Expertise in the Care of Latinos: An Interpretive Study of Culturally Congruent Nursing Practices in the Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/163091
Type:
Presentation
Title:
Expertise in the Care of Latinos: An Interpretive Study of Culturally Congruent Nursing Practices in the Emergency Department
Abstract:
Expertise in the Care of Latinos: An Interpretive Study of Culturally Congruent Nursing Practices in the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2004
Author:Nailon, Regina, RN, MS, Doctoral Candidate
P.I. Institution Name:Oregon Health & Science University
Title:Assistant Professor
Contact Address:671 - 24th Avenue, Longview, WA, 98632, USA
Purpose: A lack of insurance and regular providers lead many Latinos to access emergency departments
for primary care. Efforts to improve minority health emphasize culturally competent care. Cultural competence
is achieved when care is congruent with patients' concerns. The purpose of this study was to
describe expert nursing care of Latinos in the ED and to determine its cultural congruence.
Design: A phenomenological design was used.
Setting: The study took place in emergency departments of 4 hospitals located in a northwestern state
within selected counties that ranked among the top three with the highest percentage of Latinos, or
whose Latino population was at least 25% of the total population.
Sample: The investigator attended staff meetings, explained the study, and invited nurses to participate.
Fifteen nurses participated, four of whom were identified as experts by their peers. Expert was defined as
those nurses to whom others turned for guidance and assistance when caring for Latinos. Participants'
mean years of ED experience was 6.1 years. A bilingual research assistant recruited twenty-two Latino
patients while they waited to be seen.
Methodology: Unstructured guides with open-ended questions were used during nurse and patient interviews.
Nurses were divided into 4 groups and interviewed twice. The concerns, interpersonal behaviors,
and communication of three experts and three non-experts who were good interview informants were
observed by the investigator on two occasions each. All dialogue with nurses during observations was
audio-recorded outside patients' rooms. The investigator conducted and audio-recorded all nurse interviews,
and wrote detailed notes during interviews and observations. The research assistant, trained in interview
techniques by the investigator and one of her dissertation advisors, conducted and audio-recorded
ten individual patient interviews following their care. Data collection continued until redundancy of
themes occurred. Trustworthiness of data analysis was established through prolonged engagement, persistent
observation, triangulation, peer debriefing, thick descriptions, and reflective journaling.
Results: Expertise was found in the practices of nurses who were identified as experts and those who
were not. Expertise was manifested in nurses' abilities to maintain meaningful connections with patients
despite the language barrier, time constraints, competing demands, and lack of resources. Latino informants
indicated concerns with communication and information needs, family involvement, and feeling cared
about and valued. Nursing care that addressed these concerns was culturally competent. Enhancers and
barriers to culturally competent care included nurses' Spanish abilities, interpreter availability, and nurses'
skills in working with interpreters.
Conclusions: Emergency department administrators must foster cultural competence by providing nurses
resources necessary to this end. Latino patients' evaluation of care is requisite to determining if cultural
competence was achieved.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleExpertise in the Care of Latinos: An Interpretive Study of Culturally Congruent Nursing Practices in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/163091-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Expertise in the Care of Latinos: An Interpretive Study of Culturally Congruent Nursing Practices in the Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2004</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Nailon, Regina, RN, MS, Doctoral Candidate</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Oregon Health &amp; Science University</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Assistant Professor</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">671 - 24th Avenue, Longview, WA, 98632, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jrnailon@kalama.com / nailonr@ohsu.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: A lack of insurance and regular providers lead many Latinos to access emergency departments<br/>for primary care. Efforts to improve minority health emphasize culturally competent care. Cultural competence<br/>is achieved when care is congruent with patients' concerns. The purpose of this study was to<br/>describe expert nursing care of Latinos in the ED and to determine its cultural congruence.<br/>Design: A phenomenological design was used.<br/>Setting: The study took place in emergency departments of 4 hospitals located in a northwestern state<br/>within selected counties that ranked among the top three with the highest percentage of Latinos, or<br/>whose Latino population was at least 25% of the total population.<br/>Sample: The investigator attended staff meetings, explained the study, and invited nurses to participate.<br/>Fifteen nurses participated, four of whom were identified as experts by their peers. Expert was defined as<br/>those nurses to whom others turned for guidance and assistance when caring for Latinos. Participants'<br/>mean years of ED experience was 6.1 years. A bilingual research assistant recruited twenty-two Latino<br/>patients while they waited to be seen.<br/>Methodology: Unstructured guides with open-ended questions were used during nurse and patient interviews.<br/>Nurses were divided into 4 groups and interviewed twice. The concerns, interpersonal behaviors,<br/>and communication of three experts and three non-experts who were good interview informants were<br/>observed by the investigator on two occasions each. All dialogue with nurses during observations was<br/>audio-recorded outside patients' rooms. The investigator conducted and audio-recorded all nurse interviews,<br/>and wrote detailed notes during interviews and observations. The research assistant, trained in interview<br/>techniques by the investigator and one of her dissertation advisors, conducted and audio-recorded<br/>ten individual patient interviews following their care. Data collection continued until redundancy of<br/>themes occurred. Trustworthiness of data analysis was established through prolonged engagement, persistent<br/>observation, triangulation, peer debriefing, thick descriptions, and reflective journaling.<br/>Results: Expertise was found in the practices of nurses who were identified as experts and those who<br/>were not. Expertise was manifested in nurses' abilities to maintain meaningful connections with patients<br/>despite the language barrier, time constraints, competing demands, and lack of resources. Latino informants<br/>indicated concerns with communication and information needs, family involvement, and feeling cared<br/>about and valued. Nursing care that addressed these concerns was culturally competent. Enhancers and<br/>barriers to culturally competent care included nurses' Spanish abilities, interpreter availability, and nurses'<br/>skills in working with interpreters.<br/>Conclusions: Emergency department administrators must foster cultural competence by providing nurses<br/>resources necessary to this end. Latino patients' evaluation of care is requisite to determining if cultural<br/>competence was achieved.<br/></td></tr></table>en_GB
dc.date.available2011-10-27T10:39:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:39:23Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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