Leadership Exam 3
Chapter 9: Cultural Diversity in Health Care
I. Learning Outcomes
a. Evaluate the use of concepts and principles of acculturation, culture, cultural diversity, and cultural sensitivity
in leading and managing situations.
b. Analyze differences between cross-cultural, transcultural, multicultural, and intracultural concepts and
cultural marginality.
II. Cultural Diversity
a. Two perspectives to think about:
i. Patients
ii. Workforce
III. Goals to Promote These Perspectives:
a. Enhancing efforts to increase the recruitment, retention, and subsequent graduation of minority nurses
b. Promoting leadership development for minority nurses
c. Developing a practice environment that promotes diversity
d. Promoting the preparation of all nurses so that culturally competent care can be provided
IV. Effective Leaders
a. Shape the culture of an organization.
V. National and Global Directives
a. The ANA Code of Ethics for Nurses with Interpretive Statements, Provision 8.
i. The ANA Code of Ethics for Nurses with Interpretive Statements, Provision 8 states:
ii. “The nurse collaborates with other health professionals and the public in promoting community,
national, and international efforts to meet health needs.”
VI. Accessibility as Another Challenge
a. Linked to social strata
i. Challenge to strive for worth, recognition and individuality for patients and staff regardless of their
economic or social standing
b. Patient Protection and Affordable Care Act of 2010
VII. Health Disparities
a. Causes in Health Care
i. Poor education
ii. Health behaviors of the minority group
iii. Inadequate financial resources
iv. Access to care
v. Environmental factors
b. Related to?
i. Provider/patient relationships
ii. Provider bias and discrimination
iii. Patient variables of mistrust of the healthcare system and refusal of treatment
c. Examples
i. Cardiovascular disease 40% higher incidence in US blacks than whites
ii. Cancer is 30% higher in US blacks than whites
iii. Diabetic Hispanics are twice as likely to die from the disease than non-hispanic diabetics
VIII. How Does This Affect Healthcare Providers?
a. Effectively manage and treat disease processes.
IX. What Are the True Benefits?
a. Greater productivity!!
X. What is Culture?
a. Three key factors
i. Ethnic background/behavior
ii. Socioeconomic status
iii. Family rituals
XI. Inherent Characteristics of Culture
a. Develops over time
b. Members learn it and share it
1
, c. Essential for survival
d. Difficult to change
XII. Cultural Diversity
a. Range of differences among individuals or groups
XIII. Cultural Sensitivity
a. Affective behaviors in individuals, the capacity to feel, convey, or react to ideas, habits, customs or traditions
unique to a group of people
XIV. Acculturation
a. Adapting
b. Being raised within a culture and acquiring characteristics of that group
c. Becoming a competent participant in the dominant culture
d. Process is difficult
XV. Assimilation
a. Change
b. Developing a new cultural identity becoming in all ways like the members of the dominant culture
XVI. Managerial and Leadership Relevance
a. Positive outcomes for entire team!
XVII. Failure to Address Cultural Diversity?
a. Negative Outcomes for the Team!
XVIII. Individual and Societal Factors
a. Foster respect for differences.
XIX. How Do You Foster the Respect?
a. Multiculturalism
i. Refers to maintaining several different cultures
b. Cross-culturalism
i. Means mediating between/among cultures
c. Transculturalism
i. Denotes bridging significant differences in culture practices
XX. Ethnocentrism
a. Belief that one’s own ways are the best, most superior, or preferred ways to act, believe, or behave
XXI. Cultural imposition
a. The tendency of an individual or group to impose their values, beliefs, and practices on another culture for
varied reasons
XXII. Dealing Effectively with Cultural Diversity
a. Leaders and Managers
i. Long-term vision
ii. Financial commitment
iii. Healthcare-provider commitment
iv. Annual personal culture audit helps an individual identify opportunities for developing skills that
promote productivity and efficiency
v. Must give unwavering support to embracing diversity in the workplace
vi. Focus on building a knowledge base where employees are required to attend educational sessions to
become familiar with cultural practices and to achieve a culture friendly environment
vii. Begin programs that enrich diversity among staff
viii. Mentorship programs
ix. The pacesetter for the cultural norm on the unit is the nurse manager
x. Nurse managers hold the key to making the best use of cultural diversity
xi. Continuing education programs should help the nurse learn about the care of different ethnic groups
b. Muslims are one of the fastest growing populations in the US and worldwide El Gindy addressed the need to
show respect for accommodating Muslim nurses’ dress requirements and understanding the role of Islam in
their lives
XXIII. Tools to Help Clarify Diversity
2
, a. Mentoring
b. Continuing Education
c. Internet
XXIV. The Big Picture!
a. Understanding is key…and appreciation!
