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35820/02 CHCDIV002 Promote Aboriginal and/or Torres Strait Islander cultural safety

Task brief:

  • Download this assessment to identify the assessment guidelines
  • This is a group assessment and your group will be nominated by your educator
  • You will work with your allocated group and undertake research and preparation for a group education presentation outlining your response to the questions provided.
  • In your allocated group, plan and undertake an education presentation to your peers by answering the following twelve (12) questions to demonstrate your understanding on how to promote ABTSI cultural safety in the workplace.
  • Please answer the questions on the template provided.
  • Your educator will assess your performance in class and will complete the marking guide on the day.
  • Students will need to save an individual copy of their completed presentation template and signed marking guide for their own records and upload a copy into OpenSpace.
  • Students are to individually upload the assessment.

Solution:

Performance criteriaRecord of results
Q1What does Cultural Safety mean? How are the key aspects implemented and evaluated in health services?SNYS
Student to add answer here In clinical practice, cultural safety is the ability of the healthcare provider to meet the need of the patient by examining and self-reflection on own cultural biases and values. This helps in achieving the cultural understanding and responsiveness to acknowledge the barriers. Cultural safety is shared respect and knowledge. It consists of the experience of learning together with dignity and listening actively for shared decisions. It also includes removing the barriers to the optimal health and well-being of Aboriginal and/or Torres Strait Islander People which includes addressing the unconscious bias of racism, discrimination and superiority. The key elements of cultural safety include knowledge, respect for self, and respect to Aboriginal and/or Torres Strait Islander People. These key aspects of cultural safety can be implemented by creating an environment safe for Aboriginal and Torres Islander people. This means no challenges, denial of identity and discriminating experiences. It includes sharing power through the decision making and governance and providing resources to the communities. The culturally safe and responsive atmosphere should be provided where social determinants of health are understood. The implementation includes Proper training and fostering healthcare professionals to support cultural safety along with clinical competencies. The organization should have a multi-cultural workforce in clinical and non-clinical areas. It can be evaluated through feedback, the experience of the indigenous communities, engagement of indigenous people, change in health status and quality audits. The evaluation is also done by the evaluation tool kits and surveys that provide information regarding the culturally safe workplace, practices, procedures and policy.   Milligan, E., West, R., Saunders, V., Bialocerkowski, A., Creedy, D., Rowe Minniss, F., Hall, K., & Vervoort, S. (2021). Achieving cultural safety for Australia. Australian health review: a publication of the Australian Hospital Association, 10.1071/AH20215. Advance online publication. https://doi.org/10.1071/AH20215
Q2 How would demonstrate Cultural Safety and Cultural Competence when working with Aboriginal and/or Torres Strait Islander patients/clients?SNYS
Student to add answer here Cultural Safety and Cultural Competence when working with Aboriginal and/or Torres Strait Islander patients/clients can be demonstrated by acknowledging their cultural practices, prioritising their needs, preferences and establishing therapeutic relationship through self-reflection, communication and empathy. If providing any information or facing any inquiry it should be dealt with positive attitude and empathy. The culturally safe and competent services involve care based on the understanding of individual needs and recognition of cultural values and beliefs. Cultural safe and competent care as stated by the Australian council of nursing and midwifery should be provided through the overall experience of empowerment and learning. Respectful, open and clear communication should be established directing to develop trust and overcoming barriers. As per the Australian Commission on Safety and Quality in Healthcare the cultural competency can be demonstrated by providing a supportive environment exploring the cultural need of the Aboriginal and Torres Strait Islander patients where their families and community member may feel comfortable to engage in the service process.   Kurtz, D., Janke, R., Vinek, J., Wells, T., Hutchinson, P., & Froste, A. (2018). Health Sciences cultural safety education in Australia, Canada, New Zealand, and the United States: a literature review. International journal of medical education, 9, 271–285. https://doi.org/10.5116/ijme.5bc7.21e2
Q3What are some potential cultural issues that may impact on the delivery of care to a patient?SNYS
Student to add answer here   Some potential cultural issues that may impact the delivery of care to a patient are discrimination, racism, lack of accessibility, cultural misunderstanding, inequality, social injustice and conflicts. Cultural biasness both within the communities and healthcare providers may result in health-related perceptions and preferences which is the key cultural issue. Language and communication barrier due to lack of cultural knowledge result in poor delivery of quality healthcare services. Lack of qualitative perspective to accommodate the social and cultural needs of the communities have negative outcomes for engaging the Aboriginal and Torres Islander people. Health literacy, beliefs, trust, expectation, social values, gender and living environment are some of the other factors.   Waterworth, P., Pescud, M., Braham, R., Dimmock, J., & Rosenberg, M. (2015). Factors Influencing the Health Behaviour of Indigenous Australians: Perspectives from Support People. PloS one, 10(11), e0142323. https://doi.org/10.1371/journal.pone.0142323
