An Investigation of Cross-Cultural Communication in Nursing Education for the Reduction of Medial Errors and the Improvement of Clinical Outcomes

Monday, 22 July 2013: 1:50 PM

Luanne Linnard-Palmer, RN, CPN, EdD
Department of Nursing, Dominican University of California, San Rafael, CA

Learning Objective 1: Critially evaluate how culturally sensitive communication can assist nurses in a variety of practice settings to improve clinical outcomes and reduce the potential of errors.

Learning Objective 2: Describe how ethnography was used to discover culturally sensitive communication by capturing nurse's successful and unsuccessful communication patterns related to reducing errors and improving adherence.

Purpose: This multi-disciplinary ethnographic study was conducted to capture the clinial experienes of RNs on their culturally sensitive communication and medical errors. Current literature describes how communication remains the number one influencing factor medical and medication errors. Researchers invesitgated how experienced RN's describe their current communication patterns, both successful and unsuccessful. Data was collected by structured in-depth interviews and surveys. Research questions for this triangulation study were:
1.How does culture and communication patterns influence nursing care in relation to power distance, negotiation, teaching, and promoting adherence?
2.How do nurses perceive decision-making on the part of the diverse families? How do nurses assess who the decision maker is?
3.What are the experiences of health care team members and families while negotiating medical treatment limitations, delay or refusals due to religious or cultural doctrines?

 Ethnographic qualitative methodology captured stories and case histories. An electronic survey was also used. Data was collected via in-depth face-to-face interviews by requesting participation from members of the alumni list at Dominican University of California and the membership of the Northern California Chapter of the SPN. Purposful sampling was use by personal invitation based on extensive clinical expereince within culturally diverse large teaching hospitals in the greater Bay Area.


Results showed that nurses struggle with engaging health care team members in culturally sensitive care. Most participants stated that much more exposure to culturally sensitive situations with critical evaluation and appraisal is needed during undergraduate nursing education and during professonal education for the practicing nurse. Themes were identified during data saturation and analysis including, "Weathering the storm of moral conflict", "Power distance and paternalism often exist",  "Involvement versus retreat", and "Giving up and giving in".  


When faced with medical or medication errors based on poor communication, nurses described their anguish, frustration and ideas for improvment. All themes and suggestions for education and improving practice will be shared.