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Practice Improvement Formal Paper
Odine Jacques
Miami Dade College
NUR4945C Advance Nursing Concepts Practicum
Dr. Espinosa
11/14/21
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Call Practice Improvement Formal Paper
My advanced nursing concepts practicum was at the University of Miami Lennar Medical
Foundation. I was assigned to the Ear, Nose, and Throat (ENT) unit. Lennar Medical Foundation
is one of the recognized healthcare facilities in Miami. The facility focuses on different
specialized healthcare services such as individualized cardiology, imaging services, neurology,
ophthalmology, physical therapy, outpatient surgery, otolaryngology, pain management, sports
medicine, primary care, and urology. The healthcare services target all groups of patients in the
community. During the practicum, I realized that the healthcare facility serves diverse groups of
healthcare consumers in terms of background, behaviors, lifestyle, attitudes, knowledge, and
beliefs. For this reason, I believe that the integration of interventions to improve cultural
competence is required to reduce the witnessed health disparity across different population
groups (Curtis et al., 2019; Zarzycka et al., 2020).
The goal of reducing health disparities across different community groups remains a
primary target in the healthcare sector in the United States and across the globe. Cultural
competence is considered one of the effective interventions that could be integrated to solve this
problem. The reason for this recommendation is that cultural competence is considered as a
caring approach that pays attention to the diversity-related characteristics inclined to the culture
of different groups in a population (Truong et al., 2014; McCalman et al., 2017). For this reason,
cultural competence in healthcare integrates the cultural issues that impact different dimensions
of well-being and health care. From my practicum experience, patients who visited the facility
came from different backgrounds, and this shaped their perceptions, beliefs, and attitudes.
Culture defines healthcare experiences and outcomes among individuals, which cumulatively
shape the dimensions of disparity being witnessed.
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Scholarly evaluations have ascertained how a lack of clarity regarding the approach to
optimize cultural competence in healthcare exists. Such an occurrence has contributed to
exacerbating patients’ experiences while seeking and consuming healthcare services. Since there
is a lack of consensus around how cultural competence is conceptualized and operationalized, the
same phenomenon is shifted to the workplace (Curtis et al., 2019; Jongen et al., 2018).
Therefore, in most cases, practitioners are unable to effectively integrate cultural diversity while
delivering care services to a multicultural population. I realized that Lennar Medical Foundation
has integrated the use of targeted programs for practitioners to improve their group-specific
knowledge. At the same time, the organization has programs that seek to foster the effectiveness
of universal models of care. However, from my experience, I believe that there is more to be
done to reduce disparity in healthcare experience and outcomes in the long run.
The first dimension that I realized the facility needs to integrate into its operation is the
individuation of care interventions to promote patient well-being and quality outcomes. In this
case, providers are expected to make conscious efforts and decisions that focus on people with
their respective characteristics and behaviors as opposed to their group identities (Truong et al.,
2014; McCalman et al., 2017). Considering a patient as a separate individual from the universal
group identity to which they belong allows practitioners to optimize their experiences.
Furthermore, the idea of individuation while delivering care services calls for the consideration
of a patient’s biases and stereotypes without making them a priority over beneficence. Although
patients are to be respected all the time, it does not imply that their stereotypes and biases should
interfere with the quality of care to be delivered (Jowsey, 2019). For this reason, I realized that
Lennar Medical Foundation needs to transform its approach from a group perspective and
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identities to an individualized approach to care delivery. The collective effect of such a move
could transform the community in the long run and reduce disparity in healthcare characteristics.
