Cultural Competency in the Clinical Setting
by Robert F. Jex, RN, MHA, FACHE
Wednesday, January 20, 2009
12:00 p.m. - 1:00 p.m. (Mountain)
Robert Jex, RN, MHA, FACHE is a Trauma System Clinical Consultant within the Emergency Medical Services and Preparedness at the Utah Department of Health. He has been a practicing RN for 33 years with experience in ER, OR, Med/Surg/ICU, Nursery, Labor and Delivery, and home health care. He has a BS in Zoology, an MS in Reproductive Physiology and a Master of Health Administration. Mr. Jex is a licensed long term care administrator, a Fellow in the American College of Health Care Executives, and a certified trainer in Cultural Competency.
Cultural Competency in the Clinical Setting
by Robert F. Jex, RN, MHA, FACHE
Wednesday, January 20, 2009
12:00 p.m. - 1:00 p.m. (Mountain)
Robert Jex, RN, MHA, FACHE is a Trauma System Clinical Consultant within the Emergency Medical Services and Preparedness at the Utah Department of Health. He has been a practicing RN for 33 years with experience in ER, OR, Med/Surg/ICU, Nursery, Labor and Delivery, and home health care. He has a BS in Zoology, an MS in Reproductive Physiology and a Master of Health Administration. Mr. Jex is a licensed long term care administrator, a Fellow in the American College of Health Care Executives, and a certified trainer in Cultural Competency.
A presentation about intercultural encounters within the healthcare relationship. This presentation was give, specifically, to allied health professional students.
View the video here: https://www.youtube.com/watch?v=gCMCNReYnYs
Earn counseling CEUs here: https://www.allceus.com/member/cart/index/product/id/684/c/
Assumption 1: Counselors will not be able to sustain culturally responsive treatment without the organization's commitment to it.
Assumption 2: An understanding of race, ethnicity, and culture (including one's own) is necessary to appreciate the diversity of human dynamics and to treat all clients effectively
Assumption 3: Incorporating cultural competence into treatment improves therapeutic decision-making and offers alternate ways to define and plan a treatment program that is firmly directed toward progress and recovery
Assumption 4: Consideration of culture is important at all levels of operation—individual, programmatic, and organizational
Assumption 5: Culturally congruent interventions cannot be successfully applied when generated outside a community or without community participation.
Assumption 6: Public advocacy of culturally responsive practices can increase trust among the community, agency, and staff.
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Basavarajeeyam is a Sreshta Sangraha grantha (Compiled book ), written by Neelkanta kotturu Basavaraja Virachita. It contains 25 Prakaranas, First 24 Chapters related to Rogas& 25th to Rasadravyas.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Integrating Ayurveda into Parkinson’s Management: A Holistic Approach
Cultural Competence in Healthcare (Rue, 2002)
1. Developing Cultural Competence An Introductory Look at Cultural Competency in Health Care Presented by Tom Rue, M.A., CASAC, CCMHC – AC II Richard C. Ward Addiction Treatment Center At Core Training – March 2002
4. Cultural Norms “ Should’s and ought’s of the group. Examples are standards of behavior such as: - productivity norms - equity norms - styles of dress - power and control in relationships - acceptable behaviors, etc.
5. What is Culture? Culture is the acquired knowledge that people use to interpret experience and generate social behavior.
22. Individual Cultural Competence Continuum Model Cultural Proficiency Cultural Pre-Competency Cultural Competence Cultural Blindness Cultural Destructiveness Cultural Incapacity
23. Organizational Cultural Competence A journey, not a destination... Unaware, Competent Aware, Incompetent Aware, Competent Unaware, Incompetent
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Editor's Notes
Let’s break down this term “cultural diversity” so we better understand its meaning. The term “culture” refers to the patterns and conditions that bind people together as an identifiable group. Culture is shared with those with similar experiences. Cultural diversity refers to differences in race, ethnicity, language, nationality, religion, and other beliefs and practices among various groups within a community, organization, or nation. Although we usually associate culture with race and ethnicity, there are other cultural groups that add to diversity. What are some other cultures? Note: Ask group to name different cultural groups. Facilitate brief discussion. Note: Deaf community Single women Working mothers Working fathers Religious community People living with HIV Vegetarians Homeless
We often think of cultural diversity as referring to our differences in racial background. In fact, many other things that contribute to who we are, are factors in our cultural diversity. These include not only race but: Country of origin Native language Socio-economic status Education level Religion Mental or physical abilities Note: List continued on next page.
And: Heritage Acculturation Age Gender Sexual orientation Other characteristics that may result in a differing perspective, decision-making process, or learning style Now that we have defined culture, let’s look at why HCFA chooses to address culture in training.
