Adverse Event And Near-Miss Analysis

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Write a comprehensive analysis (5-7 pages) of an adverse event or near miss from your nursing experience. Integrate research and data on the event to propose a quality improvement (QI) initiative to your current organization.
Health care organizations strive to create a culture of safety. Despite technological advances, quality care initiatives, oversight, ongoing education and training, legislation, and regulations, medical errors continue to be made. Some are small and easily remedied with the patient unaware of the infraction. Others can be catastrophic and irreversible, altering the lives of patients and their caregivers and unleashing massive reforms and costly litigation. Many errors are attributable to ineffective interprofessional communication.
This assessment’s goal is to address a specific event in a health care setting that impacts patient safety and related organizational vulnerabilities with a quality improvement initiative to prevent future incidents.
Demonstration of Proficiency
By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

  • Competency 1: Plan quality improvement initiatives in response to adverse events and near-miss analyses.
    • Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
    • Analyze the missed steps or protocol deviations related to an adverse event or near miss.
    • Analyze the implications of the adverse event or near miss for all stakeholders.
    • Outline a quality improvement initiative to prevent a similar adverse event or near miss.
  • Competency 3: Evaluate quality improvement initiatives using sensitive and sound outcome measures.
    • Incorporate relevant metrics of the adverse event or near miss incident to support need for improvement.
  • Competency 5: Apply effective communication strategies to promote quality improvement of interprofessional care.
    • Communicate analysis and proposed initiative in a professional, effective manner, writing clearly and logically, with correct use of grammar, punctuation, and spelling.
    • Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.
  • Instructions
    For this assessment, you will prepare a comprehensive analysis on an adverse event or near miss that you or a peer experienced during your professional nursing career. You will integrate research and data on the event and use this information as the basis for a quality improvement (QI) initiative proposal in your current organization.
    The following points correspond to the grading criteria in the scoring guide. The subbullets under each grading criterion further delineate tasks to fulfill the assessment requirements. Be sure that your adverse event or near-miss analysis addresses all of the content below. You may also want to read the scoring guide to better understand the performance levels relating to each grading criterion.
  1. Analyze the missed steps or protocol deviations related to an adverse event or near miss.
    • Describe how the event resulted from a patient’s medical management rather than from the underlying condition.
    • Identify and evaluate the missed steps or protocol deviations leading to the event.
    • Explain the extent to which the incident was preventable.
    • Research the impact of the same type of adverse event or near miss in other facilities.
  2. Analyze the implications of the adverse event or near miss for all stakeholders.
    • Evaluate the short- and long-term effects on the stakeholders (patient, family, interprofessional team, facility, community). Analyze each stakeholder’s contribution to the event.
    • Analyze the interprofessional team’s responsibilities and actions. Explain what measures each interprofessional team member should have taken to create a culture of safety.
    • Describe any change to process or protocol implemented after the incident.
  3. Evaluate quality improvement technologies related to the event that are required to reduce risk and increase patient safety.
    • Analyze the quality improvement technologies put in place to increase patient safety and prevent recurrence of the near miss or adverse event.
    • Determine the appropriateness of the technology application for a specific patient or situation.
    • Research scholarly, evidence-based literature to learn how institutions can integrate solutions to prevent similar events.
  4. Incorporate relevant metrics of the adverse event or near-miss incident to support need for improvement.
    • Identify the salient data associated with the adverse event or near miss that is generated from the facility’s dashboard.
      • Note: Dashboard means data generated from the information technology platform that provides integrated operational, financial, clinical, and patient safety data for health care management.
    • Analyze what the relevant metrics show.
    • Explain research or data related to the adverse event or near miss that is available outside of your institution. Compare internal data to external data. Use resources such as the Centers for Disease Control and Prevention (CDC), Agency for Healthcare Research and Quality (AHRQ), Institute for Healthcare Improvement (IHI), and the World Health Organization (WHO).
  5. Outline a quality improvement initiative to prevent the recurrence of an adverse event or near miss.
    • Explain, from an evidence-based viewpoint, how your facility now manages or should manage the process or protocol.
    • Evaluate how other institutions addressed similar incidents or events.
    • Analyze QI initiatives developed to prevent similar incidents. Explain why they are successful. Provide evidence of their success.
    • Propose solutions for your selected institution that can be implemented to prevent similar future adverse events or near-miss incidents.
  6. Communicate analysis and proposed initiative in a professional, effective manner, writing content clearly and logically, with correct use of grammar, punctuation, and spelling.
  7. Integrate relevant sources to support arguments, correctly formatting citations and references using APA style.
  8. Example Assessment: You may use the Adverse Event or Near-Miss Analysis Exemplar [PDF] for an idea of what an assessment receiving a proficient or higher evaluation would look like.
    Additional Requirements
  • Submission length: 5–7 typed, double-spaced pages.
  • Font: Times New Roman, 12 points.
  • Number of references: Cite a minimum of 5 current scholarly and/or authoritative sources to support your evaluation, recommendations, and plans. Current literature is defined as no older than 5 years unless it is a seminal work.
  • APA formatting: Citations and references must adhere to APA style and formatting guidelines. Consult these resources for an APA refresher:
    • APA Style & Format.
    • APA Module.
    • American Psychological Association. (n.d.). APA style. Retrieved from https://www.apastyle.org/

Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry

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  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Develop a PICO(T) question to address the clinical issue of interest you identified in Module 2 for the Assignment. This PICOT question will remain the same for the entire course.
  • Use the key words from the PICO(T) question you developed and search at least four different databases in the Walden Library. Identify at least four relevant systematic reviews or other filtered high-level evidence, which includes meta-analyses, critically-appraised topics (evidence syntheses), critically-appraised individual articles (article synopses). The evidence will not necessarily address all the elements of your PICO(T) question, so select the most important concepts to search and find the best evidence available.
  • Reflect on the process of creating a PICO(T) question and searching for peer-reviewed research.

The Assignment (Evidence-Based Project)

Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews

Create a 6- to 7-slide PowerPoint presentation in which you do the following:

  • Identify and briefly describe your chosen clinical issue of interest.
  • Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest.
  • Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
  • Provide APA citations of the four relevant peer-reviewed articles at the systematic-reviews level related to your research question. If there are no systematic review level articles or meta-analysis on your topic, then use the highest level of evidence peer reviewed article.
  • Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples.Surname1

     

    Name: NURS_6052_Module03_Week05_Assignment_Rubric

     

    · Grid View

    · List View

      Excellent Good Fair Poor
    Part 2: Advanced Levels of Clinical Inquiry and Systematic Reviews Create a 6- to 7-slide PowerPoint presentation in which you do the following: · Identify and briefly describe your chosen clinical issue of interest. · Describe how you developed a PICO(T) question focused on your chosen clinical issue of interest. · Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected. · Provide APA citations of the four peer-reviewed articles you selected. · Describe the levels of evidence in each of the four peer-reviewed articles you selected, including an explanation of the strengths of using systematic reviews for clinical research. Be specific and provide examples. 81 (81%) – 90 (90%)

    The presentation clearly and accurately identifies and describes in detail the chosen clinical issue of interest. The presentation clearly and accurately describes in detail the developed PICO(T) question. The presentation clearly and accurately identifies four or more research databases used to conduct a search for the peer-reviewed articles selected. The presentation clearly and accurately provides full APA citations for at least four peer-reviewed articles selected, including a thorough and detailed explanation of the strengths of using systematic reviews for clinical research. The presentation includes specific and relevant examples that fully support the research. The presentation provides a complete, detailed, and accurate synthesis of two outside resources related to the peer-reviewed articles selected, and fully integrates at least two outside resources and two or three course-specific resources that fully support the presentation.

    		 72 (72%) – 80 (80%)

    The presentation accurately identifies and describes the chosen clinical issue of interest. The presentation accurately describes the developed PICO(T) question focused on the chosen clinical issue of interest. The presentation accurately identifies at least four research databases used to conduct a search for the peer-reviewed articles selected. The presentation accurately provides APA citations for at least four peer-reviewed articles selected, including an adequate explanation of the strengths of using systematic reviews for clinical research. The presentation includes relevant examples that support the research presented. The presentation provides an accurate synthesis of at least one outside resource related to the peer-reviewed articles selected. The response integrates at least one outside resource and two or three course-specific resources that may support the presentation.