Chapter 13: Care Delivery Strategies
I. Objectives
a. Differentiate the characteristics of nursing care delivery models used in health care
b. Determine the role of the nurse manager and the staff nurse in each model
c. Summarize the differentiated nursing practice model and related methods to determine competencies of
nurses who deliver care.
d. Consider the impact of “Transforming Care at the Bedside” (TCAB) on the delivery of care in a specific nursing
unit.
e. Evaluate the effectiveness of transitional care models aimed at reducing unnecessary rehospitalizations.
II. Model Selection
a. Nursing care delivery model: the method used to provide care to patients
b. Considerations to be addressed when selecting a model this is what managers should examine
i. Organizational mission and purpose
ii. Unit objectives
iii. Patient population
iv. Staff availability
v. Economic feasibility
III. Care Models
a. Case method
b. Functional nursing
c. Team nursing
d. Primary nursing
e. Case management
IV. Other Strategies
a. Patient-focused care
b. Differentiated practice
V. Emerging Practice Models/Influences
a. Magnet™ Recognition
b. The Synergy Model
c. The Clinical Nurse Leader
VI. Case Method (Total Patient Care- one on one)
a. Oldest method of providing care to a patient
b. One nurse provides total patient care for one patient in the entire work period
c. ICU and critical care settings are a good example
d. During a 8 or 12 hour shift, the patient receives consistent care from one nurse
e. Role of the Nurse Manager
i. Assess patient needs to determine level of care:
1. RN care
2. RN-supervised care
3. Hiring and management of appropriate staff to provide total care in a cost-effective manner
3
Chapter 9: Cultural Diversity in Health Care
I. Learning Outcomes
a. Evaluate the use of concepts and principles of acculturation, culture, cultural diversity, and cultural sensitivity
in leading and managing situations.
b. Analyze differences between cross-cultural, transcultural, multicultural, and intracultural concepts and
cultural marginality.
II. Cultural Diversity
a. Two perspectives to think about:
i. Patients
ii. Workforce
III. Goals to Promote These Perspectives:
a. Enhancing efforts to increase the recruitment, retention, and subsequent graduation of minority nurses
b. Promoting leadership development for minority nurses
c. Developing a practice environment that promotes diversity
d. Promoting the preparation of all nurses so that culturally competent care can be provided
IV. Effective Leaders
a. Shape the culture of an organization.
V. National and Global Directives
a. The ANA Code of Ethics for Nurses with Interpretive Statements, Provision 8.
i. The ANA Code of Ethics for Nurses with Interpretive Statements, Provision 8 states:
ii. “The nurse collaborates with other health professionals and the public in promoting community,
national, and international efforts to meet health needs.”
VI. Accessibility as Another Challenge
a. Linked to social strata
i. Challenge to strive for worth, recognition and individuality for patients and staff regardless of their
economic or social standing
b. Patient Protection and Affordable Care Act of 2010
VII. Health Disparities
a. Causes in Health Care
i. Poor education
ii. Health behaviors of the minority group
iii. Inadequate financial resources
iv. Access to care
v. Environmental factors
b. Related to?
i. Provider/patient relationships
ii. Provider bias and discrimination
iii. Patient variables of mistrust of the healthcare system and refusal of treatment
c. Examples
i. Cardiovascular disease 40% higher incidence in US blacks than whites
ii. Cancer is 30% higher in US blacks than whites
iii. Diabetic Hispanics are twice as likely to die from the disease than non-hispanic diabetics
VIII. How Does This Affect Healthcare Providers?
a. Effectively manage and treat disease processes.
IX. What Are the True Benefits?
a. Greater productivity!!
