1. 1 Transcultural Guidelines for Health Care Givers Reviewed 10/2014

2. 2 Definitions (Cornell University) - Describes your family “origins” e.g. American Native or Alaskan Native Origins in any of the original peoples of North & South America (including Central America), & who maintain tribal affiliation or community attachment Ethnicity

3. 3 Asian Far Eastern countries Black/African American African or Caribbean Caucasian/White/Not of Hispanic origin Europe, Middle East, North Africa, Australia, New Zealand Mexican American Mexican culture or origin regardless of race Ethnicity

4. 4 Native Hawaiian or other Pacific Islander Hawaii, Guam, Samoa, Pacific Islands Puerto Rican Puerto Rican culture or origin, regardless of race Other Hispanic Cuban, South or Central American, Dominican Republic, or other Spanish culture or origin, regardless of race Ethnicity

5. 5 Hispanic vs. Non-Hispanic 2010 Statistics Approximately 84.13% Hispanic Non-Hispanic 15.87% What other things contribute to diversity? If I’m Hispanic is a non-Hispanic another culture? Maybe… Reviewed October, 2008 El Paso’s Population

6. 6 Including culture, religion, language, age, and gender have an effect on how we access and view health care services. Many Things..

7. 7 Some may think culture determines certain things: Physical attributes hair or skin color Diet Language Our religious & spiritual beliefs Culture

8. 8 Ethnocentrism Despite the fact that we understand that everyone is different, we still tend to subconsciously believe that our culture & religion is the right one. We may view other cultures or religions as bizarre, strange, inferior or unenlightened. This is called ethnocentrism.

9. 9 Ethnocentrism It can cause misunderstandings and harm patients by: –Incorrect diagnosis –Failure to provide adequate pain relief –Arrest of parents for child abuse due to misunderstood cultural childrearing beliefs and practices

10. 10 Understanding of own self Knowledge of various cultural characteristics Understanding of cultural characteristics Application of cultural knowledge & understanding in the healthcare setting Cultural Competency

11. 11 Avoid Stereotyping We must not presume that all people of a certain cultures adhere to all aspects of their culture The healthcare provider must identify which aspects are appropriate for each patient during the admission process

12. 12 Do Not Assume Anything Be truly open-minded & respectful toward other’s beliefs, values, & practices You can help patients feel more comfortable Many of us belong to more than one ethnic group, cultural group, age group, and social group

13. 13 Family members are not good translators Issues of privacy and confidentiality Interpreter errors could be a previously unrecognized root cause of medical errors (Healthcare Risk Management) Lost in Translation

14. 14 Language & Translation Those whose English is limited often wish to speak their native language when possible Feel that both their explanations & their understandings can be more accurate It is more comfortable

15. 15 Facility approved Translation Services should be used Find someone in your facility who knows the policy It is important to be facility specific Should be HIPAA & The Joint Commission Compliant Policy & Procedure

16. 16 Facial expressions, body language & tone of voice play a much greater role in many cultures. Face & Body Language

17. 17 Some Cultures: May perceive a response like “maybe” or “that would be difficult” as a polite no Some cultures prefer indirect communication and talking around the issue Cultural Differences

18. 18 Gestures Use with care – may have negative meanings in other cultures Thumbs-up and the OK sign are obscene gestures in parts of South America & the Mediterranean Pointing or beckoning with the index finger as “come here”, or snapping fingers are seen as rude in some cultures

19. 19 To touch or not to touch is only part of the question Cultures also have different rules about who can be touched & where Even casual touching people of the opposite gender can be offensive in some cultures Touch

20. 20 The National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care. CLAS Standard 1-15 (CLAS)

21. Medical care is complex and confusing, and many people struggle with understanding medications, self care instructions and follow up plans because of cultural differences. Not having a cultural awareness of our patients and an understanding of their health literacy can create significant problems that go beyond the walls of the hospital and into our community. Overview

22. Responding to demographic changes Eliminating disparities in the health status of people of diverse racial, ethnic and cultural backgrounds Improving the quality of services and outcomes Significance for Culturally Competent Health Care

23. The National CLAS Standards are intended to advance health equity, improve quality, and help eliminate health care disparities by establishing a blueprint for health and health care organizations CLAS Standards 1-15

24. Principal Standard: (Standard 1) Governance, Leadership and Workforce: (Standard 2-4) Communication and Language Assistance: (Standard 5 – 8) Engagement, Continuous Improvement, and Accountability: (Standards 9-15) CLAS Standards 1-15

25. 25 In Summary Observe the kinds of cultures you see in your patient population Adjust your care for patients of different cultures Look for resources available for patients of different cultures Provide translation for a patient that doesn’t speak English