Emerging Standards of CareTitleCourse NameTopi.docx

Emerging Standards of Care
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Introduction
Define Cultural Competency is a well set of congruent or
harmonious behaviors, policies, and attitudes that come together
in a professional, system, or among agencies that enables actual
work in cross-cultural circumstances (HHS, 1997). In our world
increasing population growth dealing with cultural and ethnic
and racial communities, every people have their own health
profiles and cultural personality, so for these things it creates a
great challenge for US health care system (Behn J D & Gonwa
T, 1992). In United States Cultural Competency is most
important to the health care because it’s the best way doctors
and patients discuss about health related matter without any
cultural differences distressing the conversation but
simultaneously enhancing it (HHS, 1997). For a health care
organization cultural competency has more benefits. Such as it
increases trust, increases respect, decrease unwanted surprises,
increases creativity, helps the defeat fear of mistakes, increase
involvement from other cultural groups, and promotes fairness
and inclusion. Health care organization can show cultural

competency by writing a good mission statement that bind to
cultural competence as portion of the organizations behavior.
Emerging Standards of Care
According to the United States department of DHHS Office of
Minority Health, Incorporated health care attitude must obey the
entire person, work diagonally the lifetime, include early
intrusion methods and prevention method, and be person-
centered, recovery focused and strength-based" (U.S.
Department of Health and Human Services, 2000). In the model
of healthcare, patient must be treated or cared not only
according to usual nursing practice but respect for the people’s
belief system with their culture and integrate into the care.
Providers that esteem the languages, cultures, and people’s
worldviews they serve are more victorious in activating and
engaging individuals, communities and families to be an
effective accomplice in their own health care (U.S. Department
of Health and Human Services, 2000)
By integrating into people’s care beliefs and requirements, the
professional can make rapport with the people in such a good
way that must be encourages the people to be functioning or
more active in their own health care decisions based on the
individual's belief system and professional's medical
understanding. Culturally competent care is care that responsive
or respectful to an individual's health requirements, beliefs, and
practices. This particular type of care is responsive to the
individual's religious and cultural beliefs as well as ethnic
beliefs that have been revealed to engage individuals into share
or in some cases participating in their healthcare.
The skill to provide culturally competent care is most important
for all nurses. Those nurses who work in high-stress or high-
acuity healthcare system surroundings, culturally competent
care is mainly significant to patient effects. Nurses need to
evolve their cultural competency to be very effective in
developing health bonds with patients, and to evaluate properly,
and to develop and execute nursing involvements designed to
get together patients’ requirements. As patient encourages,

nurses are compelled to support good choices made by specific
patients or the families of patients that may replicate a cultural
perspective that divergence with predictable healthcare
practices and may even variance with the nurse’s personal
healthcare thinking. In the present society, culturally competent
care cannot be available to all the patients unless the nurses
have a good understanding of various cultural backgrounds.
In USA, we have clearly observed that the globalization of the
world. According to the United States National Center for
Cultural Competence (NCCC), the structure of the US
population is changing as a consequence of immigration plan
and significant raises among linguistically, racially, culturally,
and ethnically diverse populations residing in America (Sue D
W, Arredondo P & McDavis R J, 1992).
The United States alone has experienced a transformation that is
motivated by an incursion of people from assorted ethnic and
cultural groups. If the present trends of population continue, by
the year 2080 it is predicted that those population is Caucasian
which is now the majority part, will become a low minority
group, consisting of 47.9% of the whole projected population of
the America. The census data of 1980 and 2000 show a clear
variation in the trends of ethnic population with four ethnic
groups: Native American, African American, White, and
Hispanic. These specific trends are a symbol for the absolutely
need of culturally experienced nurses for the future.
Populations served and any issues of population vulnerability
Working for a large, internationally recognized healthcare
organizations makes it very important that the cultural
competence must be trained to all staff. In orientation program,
new staff of the organization are required full four-hour training
on the competence of cultural that must be implicate on patient
experience surpass the patients and the patients families beliefs
(Sue D W, Arredondo P & McDavis R J, 1992). The healthcare
organization makes obtainable interpreters to help
communication between the patients, healthcare organization
staff and the patient’s family. As a whole the organization is

