Apply the concepts that assist in fostering diverse relationships in providing health care on a global level.

Learning Outcomes
1. Examine personal tendencies for cultural bias, generalization, and assumptions as they influence the delivery of quality health care.
2. Discuss the relationship of health care insurance coverage related to disparities of various culture groups.
3. Compare and contrast the nurse’s role in the delivery of culturally competent care.
4. Apply the concepts that assist in fostering diverse relationships in providing health care on a global level.

Introduction

The course begins with an exploration of cultural influences and personal values in the delivery of culturally competent nursing care to diverse population groups. What we think, feel, and experience throughout our lives both personally and professionally can affect the manner in which we deliver health care. It is imperative for the nurse to practice with the patient’s health and cultural needs as a primary focus. Health care organizations provide guidelines and policies to assist in delivering culturally competent care, but it remains the nurse’s role to ensure they are followed. An evaluation of a case study requires the development of assessment techniques that enhance the student’s ability to apply the learned concepts.

Required Resources
Text
Dayer-Berenson, L. (2014). Cultural competencies for nurses: Impact on health and illness (2nd ed.). Burlington, MA, Jones & Bartlett Learning.
• Chapter 3: Global Diversity
• Chapter 4: Organization of Health care Delivery in the 21st Century

Articles
Chou, C., PhD., Tulolo, A., PharmD., Raver, E. W., B.S., Hsu, C., PhD., & Young, Gary,J.D., PhD. (2013). Effect of race and health insurance on health disparities: Results from the national health interview survey 2010. Journal of Health Care for the Poor and Underserved, 24(3), 1353-63. doi: 10.1353/hpu.2013.0131
• This article investigates how insurance coverage via the PPACA has influenced health disparities based on race/ethnicity.
Dovidio, J. F., & Fiske, S. T. (2012). Under the radar: How unexamined biases in decision-making processes in clinical interactions can contribute to health care disparities. American Journal of Public Health, 102(5), 945-952. doi:10.2105/AJPH.2011.300601
• The full text of this article is available in the EBSCOhost database in the Ashford University Library. This article addresses how racial and ethnic biases contribute to health disparities among African/Black, Hispanic, and Native American people.
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: Implications for public health policy and practice. Public Health Reports, 126(1), 130–135. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3001814/
• This reviews PPACA as it relates to its effect on care for diverse populations.

Multimedia
Nevco Healthcare Education. (1991). Understanding our biases and assumptions [Video file]. In Films on Demand. Retrieved from http://digital.films.com.proxy-library.ashford.edu/PortalPlaylists.aspx?aid=18596&xtid=2574
• This video allows you to understand how your own experiences in life influence your perceptions about others. It also shares information from members of minority populations to show how bias affects their lives.

Practice Activity. (2015). Transcultural Nursing. Burlington, MA: Jones & Bartlett Learning Navigate.
• The practice activities provide an opportunity to reinforce the concepts presented in the textbook readings.
• Complete the following practice activities: 3.1, 3.2, 3.3, 3.4, 4.1, 4.2, 4.3, 4.4

Website
Teaching Tolerance: A Project of the Southern Poverty Law Center. (2011). Test yourself for hidden bias. Retrieved from: http://www.tolerance.org/activity/test-yourself-hidden-bias
• This website allows you to test your own biases through a series of questions and sorting exercises. The sorting exercises are fast-paced and an outcome is provided when you complete each test. YOU DO NOT NEED TO SHARE THE TEST NAMES YOU TOOK OR YOUR OUTCOMES WITH THE CLASS OR INSTRUCTOR. This activity is for your confidential use only and gives you an idea of any possible biases you have.
• DIRECTIONS: When you reach the website, choose the CLICK HERE link in the second paragraph. A new tab/window will open, called PROJECT IMPLICIT. REGISTER with your either email address or CONTINUE AS A GUEST. Click GO. The page will change. Read the material and click I WISH TO PROCEED at the bottom of the page. The page will change, showing a list of tests you can take. If this list does not show, choose TAKE A TEST from the tabs at the top of the page. Take three or more of the bias tests from the list, of your topic choice. Topic choices are: Native American, Asian American, Sexuality, Arab-Muslim, Religion, Presidents, Weight, Age, Disability, Gender [in] Science, Skin-tone, Race, Weapons, and Gender [in] Career.

Recommended Resources
Text
Dayer-Berenson, L. (2014). Cultural competencies for nurses: Impact on health and illness (2nd ed.). Burlington, MA, Jones & Bartlett Learning.
• Chapter 6: Hispanics/Latinos
Articles
Cogan, J.A. (2011). The affordable care act’s preventive services mandate: Breaking down the barriers to nationwide access to preventive services. Journal of Law, Medicine & Ethics, 39(3), 355-365. doi: 10.1111/j.1748-720X.2011.00605.x
• The full-text version of this article can be accessed through the EBSCOhost database in the  University Library.
Worthen, M. S. (2014). The PPACA’s potential impact on hospitals. The RMA Journal, 96(7), 37-37, 11. Retrieved from http://www.rmahq.org/thermajournal/
• The full-text version of this article can be accessed through the ProQuest database in the University Library.

Supplemental Material
College of Health, Human Services, and Science: Department of Health Promotion (Producer). The Affordable Care Act and you: History, implications, and the future of health care [Webinar]. .
• This webinar discusses the impact of PPACA on the future of health care.

Websites
H.R. 3590–111th Congress: Patient Protection and Affordable Care Act [PDF]. (2010). In www.gpo.gov. Retrieved from http://www.gpo.gov/fdsys/pkg/BILLS-111hr3590enr/pdf/BILLS-111hr3590enr.pdf
• This website describes the updates to PPACA.
Kaiser Family Foundation. (2013). Summary of the affordable care act. Retrieved from: http://kff.org/health-reform/fact-sheet/summary-of-the-affordable-care-act/
• This website provides a summary of PPACA.
Williams, E., & Redhead, C.S. (2010). Public health, workforce, quality and related provisions in the Patient Protection and Affordable Care Act (PPACA). Congressional Research Service. Retrieved from: https://www.aamc.org/download/130996/data/ph.pdf.pdf
• This document gives a brief synopsis of PPACA as it relates to the workforce, public health, and quality care.