Cultural CompetencyTraining in Nurse Anesthesia Education by ProQuest


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Suzanne M. Wright, CRNA, MSNA

Cultural Competency Training in Nurse Anesthesia Education
 The population of the United States is becoming             integrating cultural competency content into the train-
 increasingly more diverse both in culture and ethnic-       ing of all healthcare professionals.
 ity. Today, more than 47 million people speak a lan-            Numerous evidence based resources are available
 guage other than English. In 2001, the US Census            that support the development and integration of cul-
 Bureau revealed that 1 in every 10 persons in the           tural competency training in graduate nurse anesthe-
 United States is foreign born. People born in another       sia education. These resources contain a review of the
 country now represent a larger segment of the US            literature, including article abstracts and a compre-
 population than at any time in the past 5 decades.          hensive research agenda. Integrating cultural compe-
     The Institute of Medicine, in its report Unequal        tency training into graduate nurse anesthesia educa-
 Treatment, recommends ways for the healthcare sys-          tion has the potential to positively impact the
 tem to address this issue. These include increasing         anesthesia care provided by nurse anesthetists.
 awareness among practitioners regarding the health-
 care gap that has an impact on racial and ethnic            Keywords: Cultural competency, diversity, health dis-
 groups, increasing the diversity of the workforce, and      parities, nurse anesthesia education, patient safety.

The demographic profile of the popu-    these differences encourages the per-     healthcare services. In the mid-1980s
lation in the United States continues   sistence of inequality and disparity      the Report of the Secretary’s Task
to change. Today, more than 47 mil-     in the health of the people of our        Force on Black and Minority Health
lion people speak a language other      nation and challenges the elements        from the US Department of Health
than English.1 In January 2001, the     of a patient’s most fundamental           and Human Services described the
US Census Bureau revealed that 1 in     rights. Good health is essential to       burden of death and illness experi-
every 10 persons, about 28.4 million    our social, economical, and political     enced by black and other minority
residents, is foreign born.2 Today,     future, and profound health dispari-      Americans.5 For example, the report
people born in another country repre-   ties exist among our nations’             revealed that blacks, when compared
sent one of the largest growing         minority populations that threaten        to whites, had higher death rates
segments of the US population. By       this foundation.3                         from cancer, stroke, heart disease,
2010, the number of Latino children                                               and chronic liver disease; experi-
in the United States is expected to     Health Disparities                        enced twice the incidence of infant
rise by 5.5 million, the number of      Compelling evidence suggests that         mortality; were less likely to see a
African American children by 2.6        although there is progress in the         cardiologist; were less likely to
million, and the number of children     overall health of the nation, race and    undergo coronary artery bypass graft
of other nonwhite races by 1.5 mil-     ethnicity correlate with unwavering       surgery; and were more likely to
lion.1 By 2020, an estimated 40% of     health disparities among African          present to emergency rooms and hos-
school aged children will be a mem-     Americans, Hispanic Americans,            pital clinics.5
ber of a recognized minority group.2    native Americans, Alaskan Natives,
    These demographic trends sug-       and Asian and Pacific Islanders.4         Cultural Competency
gest that about 1 of every 4 patients   These disparities are attributed to the   Cultural competency incorporates
accessing the healthcare system will    complex interaction between individ-      attitudes, skills, behaviors, and poli-
not share the same cultural, ethnic,    ual genetic variation, environmental      cies that enable providers to work
or linguistic heritage as his or her    factors, specific health behaviors, and   effectively in cross-cultural situa-
healthcare provider. Ignorance of       factors related to the delivery of        tions. Cultural competency is the                              AANA Journal      December 2008        Vol. 76, No. 6     421
ability to recognize and respond to       miliar with this practice may become      review of the AANA Standards of
health-related beliefs and cultural       suspicious when examination of an ill     Practice reveals that in order to pro-
values, disease incidence, and to pro-    child reveals multiple bruises. This      vide high quality anesthesia care, the
vide appropriate and effective            practice is not usually painful and       provider should perform a thorough
treatment. Culturally competent           does not constitute physical abuse.       and complete preanesthesia assess-
healthcare providers have a deep          Miscommunication has the potential        ment (Standard I), obtain informed
respect for cultural differences and      to contribute to errors and lead to the   consent for the planned anesthetic

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