Q4Identify how these potential issues may impact on the relationship and communication you would have with a patient?SNYS
Student to add answer here   Potential cultural issue such as racism, dissociation, social isolation, inequality may result in the development of distrust and barrier between the patient and the healthcare providers, this impact on the relationship and communication I would have with a patient. When these cultural issues are present it affects the communication increasing the dissatisfaction of experiences and perceptions hindering participation in decision making and treatment adherence. The cultural issue may influence the behaviour choices, education, skills, resource utilization and responses of Aboriginal and Torres Islander individuals. The cultural issues and lack of understanding of culture among healthcare professionals result in stereotyping and discrimination based on cultural belief rather than individual need. Conway, J., Tsourtos, G., & Lawn, S. (2017). The barriers and facilitators that indigenous health workers experience in their workplace and communities in providing self-management support: a multiple case study. BMC health services research17(1), 319. https://doi.org/10.1186/s12913-017-2265-5   The recommendation should include following points:  Pathways between the hospital and community care providers which can provide collaborative healthcare support to patient aligning with the Aboriginal and Torres Strai Islander community support. This includes collaboration with local healthcare support organisation such as or referring to local healthcare worker or liaison officer to address any concern. Arranging the travel arrangement or allowances, most of the patients from indigenous communities travel far to avail the healthcare services hence proper travelling and accommodations should be arranged. Can be recommended to government run support system such as Friends of RPH, which assist Aboriginal and Torres Islander people with banking, connecting with families, phone call, treatment ensuring that patient have smooth transition.
Q5How do you ensure your nursing care meet the cultural safety needs of your patient?  SNYS
Student to add answer here   Language, communication style, cultural understanding, appropriate use of medical terminology, and cross-cultural variations should be considered by the nurse for good patient-nurse communication and meeting the cultural safety needs. A nurse working within the Aboriginal and Torres Islander community should identify the challenges in cross-cultural communication and accommodate the culture-specific needs within the broader healthcare system including better communication with indigenous patients. To meet the cultural safety needs of the patient the nurse needs to be respectful to cultural sense and diversity, maintain the nurse-patient relationship with compassion and honesty adhering to obligations such as privacy and confidentiality. Encouraging active patient and family involvement with shared decision making helps in meeting the cultural safety needs of the clients. The nurse should also reflect on her own practices and cultural values to minimize the power differentials between oneself and the client.   Shahid, S., Durey, A., Bessarab, D., Aoun, S. M., & Thompson, S. C. (2013). Identifying barriers and improving communication between cancer service providers and Aboriginal patients and their families: the perspective of service providers. BMC health services research, 13, 460. https://doi.org/10.1186/1472-6963-13-460
Q6How do you ensure that you are aware of your own cultural bias and how do you eliminate the bias from your care? How would you ensure your bias is eliminated when you work with all cultures?SNYS
Student to add answer here     Nurses need to understand their own attitude, values and behaviour as they interact with clients that are unique with diverse characteristics. Self-awareness of the cultural bias can be achieved by the process of looking inward to recognize one own belief and values which might result in cultural bias in routine interaction with patients. I will also adopt the reflective practices to make sure that I do not discriminate or do exclusion towards patients based on race, ethnicity, religion, socioeconomic status, gender, age, mental health; cognitive, sensory, or physical disability; orientation or gender identity and geographic location. To eliminate the unconscious bias five strategies can be utilized by the nurse, these are personal awareness, acknowledgement, empathy, advocacy and education. Personal awareness helps in evaluating the internal thought process that might cause unconscious bias. Acknowledgement of the problem allows reflection and actions on further situations. Empathy helps to make positive efforts toward the recognized issues and barrier existed. Advocacy ensures that the bias is removed among the other healthcare professionals also and patients’ rights are not overlooked. Education allows a better knowledge base and raising awareness about the consequences of unconscious bias. I will ensure that my bias is removed when I work with all culture by providing them quality services without any discrimination and assumptions, by building an appropriate nurse-patient relationship and be conscious of the health disparities they might have faced as a community. Cuevas, A. G., O’Brien, K., & Saha, S. (2017). What is the key to culturally competent care: Reducing bias or cultural tailoring?. Psychology & health, 32(4), 493–507. https://doi.org/10.1080/08870446.2017.1284221
