PICOT: the needs of culturally diverse ROC

PICOT:  For nursing staff at Kings County Hospital Center does an implementation of educational training on cultural competence using Campinha-Bacote Model of the Process of Cultural competence improve cultural sensitivity and competency of staff compared to current practice in eight weeks?


1. Practice Problem 

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Being one of the largest city hospitals in Brooklyn, Kings County Hospital Center (KCHC) care for racially diverse populations. One of the practice problem identified at my practicum site is the deficiency of cultural sensitivity and cultural competency among staff in responding to and caring for the unique needs of the individuals with several healthcare needs from various cultural backgrounds.  Multiple complaints from the clients at KCHC in regards to the staff being strict on guidelines and practices, not showing regard to the clients’ culture and traditions and unsatisfactory Press Ganey scores had identified lack of cultural sensitivity in staff as definitely an issue.  Multiple calls to Justice Center in regards to this issue also brought forth a need for corrective actions.  Meeting the needs of culturally diverse ROC has always been a challenge and it can only be achieved by preparing the nurses/health care professionals to become culturally sensitive to the needs of the clients they care for. 

Campinha-Bacote (2011) described cultural competence as a “continuous learning process, that builds knowledge, skills, and capacity to identify, understand and respect the unique beliefs, values, customs, languages of our clients in a manner that preserves the dignity of the individuals”.  Crawford, Candlin & Roger (2017) stated that becoming culturally competent would help to inspire nurses to communicate effectively with their clients, augmenting therapeutic interactions and thus improving health outcomes and patient satisfaction and safety.


2. Practice Change


One of the practice changes I am planning to make is the implementation of an educational training for nurses and other healthcare professionals in improving staff’s self-assessment and cultural sensitivity and competence, compared to current practice. The training will be incorporated into orientation curriculum and mandatory annual in-service thereafter.   The literature review revealed that cultural competence education is an effective intervention that empowers staff in delivering culturally sensitive care, which increases patient satisfaction and improves health outcomes (Govere, & Govere, 2016). 

3. Population


The population for my DNP project will be nursing staff/healthcare professionals at KCHC ranging from newly hired to seasoned staff.   Due to the rapid growth of minority population and the rise in health disparities, national attention is concentrated on training staff in delivering culturally competent care (Holden et al. 2014).  According to Govere, & Govere (2016), professional associations and accreditation agencies are taking cultural competence as exceptionally vital and demanding health professionals to be trained to provide patient-centered care


4. Intervention

The DNP project will consist of an evidence-based educational training using Campinha-Bacote Model of the Process of Cultural Competence, which is intended to increase cultural sensitivity and cultural skill of staff.  This intervention is within my locus of control as an advanced practice nurse and it is an evidence-based practice change, which is not executed previously in our facility. 


5. Comparison

The project will include the Cultural Competence Training presentation and subsequent evaluation of the cultural competence training.  I will be comparing the effectiveness of the training through a pre-test and post-test format using the tool, Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Revised (IAPCC-R), which is a self-assessment tool designed by Campinha-Bacote to gauge the level of cultural competence among staff (Campinha-Bacote, 2011). 

6. Outcome


The projected outcome of the project is improved cultural competency and cultural sensitivity of staff.  The outcome of this project will be measured using Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Revised (IAPCC-R).  Literature review reveals IAPCC-R as being a frequent choice for research concentrating on health care professionals’ cultural competency, which shown statistically substantial enhancements in overall cultural competence from baseline to post-test (Kardong-Edgren, et.al, 2010).   Kardong-Edgren, et.al, (2010) claimed that IAPCC-R has had a widespread review and multiple testing and acceptable reliability and validity. 

7. Timing

After the initiation of the project, a change in the outcome is expected in 8 weeks. 


8. Feasibility

The stakeholders at my facility consider this project and practice change as significant and very well needed.  The decision makers at KCHC are very supportive of this project.  This project is expected to occur within the timeframe of 8 weeks.