responsive to the differing religions and cultures that enter their
health organization.
On any given day the organization of healthcare takes good care
of people from around the globe. All over the world they have
some hospitals including the America, Saudi Arabia and
Canada. In northeast Ohio in several of the hospitals we
observed the hospital and the staff that many of these are
diverse populations. Christian, Muslim, Catholic, Atheist, and
Jewish religious belief usage have been observed at the health
care as well as African-American, Hispanic, Asian, Latino, ,
and Islamic cultures. While the healthcare unit is very sensitive
to the culture and religious beliefs that every day comes in
communication with its employees, there is helplessness to
providing good competent care to different patients that come
for hospital (Sue D W, Arredondo P & McDavis R J, 1992). In
these hospital one hospitals that mostly serves a higher than
standard Hispanic people, and within the hospital all are signs
and written both in Spanish and English. While the signage of
bilingual is caring for those who cannot speak and read English,
if the people cannot read in any way, the signs of bilingual are
of no assist. Within the organization the main hospital serves a
diversity of religious and cultural systems. Within the effective
system the organizations staff has good resources such as
interpreters, information resources of computer based, bilingual
staff, and to make easier to educate staff and for the patients
provide competent care. Another important issue that stands out
inside the system is its food and cafeteria departments. For the
cafeteria while all of the foods make and prepared it must be
health determined choices with the dietary content openly stated
on the food menus, the religious and cultural trust are not.
Within the health care system observing the different hospitals
cafeteria, there is not a constant attempt at presenting culturally
suitable foods on their patient options as well as in the health
cafeteria.
Comment on standards of cultural competence
The preferences of cultural food have been a big issue in health

care system for many years. The food manufacturing unit has
capitalized on the favorite for American hospitals and foods are
no diverse (Sue D W, Arredondo P & McDavis R J, 1992). You
find in a standard cafeteria a pizza, hot dogs, soda pop,
hamburgers, and French fries. For some cultures stricter dietary
rules, these specific types of foods are unacceptable for eating.
Cultural food mostly preferences are taken into consideration
when choosing a selective cafeteria; however, the preferences of
religious food are given a back seat. For example, the doctor
that I work with is a traditional Jew, and he must follow the
laws of the Torah. It symbolize all food that he consume has to
be Kosher. According to Jewish law Kosher is suitable and pure.
The Kashrus laws include widespread rules concerning
forbidden and permitted foods. There are some numbers of
aspects to these specific dietary rules that the dedicate and
devote Jew must pursue.
In a diet of kosher, there are specific animals that may be eating
while other animals may not. In this law Animals considered
such as veal, bulls, lambs, cows, goats, sheep, lambs, and
springbok while in Torah law the camels and pigs may not be
consumed because due to their incapability to chew cud or
having tear hooves which is prohibited according to the Torah
laws (Tellis G, 2002). About animals, when these specific
animals are killed for consumption, a ritual or Schochet killer
needs to slaughter the animal in accordance to Torah law (Tellis
G, 2002). In such a way the overwhelm animal has to be done
when death happen almost instantaneously and there is no pain
to the animal (Tellis G, 2002). In the practice of the killing of
the animal, the Torah prohibits the eating of the sciatic
insolence. In the world you see most western country the animal
generally sold off to non-kosher kills to sell. Eggs and poultry
follow the similar rules of consumption and slaughter as the
other animals that are measured kosher. Traditionally, turkey,
goose, chicken, and duck are mostly considered kosher rule and
these animals may be eaten. Kosher animals eggs only may be
consumed if these animals are free of blood that means each

