Abstract
The final stage in implementing culturally competent healthcare is selecting those interventions that are grounded in evidence generated by research that has shown positive patient outcomes. Evidence-based practice (EBP) programs require staff educated in the principles of EBP, mentors to guide the process, library and time resources, and administrative support. Both qualitative and quantitative research methodologies can be used to study cultural phenomena and health behaviors, as well as to test the efficacy of interventions that have improved patient outcomes and decreased health disparities. Studies should also measure the impact of culturally specific interventions on healthcare organizations and the community since these are programs can influence the fiscal feasibility and sustainability of these interventions. Healthcare systems with limited personnel and financial assets may not have the resources to develop an extensive EBP or research program but could employ site-specific quality improvement (QI) projects or program evaluations to determine whether their culturally competent interventions improve outcomes for their patient populations. Three detailed case studies are provided to illustrate how this guideline is implemented in their culture-specific populations.
Guideline: Nurses shall base their practice on interventions that have been systematically tested and shown to be the most effective for the culturally diverse populations that they serve. In areas where there is a lack of evidence of efficacy, nurse researchers shall investigate and test interventions that may be the most effective in reducing the disparities in health outcomes.
Douglas et al. (2014: 115)
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References
American Academy of Nursing (2017) Transforming health policy and practice through nursing knowledge: 2017-2020 strategic plan. www.aannet.org/about/strategic-plan-2014-2017. Accessed 25 Apr 2017
American Nursing Credentialing Center (2013) Chapter 4. New knowledge, innovations and improvements. In: 2014 Magnet® application manual. Author, Silver Spring, MD
American Nursing Credentialing Center (2015) Annual report 2015. http://www.nursecredentialing.org/Documents/Annual-Reports-Archive/2015-AnnualReport.pdf. Accessed 26 Apr 2017
Bloomer MJ, Cross W, O’Connor M, Moss C (2012) Qualitative observational in a clinical setting: challenges at end of life. Nurs Health Sci 14:25–31
Boucher LM, Marshall Z, Martin A, Larose-Hébert K, Flynn JV, Lalonde C, Pineau D, Bigelow J, Rose T, Chase R, Boyd R, Tyndall M, Kendall C (2017) Expanding conceptualizations of harm reduction: results from a qualitative community-based participatory research study with people who inject drugs. Harm Reduct J 14:1–18. https://doi.org/10.1186/s12954-017-0145-2
Brown MM, Brown GC, Sharma S (2005) Evidence-based medicine to value-based medicine. AMA Press, Chicago, IL. 5–7, 125–149, 151–181, 193–217, 267–279, 319–324
Carvajal A, Centeno C, Watson R, Martinez M, Rubiales AS (2011) ¿Como validar un instrumento de medida de la salud? [How is an instrument for measuring health to be validated?]. Anales del Sistema Sanitario de Navarra 34(1):63–74
Cheng L, Feng S, Hu Y (2017) Evidence-based nursing implementation in Mainland China: a scoping review. Nurs Outlook 65:27–35
Choi TST, Walker KZ, Palermo C (2017) Culturally tailored diabetes mellitus education for Chinese patients: a qualitative case study. J Transcult Nurs 38:315–323
Creswell JW (2013) What is mixed methods research. https://cirt.gcu.edu/research/developmentresources/research_ready/mixed_methods/choosing_design. Accessed 6 May 2017
Davidson JE, Brown C (2014) Evaluation of nurse engagement in evidence-based practice. AACN Adv Crit Care 25:43–55
De Gagne JC, Oh J, So A, Haidermota M, Lee SY (2015) A mixed method study of health care experiences among Asian Indians in the southeastern United States. J Transcult Nurs 26:354–364