The second element that I believe could improve culturally competent care at Lennar
Medical Foundation is patient advocacy from a cultural perspective. Practitioners such as nurses,
physicians, and other paraprofessionals in healthcare are patient advocates. When it comes to
culture, it is necessary to reconsider an approach that is beyond the universal framework of care
delivery since one size does not fit all (Jongen et al., 2018). The population being served at
Lennar Medical Foundation is diverse with unique backgrounds, and the use of a universal
approach could jeopardize the desire to maximize care experiences and outcomes. Apart from an
individualized approach, it is equally important to consider the needs of the patients and ensure
that those needs are met within the provided scope of practice and guidelines. Being the advocate
of patients, especially when culture is involved, could enhance their experiences and improve
care outcomes. From my practicum experience, I realized that practitioners at Lennar Medical
Foundation should consider engineering a system that will create an environment where they
could easily and effectively advocate for patients, especially in terms of cultural competence.
Moreover, I learned that effective culture-based care also depends on the patient-provider
relationship. For practitioners to implement care founded on cultural competence, they need to
create an environment that allows patients to freely navigate the opportunities for professional
practitioner-patient relationships (Zarzycka et al., 2020; McCalman et al., 2017). A positive
professional relationship provides a baseline for nurses and other healthcare practitioners to
understand the background of the patient and how their values, attitude, beliefs, and perceptions
shape their health outcomes and experiences. when patients feel free to interact with healthcare
practitioners, there is a high probability that they will be willing to share their experiences and
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expectations. Patient-provider interactions create the opportunity for cultural understanding and
the individualization of care interventions. While at Lennar Medical Foundation, I realized that
when practitioners engage and communicate with patients, empathy, respect, and compassion are
required. Such a scenario allows practitioners to understand the patients effectively, including
their cultural diversities.
Furthermore, from my observation, professional knowledge, and experience, I learned
that the other aspect that could improve cultural competence at Lennar Medical Foundation is
awareness and education. Healthcare practitioners are competent professionals trained and
certified to practice. However, this does not imply that continuous learning and awareness are
not needed at the workplace. Already Lennar Medical Foundation has a comprehensive
education and training program for the practitioners, but there is a need for a more intensified
approach inclined towards cultural competence. On-job training, education, and awareness
interventions have been used across the globe to enhance and align the skills of practitioners
based on the presented need at their respective workplaces.
In conclusion, my practicum experience enabled me to understand the role of cultural
competence in a healthcare setting. While working at Lennar Medical Foundation, I learned that
patients have diverse needs, but at the same time, they equally have diverse backgrounds. The
beliefs, attitudes, perceptions, values, and knowledge of patients shape their healthcare
experiences and outcomes. For this reason, different frameworks, approaches, and methods are
needed to enhance cultural competence among practitioners.
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References
Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S. J., & Reid, P. (2019).
Why cultural safety rather than cultural competency is required to achieve health equity:
a literature review and recommended definition. International Journal for Equity in
Health, 18(1), 174. https://doi.org/10.1186/s12939-019-1082-3
Jongen, C., McCalman, J., & Bainbridge, R. (2018). Health workforce cultural competency
interventions: a systematic scoping review. BMC Health Services Research, 18(1), 232.
https://doi.org/10.1186/s12913-018-3001-5
Jowsey T. (2019). Three zones of cultural competency: surface competency, bias twilight, and
the confronting midnight zone. BMC Medical Education, 19(1), 306.
https://doi.org/10.1186/s12909-019-1746-0
McCalman, J., Jongen, C., & Bainbridge, R. (2017). Organizational systems’ approaches to
improving cultural competence in healthcare: a systematic scoping review of the
literature. International Journal for Equity in Health, 16(1), 78.
https://doi.org/10.1186/s12939-017-0571-5
Truong, M., Paradies, Y., & Priest, N. (2014). Interventions to improve cultural competency in
healthcare: a systematic review of reviews. BMC Health Serv Res 14, 99.
https://doi.org/10.1186/1472-6963-14-99
Zarzycka, D., Chrzan-Rodak, A., Bąk, J., Niedorys-Karczmarczyk, B., & Ślusarska, B. (2020).
Nurse Cultural Competence-cultural adaptation and validation of the Polish version of the
Nurse Cultural Competence Scale and preliminary research results. PloS One, 15(10),
e0240884. https://doi.org/10.1371/journal.pone.0240884
5:14
f NUR 4945-C Projects and A…
Practice Improvement Formal Paper using Current Nursing Leadership Strengths and
Philosophy CC2.