Q7Explain the communication techniques you would use to demonstrate respect for the cultural differences of Aboriginal and/or Torres Strait Islander patients.SNYS
Student to add answer here   The appropriate techniques of communication include active listening, indirect questioning, encouraging participation, exhibiting respect and sensitivity; no use of complex medical terminology and appropriate use of words. A clear concise and understandable language should be used, use of words that might have different meaning in different communities should be avoided. Direct question regarding cultural differences should be avoided these can lead to misunderstandings and discourage the participation of the client. Body language depicting positive body gesture and respect should be used.   FitzGerald, C., & Hurst, S. (2017). Implicit bias in healthcare professionals: a systematic review. BMC medical ethics, 18(1), 19. https://doi.org/10.1186/s12910-017-0179-8    
Q8How would you engage Aboriginal and/or Torres Strait Islander interpreters, colleagues or cultural brokers with your patients care? Explain how you would engage and develop effective culturally appropriate partnerships between staff and patients?SNYS
Student to add answer here   Indigenous Australian interpreters and liaison officers have a positive influence on the professional relationship with Aboriginal and Torres Strait Islander especially in bridging the cultural gap. Aboriginal and/or Torres Strait Islander interpreters, colleagues or cultural brokers face to face interpretation, community meetings, conflict solution. Social relationships, mediation, translation and audio recordings.  People such as healthcare workers, teachers, community workers and colleagues can act as effective cultural broker and translator. For engaging, the role clarifications or negotiations should be done and role, responsibilities should be well-defined. Engagement should be done as per the practices and policies of the organisation, empathy and respect should be exhibited appropriately and professionals.  Ensure two ways of communication, resources and information. The relationship should be built on basis of mutual benefits and respect. Following strategies should be used to engage and develop effective culturally appropriate partnerships between staff and patients: Gaining trust and building relationship putting the Aboriginal and Torres Islander life, healthcare needs and their challenges in the central role. Make efforts to identify the right community individuals and groups to approach and enquire about the key leaders and point of contact in the community to build the relationship. As the Aboriginal and Torres Strait Islander community represents the diverse, unique needs and understandings which should be respected and represented. The communication should be made clear, interactive to enable the culturally appropriate environment and working. Investment of resources and time to ensure that the relationship building is effective and sustainable with mutual interests.  Facilitating empowerment, participation through knowledge sharing, share decision making and effective communication.         Durey, A., McEvoy, S., Swift-Otero, V., Taylor, K., Katzenellenbogen, J., & Bessarab, D. (2016). Improving healthcare for Aboriginal Australians through effective engagement between community and health services. BMC health services research, 16, 224. https://doi.org/10.1186/s12913-016-1497-0    
Q9Outline the following resources for your audience Resources you identified to support partnerships in the care for patients while in hospital Recommendations for programs used upon discharge that are culturally safeStrategies used to increase patient participation in careSNYS
Student to add answer here   Resource to support partnerships in the care for patients while in hospital:  The National Aboriginal Community Controlled Health Organisation (NACCHO), the community resource has the collaborative partnership with Australian Healthcare & Hospitals Association (AHHA) for developing and maintaining culturally appropriate health care services for Aboriginal and Torres Strait Islander people.   https://www.naccho.org.au/   The recommendation should include following points:  Pathways between the hospital and community care providers which can provide collaborative healthcare support to patient aligning with the Aboriginal and Torres Strait Islander community support. This includes collaboration with local healthcare support organisation such as NACCHO or referring to local healthcare worker or liaison officer to address any concern. Recommending to organisation such as TracsWA which provides rehabilitation and care such as nutrition and mental health support through health alliance between community and healthcare services. Arranging the travel arrangement or allowances, most of the patients from indigenous communities travel far to avail the healthcare services hence proper travelling and accommodations should be arranged. Can be recommended to government run support system such as Friends of RPH, which assist Aboriginal and Torres Islander people with banking, connecting with families, phone call, treatment ensuring that patient have smooth transition. Patient-centric discharge care planning improves the transitional care and health outcomes for vulnerable communities hence recommendations should be provided .through shared decisions of the patient itself     Strategies to use for increasing the patient participation in care are: 1.Appropriate communication: communication that develops trust, mutual relation       and confidence 2.Cultural competence: exhibiting respect towards culture, beliefs and traditions 3.Encouragement: for freedom of decision making and understanding the health needs of the self and the community 4.Self-management and self-determination: empowerment to take own decisions, relates and understand the care plan, acknowledgment of their own role in their own health 5.Engagement and partnership: engaging the translator or the cultural liaison officer to make more collaborative partnership.   Wilson, J. D., Shaw, K. C., & Feldman, L. S. (2018). Using Post-discharge Home Visitation to Improve Cultural Sensitivity and Patient-centered Discharge Planning by Internal Medicine Trainees. Journal of health care for the poor and underserved29(4), 1288–1299. https://doi.org/10.1353/hpu.2018.0096  
