Erin Krening, Caitlin Meaney, Rachel Naftulin, Samantha Rabb, & Sydney Reed

Wednesday November 29th, 2017

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 Banner University Medical Center

Labor and Delivery Unit

Focus:
o Education and training related to cultural
sensitivity and patient centered care

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 Authoritarian Leadership: - strong control over the work
group, motivating others through coercion, directing
others with commands, communication flows downward,
decision making does not involve others, criticism is
punitive, and emphasis is on difference in status.
o Patient Wristbands
Decisions made quickly
Lack of quality communication in changes & poor
follow through
o Committees
Centralized
o Self Scheduling
Concerns not heard Safety Compromised
Marquis, B.L., & Huston, C.J. (2015b). Leadership roles and management functions in nursing theory and application
(8th
ed., pp. 40-41). Philadelphia, PA:Wolters Kluwer health/ Lippincott Williams & Wilkins.
3
 Inconsistent and unpredictable in providing
recognition, information, and resources needed to
enhance the nurses work
Reliance on informal structure and communication
o Limited information sharing amongst levels of
hierarchy
Limited human resources for staffing with
centralized system
Learning environment that supports a strong team
unity
Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx

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 Patient Focus: Patient-centered culturally sensitive health is
associated with positive health behaviors and outcomes for
both minority and majority patients
o Patient advocate, welcome visitation, designated refrigerator
o Lack of sensitivity toward patients with unfamiliar cultures
Staff Focus: Staff development is a cost effective method of
increasing productivity
o Tuition reimbursement, awards, benefits, orientation,
committees
o Understaffed, poor communication, centralized system
Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing theory and application (8th ed., pp. 366). Philadelphia, PA: Wolters Kluwer health/
Lippincott Williams & Wilkins.
Tucker, C. M., Marsiske, M., Rice, K., Jones, J. D., & Herman, K. C. (2011). Patient-centered culturally sensitive health care: Model testing and refinement. Health Psychology,
30(3), 342-350. doi: 10.1037/a0022967
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 Interdependence among the healthcare team is an
important aspect to promote positive patient
outcomes
o Focus becomes all on patient
o Patient comfort
o Decreased stress and increased job satisfaction
Effective communication between a team can lead
to more discussions, ideas and solutions that may
lead to improved patient care.
A decline in management communication with staff
can lead to a breakdown of the team
interdependence
Youngwerth, J., & Twaddle, M. (2011). Cultures of interdisciplinary teams: How to foster good dynamics. Journal of palliative medicine, 14(5), 650-654. doi:
10.1089/jpm.2010.0395
Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx 6
 Banner provides and utilizes a large amount of different
technology to provide services to patients.
Technology is not always used to its full benefit
o Lack of knowledge or instruction of the technology
o Staff dont know how to access it
o Lack of resource
Change to Cerner computer program
o Time consuming
o Confusion & frustration
o Slow patient care
Banner offers many beneficial, extra services to patients
Additional education required on important hospital
technology, like the translator phone and computer programs
Youngwerth, J., & Twaddle, M. (2011). Cultures of interdisciplinary teams: How to foster good dynamics. Journal of palliative medicine, 14(5), 650-654. doi:

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10.1089/jpm.2010.0395
Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx
 Benchmarking
Staff empowerment
Auditing
Safety record keeping
o Safety is considered the first domain in
quality
Staff satisfaction

Marquis, B.L., & Huston, C.J. (2015). Leadership roles and management functions in nursing theory and application
(8th ed., pp. 547). Philadelphia, PA: Wolters Kluwer health/Lippincott Williams & Wilkins.

8
 Baby-to-breast: Golden Hour
Incentives for month without falls
Safety and Quality Committees
JCAHO National Patient Safety Goal: Prevent
infection
Programs for charge nurses
Team member of the month
Surveys: staff satisfaction

Blegen, M. A., Goode, C. J., Spetz, J., Vaughn, T., & Park, S. H. (2011). Nurse Staffing effects on patient outcomes:
Safety-net and Non-safety-net hospitals. Medical Care, 49(4), 406-414.
Twigg, D., Duffield, C., Thompson, P. L., & Rapley, P. (2010). The impact of nurses on patient morbidity and mortality -
the need for a policy change in response to the nursing shortage. Australian Health Review, 34(3), 312-316. 9
 Tucson is a culturally diverse place
o BUMC L&D receives patients of many different
cultures
Lack of education around cultural sensitivity
Studies found
o Lack of education in the workplace
o Lack of comfortability interacting with patients of
different cultures
Goal: improve education for nursing staff on cultural
sensitivity
Mareno, N., Hart, P. L. (2014). Cultural competency among nurses with undergraduate and graduate degrees: implications for nursing
education. Nurs Educ Perspect, 35(2), 83-8. doi: 10.5480/12-834.1

