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Essay Instructions: Rubric
PURPOSE
Creation of a final ?Design for Change? proposal inclusive of your draft, peer review feedback, and the contribution your project will make to the future of healthcare.
COURSE OUTCOMES
This assignment enables the student to meet the following course outcomes:
CO3 Communicates effectively with patient populations and other healthcare providers in managing the healthcare of individuals, families, aggregates, and communities. (PO #3)
CO6 Plans clinical practice activities that integrate professional nursing standards in accordance with the nursing code of ethics and American Nurses? Association (ANA) standards of practice. (PO #6)
CO7 Integrates the professional role of leader, teacher, communicator, and manager of care to plan cost-effective, quality healthcare to consumers in structured and unstructured settings. (PO #7)

DIRECTIONS
This is the final revision of your ?Design for Change Assignment?. The final consists of your revised Design for Change draft, incorporated peer review feedback, and the contribution your project will make to the future of healthcare.
1. Create a proposal for your management team to convince them that the problem you have uncovered is significant and your plan for improvement will benefit the stakeholders.
2. Integrate the feedback received in from your peers in Milestone # 3 and your professor in Milestone #2.
3. The format for this proposal will be a paper following APA 6th edition.
4. The paper is to be 5-7 pages excluding Title page and Reference page.
5. As you organize your information and evidence, include the following topics:
a. Introduction ? to the plan with evidence-based problem identification and solution.
b. Description of the contribution to the future of healthcare, inclusive of the stakeholders.
c. Change Plan overview using the six steps of the Rosswurm and Larrabee Model (1999).
i. Assess need for change
ii. Link problem-intervention-outcomes
iii. Synthesize best evidence (literature review)
iv. Design practice change
v. Implement and evaluate change (evaluation must be measureable and time bound)
vi. Integrate and maintain change
d. Evaluation Plan
e. Next Steps to maintain the change

6. Citations and References must be included to support the information within each topic area. Refer to the APA manual ? Chapter 7 ? for examples of proper reference format. Citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself ?how do I know this?? and then cite the source. Scholarly sources are expected, which means using peer-reviewed journals and credible websites.
7. Tables and Figures may be added as appropriate to the project should be embedded within the body of the paper (see your APA manual for how to format and cite). Creating your own tables and figures offers visual aids to the reader and enhances understanding of your literature review and design for change.
CULTURAL COMPETENCY
2

OUTLINE TO USE

This paragraph(s) is to introduce the paper. State the problem and potential solutions backed by evidence. Briefly, introduce the nursing focused plan. Remember this is a scholarly APA assignment so you cannot use first person.

Contribution to the Future of Healthcare
Provide one-two paragraph(s) as to how your project will contribute to the future of healthcare. Please identify any key stakeholders.

Change Model Overview
In this first paragraph, provide an overview of the Rosswurm and Larrabee?s change model. Feel free to state why nurses should use this model as a guide to facilitate change. Under each of the second level headers listed below, you now link your identified topic to the Rosswurm and Larrabee?s six steps.

Step 1: Asses the Need for Change
Discuss the first step of assessing the need for change as it related to your topic. Restate the PICOT question from Milestone 1. Provide the internal data (what the current practice is) and compare the internal data to the external data (or evidence-based practices).

Step 2: Link the problem, interventions, and outcomes
In this paragraph discuss the problem, potential interventions one might undertake, and the desired outcomes as a result of the planned change.

Step 3: Synthesize the Best Evidence
Incorporate the literature review conducted in Milestone 1. Provide the important findings within the literature, by identifying at least six (6) studies in peer-reviewed articles supporting the need for change. Please do not use one paragraph for each of the six articles ?
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instead synthesize the articles. Feel free to cite multiple articles within one sentence. Ideally this
section should only be a couple of paragraphs.

Step 4: Design Practice Change
Following step four of Rosswurm and Larrabee?s model, provide a paragraph or two describing how the desired practice change will be designed. Include the stakeholders and the key players who will be involved in the design for change.

Step 5: Implement and Evaluate the Change in Practice
In this paragraph, concisely provide an overview of how you are going to implement and evaluate the change in practice. This is to be an overview paragraph as you are going to go in great detail in a later section.

Step 6: Integrate and Maintain the Change in Practice
In this paragraph, concisely provide an overview of how you are going to integrate and maintain the change in practice. This is to be an overview paragraph as you are going to go in great detail in a later section.

Implement & Evaluation Plan
. In this section you are to clearly identify the steps for implementation and the steps for evaluation for your proposed change. Although you mentioned this in the preceding section (step 5) ? here is where you go into greater detail. Be sure that you have identified measurable
goals within a specified time frame. This section is worth 40 points ? so great detail is expected.