Q10What strategies would you use to evaluate your care and why?SNYS
Student to add answer here   Strategies that can be used as a nurse for evaluating the care provided might include the use of the Transcultural self-efficacy tool (TEST), feedbacks, reflection on the previous clinical experiences. The improved experience of Aboriginal and better participation can be evaluated through surveys, feedback forms and interviews. The use of reflective practice also helps in evaluating the situation and formulation of the future action plan. Improved participation of the community with better nurse-patient relationship also indicated towards the appropriate nursing care. Transcultural self-efficacy tool (TEST)is used to analyse and evaluate the capabilities for performing culturally safe and competent skills while caring for diverse patients. Zarzycka, D., Chrzan-Rodak, A., Bąk, J., Niedorys-Karczmarczyk, B., & Ślusarska, B. (2020). Nurse Cultural Competence-cultural adaptation and validation of the Polish version of the Nurse Cultural Competence Scale and preliminary research results. PloS one, 15(10), e0240884. https://doi.org/10.1371/journal.pone.0240884  
Q11Provide a definition of Self- determination and explain the strategies you would use to encourage Self-determination of Aboriginal and/or Torres Strait Islander patients, when using community services and programs.SNYS
Student to add answer here   Self-determination is defined as the process by which a group of people make their own choices in life. Self-determination is an ongoing process that ensures that the indigenous communities can to meet their social, cultural, health and economic needs. Self-determination is the key for Aboriginal and Torres Islander pope to overcome the health barriers and disadvantages. The relation of self-determination among the indigenous population helps them have more control and influence over their decision-making regarding healthcare needs. The strategies that can be used to encourage Self-determination of Aboriginal and/or Torres Strait Islander patients, when using community services and programs are as follows: Education: Self-determination enables opportunities for Aboriginal people to prioritize their own decisions in program development and ensures the ongoing services are relevant and appropriate. An awareness of self-determination and the ability to recognize health issues in the community is a requirement of community control. Therefore, a more holistic view is adopted as health is seen not only at the individual level of disease but also at the wider community level. Empowerment: feeling empowered and accountable for their own decisions encourages them to adopt self-determination.  This also develops confidence and trust with maximum participation in the participation activities within the programs. Engagement: Engaging with the Aboriginal run healthcare facilities such as aboriginal healthcare centers or Aboriginal PHCs and District Aboriginal Health Action Groups (DAHAGs) to collaborate encourages the proper to adopt more self-determination strategies due to authority and leadership within their community hence developing better communication.   Harfield, S. G., Davy, C., McArthur, A., Munn, Z., Brown, A., & Brown, N. (2018). Characteristics of Indigenous primary health care service delivery models: a systematic scoping review. Globalization and health, 14(1), 12. https://doi.org/10.1186/s12992-018-0332-2  
Q12Choose a community health care resource for Aboriginal and/or Torres Strait Islander people and evaluate their program/service against the principles of Cultural Safety.SNYS
Student to add answer here One community chosen for the Aboriginal and Torres Islander is AMSANT: Aboriginal medical services Alliance Northern Territory. The resource has various programs and projects such as workforce leadership support., digital health, social and emotional well-being and mental health support program. http://www.amsant.org.au/ The evaluation of the community resources is done based on five principles of cultural safety that are a partnership, Personal knowledge, process, protocols and purpose. The resource hires and works along with the people of the indigenous community hence it gives a sense of security, ownership and trust. This fulfils the partnership between the community and the resource. The organization is well aware of the indigenous culture, its struggle and disparity of resources in healthcare. The organization world to develop equity, commitment and positive beliefs. It provides collaborative practice seeking helps form leaders of the community for the decision-making process. It engages in the process of mutual learning and ideas and ensures that positive steps are taken to achieve the goals. Hence the community resource is apt for Aboriginal and Torres Islander.   Harding T. (2013). Cultural safety: a vital element for nursing ethics. Nursing praxis in New Zealand inc29(1), 4–11. Richardson, A., Yarwood, J., & Richardson, S. (2017). Expressions of cultural safety in public health nursing practice. Nursing inquiry24(1), 10.1111/nin.12171. https://doi.org/10.1111/nin.12171  

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