Case study: A local hospital system’s Nursing

Case study: A local hospital system’s Nursing Practice Council has decided to redesign their cultural competency training and evaluation for their nursing and APN staff. They have done some initial focus groups with nurses and a literature review, and they found that the staff does not feel adequately prepared to meet the cultural needs of their very diverse patient population. The nurses and APN’s in the system also identified that several units wanted to develop a unique model because the type of care needs of their patients substantially differ from the more general patient population. The renal/transplant unit has identified the fact that their patients often have distinct care needs because of the quality-of-life burden imposed by their outpatient dialysis, by the experience of waiting for a transplant or navigating the process of identifying a known donor, and then the experience of actually getting a transplant. They want to pay particular attention to the experience of patients who are in a known-donor situation, where both the donor and recipient are hospitalized at the same time. This is a pressing need because the staff has stated that they never really comprehensively assessed the cultural care needs of the living donor and how they may differ when they know the recipient. One of the nurses stated, It really makes me think about how their family can be burdened by the worry over both patients at once; and also, how they divide their time between caring for the 2 patients. Like, right after the post-op, how do they decide which room to visit first? How do donors feel when they are known to the patient, but don’t know the donor’s family very well—like when a coworker or friend donates? It’s such a generous, beautiful gift—but how does that donor’s family feel when they donate a kidney and go through this surgery for someone that they don’t know well? What about when there are complications? Do those families worry that their loved one will have kidney disease in their remaining kidney? Do they feel as generous as the donor does; or do they sometimes worry about whether this is worth the risk? There are so many things to consider! The nursing staff, including the CNS and the ACNPs have met with the APN Transplant coordinators, who work with transplant patients before the surgery/hospitalization and after the hospitalization. The team has decided to work together to be sure their cultural assessments happen early and are updated as the patient moves through the different care settings. They also decide to model their patient assessment tool on Madeline Leininger’s Cultural Care Model (Leininger, 1988). Group II will discuss the assessments needed for: the recipient, during the transplant hospitalization the donor, during the transplant hospitalization the recipient, for the establishment of post-transplant care Each group must include in their discussion: In 5-minutes provide a brief overview of Leininger’s Theory. Remember: you are assisting the group to understand the theory and why using it will improve assessment and outcomes. During the next 10 minutes, discuss specific details of the assessment process assigned to your group During the discussion, include how Leininger’s Theory is incorporated into the assessment process Would the questions be asked electronically, face-to-face, and/or by phone? Are questions open or close-ended? Explain your choice. Be sure to include general process instructions. Who would conduct the assessment? How long will it take to conduct the assessment? Would questions be asked once or multiple times? If multiple times, when and why? Would some recipients/donors require phone or electronic calls and follow-up? The expected outcome(s) from the assessment process related to the transplant and cultural needs of the patient. 3. During the next 10 minutes: Provide a 5-minute overview of Purnell’s Cultural Competence Model In the next 5 minutes: Discuss why an organization would need to implement this model Discuss how an organization would implement the Purnell model What is the rationale for its implementation? How would your organization and patients know that this model is making a difference? What outcomes would you look for in the transplant clinic and inpatient unit? 4. As a group provide a 5 minute closing summary of next steps for implementation of this process. SCIENCE HEALTH SCIENCE NURSING NURS MISC

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