This paper examines the implementation of cultural competency in nursing practice through the Rosswurm and Larrabee six-step model for evidence-based change. Drawing on Watson's theory of human caring, the paper argues that nurses must develop cultural awareness to effectively serve patients from diverse ethnic, racial, and cultural backgrounds. Each step of the change model is outlined in detail — from assessing the need for change and synthesizing research evidence, to designing a pilot training program, evaluating outcomes, and sustaining the change organization-wide. The paper also presents a concrete six-month implementation and evaluation plan, concluding with recommended strategies for maintaining cultural competency as an enduring organizational value.
The foundational knowledge required in nursing and medical practice needs substantial development in order to be effective and appropriate in addressing the needs and preferences of patients. Watson emphasizes the importance of integrating a humanistic dimension into the nursing profession and believes in the necessity of establishing a caring relationship between patients and nurses — one that demonstrates unconditional acceptance of patients in any condition. Nurses should integrate holistic and positive treatment with the aim of promoting health through knowledge and evidence-based interventions, thereby eliminating interruptions during treatments, or what Watson calls "caring moments."
Modern patients present diverse problems and concerns stemming from cultural differences, racial backgrounds, and ethnicity, which underscores the need to strengthen the capacities of nurses. Ensuring that nurses obtain cultural competencies is essential for enhancing their ability to address the wide range of issues and needs faced by patients across different backgrounds.
This model of change has a significant influence on the future of healthcare because of its potential to increase the output of medical practitioners and institutions. The model will ensure that every nurse in the workplace possesses valuable cultural competency as a prerequisite for working within medical facilities. It is clear and precise in aligning with the policies that call for cultural competency among nurses.
Cultural competency will enhance nurses' ability to address the needs and preferences of patients in an era of globalization characterized by diversity in ethnicity, race, and culture. It will also improve the quality of services delivered to patients and foster the development of meaningful, respectful relationships between patients and healthcare providers.
The Rosswurm and Larrabee Model of Evidence-Based Practice Change provides six critical stages toward achieving meaningful change in the healthcare sector through nursing. The first step focuses on assessing the need for change in nursing practice. The second step involves linking the identified problem, relevant interventions, and expected outcomes to nursing practice. The third step synthesizes the best available evidence through literature review and key research findings. The fourth step focuses on designing the desired practice change and identifying the key players and stakeholders involved. The fifth step involves implementing and evaluating the change. Finally, the sixth step addresses the integration and maintenance of the change in practice.
Three factors were essential in assessing the need for change in nursing practice: dissatisfaction with current services, patient complaints, and a comparison between current practice and an ideal state in which cultural competency is fully integrated. This step involves collecting data from patients through interviews and conducting literature reviews related to culturally sensitive treatment within nursing institutions. Stakeholders — including proprietors, colleagues, and administrators — are essential contributors to this data-collection process.
Team-focused techniques, brainstorming, and motivation strategies are useful for gathering information, while benchmarking enables comparison between the current and desired states of nursing practice. The assessment also draws on both internal and external sources of information. The primary outcome of this step is the identification of the need to integrate cultural competencies into nursing practice in order to improve nurses' ability to address the diverse needs and preferences of their patients.
This stage focuses on the integration of standardized classification language. Nurses must classify culturally sensitive practices against non-culturally sensitive ones, as well as identify the core components of cultural competency in nursing. It is equally important for nurses to recognize how culturally insensitive treatment manifests in patients. Secondary effects — such as dietary issues, emotional distress, and signs of culture shock — should inform the development of cultural competencies as nurses carry out their roles.
Progress at this stage can be measured through client satisfaction, the quality of social relations between patients and nurses, the ease with which nurses perform their duties, and a reduction in complaints to administration — all of which reflect improved efficiency in service delivery.
"Detailed application of each step to nursing training"
"Six-month timeline and pilot program logistics"
Vanguard Health System. (2011). Jean Watson's theory on human caring. Retrieved August 1, 2013, from www.innovativecaremodel.com
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