    		 63 (63%) – 71 (71%)

    The presentation inaccurately or vaguely identifies and describes the chosen clinical issue of interest. The presentation inaccurately or vaguely describes the developed PICO(T) question focused on the chosen clinical issue of interest. The presentation inaccurately or vaguely identifies at least four research databases used to conduct a search for the peer-reviewed articles selected. The presentation inaccurately or vaguely provides APA citations for at least four peer-reviewed articles selected, including an inaccurate or vague explanation of the strengths of using systematic reviews for clinical research. The presentation includes inaccurate or vague examples to support the research presented. The presentation provides a vague or inaccurate synthesis or outside resources related to the peer-reviewed articles selected. The response minimally integrates resources that may support the presentation.

    		 0 (0%) – 62 (62%)

    The presentation inaccurately and vaguely identifies and describes the chosen clinical issue of interest or is missing. The presentation inaccurately and vaguely describes the developed PICO(T) question, or is missing. The presentation inaccurately and vaguely identifies less than four research databases used to conduct a search for the peer-reviewed articles selected or is missing. The presentation inaccurately and vaguely provides APA citations for at least four peer-reviewed articles selected, including an inaccurate and vague explanation of the strengths of using systematic reviews for clinical research, or is missing. The presentation includes inaccurate and vague examples to support the research presented or is missing. The presentation provides a vague and inaccurate synthesis of no outside resources related to the articles selected and fails to integrate any resources to support the presentation or is missing.
    Written Expression and Formatting—Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided, which delineates all required criteria. 5 (5%) – 5 (5%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity. A clear and comprehensive purpose statement, introduction, and conclusion are provided, which delineates all required criteria.

    		 4 (4%) – 4 (4%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time. Purpose, introduction, and conclusion of the assignment is stated yet is brief and not descriptive.

    		 3.5 (3.5%) – 3.5 (3.5%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60–79% of the time. Purpose, introduction, and conclusion of the assignment is vague or off topic.

    		 0 (0%) – 3 (3%)

    Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time. No purpose statement, introduction, or conclusion are provided.
    Written Expression and Formatting—English Writing Standards: Correct grammar, mechanics, and proper punctuation. 5 (5%) – 5 (5%)

    Uses correct grammar, spelling, and punctuation with no errors.

    		 4 (4%) – 4 (4%)

    Contains a few (one or two) grammar, spelling, and punctuation errors.

    		 3.5 (3.5%) – 3.5 (3.5%)

    Contains several (three or four) grammar, spelling, and punctuation errors.

    		 0 (0%) – 3 (3%)

    Contains many (five or more) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
    Total Points: 100

    Name: NURS_6052_Module03_Week05_Assignment_Rubric

     

     

     

     

    Exit

Insurance And Payer Sources

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Insurance and Payer Sources – Develop a 15 slide PowerPoint presentation. Be thorough and include rational and references for your recommendations. Write notes in the note section with proper references.

Imagine you have been asked to present a presentation on payer sources and insurances to the board of governors. Develop a presentation that describes the reimbursement entities and how reimbursement is influenced by the organizations responsible for reimbursement.

Diagnostic Writing Samples Articles

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Module 02 Content

Previously, you selected an article from this list.

Diagnostic Writing Samples Articles

You also submitted a one-sentence summary of the article.
For this assignment, write a summary paragraph about your chosen article. The summary should include:

  • An introductory sentence that identifies the title of the article, who wrote it, and the main idea of the article.
  • At least 3-5 body sentences that identify supporting details and any questions the article left unanswered.
  • A sentence that comments on the effectiveness of the article’s conclusion.
  • A concluding sentence that restates the main idea and provides closure for the paragraph.
  • An APA style citation for the article. For more information on APA, click on the Resources tab in this course.
  • Use of appropriate, standard grammar and mechanics, as well as careful proofing. The final product should be relatively error-free.Diagnostic Writing Samples

    Business

    Gresty, H. (2019). More than a feeling: The rise of EQ. Director, 72(6), 41-44.

