Art and science (2009) claims the five steps of EBP are: asking an important clinical question, collecting the most relevant and best evidence, critically appraising the evidence, integrating the evidence with ones clinical expertise and patient preferences to make a practice decision, and evaluating the outcomes of that decision.
Some barriers to incorporating EBP to improve patient outcomes include funding
sources, poor access to quality information, lack of leadership, motivation or
“From an education perspective found that 83% of participation from various
professions in primary care had never undertaken a research course, indicating
that only 17% of participants had done so. This suggests that critical appraisal
skills and discernment in applying research findings are likely to be lacking in
this group.” (37) Education is essential for research to improve patient
outcomes and to help generate more EBP.
Nursing Research to Improve Patient Outcomes through Evidence Based Practice and Trans-Cultural Nursing Globalization has transformed the workplaces around the globe including the health sector and health profession like nursing. Such phenomenon significantly led to the emergence of trans-cultural nursing. Trans-cultural nursing as study and practice in nursing that focus on differences and similarities among cultures with respect to human care, health, and illness based upon the people’s beliefs, practices and cultural values wherein such knowledge and skills , are utilized by the professional nurse to provide cultural specific or culturally congruent nursing care to people. Trans-cultural nursing is applicable in nursing homes and hospitals of culturally diverse patients and colleagues. It addresses the issue intertwined with cultural diversity in the nursing field in different venues of which the professionals are guided on how to deal with the complexities associated in providing nursing care to culturally diverse elderly patients as well as their colleagues as implied by the article research Leininger’s Transcultural Nursing Model by C. Cameron and & L. Luna. It implies the complex ways of different ethnic groups’ expression of their respective cultures and societies to find expression as they merge in a healthcare venue like the nursing homes of the elderly of which I experienced working. ‘From the diverse forms taken by culture over time and space stem the uniqueness and plurality of the identities and cultural expressions of peoples and societies that make up the healthcare patients of today. It is a fact that cultural differences naturally produce conflicts in a culturally diverse healthcare firm like the nursing home composed of culturally diverse patients especially when “tolerance and mutual respect” are not present or there is prevalence of racism or any forms of bigotry. Healthcare Institutions or organizations and communities that are composed of diverse members or population/patients have innate individual differences and opposing paradigms peculiar to their counter parts/each other entwined with communication and language barriers, political beliefs, different sets of values, religion, personal-moral-ethical and philosophical paradigms. ‘Such conditions are fertile grounds of misunderstandings that eventually lead conflict if not cope up or proactively addressed by the leaders or the administrators of the healthcare firm and the culturally diverse members themselves and their patients who are also came from different ethnic groups which makes the knowledge of trans-cultural nursing very important to make one’s profession efficient and productive in providing the healthcare needs of culturally diverse patients’ (Cameron and Luna, 1996). As this research article utilized the survey and research method in formulating this study that would help nursing profession more productive, efficient and innovative in today’s workplace entwined with culturally diverse patients, and colleagues. This also implies that nurses today must find the ways and means to adapt to the increasingly culturally diverse patients and must know how to utilize the known tools of transcultural nursing in order for them to be effective in giving the best service for their patients that consequently make their firms competitive in the market. It is ‘a major challenge facing the nursing profession is to educate and assist nurses to develop the skills to provide culturally relevant care’ (Hughes, 2007, p. 57). The knowledge and experience I gained with the said patients have shown how complex the nursing profession is especially in this age where cultural divergence is becoming a norm intertwined with the healthcare firms and system. Such present condition creates the need for nurses to be constantly updated with the latest trends in transcultural nursing and utilize tools like Gibbs model of reflection (Gibbs reflective cycle) and Giger & Davidhizars models as the very sources on how to innovate one’s profession, skills and interaction with patients and elements in the workplace proactively, efficiently and productively as nursing professional. As these kind of tool emphasized the importance of reflection. Reflection in the nursing profession is very important in helping improving the quality of nursing care towards the culturally diverse patients. Transcultural Nursing significantly conforms to the ethical principles of utilitarianism (which emphasizes the importance of giving happiness to the greatest number of people) as it would empower professional nurses to analyze their own selves and professional performance particularly on their respective strengths and weaknesses. It enables them to mitigate their weaknesses through acquisition of more in-depth knowledge derived from the implications of trans-cultural nursing and latest trends of nursing profession, new skills through profession empowering workshops and new work venues that cater diverse patients and retraining if necessary. With regards to their individual strengths trans-cultural nursing will help improve their way of caring the culturally diverse patients as well as their interpersonal skills with their colleagues, superiors and other people in the workplace. The knowledge and application of Trans-cultural nursing definitely change their behavior towards their profession and towards their patients which would positively impact their cognitive, affective and psycho-motor functions in fulfilling their duties and responsibilities as a professional nurse confined in the culturally diverse workplace. Acquiring skills and knowledge through job exposure or experience are the most concrete form of learning, so professional nurses must find the ways and means to acquire it from such venues as much as possible. To end, Experience and training in intercultural nursing are very important elements in nursing profession and providing healthcare service to the elderly with multicultural backgrounds wherein lack of it makes them incompetent. Because of the lack of skills on how to utilize it on the field which makes tools like Gibbs model of reflection and combined exposure on the highly diverse field necessary. It is important for me to understand the dynamics of nursing profession to assist the culturally diverse patients and to retain, attain, or maintain optimal system stability particularly in providing their healthcare needs whether in nursing homes or in hospitals. As inadequacy of cultural and care knowledge are the missing link to nursing’s understandings of the many complex variations required in patient care who have different cultural backgrounds to support compliance, healing, and wellness. Therefore, it is a must that every nurse should be equipped with the skills and knowledge of trans-cultural nursing.
Cameron, C., & Luna, L. (1996). Leininger’s transcultural nursing model. In J. J. Fitzpatrick & A. L. Whall Ed. Conceptual models of nursing: Analysis and application. Stramford, CT: Appleton & Lange.
Hughes, K. H. and Hood, L. J. (2007). Teaching Methods and an Outcome Tool for Measuring Cultural Sensitivity in Undergraduate Nursing Students. Journal of Transcultural Nursing, issue 18, pp. 57-62
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