Utley-Smith, Q. E. (2017). Meeting a growing need: an online approach to cultural competence education for health professionals. Nurs
Educ Perspect, 38(3), 159-161. doi: 10.1097/01.NEP.0000000000000120

Delgado, D.A., Ness, S., Ferguson, K., Engstrom, L., Gannon, T.M., Gillet, C. (2013). Cultural competence training for clinical staff. Journal
of Transcultural Nursing, 24(2), 204-213. doi: 10.1177/1043659612472059 10
 Continued Computerized Cultural Sensitivity Education
Literature: continued education on cultural competency
empowers nurses to deliver culturally appropriate care to
their patients.
One year timeline:
o Develop Committee: 1-2 mo
o Develop Education: 3-5 mo
o Educate Nurses: 6-7 mo
o Time to Allow Education in Practice: 8-9 mo
o Eval: 10-11 mo
o Introduce Housewide: 12 mo
Mareno, N., Hart, P. L. (2014). Cultural competency among nurses with undergraduate and graduate degrees: implications for nursing education. Nurs Educ Perspect, 35(2), 83-8. doi: 10.5480/12-834.1

Utley-Smith, Q. E. (2017). Meeting a growing need: an online approach to cultural competence education for health professionals. Nurs Educ Perspect, 38(3), 159-161. doi:
10.1097/01.NEP.0000000000000120

Delgado, D.A., Ness, S., Ferguson, K., Engstrom, L., Gannon, T.M., Gillet, C. (2013). Cultural competence training for clinical staff. Journal of Transcultural Nursing, 24(2), 204-213. doi:
10.1177/1043659612472059
11
 Blegen, M. A., Goode, C. J., Spetz, J., Vaughn, T., & Park, S. H. (2011). Nurse Staffing effects on patient
outcomes: Safety-net and Non-safety-net hospitals. Medical Care, 49(4), 406-414.

Delgado, D.A., Ness, S., Ferguson, K., Engstrom, L., Gannon, T.M., Gillet, C. (2013). Cultural competence training
for clinical staff. Journal of Transcultural Nursing, 24(2), 204-213. doi: 10.1177/1043659612472059

Institute for Healthcare Improvement.(2015). Clinical microsystem assessment tool. Retrieved from
http://www.ihi.org/resources/pages/tools/clinicalmicrosystemassessmenttool.aspx

Mareno, N., Hart, P. L. (2014). Cultural competency among nurses with undergraduate and graduate degrees:
implications for nursing education. Nurs Educ Perspect, 35(2), 83-8. doi: 10.5480/12-834.1

Marquis, B.L., & Huston, C.J. (2015a). Leadership roles and management functions in nursing theory and
application (8th ed., pp. 40-41). Philadelphia, PA:Wolters Kluwer health/ Lippincott Williams & Wilkins.

Marquis, B.L., & Huston, C.J. (2015b). Leadership roles and management functions in nursing theory and
application (8th ed., pp. 366). Philadelphia, PA: Wolters Kluwer health/ Lippincott Williams & Wilkins.

Marquis, B.L., & Huston, C.J. (2015c). Leadership roles and management functions in nursing theory and
application (8th ed., pp. 547). Philadelphia, PA: Wolters Kluwer health/Lippincott Williams & Wilkins.

12
 Tucker, C. M., Marsiske, M., Rice, K., Jones, J. D., & Herman, K. C. (2011).
Patient-centered culturally sensitive health care: Model testing and
refinement. Health Psychology, 30(3), 342-350. doi: 10.1037/a0022967

Twigg, D., Duffield, C., Thompson, P. L., & Rapley, P. (2010). The impact of
nurses on patient morbidity and mortality - the need for a policy change in
response to the nursing shortage. Australian Health Review, 34(3), 312-
316.

Utley-Smith, Q. E. (2017). Meeting a growing need: an online approach to

cultural competence education for health professionals. Nurs Educ
Perspect, 38(3), 159-161. doi: 10.1097/01.NEP.0000000000000120

Youngwerth, J., & Twaddle, M. (2011). Cultures of interdisciplinary teams:

How to foster good dynamics. Journal of palliative medicine, 14(5), 650-654.
doi: 10.1089/jpm.2010.0395

13