    https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=keh&AN=138130136&site=eds-live&custid=s9076023

    ECE

    Orlando, A. (2020). Growing up wired. Discover, 41(3), 42-47.

    https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=a9h&AN=142241565&site=ehost-live&scope=site&custid=s9076023

    General Interest

    Lim, X. (2020). Out of our mines. Discover, 41(4), 30-37.

    https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=a9h&AN=142788990&site=ehost-live&scope=site&custid=s9076023

    Human Services

    Russo, A. (2019). Partnering for family success: Family resource centers and family support and strengthening networks. Policy & Practice, 77(6), 8-11.

    https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=keh&AN=140756764&site=ehost-live&scope=site&custid=s9076023

    Justice Studies

    Dauber-Griffin, A. (2020). Gender equity: Why it is important for corrections. American Jails, 33(6), 15-20.

    https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=i3h&AN=141249214&site=ehost-live&scope=site&custid=s9076023

    Nursing/Health Sciences

    Younas, A. (2020). Self-awareness: A tool for providing culturally competent care. Nursing, 50(2), 61-63. https:/doi.org/10.1097/01.NURSE.0000651628.71776.b3

     

     

    Note : Double-click the Adobe Acrobat icon to open the PDF file.

    Technology

    Snyder, K., Paulson, P., & Bergen, S. (2020). A website assessment tool for patient engagement: A verification. International Journal of Healthcare Management, 13(1), 58-64. https://doi.org/10.1080/20479700.2019.1616385

    https://search.ebscohost.com/login.aspx?direct=true&AuthType=ip,shib&db=bth&AN=142399873&site=eds-live&custid=s9076023

    Adobe Acrobat

    Document

     

    www.Nursing2020.com February l Nursing2020 l 61

    M A

    D E N

    IN IT

    IA LY

    4 K /

    S H

    U T T E R

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    C K

    BY AHTISHAM YOUNAS, BSN, MN, RN

    Self-awareness: A tool for providing culturally competent care

    CULTURAL COMPETENCE is es- sential for establishing rapport with patients and for assessing patients’ needs, including those arising from their cultural and social values and beliefs. This article discusses how self-awareness can help nurses pro- vide culturally competent care to patients and their families.

    Culturally competent care and its importance Cultural competence can be defined as “the gradually developed capac- ity of nurses to provide safe and quality healthcare to clients with

    different cultural backgrounds.”1 The most significant aspects of cul- turally competent care are accepting and respecting racial, cultural, and religious differences and promoting social justice in healthcare settings.2 At a broader sociocultural level, cul- tural competence can enhance cross- cultural communication, decrease health inequalities and promote equality, improve access to health- care services, and increase health literacy.3

    A comprehensive nursing assess- ment that includes awareness of patients’ cultural and social values

    Abstract: Cultural competence is essential for establishing rapport with patients and for assessing patients’ needs. This article discusses how self-awareness can help nurses provide culturally competent care to patients and their families.

    Keywords: cultural competence, reflective thinking, self-awareness, transcultural nursing

    Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

     

     

    62 l Nursing2020 l Volume 50, Number 2 www.Nursing2020.com

    helps the nurse develop and imple- ment nursing interventions that are most relevant to the patient’s needs.10 By improving communication with patients, culturally competent nurs- ing care increases patient satisfaction and encourages patients to partici- pate in and adhere to the treatment regimen.4

    Working effectively and efficiently in today’s complex healthcare en- vironment requires nurses to be aware of different intrapersonal, interpersonal, and contextual factors that influence their interactions with patients.5 Intrapersonal factors relate to the nurse personally; interpersonal factors are those that can affect the nurse’s interactions with patients, their families, and other healthcare professionals. For example, if a nurse has a stressful day at work and is also caring for some challenging patients (intrapersonal factor), the nurse’s in- teractions and relationships with oth- er patients (interpersonal factor) may be negatively affected. Similarly, if a nurse is caring for a critically ill pa- tient, both the patient and the family require emotional support. But if the nurse’s workload prevents the nurse from being fully present to the family, overall patient care may be affected.