Dearholt SL, Dang D (2012) Johns Hopkins nursing evidence based practice and guidelines, 2nd edn. Sigma Theta Tau International, Indianapolis, IN
Diekelmann N, Allen D, Tanner CA (1989) The NLN criteria for appraisal of baccalaureate programs: a critical hermeneutic analysis. National League for Nursing Press, Washington, DC
Douglas M, Rosenketter M, Pacquiao D, Clark Callister L, Hattar-Pollara M, Lauderdale L, Milsted J, Nardi D, Purnell L (2014) Guidelines for implementing culturally competent nursing care. J Transcult Nurs 25(2):109–221
Fineout-Overholt B, Melnyk BM (2006) Organizational culture & readiness for system-wide integration of EBP. ARCC, IIc, Gilbert, AZ
Ge L, Albin B, Hadziabdic E, Hjelm K, Rask M (2016) Beliefs about health and illness and health-related behavior among urban women with gestational diabetes mellitus in the southeast of China. J Transcult Nurs 27:593–602
Groenewald T (2004) A phenomenological research design illustrated. Int J Qual Methods, 3(1). Article 4. http://www.ualberta.ca/~iiqm/backissues/3_1/html/groenewald.html. Accessed 20 May 2017
Haynes RB (2006) Of studies, syntheses, synopses, summaries and systems: the “5S” evolution of services for evidence-based health care decisions. ACP J Club 145(3):A8–A9. 107326/ACPJC-2006-145-3-A08
Herrero-Hahn R, Rojas JG, Ospina-Diaz JM, Montoya-Juarez R, Restrepo-Medrano JC, Hueso-Montoro C (2017) Cultural adaptation and validation of the cultural self-efficacy scale for Colombian nursing professionals. J Transcult Nurs 28:195–202
Institute of Medicine, McClellan MB, McGinnis M, Nabel EG, Olsen LM (2008) Evidence-based medicine and the changing nature of healthcare: meeting summary (IOM roundtable on evidence-based medicine). National Academies Press, Washington, DC. http://www.nap.edu/catalog/12041.html. p 189. Accessed 5 May 2017
International Council of Nurses (2012) Closing the gap: from evidence to action. International Nurses Day 2012. http://www.icn.ch/images/stories/documents/publications/ind/indkit2012.pdf. Accessed 22 Mar 2017
International Council of Nurses (2013) Position statement: scope of practice. http://www.icn.ch/images/stories/documents/publications/position_statements/B07_Scope_Nsg_Practice.pdf. Accessed 26 Apr 2017
Johns Hopkins Nursing Evidence-Based Practice Model. http://www.hopkinsmedicine.org/evidence-based-practice/jhn.html. Accessed 11 May 2017
Jordan Z, Lockwood C, Aromataris E, Munn Z (2016) The updated JBI model for evidence-based healthcare. The Joanna Briggs Institute. http://joannabriggs.org/assets/docs/approach/The_JBI_Model_of_Evidence_-_Healthcare-A_Model_Reconsidered.pdf. Accessed 15 Aug 2017
Joseph R, Pekmezi D, Dutton GR, Cherrington AL, Kim YI, Allison JJ, Durant NH (2016) Results of a culturally adapted internet-enhanced physical activity pilot intervention for overweight and obese young African American women. J Transcult Nurs 27:136–146
Kara B, Tenekeci EG (2017) Sleep quality and associated factors in older Turkish adults with hypertension: a pilot study. J Transcult Nurs 28:296–305
Khammarnia M, Mohammadi MH, Amani Z, Rezaeian S, Setoodehzadeh F (2015) Barriers to implementation of evidence based practice in Zahedan teaching hospitals, Iran, 2014. Nurs Res Pract. 2015: 1–5. Article ID 357140. https://doi.org/10.1155/2015/357140. Accessed 5 May 2017
Marzorati C, Pravettoni G (2017) Value as the key concept in the health care system: how it has influenced medical practice and clinical decision-making processes. J Multidiscip Healthc 10:101–106
Melnyk BM (2017) The difference between what is known and what is done is lethal: evidence-based practice is a key solution urgently needed. Worldviews Evid Based Nurs 14:3–4
Melnyk BM, Fineout-Overholt E (2015) Evidence-based practice in nursing and healthcare. A guide to best practice, 3rd edn. Wolters Klower, Philadelphia, PA