individual egg of Kosher must be consider before eating.
When dealing about kosher animals milk products this is more
difficult. Those animals only kosher they can produce milk
(Tellis G, 2002). In this point, non-kosher products and no
animal additives must be added to kosher milk otherwise the
milk of the other animals is no longer kosher. According to the
law of Torah you may not consider or cook young animal
mother milk (Ayonrinde O, 2003). As the Torah prohibits the
combination of addition milk and meat together for eating, it
makes the food non-kosher (Ayonrinde O, 2003). In some
precise religious system Jewish sects, they needed the
separation of milk and meat during the period of preparation to
the extent of having to separate instruments and pans that must
be cleaned separately (Ayonrinde O, 2003). Also, the utilization
of meat and milk must be timed properly so that at the time
meat and milk consumption avoid being mixed in a peoples
stomach. For an individual it is not uncommon to eat meat and
wait some time before eating dairy as to respect kosher law.
In kosher diet law, only fish with scales and fins may be eating
such salmon, tuna, and herring (Ayonrinde O, 2003). Shellfish
such as crawfish, shrimp, crabs and lobster are mostly
forbidden. In the soil all plants are grown, plants and trees their
vegetables, flowers and fruits are kosher. According to the
kosher diet consuming vegetables and fruits, must be carefully
examined for insects as insects are not acceptable. Other some
laws may be applying particularly to the sowing and planting of
grains, vegetables, and fruits. From trees any of fruits may not
be eating if the special tree planted within last three years.
Biblically, new trees or grain may not be bread baked or eaten
before one brings an omer of the first fruits of the trees or
grains on the Passover of second day (Ayonrinde O, 2003).
At the end, some of the beverages must be kosher as well to be
eating. Grape-based derivatives and those beverages produced
from grape only are drunk if these specific grapes come from a
kosher wine grower, and it must be prepared under strict
rabbinical regulation (Hallowell B & Henri B, 2007). As for

kosher casein, wine, bull blood, and gelatin are mostly
prohibited in the wine-making method. For fermentation only
kosher enzymes and bacteria from the bowl may be used
(Hallowell B & Henri B, 2007). All of the utensils and devices
used for the produce and processing of the grapes must be
purify under kosher regulation.
By dietary restrictions another great population that is effected
is the Muslim society. According to the Quran law and
regulation to Muslims communities, eating is a important matter
of faith for those Muslims who must follow the dietary laws and
regulation that is called permitted foods or Halal Hallowell B &
Henri B, 2007). Those specific foods that are prohibited, such
as birds of prey and pork, are well known as Haram Hallowell B
& Henri B, 2007). While these foods that are indecisive for no
consuming are also known as Mashbooh Hallowell B & Henri B,
2007). Mainly Muslim communities eat to preserve and also
they maintain their health. Use of refreshments or
overindulgence such as alcohol, tea, and coffee are strongly
prohibited. On Mondays and Thursdays fasting is commonly
practiced, and more regularly for other holy holidays Hallowell
B & Henri B, 2007). On these specific occasions fasting
comprises abstention from all drink and food from starting
sunrise to ending sunset. Fasting can amplify the risk of a
number of health problems especially if solids as well as liquids
are must be included in the fast. When problem symptoms arise,
it is very important to add water to the fast or end the fast to
maintain health. Depending on the symptoms, the only
alternative is ending the fast. In some cases of dehydration
symptoms, primary medical care must be followed as soon as
possible to reinstate health. In a present day hospital setting of
western part, being able to stand by these nutritional restrictions
can be very difficult if not practically impossible.
In Muslim community in ninth month of the Islamic year is the
holy and pure month of Ramadan. It is a time devoted to
charity, prayer, and fasting (Hallowell B & Henri B, 2007).
Most Muslims peoples are required to desist from drink and

food during the daylight hours for the whole month. Each
evening after sunset the fasting is broken by a mealtime known
as iftar, which usually includes sweet drink, dates and water and
is restart again at sunrise. During Ramadan fasting is one of the
five important Pillars of religion faith, in Islam it is the most
important religious duties. In a medical setting, to respect or
honor the fasting during the time period of Ramadan may be
very difficult as well as not in the greatest interest of the
patient physical condition. The religious practice is to prompt
Muslims cleanse the body, of the poor, spiritual devotion and
foster serenity. With these specific religious dietary thinking, it
illustrates the problems that the general hospital culture must
have in obeying each ethnic beliefs, religion, and culture in a
large health organization. Although those people who observe
contradictory beliefs, it would be very practical for those
patients and their families if the healthcare organization would
be particularly equipped to moderate a diet or another
requirement to respect the patient's culture and belief system.
From a patient's opinion, being able to have some well control
of their valuable lives while being a patient in the healthcare is
most important. By obeying and understanding religious and
cultural beliefs of the patient, nurses must be individualizing
the health care as well as providing ethnically competent care
for patients.
Nursing Care
In most part nursing care is specially provided in regards to
cultural competence as well as nursing standards of practice
(Teresa M Kielhorn & J D LLM, 1997). In healthcare system
nurses provide direct patient care are some of the hardest
working and most compassionate nurses I have meet in my
nursing professional career. The organization should present a
full orientation program to the nursing floor as a new appoint as
well as a skills ability check. For those specific nurses that have
been with the healthcare system for any duration of time over
one year, an annual skills ability day is compulsory. The annual
skills competency also comprises a part on cultural diversity in