Cultural Competence is use of knowledge about individuals and groups of people to produce specific standards policies practices attitudes to be used in appropriate cultural settings to increase the quality of services, thereby producing better outcomes.
Note: HCFA’s definition of Cultural Competency. Please read: “Cultural Competency in health is a set of attitudes, skills, behaviors, and policies that enable organizations and individuals to work effectively in cross-cultural situations. It reflects an understanding of the importance of acquiring and using knowledge of the unique health-related beliefs, attitudes, practices, and communication patterns of beneficiaries and their families to improve services, enhance beneficiary understanding of programs, increase community participation, and eliminate disparities in health status among diverse population groups.” This definition was taken from Cross, T, 1992 Culture shapes how people experience their world, interpret their environment, live with their families, choose their lifestyles, work, play, and reside in their communities. Most importantly, culture defines: How health care information is received How rights and protections are exercised What is considered to be a health problem How symptoms and concerns about the problem are expressed Who should provide treatment for the problem What type of treatment should be given
Some Current and Projected Socio-Demographic Characteristics : An estimated 1 in 4 Americans (about 67 million) is classified by the U.S. Census as a member of one of the four major racial or ethnic minority population groups: African American, Latino/Hispanic, Native American, or Asian/Pacific Islander. Latinos almost equal African Americans in number, representing almost half of minority Americans: and, they are projected to be the largest racial/ethnic minority population by 2025 By the year 2050, the U.S. Census estimates that people of color will represent 1 in 3 Americans. This is largely due to higher birth rates and immigration among racial and ethnic minority populations. Diversity is found not only between the major U.S. minority population groups, but within them as well. Using Latinos as an example, the health beliefs or practices of a person with origins in Puerto Rico may differ greatly from those of someone from Mexico or El Salvador. Minority Americans, on average, are poorer than whites. While more than 20% of whites are poor or near poor (i.e., incomes below 200% of poverty), at least one-half of African Americans, Latinos, and Native Americans are poor or near poor. Similarly, elderly minority Americans are far more likely than their white counterparts to live in poverty. Eliminate disparities in the health status of people of diverse racial, ethnic and cultural backgrounds While the gap between blacks and whites cardiac catheterizations (used to diagnose heart disease) has narrowed over time, large racial disparities in the treatment of heart disease with angioplasty and coronary bypass surgery persist, with the chances of blacks undergoing these procedures about half those for whites Most telling are the (HCSUS) indicators that looked at the use of triple drug anti-retroviral therapy, a treatment regimen that is very effective in delaying disability and prolonging the life to persons with HIV. African Americans were more than twice as likely as whites to not receive combination drug therapy and 1.5 times more likely to not get preventive treatment for pneumocystic carinii pneumonia (a common, but preventable, infection in people with HIV) than whites. Latinos were 1.5 times more likely than whites to not get combination drug therapy (Shapiro et al, 1999). In a study of Medicaid beneficiaries (all from low-income families with health coverage for preventive services) African American children were more likely than white children to be treated for their asthma in emergency departments, to be hospitalized for asthma, and were less likely to have office visits for their asthma. While there were no differences in the amount of well-child care visits or prescriptions for asthma drugs, African American children were less likely to receive the drug therapy recommended in national asthma guidelines. A study of previously hospitalized African American and white adults (age 18-50) enrolled in a health maintenance organization, where financial barriers to care are minimized, found that African Americans made more emergency department visits, while whites made more primary care and allergy/pulmonary visits. In addition, while there were no racial differences in re-hospitalization for asthma, African Americans with Medicaid coverage were twice as likely to be re-hospitalized than African Americans with private coverage. Even in studies where everyone is similarly insured, racial differences in the use of cardiac procedures remain. For example, among Medicare beneficiaries, blacks were 60% less likely than whites to undergo heart bypass surgery. Adjusting for income made little difference in the findings -- black beneficiaries were still less than half as likely to undergo surgery than white beneficiaries. Improve the quality of Services and Health outcomes . In making a diagnosis, health care providers must understand the beliefs that shape a person’s approach to health and illness. Knowledge of customs and healing traditions are indispensable to the design of treatment and interventions. Health care services must be received and accepted to be successful. Increasingly, cultural knowledge and understanding are important to personnel responsible for quality assurance programs. In addition, those who design evaluation methodologies for continual program improvement must address hard questions about the relevance of health care interventions. Cultural competence will have to be inextricably linked to the definition of specific health outcomes and to an ongoing system of accountability that is committed to reducing the current health disparities among racial, ethnic and cultural populations. Some Current and Projected Socio-Demographic Characteristics : An estimated 1 in 4 Americans (about 67 million) is classified by the U.S. Census as a member of one of the four major racial or ethnic minority population groups: African American, Latino/Hispanic, Native American, or Asian/Pacific