X. What is Culture?
a. Three key factors
i. Ethnic background/behavior
ii. Socioeconomic status
iii. Family rituals
XI. Inherent Characteristics of Culture
a. Develops over time
b. Members learn it and share it
1
, c. Essential for survival
d. Difficult to change
XII. Cultural Diversity
a. Range of differences among individuals or groups
XIII. Cultural Sensitivity
a. Affective behaviors in individuals, the capacity to feel, convey, or react to ideas, habits, customs or traditions
unique to a group of people
XIV. Acculturation
a. Adapting
b. Being raised within a culture and acquiring characteristics of that group
c. Becoming a competent participant in the dominant culture
d. Process is difficult
XV. Assimilation
a. Change
b. Developing a new cultural identity becoming in all ways like the members of the dominant culture
XVI. Managerial and Leadership Relevance
a. Positive outcomes for entire team!
XVII. Failure to Address Cultural Diversity?
a. Negative Outcomes for the Team!
XVIII. Individual and Societal Factors
a. Foster respect for differences.
XIX. How Do You Foster the Respect?
a. Multiculturalism
i. Refers to maintaining several different cultures
b. Cross-culturalism
i. Means mediating between/among cultures
c. Transculturalism
i. Denotes bridging significant differences in culture practices
XX. Ethnocentrism
a. Belief that one’s own ways are the best, most superior, or preferred ways to act, believe, or behave
XXI. Cultural imposition
a. The tendency of an individual or group to impose their values, beliefs, and practices on another culture for
varied reasons
XXII. Dealing Effectively with Cultural Diversity
a. Leaders and Managers
i. Long-term vision
ii. Financial commitment
iii. Healthcare-provider commitment
iv. Annual personal culture audit helps an individual identify opportunities for developing skills that
promote productivity and efficiency
v. Must give unwavering support to embracing diversity in the workplace
vi. Focus on building a knowledge base where employees are required to attend educational sessions to
become familiar with cultural practices and to achieve a culture friendly environment
vii. Begin programs that enrich diversity among staff
viii. Mentorship programs
ix. The pacesetter for the cultural norm on the unit is the nurse manager
x. Nurse managers hold the key to making the best use of cultural diversity
xi. Continuing education programs should help the nurse learn about the care of different ethnic groups
b. Muslims are one of the fastest growing populations in the US and worldwide El Gindy addressed the need to
show respect for accommodating Muslim nurses’ dress requirements and understanding the role of Islam in
their lives
XXIII. Tools to Help Clarify Diversity
2
, a. Mentoring
b. Continuing Education
c. Internet
XXIV. The Big Picture!
a. Understanding is key…and appreciation!
Chapter 13: Care Delivery Strategies
I. Objectives
a. Differentiate the characteristics of nursing care delivery models used in health care
b. Determine the role of the nurse manager and the staff nurse in each model
c. Summarize the differentiated nursing practice model and related methods to determine competencies of
nurses who deliver care.
d. Consider the impact of “Transforming Care at the Bedside” (TCAB) on the delivery of care in a specific nursing
unit.
e. Evaluate the effectiveness of transitional care models aimed at reducing unnecessary rehospitalizations.
II. Model Selection
a. Nursing care delivery model: the method used to provide care to patients
b. Considerations to be addressed when selecting a model this is what managers should examine
i. Organizational mission and purpose
ii. Unit objectives
iii. Patient population
iv. Staff availability
v. Economic feasibility
III. Care Models
a. Case method
b. Functional nursing
c. Team nursing
d. Primary nursing
e. Case management
IV. Other Strategies
a. Patient-focused care
b. Differentiated practice
V. Emerging Practice Models/Influences
a. Magnet™ Recognition
b. The Synergy Model
c. The Clinical Nurse Leader
VI. Case Method (Total Patient Care- one on one)
a. Oldest method of providing care to a patient
b. One nurse provides total patient care for one patient in the entire work period
c. ICU and critical care settings are a good example
d. During a 8 or 12 hour shift, the patient receives consistent care from one nurse
e. Role of the Nurse Manager
i. Assess patient needs to determine level of care:
1. RN care
2. RN-supervised care
3. Hiring and management of appropriate staff to provide total care in a cost-effective manner
3