Steps to Maintain Change
This section is also worth 40 points so you are to list all steps needed to maintain your proposed change. Here you provide all the details as to how you are going to make sure that this
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change will still be around in one year, five years or even 10 years. This section is different than the overview you provided in the preceding section as here you provide great detail.

Conclusion
Provide a conclusion summarizing the key points of the paper.

Essay Instructions: Write a 2- 3 Page Paper (using APA 5th edition Form & Style) about a folk, alternative or complementary medicine of your choice. It can be drawn from a personal experience, a review of a journal article or other sources. Be sure your paper includes an analysis (who, what, where, why & how) of the topic of choice discussion or suggestions how to of integrate this information into increasing the knowledge base of cultural competency. References are required.

Essay Instructions: Address the cultural information gleaned from the movie “Selena” that would impact you as a healthcare provider when delivering care to a person or family if this culture. This is just not a movie review assignment. This needs to be done From a Health Providers point view. Identify following as they relate to culture:
Using The Purnell Model for Cultural Competency which presents the 12 Domains of Culture write a culturally competent guide/review of a culture of your choice and address all of Purnell's Marco and Micro Aspects of the Model.


1. Short synopsis
2. Cultural Overview and Heritage
3. Communiction
4. Family Roles and Organization of the Society
5. Acculturation and Autonomy
6. Biocultural Issues
7. Health Risk Behaviors
8. Nutrition (meaning of food, common foods, rituals, limitations, deficiencies, etc.)
9. Pregnancy, ( fertility practices, pregnancy beliefs, birthing, post partum, etc).
10. Death Rituals.
11. Spirituality (e.g. religious practices, use of prayers, meaning of life, connection to health, etc).
12. Health Care Practices, (e.g. focus on health care, traditional practices, folk medicine/beliefs, pain sick roles, mental health barriers, etc).
13. Health Care Practioners (perceptions of practitioners, folk practitioners, gender & health care etc).

You are not required to focus your answers and discussions on the main character. However, you will need to focus on only one of the cultures represented in the movie.
As previously stated you need to address from a health provider’s point of view ALL of the areas outlined in each week’s assignment pages. After viewing the movie you are to address these areas based on your interpretation, existing knowledge and the movie’s portrayal of the culture you chose to focus on while as much as possible integrating/including cultural competent concepts, tips or skills that could be used by others when they encounter these cultural beliefs. If one of these areas is not addressed in the movie you still need to provide information on this topic by researching outside sources.



There are faxes for this order.

Essay Instructions: Open to all writers!!

CULTURAL SELF-ASSESSMENT INSTRUCTIONS
AND GRADING RUBRIC

This exercise will allow you to do some self-reflection related to cultural competency. In order to complete this exercise, follow the instructions listed below:

CRITERIA POINTS POSSIBLE POINTS EARNED
1. Go to the Cultural Competence Self-Test link provided and complete the questions related to cultural competency.
2. After completing the questions, write a brief narrative (1–2 pages) explaining what you learned from completing the exercise.
3. Identify areas of opportunity for growth. Note: This area may require more information/education related to a particular culture or population. 25
4. Discuss how you could better incorporate cultural competence into your practice. 15
5. Submit your completed assignment as a Microsoft Word document via the View/Complete Assignment link in Module 2 Assignments no later than 11:59 p.m. (ET) on Sunday of that week.
TOTAL POINTS 40