    Contextual factors are those hid- den social, cultural, political, and economic factors that influence the nurse’s relationship with patients.5 For example, a patient may refuse a surgical procedure for financial or familial reasons. If the nurse is not aware of the patient’s reasons, the nurse might consider the patient “nonadherent” or resistant to the treatment plan.6

    Among these described factors, intrapersonal factors such as patients’ and nurses’ cultural and social values can significantly affect the devel- opment of effective nurse-patient relationships, ultimately affecting the quality of overall nursing care.6,7 Many nations, including the US, United Kingdom, and Canada, have

    multicultural populations in which nurses from various cultures care for patients who are also culturally diverse. Because culture is an intrin- sic part of who a person is, cultural competence is essential for delivering quality nursing care.8-10 However, it has also been argued that to promote culturally competent care, a greater emphasis has been placed on devel- oping a culturally diverse workforce than on modulating the individual nurse’s behaviors, awareness, and characteristics.3 Developing self- awareness, the focus of this article, can help individual nurses provide more culturally competent care to patients and their families regardless of their own cultural background.

    What is self-awareness? Self-awareness is an intrapersonal and introspective process one can use to explore and recognize personal,

    familial, and professional nursing values, social and cultural beliefs, and life experiences in different nursing situations.7 Self-aware nurses reflect on their strengths and limitations; acknowledge their racial, cultural, and religious prejudices; and recognize negative and positive potentials to care for patients in dif- ferent contexts and settings.7,11

    Besides cultivating an understand- ing of one’s own personal strengths, limitations, emotions, and feelings, nurses who are self-aware recognize environmental factors and condi- tions that can influence their ability to provide effective care, such as time constraints or a heavy workload.11 In short, self-awareness is foundational for developing and fostering cross- cultural therapeutic relationships.12

    Points for reflection To learn more about your patients’ cultural values and beliefs and com- pare them with your own beliefs, incorporate the following consider- ations into your nursing practice. • What are my patient’s cultural be- liefs and values? • How are my own cultural beliefs and values different from those of my patient? • What are my patient’s fears, hopes, expectations, and beliefs about healthcare treatments and proce- dures? • How do my patient’s views and beliefs contradict or concur with my own cultural beliefs? • Are any recommended healthcare treatments or nursing interventions likely to be culturally unacceptable to my patient?

    Nurses can seek answers to these questions through patient and family interviews and personal observations at the time of patient admission and update the information as they learn more about their patients and fami- lies. Using this awareness, nurses can explore ways to provide better nurs- ing care while respecting patients’

    Nurses who are self- aware recognize

    environmental factors and conditions that can influence their ability to provide effective care.

    Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.

     

     

    www.Nursing2020.com February l Nursing2020 l 63

    cultural values and differences. Reflecting on previous encounters requiring cultural competence and learning from those experiences can significantly enhance a nurse’s ability to care for other patients with similar cultural values.

    A recent systematic review of six experimental studies that focused on educational interventions to enhance cultural competence reported that self- awareness and reflection are necessary for developing cultural competence in nurses.13 This review reported that the most useful educational interventions were those that encouraged nurses to explore their own culture and cultural values, professional background, biases, and prejudices.

    Reflecting on personal biases A nurse’s personal religious and cul- tural beliefs can affect the ability to care for patients in a culturally compe- tent manner. For example, if a nurse does not believe in the effectiveness of prayer as a healing method, this personal belief may prevent the nurse from cooperating with a patient’s request for clergy or a nontraditional healer, leading to a failure to fulfill the patient’s needs. When you are aware of your own biases and ingrained cul- tural values, you can prevent yourself from projecting those biases on to pa- tients when providing care.7

    Other examples of patients and situations that require cultural sen- sitivity and self-awareness include a patient who refuses a blood transfu- sion due to religious beliefs, a male Muslim patient who is not comfort- able receiving physical care from female nurses, and a patient who may not speak English and requires the services of an interpreter. In line with these examples, a recent study reported that nurses indicated that when they are more aware of their own beliefs and assumptions about folk remedies and stereotypical views of ethnic groups, their ability to provide culturally competent care is

    enhanced.14 Acknowledging personal biases and judgments can help nurs- es genuinely view a nursing situation from the patients’ perspective.