Melnyk BM, Fineout-Overholt E, May MZ (2008) The evidence-based practice beliefs and implementation scales: psychometric properties of two new instruments. Worldviews Evid Based Nurs 5:208–216
Melnyk BM, Gallager-Ford L, Long LE, Fineout-Overholt E (2014) The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews Evid Based Nurs 11:5–15
Melnyk BM, Gallagher-Ford L, Kosky BK, Troseth M, Wyngarden K, Szalacha L (2016) A study of chief nurse executives indicates low prioritization of evidence-based practice and shortcomings in hospital performance metrics across the United States. Worldviews Evid Based Nurs 13:6–14
Melnyk BM, Fineout-Overholt E, Giggleman M, Choy K (2017) A test of the ARCC© model improves implementation of evidence-based practice. Healthcare culture, and patient outcomes. Worldviews Evid Based Nurs 14:5–9
Miner SM, Liebel D, Wilde MH, Carroll JK, Zicari E, Chalupa S (2017) Meeting the needs of older adult refugee populations with home health services. J Transcult Nurs 28:128–136
Mohammed K, Nolan MB, Rajjo T, Shah ND, Prokop LJ, Varkey P, Murad MH (2016) Creating a patient-centered health care delivery system: a systematic review of health care quality from the patient perspective. Am J Med Qual 31:12–21
Morse JM (2010) Simultaneous and sequential qualitative mixed method designs. Qual Inquiry 16:483–491. https://doi.org/10.1177/1077800410364741
Morse J (2015) Using qualitative methods to assess the pain experience. Br J Pain 9:26–31
Morse J (2016) Underlying ethnography. Qual Health Res 26:875–876
Morse JM, Cheek J (2015) Introducing qualitatively-driven mixed-methods designs. Qual Health Res 25:731–733
Munten G, van den Bogaard J, Cox K, Garretsen H, Bongers I (2010) Implementation of evidence-based practice in nursing using action research: a review. Worldviews Evid Based Nurs 7:135–157
Musa AS, Pevalin DJ, Shahin FJ (2016) Impact of spiritual well-being, spiritual perspective, and religiosity on the self-rated health of Jordanian Arab Christians. J Transcult Nurs 27:550–557
National Institute of Minority Health and Health Disparities (2017) Community-based participatory Research program, program description. https://www.nimhd.nih.gov/programs/extramural/community-based-participatory.html. Accessed 15 May 2017
Nikfarid L, Rassouli M, Borimnejad L, Alavimajd H (2017) Experience of chronic sorrow in mothers of children with cancer: a phenomenological study. Eur J Oncol Nurs 28:98–106
Nypaver CF, Shambley-Ebron D (2016) Using community-based participatory research to investigate meaningful prenatal care among African American Women. J Transcult Nurs 27:558–566
Patelarou A, Patelarou E, Brokalaki H, Dafermos V, Thiel L, Melas C, Koukia E (2013) Current evidence on the attitudes, knowledge and perceptions of nurses regarding evidence-based practice implementation in European community settings: a systematic review. J Commun Health Nurs 30:230–244. https://doi.org/10.1080/07370016.2013.838501
Pearson A, Wiechula R, Court A, Lockwood C (2005) The JBI model of evidence-based healthcare. Int J Evid Based Healthc 3:207–215
Pericas-Beltran J, Gonzalez-Torrente S, Pedro-Gomez J, Morales-Asencio J, Bennasar-Veny M (2014) Perception of Spanish primary healthcare nurses about evidence-based clinical practice. A qualitative study. Int Nurs Rev 61:230–244. https://doi.org/10.1080/07370016.2013.83851
Phillips CB, Dwan K, Hepworth J, Pearce C, Hall S (2014) Using qualitative mixed methods to study small health care organizations while maximizing trustworthiness and authenticity. BMC Health Serv Res 14:559–571. https://doi.org/10.1186/s12913-014-0559-4
Rew L (2011) The systematic review of literature: Synthesizing evidence for practice. J Spec Pediatr Nurs 16:64–69
Royal College of Nursing (2014) Defining nursing 2014. ISBN: 9781910672020. https://www.rcn.org.uk/professional-development/publications/pub-004768. Accessed 4 May 2017