the workplace (Teresa M Kielhorn & J D LLM, 1997). The
healthcare organization also provides its employees one day per
year for a learning day so that they can concentrate or attain
other such education program such as a seminar, conference in
order to convene the CEU obligations for licensure. So, the
health organization provides its employees many good
opportunities for educating themselves concerning cultural
diversity.
In the ground of patient care, the nursing staff takes special care
to aware to the religious practices and cultural beliefs that are
important part of their patient's care. For example, if there are
requirements of certain bathing such as Islamic culture, the
nursing staff does their best work to maintain the patient's
custom. The culture of Islam strongly believes in spiritual as
well as physical honor and purity. In the verses of Qur'an
outlines it demonstrate that how to achieve tradition cleanliness
and maintain purity. In Islam taking care of an individual the
nurse must required to be aware of these specific rules and he or
she must be abide by them also. For instance, the holy Qur'an
goes into big point on the step by step directions on how an
individual perform Wudu. Maintaining the patient and their
family at ease by enduring by their religious customs during a
complicated time can take them a feeling of peace and comfort.
Solution
s that could be implemented
In the performance of how the healthcare organization attempts
to be aware of the diverse people that enter doors, their valuable
plans are not taking in proof (Teresa M Kielhorn & J D LLM,
1997). I have observed one big issue that has spoken at part

about good deals with dietary assortments for patients with
families in the cafeteria. We the people of world must not forget
those family is just as essential in the patient care. For the
religious customs that strict roles and control diets to stand by
such as Islamic, Jewish, and Catholic religions, the selection
standard leave slight for patients and their families to select
from that principles their conventional beliefs. To the issues the
valuable solution would be to execute some good changes to the
cafeteria choice as well as increasing food selections that would
respect and honor each and every belief system.
Conclusion
In cultural competence with all efforts, it is very difficult for
any physician to enter a patient room with full armed with a
comprehensive awareness and knowledge of the expected
cultural suitable experience. It is really difficult for a nurse to
be completely versed in every religious aspect and even the
most culturally part nurse cannot understand what useful
experience the patient and their families are deal with. Even
most culturally expert practitioner cannot understand the
patient’s experience, and should not guess to do so. In spite of
the professional’s knowledge and experience, their particular
job is to remain intrusive and open to the difference and
complexities that make up the patients lives and describe their
reality. There dishonesty the advantage of our work; a eminent
honor we are given each and every time our patients invite us

into their valuable lives, and they must give us a good
opportunity to see the entire world from their eyes, a diverse
and new perspective.
References
Dana R. H., Behn, J. D., & Gonwa, T. (1992). A checklist for
the examination of cultural competence in social service
agencies. Research on Social Work Practice, 2(2), 220-233.
U.S. Department of Health and Human Services. Policy
statement on inclusion of race and ethnicity in DHHS data
collection activities, October 1997.
U.S. Department of Health and Human Services. Protecting the
privacy of patients’ health information: summary of the final
regulation (fact sheet), December 20, 2000.
Sue, D. W., Arredondo, P., and McDavis, R.J. (1992)
“Multicultural Competencies and Standards: A Call to the
Profession.” Journal of Multicultural Counseling and
Development, 20, 64-88.
Tellis, G. (2002). Multicultural aspects of stuttering.
Perspectives on Communication Disorders and Sciences in
Culturally and Linguistically Diverse Populations, 8, 8-11.
Ayonrinde, O. (2003). Importance of cultural sensitivity in
therapeutic transactions: Considerations for healthcare
providers. Disability Management and Health Outcomes, 11(4),

234-246.
Hallowell, B., & Henri, B. (2007). Strategically promoting
access to speech-language pathology and audiology services. In
R. Lubinski, L. A. C. Golper & C. Frattali (Eds.), Professional
issues in speech-language pathology and audiology (pp.387-
408). Clifton Park, NY: Thomson Learning
Teresa M. Kielhorn, JD, LLM, "Reducing Risk by Improving
Communication", Permanente Journal Home Page, Kaiser
Permanente Home Page, 1997.

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