Islander. Latinos almost equal African Americans in number, representing almost half of minority Americans: and, they are projected to be the largest racial/ethnic minority population by 2025 By the year 2050, the U.S. Census estimates that people of color will represent 1 in 3 Americans. This is largely due to higher birth rates and immigration among racial and ethnic minority populations. Diversity is found not only between the major U.S. minority population groups, but within them as well. Using Latinos as an example, the health beliefs or practices of a person with origins in Puerto Rico may differ greatly from those of someone from Mexico or El Salvador. Minority Americans, on average, are poorer than whites. While more than 20% of whites are poor or near poor (i.e., incomes below 200% of poverty), at least one-half of African Americans, Latinos, and Native Americans are poor or near poor. Similarly, elderly minority Americans are far more likely than their white counterparts to live in poverty. Eliminate disparities in the health status of people of diverse racial, ethnic and cultural backgrounds While the gap between blacks and whites cardiac catheterizations (used to diagnose heart disease) has narrowed over time, large racial disparities in the treatment of heart disease with angioplasty and coronary bypass surgery persist, with the chances of blacks undergoing these procedures about half those for whites Most telling are the (HCSUS) indicators that looked at the use of triple drug anti-retroviral therapy, a treatment regimen that is very effective in delaying disability and prolonging the life to persons with HIV. African Americans were more than twice as likely as whites to not receive combination drug therapy and 1.5 times more likely to not get preventive treatment for pneumocystic carinii pneumonia (a common, but preventable, infection in people with HIV) than whites. Latinos were 1.5 times more likely than whites to not get combination drug therapy (Shapiro et al, 1999). In a study of Medicaid beneficiaries (all from low-income families with health coverage for preventive services) African American children were more likely than white children to be treated for their asthma in emergency departments, to be hospitalized for asthma, and were less likely to have office visits for their asthma. While there were no differences in the amount of well-child care visits or prescriptions for asthma drugs, African American children were less likely to receive the drug therapy recommended in national asthma guidelines. A study of previously hospitalized African American and white adults (age 18-50) enrolled in a health maintenance organization, where financial barriers to care are minimized, found that African Americans made more emergency department visits, while whites made more primary care and allergy/pulmonary visits. In addition, while there were no racial differences in re-hospitalization for asthma, African Americans with Medicaid coverage were twice as likely to be re-hospitalized than African Americans with private coverage. Even in studies where everyone is similarly insured, racial differences in the use of cardiac procedures remain. For example, among Medicare beneficiaries, blacks were 60% less likely than whites to undergo heart bypass surgery. Adjusting for income made little difference in the findings -- black beneficiaries were still less than half as likely to undergo surgery than white beneficiaries. Improve the quality of Services and Health outcomes . In making a diagnosis, health care providers must understand the beliefs that shape a person’s approach to health and illness. Knowledge of customs and healing traditions are indispensable to the design of treatment and interventions. Health care services must be received and accepted to be successful. Increasingly, cultural knowledge and understanding are important to personnel responsible for quality assurance programs. In addition, those who design evaluation methodologies for continual program improvement must address hard questions about the relevance of health care interventions. Cultural competence will have to be inextricably linked to the definition of specific health outcomes and to an ongoing system of accountability that is committed to reducing the current health disparities among racial, ethnic and cultural populations.
An estimated 1 in 4 Americans (about 67 million) is classified by the US Census as a member of one of the four major racial or ethnic population groups: African American, Latino/Hispanic, Asian/Pacific Islander.
At each age of the life-span until age 44, African Americans, Latinos, and Native Americans have, on average, higher mortality rates than whites. Only Asians have, on average, lower mortality rates than whites. When overall mortality is examined by a measure of socio-economic conditions (e.g., income), differences between African Americans and whites are reduced but not eliminated. Infant mortality rates, considered one of the most sensitive indicators of the health and well-being of a population, are twice as high among African American infants as whites, even when analyzed by a measure of socio-economic conditions, such as the mother’s education. African Americans are more likely to rate their health as fair or poor than whites of similar incomes; however, this disparity is smaller between those with higher incomes than between those with lower incomes. In 1996, the top five leading causes of death for whites and minority Americans were very similar, with heart disease and cancer ranking number one and two across all groups. However in the past decade deaths due to HIV/AIDS have increased dramatically in the African American and Latino populations, moving this disease to the top five causes of death for both groups. In a study of Medicaid beneficiaries (all from low-income families with health coverage for preventive services) African American children were more likely than white children to be treated for their asthma in emergency departments, to be hospitalized for asthma, and were less likely to have office visits for their asthma. While there were no differences in the amount of well-child care visits or prescriptions for asthma drugs, African American children were less likely to receive the drug therapy recommended in national asthma guidelines.