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EDUCATION NEWS 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 www.aana.com/aanajournal.aspx 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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