Abstract Title:

Cultural competency Addition to Registered nurses' existing Education (CARE) at NYPH Lower Manhattan

Study Investigators and Credentials:

Carolyn Sun, PhD, RN, ANP-BC

Anne Cummings, BSN, RN, CAPA

Denise King, BSN, RN, CAPA (pending)

Natasha Kendrioski, BSN, RN, CCRN (pending)

Ann Marie Lanza-Bisciello, MSN, RN-BC, CWOCN

Jessica O’Brien, MS, RN, AGCNS-BC, PCCN

Kevin Xeureb, MSN, MSEd, RN, CCRN, ACCNS-AG

Alexa Shelley, MS, RN-BC, FNP-BC

Brief Presenting Author Bios:

Alexa Shelley, MS, RN-BC, FNP-BC, is a Clinical Project Coordinator for the Department of Nursing at
NYP/LM. She participates in planning, facilitating, and implementing projects and initiatives to improve
patient care processes and outcomes, staff engagement, and the nurse work environment.

Background:

As population characteristics in the United States continue to shift, so do the requirements for a
competent nursing workforce in order to optimize patient-centered care delivery. Although cultural
competency has been among the core of nursing curriculum for the past 20 years, there remains
evidence that continued, adapted education is required to ensure that nurses remain sensitive to the
many and varied cultures they may encounter in their work. In New York City in particular, there is a
diverse population, with over 200 languages spoken, and is home to the largest Chinese population
outside of Asia. New York-Prebyterian/Lower Manhattan Hospital (LMH) provides a unique setting for
such testing cultural competency interventions with a staff that is diverse and serving a diverse
population.

Purpose:

The overall aim of this project is increase the cultural competency of clinical nurses through an
educational intervention. Secondary aims include assessing the utility of an online training module in
increasing the cultural competency of nurses and testing the association between an online educational
cultural competency intervention and patient satisfaction scores.

Design:
This is a non-randomized controlled pilot study.

Methods:

Cultural competence educational interventions were tested using a pre and post test validated "Nursing
Staff Cultural Awareness Scale (NSCAS)" survey for nurses on two units of similar size and characteristics;
one unit received training that is currently available at NYPH and nurses on the second unit received the
educational intervention "Think Cultural Health" developed by the Office of Minority Health, U.S.
Department of Health and Human Services. Differences will be compared between survey scores
between the two groups as well as the HCHAPS scores on patient satisfaction.

Results:

Thirty-three nurses participated in the baseline survey; 19 from the control unit and 14 from the
intervention unit. A test for differences between the control and intervention groups indicate that there
were no statistically significant differences between the two groups (control and intervention) at
baseline for all questions (p > 0.05 for all questions).

Further data collection is ongoing. Post-test survey data, as well as HCAHPS scores, will be analyzed and
compared for both units, and this data analysis is expected to be available by September of 2018. We
will conduct descriptive statistics to assess 1) current levels of cultural competency among nurses
related to demographic factors (age, race, ethnicity, gender, education, experience) and 2)
improvements in cultural competency post intervention and related association with these same
demographic factors (age, race, ethnicity, gender, education, and experience). We will also use patient
satisfaction as a surrogate maker for improved patient experience based on the intervention. A chi-
square test will be used for associations between the intervention and 1) cultural competency scores
and 2) patient satisfaction scores. Multivariate regression will be used to test for improved patient
satisfaction factoring in cultural competency as measured by the Nursing Staff Cultural Awareness Scale
(NSCAS) tool and accounting for nurse educational level, age, gender and years of experience.

Conclusion:

Cultural competency is an important aspect of nursing care. This study will help determine implications
for nursing practice as it relates to cultural competency training in diverse areas such as the Lower
Manhattan region of New York City.