1. Each student is asked to consider their leadership growth and evolution in their own practice
improvement model of nursing as well as their leadership strengths as identified in QSEN
(https://qsen.org/leadership-in-healthcare/). The reflection should be 4-5 pages of the body and
cover the following areas.
1. Overview of your current professional leadership strengths and nursing philosophy. (Use your
leadership strengths assessment in your ion)
2. Lessons learned to date pertaining to nursing leadership. (What situations or lessons learned
which has significantly improved your practice).
3. Utilizing the concepts listed below.
4. Describe specific areas that you would like to focus on to attain your use personal goals in
professional development).
5. There should three to five references.
6. The formal paper should be APA 7th edition format
Practice Improvement Formal Paper using Current Nursing Leadership
Strengths and Philosophy CC2.
Criteria
EXCEEDS EXPECTATIONS
NEEDS IMPROVEMENT
MEETS EXPECTATIONS
Reflective Thinking
Analysis
Making
Connections
The reflection explains the student’s own The reflection attempts to demonstrate The reflection explains the student’s
thinking and learning processes, as well thinking about learning but is vague and/or thinking about his/her own learning
as implications for future learning. unclear about the personal learning process processes.
The reflection is an in-depth analysis of The reflection attempts to analyze the The reflection is an analysis of the
the learning experience, the value of the learning experience but the value of the learning experience and the value of the
derived learning to self or others, and the learning to the student or others is vague derived learning to self or others.
enhancement of the student’s appre and/or unclear
for the discipline
The reflection articulates multiple The reflection attempts to articulate The reflection articulates connections
connections between the learning connections between this leaming between the learning experience and
experience and content from other experience and content from other courses, content from other courses, past leaming
courses, past learning, meaningful life past learning experiences, or personal experiences, and/or future goals.
experiences and/or future goals. goals, but the connection is vague andor
unclear
No errors in grammatical or punctuations. More than 8 grammatical, punctuations. Between 1-4 grammatical, punctuation,
but they are minor and do not detract from
the paper
Meets the APA criteria with consistent use Does not meet criteria for APA writing. Meets the overall APA criteria but is
of appropriate citations within paper and
inconsistent with citations and references
uses appropriate citation for each
reference
Synergy
APA 7 edition format
Steps to Execute Here is where you will write the steps that you are going to take in this cycle. You will want to include the following:
Problem Identification: Identify a clinical problem that you observed in the clinical site. Digging up clinical problems can start with observations of
clinical practice on your unit, asking staff about the problems they face when delivering care, looking through policies and procedures and guidelines
of care to assess if there is a standard or policy to improve practice. Talking with patients about their perceptions of the care they are receiving and
asking clinical questions that address the clinical implication of the observation. Is there a problem, a patient or a population there is negatively
affected by the present standard of practice? Once this P factor is determined without a present resolution, them a clinical question should be
developed using the PICO process.
The population this could be a patient, a problem, a population, a unit, a division, or organization problem.
The time limit that you are going to do this project-remember, it does not have to be long, just long enough to get your results. You may set a time
limit of 1 week but find out after 4 hours that it does not work. You can terminate the cycle at that point because you got your results.
Review of literature: What level of knowledge is out there to address the problem, are there any evidence-based guidelines already published. Most
of the literature reviewed should utilize systematic reviews, meta-analysis, clinical guidelines. Individual studies review expert opinion articles and
clinical articles can be used as supportive literature for clinical issues with limited research.
Example: Steps to execute:
Problem and population same day post-surgical patients do not answer the survey about satisfaction with services.
Found that if surveys are easily accessible the response may be increased.
We will display the surveys at the checkout desk.
The checkout attendant will encourage the patient to fill out a survey and put it in the box next to the surveys.
We will try this for 1 week
PDSA Practice Improvement Plan

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