Review the Institute of Medicine’s 2010 report “The Future of Nursing: Leading Change, Advancing Health.” Write a 750-1,000 word paper discussing the influence of the IOM report on nursing practice. Include the following:

1. Summarize the four messages outlined in the IOM report and explain why these are significant to nursing practice.
2. Discuss the direct influence the IOM report has on nursing education and nursing leadership. Describe the benefits and opportunities for BSN-prepared nurses.
3. Explain why it is important that a nurse’s role and education evolve to meet the needs of an aging and increasingly diverse population.
4. Discuss the significance of professional development, or lifelong learning, and its relevance in caring for diverse populations across the life span and within the health-illness continuum.
5. Discuss how nurses can assist in effectively managing patient care within an evolving health care system.

Prepare this assignment according to the guidelines found in the APA Style Guide.  An abstract is not required.

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Outline the concept of professional accountability as it pertains to nursing. Provide examples of how a nurse demonstrates professional accountability in clinical expertise, the nursing process, and evidence-based practice. 

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I need a comment for each paragraph 

Paragraph 1

Cultural competence can be defined as “effective, individualized care that demonstrates respect for for the dignity, personal rights, preferences, beliefs, and practices of the person receiving care while acknowledging the biases of the caregiver and preventing these biases from interfering with the care provided” (Cheever & Hinkle, 2014). Nurses are expected to provide culturally competent care to an emerging diverse population of patients. In order to provide the most appropriate care to a patient the nurse must first assess how much they already know and believe pertaining to a patients culture and ethnic background and then thoroughly assess the patients background and identify areas that are important to them or highly value. Honoring the patients cultural traditions and belief system will gain the patients trust and sense of safety with the nurse who is providing direct care to them. Patients will be more receptive to education and adhere the treatment plan when given by a nurse who is respectful of their differences, thus resulting in positive patient outcomes.  A beneficial method to assessment is The Heritage Assessment Tool, this questionnaire is geared specifically towards collecting cultural information that will paint a picture for the nurse to use when creating an individual plan of care.  Another tool is the use of Giger and Davidhizar assessment model which guide nurses in exploring the the six cultural phenomena that might affect nursing care. Communication, space, time orientation, social organization, environmental control, and biologic variations are the identified phenomenas( Cheever & Hinkle, 2014). Some examples of nurses providing culturally competent care include, a nurse observing and being aware of a patients body positioning towards them and then determining how much space between the nurse and patient is comfortable and acceptable to the patient, by knowing that some people in the Native American culture view avoiding direct eye contact and looking at the floor while one is speaking as a sign of respect and active listening the nurse can better understand the patients behavior that may seem strange to them at first, among many Asian cultures people believe that the head is sacred and that the “spirit resides there” (Cheever & Hinkle, 2014) and that it is impolite to touch a persons head without asking permission first, therefore, it is culturally sensitive of the nurse to ask the patient before performing a close up head/neck assessment ( Cheever & Hinkle, 2014).   

Paragraph 2

Assessment of culture is an essential step in providing effective nursing care to a culturally diverse Patient population. The purpose of this study was to describe the beliefs and self-reported practices of pediatric nurses from four Children’s Hospitals regarding the process of assessing culture. The 584 respondents indicated they worked with a culturally diverse patient population and frequently experienced culture conflicts. Findings indicated cultural assessment were not routinely performed. The majority indicated that learning more about the child’s culture would improve the effectiveness of their nursing care (journal of Pediatric Nursing,1999). For example, I always find out about the culture of my patients by assessing them and by asking them questions about their country and their culture. I tried to be familiar to their culture in order to understand them and care for them more effectively. Cultural competence represents good clinical practice and can be defined as such that a clinician regards each patient in the context of the patient’s own culture as well as from the perspective of the clinician’s cultural values and prejudices. The EPA Guidance on cultural competence training outlines some of the key issues related to cultural competence and how to deal with these. It points out that cultural competence represents a comprehensive response to the mental health care needs of immigrant patients and requires knowledge, skills and attitudes which can improve the effectiveness of psychiatric treatment. (European Psychiatry,2015). Cultural competence is one of the principal foundations of clinical nursing. The six defining attributes of cultural competence were cultural awareness, cultural knowledge, Cultural sensitivity, cultural skill, cultural proficiency, and dynamicity. Antecedents included cultural diversity, cultural encounter and interaction, cultural desire, cultural humility, general humanistic competencies, educational preparation, and organizational support. (International Journal of Nursing, 2019. One of my supervisors used to tell that Nurses who care for patients with different culture need to good communication skill, to ability to listen to their patients, to respect their belief, and to be non judgemental.

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I need a comment for each paragraph

Paragraph 1

One way for the nurse to gather cultural information from patient would be the use of the Heritage Assessment Tool (HAT). This method helps nurses to gather cultural information on their patients by asking questions such as: where was your mother born, in what setting did you grow up, who lived with you while growing up, do you practice religion in your home and do you participate in ethnic activities. This helps the nurse in obtaining information based on the patient’s culture, beliefs, needs and practices that can affect their health care and treatment (Falkner, 2018). Nurses are culturally competent when caring for patients. This means a nurse provides care while being aware of differences related to culture, and is able to tailor plans of care based on patient choices that can be based on their culture (Falkner, 2018). This approach helps to provide holistic care to patients and the nurse addresses psychosocial and physical needs. Cultural competence relates to better care because the nurse incorporates the patient’s beliefs and wants into their health care. There is a trusting relationship between the health care team and patient, increased cooperation from the patient and increased participation from the community. With this cooperation, there is an action plan to help reduce health disparities. One way a nurse provides culturally competent care to Arab Americans, for example, would be having same-sex health care providers. Modesty is valued, so therefore, should be honored by the nurse to preserve this value.

Paragraph 2

Nurses can improve healthcare delivery and close the gap on healthcare disparities when they provide culturally competent care (Falkner, 2018). Nurses can gather cultural information from their patients by asking about their diet at home, carefully taking note of any restrictions that are important to the patient such as vegetarianism. I have had experience with patients who are Kosher and therefore are unable to have Heparin. It is important for nurses to continually educate themselves on other cultures, especially if they are unfamiliar with the patient’s culture. Also, nurses must remain aware of their own biases while delivering culturally competent care (Murphy, 2011). Nurses demonstrate cultural competence when they use a translator to communicate with their patients. The beds in the ICU where I work all have some basic phrases and even some questions that can be played on the bed’s speaker for the patient to hear; for example, telling the patient where they are/what the day is to help reorient intubated/sedated patients. We use the beds language feature along with the hospital approved translator.

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