Santos Prudencio P, Hilfinger Messias DK, Villela Mamede F, Spadoti Dantas RA, de Souza L, Villela Mamede M (2016) The cultural and linguistic adaptation to Brazilian Portuguese and content validity of the patient expectations and satisfaction with prenatal care instrument. J Transcult Nurs 27:509–517
Saunders H, Vehviläinen-Julkunen K (2017) Nurses evidence-based practice beliefs and the role of evidence-based practice mentors at university hospitals in Finland. Worldviews Evid Based Nurs 14:35–45
Sigma Theta Tau International (2017) Evidence-base nursing position statement. http://www.nursingsociety.org/why-stti/about-stti/position-statements-and-resource-papers/evidence-based-nursing-position-statement. Accessed 4 May 2017
Speziale HJS, Carpernter DR (2007) Qualitative research in nursing. Advancing the humanistic imperative, 4th edn. Lippincott Williams & Wilkins, Philadelphia
Squires A, Aiken LH, van den Heede K, Sermeus W, Bruyneel L, Lindqvist R, Schoonhoven L, Stromseng I, Busse R, Brzostek T, Ensio A, Moreno-Casbas M, Rafferty AM, Schubert M, Zikos D, Matthews A (2013) A systematic survey instrument translation process for multi-country, comparative health workforce studies. Int J Nurs Stud 50:264–273
Stillwell SB, Fineout-Overholt E, Melnyk BM, Williamson KM (2010) Searching for the evidence: strategies to help you conduct a successful search. AJN 110:41–47
Teshuva K, Borowski A, Wells Y (2017) The lived experience of providing care and support services for Holocaust survivors in Australia. Qual Health Res 27:1104–1114
Titler MG, Kleiber C, Steelman VJ, Goode C, Rakel B, Barry-Walker J, Small S, Buckwalter K (1994) Infusing research into practice to promote quality care. Nurs Res 43:307–313
Titler MG, Kleiber C, Steelman VJ, Rakel BA, Budreau G, Everett LQ, Buckwalter KC, Tripp-Reimer T, Goode CJ (2001) The Iowa model of evidence-based practice to promote quality care. Crit Care Nurs Clin North Am 13:497–509
Townsend W, Donovan K, Ginier E, MacEachern M, Mani N (2015) Integrated “5S” levels of organization of evidence pyramid. September 2015. (http://hdl.handle.net/2027.42/138965). CCBY 4.0 https://creativecommons.org/licenses/by/4.0/. Adapted from: Haynes RB. Of studies, syntheses, synopses, summaries and systems: the “5S” evolution of services for evidence-based health care decisions. ACP J Club 145(3):A8–A9
Ubbink DT, Guyatt GH, Vermeulen H (2013) Framework of policy recommendations for implementation of evidence-based practice: a systematic scoping review. BMJ Open 3(1): e001881. https://doi.org/10.1136/bmjopen-2012-001881. https://www-ncbi-nlm-nih-gov.ucsf.idm.oclc.org/pmc/articles/PMC3563143/. Accessed 25 Apr 2017
University of Michigan Library (2017) Research guides/nursing/hierarchy of evidence resources. http://guides.lib.umich.edu/c.php?g=282802&p=1888245. Accessed 2 Aug 2017
Warren JI, McLaughlin M, Bardsley J, Eich J, Esche CA, Kropkowski L, Risch S (2016) The strengths and challenges of EBP in healthcare systems. Worldviews Evid Based Nurs 13:15–24
Watson CA, Bulechek GM, McCloskey JC (1987) QAMUR: a quality assurance model using research. J Nurs Qual Assur 2:21–27
Whittemore R, Knafl K (2005) The integrative review: updated methodology. J Adv Nurs 52:546–553
World Health Organisation (2004) World report on knowledge for better health: strengthening health systems. WHO, Geneva
Yost KJ, Bauer MC, Buki LP, Austin-Garrison M, Garcia LV, Hughes CA, Patten CA (2017) Adapting a cancer literacy measure for use among Navajo women. J Transcult Nurs 28:278–285
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Douglas, M.“. (2018). Designing Culturally Competent Interventions Based on Evidence and Research. In: Douglas, M., Pacquiao, D., Purnell, L. (eds) Global Applications of Culturally Competent Health Care: Guidelines for Practice. Springer, Cham. https://doi.org/10.1007/978-3-319-69332-3_39
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