implementation are provided. A glossary of terms is appended. All standards are based on the concepts of social justice and human rights, as defined by the United Nations and the International Council of Nurses. These concepts are manifested at a systems or governmental level by political, economic, and social policies that exhibit impartiality and objectivity. All task force members have experience working with peoples from a variety of cultures throughout the world. In developing this document, the task force reviewed more than 50 documents on cultural competence published by nursing and health care organizations worldwide. In addition, an on-line survey solicited comments from nurses in many countries. Responses from nurses representing a variety of settings and educational backgrounds were incorporated into the final document. Every attempt was made to develop standards that can be used globally.

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12-30-10 Expert Panel on Global Nursing & Health

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Standards of Practice for Culturally Competent Nursing Care

PREFACE The purpose of this document is to initiate a discussion of a set of universally applicable standards of practice for culturally competent care that nurses around the globe may use to guide clinical practice, research, education, and administration. The recipient of the nursing care described in these standards is assumed to be an individual, a family, a community, or a population. These standards are based on a framework of social justice(1), that is, the belief that every individual and group is entitled to fair and equal rights and participation in social, educational, economic, and, specifically in this context, healthcare opportunities. Through the application of the principles of social justice and the provision of culturally competent care, inequalities in health outcomes may be reduced. The worldwide shortage of nurses and the global migration of both nurses and populations have heightened the need to educate nurses to deliver culturally competent care for an increasingly diverse patient population, regardless of geographic location.(2)(3) This need served as the primary impetus for this work. Cultural standards exist within political, economic, and social systems. Many health organizations throughout the world have defined care for their specific populations from the perspective of these systems. The variation among standards and the context within which standards are practiced precludes a single set that fits all cultures. In preparing these standards, nearly 50 relevant documents from nursing organizations around the world were examined, as well as related materials from other healthcare professions, governmental, non-governmental (NGO), and health and human service organizations. Examples included, but were not limited to the following: the United Nations’ Declaration of Human Rights,(4) the International Council of Nurses (ICN)’s Nurses and Human Rights,(5) the Nursing Council of New Zealand’s Code of Conduct for Nurses,(6) the National Association of Social Workers’ Standards for Cultural Competence in Social Work Practice,(7) the World Health Organization’s Declaration of Alma Alta,(8) the American Nurses Association (ANA)’s Code of Ethics,(9), The ICN Code of Ethics for Nurses, (10).and the American Association of the Colleges of Nursing (AACN) Toolkits (11.) These 12 standards can serve as a guide and resource for nurses in practice, administration, education and research by emphasizing cultural competence as a

12-30-10 Expert Panel on Global Nursing & Health