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The diverse cultural landscape of Europe underscores the importance of culturally safe healthcare. There is a necessity to assess cultural competence among European nursing faculty to provide an international perspective on cultural competence.
A descriptive, cross-sectional study.
An assessment of cultural competencies was conducted using the Cultural Competence Assessment scale, either in its original language (English) or in its translated and validated versions in Spanish, Italian, Portuguese, and Turkish. An online questionnaire was used to collect data.
The study was conducted in 71 higher institutions, distributed across 17 countries through a consecutive sample of 1364 nursing faculty.
The ethical principles of biomedical research were respected during the study, and the confidentiality of the data was guaranteed.
The mean level of cultural competence of the European nursing faculty was at the level of ‘good’. They showed greater cultural awareness and sensitivity than cultural competence behaviors. Significant associations were found between cultural competence level and the language of the questionnaire, level of education, having a nursing degree, leisure stays abroad, having friends from other countries or cultures, and international experiences abroad and at home. The better levels of cultural competence were found in profiles with the categories of: women with a Nursing Degree, a higher level of education, and with an ERASMUS+ stay experience.
This study offers an international overview of the cultural competence of nursing faculty. While the overall level of cultural competence was good, there is a need to reinforce the behaviors and factors that influence it.
Delay in detecting acute deterioration in older adults in care homes is associated with avoidable hospitalizations and adverse outcomes, including premature death.
Underpinned by the Knowledge to Action Framework, this study aimed to understand the barriers and enablers to direct care staff detecting and responding to the early signs of acute deterioration in care home residents.
Online focus groups or interviews with regulated (registered and enrolled nurses) and unregulated (assistants in nursing and personal care workers) direct care staff from participating care homes were conducted. Homes were recruited using disproportionate stratified random sampling to include metropolitan, inner regional, and outer regional care homes. Interview and focus group recordings were transcribed verbatim and analyzed using inductive thematic analysis.
Eighty direct care staff (n = 48 regulated; n = 32 unregulated) from eight care homes participated. Fifteen focus groups (n = 7 unregulated staff, n = 8 regulated staff) and two interviews (n = 1 regulated staff, n = 1 unregulated staff) were conducted between July 2021 and October 2022. Four themes related to the barriers and enablers of detecting and responding to acute deterioration were generated: decision-making within the scope of practice; resource availability; streamlined communication; and teamwork.
Findings highlight the challenges direct care staff encounter in being able to detect early signs of acute deterioration and implement appropriate care pathways. Perceived barriers and enablers highlighted in this study need to be considered when developing and implementing programs to optimize the timely detection of, and response to, acute deterioration in care homes.
Workforce knowledge, experience, and confidence deficits are significant barriers to detecting acute deterioration, while the unique workforce mix in care homes poses additional challenges for the accurate detection of early signs of acute deterioration. Knowing the resident, working as a team, and valuing the contribution of aged care staff and families in managing acute deterioration are enablers to achieving better outcomes for residents experiencing acute deterioration.
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