Cultural competence selftest
The following self-assessment can assist physicians in identifying areas in which they might
improve the quality of their services to culturally diverse populations.
Promoting Cultural and Linguistic Competency
Self-Assessment Checklist for Personnel Providing Primary Health Care Services
Directions: Please enter A, B or C for each item listed below.
A = Things I do frequently
B = Things I do occasionally
C = Things I do rarely or never
Physical Environment, Materials & Resources
____ 1. I display pictures, posters, artwork and other decor that reflect the cultures and
ethnic backgrounds of clients served by my program or agency.
____ 2. I ensure that magazines, brochures and other printed materials in reception areas
are of interest to and reflect the different of individuals and families served by my program or
agency.
____ 3. When using videos, films or other media resources for health education, treatment or
other interventions, I ensure that they reflect the cultures and ethnic background of
individuals and families served by my program or agency.
____ 4. I ensure that printed information disseminated by my agency or program takes into
account the average literacy levels of individual families receiving services.
Communication Styles
5. When interacting with individuals and families who have English proficiency, I always keep
in mind that:
____ Limitations in English proficiency are in no way a reflection of their level of
intellectual functioning.
____ Their limited ability to speak the language of the culture has no bearing on their
ability to communicate effectively in language of origin.
____ They may or may not be literate in their language of origin or English.
____ 6. I use bilingual-bicultural staff and/or personnel and volunteers skilled or certified in
the provision of medical interpretation treatment, interventions, meetings or other events for
individuals and families who need or prefer this level of assistance.
____ 7. For individuals and families who speak languages other than English, I attempt to
learn and use key words in their language so that I am better able to communicate with them
during assessment, treatment or other interventions.
____ 8. I attempt to determine any familial colloquialisms used by individuals or families that
may have an impact on assessment, treatment or other interventions.
____ 9. When possible, I ensure that all notices and communiqués to individuals and families
are written in their language of origin.
____ 10. I understand that it may be necessary to use alternatives to written
communications for some individuals and families, as word of mouth may be a preferred
method of receiving information.
Values & Attitudes
____ 11. I avoid imposing values that may conflict or be inconsistent with those of cultures or
ethnic groups other than my own.
____ 12. I screen books, movies and other media resources for cultural, ethnic or racial
stereotypes before sharing them with individuals and families served by my program or
agency.
____ 13. I intervene in an appropriate manner when I observe other staff or clients within my
program or agency engaging in behaviors that show cultural insensitivity, racial biases and
prejudice.
____ 14. I recognize and accept that individuals from diverse backgrounds may desire
varying degrees of acculturation into dominant culture.
____ 15. I understand and accept that family is defined differently by other cultures (e.g.,
extended family members, fictive kin, and godparents).
____ 16. I accept and respect that male-female roles may vary among different cultures and
ethnic groups (e.g., who makes major decisions for the family).
____ 17. I understand that age and life-cycle factors must be considered in interactions with
individuals and families (e.g., high value placed on the decision of elders, the role of eldest
male or female in families, or roles and expectation of children within the family).
____ 18. Even though my professional or moral viewpoints may differ, I accept individuals
and families as the ultimate decision makers for services and supports impacting their lives.
____ 19. I recognize that the meaning or value of medical treatment and health education
may vary greatly among cultures.
____ 20. I accept that religion and other beliefs may influence how individuals and families
respond to illnesses, disease and death.
____ 21. I understand that the perception of health, wellness and preventive health services
have different meanings to different cultural or ethnic groups.
____ 22. I recognize and accept that folk and religious beliefs may influence an individual's
or family's reaction and approach to a child born with a disability, or later diagnosed with a
disability, genetic disorder or special health care needs.
____ 23. I understand that grief and bereavement differ by culture.
____ 24. I seek information from individuals, families or other key community informants that
will assist in service adaptation to respond to the needs and preferences of culturally and
ethnically diverse groups served by my program or agency.
____ 25. Before visiting or providing services in the home setting, I seek information on
acceptable behaviors, courtesies, and customs that are unique to the culturally and
ethnically diverse groups served by my program or agency.
____ 26. I keep abreast of the major health concerns and issues for ethnically and racially
diverse client populations residing in the geographic locale served by my program or agency.
____ 27. I am aware of the socioeconomic and environmental risk factors that contribute to
the major health problems of culturally, ethnically and racially diverse populations served by
my program or agency.
____ 28. I am well versed in the most current and proven practices, treatments and
interventions for major health problems among ethnically and racially diverse groups within
the geographic locale served by my agency or program.
____ 29. I avail myself to professional development and training to enhance my knowledge
and skills in the provision of services and supports to culturally, ethnically, racially and
linguistically diverse groups.
____ 30. I advocate for the review of my program or agency's mission statement, goals,
policies and procedures to ensure that they incorporate principles and practices that
promote cultural and linguistic competence.
How to use this checklist
This checklist is intended to heighten the awareness and sensitivity of personnel to the
importance of cultural and linguistic competence in health and human service settings. It
provides concrete examples of the kinds of beliefs, attitudes, values and practices that foster
cultural and linguistic competence at the individual or practitioner level. There is no answer
key with correct responses. However, if you frequently responded "C," you may not
necessarily demonstrate beliefs, attitudes, values and practices that promote cultural and
linguistic competence within health care delivery programs.
Self-assessment developed by Tawara D. Goode, Georgetown University Child Development
Center-UAP. Adapted with permission Promoting Cultural Competence and Cultural Diversity
in Early Intervention and Early Childhood Settings and Promoting Cultural Competence and
Cultural Diversity for Personnel Providing Services and Supports to Children With Special
Health Care Needs and Their Families (June 1989? latest revision July 2000