    Applying CULTURE to practice Self-awareness reminds nurses not to make judgments about their patients’ cultural values. The author offers the CULTURE acronym to delineate how self-awareness can be used as a tool to enhance cultural competence and provide more sensitive care. • Challenge your own and others’ biases and prejudices that may nega- tively affect your caring abilities. • Uncover how your cultural val- ues and sociocultural and historical beliefs may affect your interactions with patients, their families, and other healthcare professionals. • Listen to the viewpoints of patients and others and learn about other cultures and religions. • Tune in to diversity in nursing situations and situate yourself among diverse cultural groups. • Use your experiences caring for culturally diverse patients to discern more meaningful ways of caring for patients in other similar nursing situ- ations. • Respect your own and others’ cul- tural values. • Evaluate how your awareness of your own and your patients’ cultural beliefs allows you to provide cultur- ally competent care and how you can use this knowledge in the future.

    Various strategies can help nurses apply the CULTURE acronym in ev- eryday nursing situations. Elements of reflective practice include keenly observing every nursing practice situation and noticing patient-care needs; keeping a diary; developing portfolios; and seeking feedback from patients, their families, and your col- leagues.7 For example, nurses can use a diary to recount and reflect upon interesting experiences with patients from various cultural and religious backgrounds, identifying positive and

    negative aspects of these interactions. Based on what they learn from these experiences, they may find ways to modify future actions and interven- tions. Reflective accounts can also be placed in a portfolio.

    Self-awareness is integral to cultur- ally competent nursing care. Nurses who recognize their cultural biases are better prepared to manage them. ■

    REFERENCES

    1. Cai DY. A concept analysis of cultural competence. Int J Nurs Sci. 2016;3(3):268-273.

    2. French BM. Culturally competent care: the awareness of self and others. J Infus Nurs. 2003;26(4): 252-255.

    3. Campinha-Bacote J. Cultural competemility: a paradigm shift in the cultural competence versus cultural humility debate–Part I. Online J Issues Nurs. 2019;24(1):1.

    4. Tang C, Tian B, Zhang X, et al. The influence of cultural competence of nurses on patient satisfaction and the mediating effect of patient trust. J Adv Nurs. 2019;75(4):749-759.

    5. Doane GH, Varcoe C. How to Nurse: Relational Inquiry with Individuals and Families in Changing Health and Health Care Contexts. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins; 2015.

    6. Younas A. Relational inquiry approach: nursing practice in Pakistan—a case study. Nurs Sci Q. 2017;30(4):336-340.

    7. Rasheed SP, Younas A, Sundus A. Self-awareness in nursing: a scoping review. J Clin Nurs. 2019;28(5-6):762-774.

    8. Burchum JL. Cultural competence: an evolutionary perspective. Nurs Forum. 2002;37(4):5-15.

    9. Saha S, Beach MC, Cooper LA. Patient centeredness, cultural competence and healthcare quality. J Natl Med Assoc. 2008;100(11):1275-1285.

    10. Murphy K. The importance of cultural competence. Nurs Made Incredibly Easy. 2011;9(2):5.

    11. Eckroth-Bucher M. Self-awareness: a review and analysis of a basic nursing concept. ANS Adv Nurs Sci. 2010;33(4):297-309.

    12. Yan MC, Wong YL. Rethinking self-awareness in cultural competence: toward a dialogic self in cross- cultural social work. Fam Soc. 2005;86(2):181-188.

    13. Oikarainen A, Mikkonen K, Kenny A, et al. Educational interventions designed to develop nurses’ cultural competence: a systematic review. Int J Nurs Stud. 2019;98:75-86.

    14. Lin MH, Wu CY, Hsu HC. Exploring the experiences of cultural competence among clinical nurses in Taiwan. Appl Nurs Res. 2019;45:6-11.

    Ahtisham Younas is a doctoral student at the Faculty of Nursing, Memorial University of Newfoundland in St. John’s, Canada.

    The author has disclosed no financial relationships related to this article.

    DOI-10.1097/01.NURSE.0000651628.71776.b3

    Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.