Advanced Directives Standards and Cultural Competence, Research Paper Example

Abstract

This research paper is intent in finding out the cultural competence of advanced directives policy at Springfield Medical Center. The paper will rely on information obtained from JCAHO (The Joint Commission on Accreditation of Healthcare Organizations) as well as CLAS (National Standards on Culturally and Linguistically Appropriate Services). The information will be used to determine whether Springfield Medical Center is meeting the statutory standards outlined. The paper will also identify the languages in which the advanced directive forms are available.

Keywords: standards, cultural competence, advanced directive standards/policy

Introduction

Advanced directives in health care let the patient’s physician, friends, as well as family to be conversant with his or her health care preferences (King, 2006). This includes any type of special treatment they would want or not want at the end of their lives. Such a directive also expresses the patient’s desire for diagnostic testing, organ donation, cardiopulmonary resuscitation, and surgical procedures. Springfield Medical Center has an advanced directive policy, which has adopted the federal law definition of an advance directive. This is stated as a written instruction, which may be in form of durable power of attorney for healthcare or a living will recognized under state law and is related to provision of healthcare at the point of the individual’s incapacitation (Murphy & Others, 2009). The state law may either be statutory or one recognized by courts of the State.

Advanced Directives Policy

Springfield Medical Center has an advanced directives policy, which respects the patient’s individual desires that are unique and case-specific due to religious beliefs, principles, and personal values. The medical center acknowledges three types of advanced health care directives in its policy. These are living will, health care power of attorney, as well as a combination document made up of both (Marshall, 2008). The policy does not provide for specific types of forms to be used in making an advanced directive. The recommended sample form in federal law is acceptable alongside a personally drafted directive. The reason for this is to accommodate the culturally and linguistically diverse community. This fulfills the Principal Standard in CLAS for provision of respectful, understandable, equitable, as well as effective quality services and care (Messias, 2003). These are responsive to varying cultural health practices and beliefs, communication needs, health literacy, and preferred languages. Where forms are provided, they are available in English as the official language, French, and German as alternative international languages.

Under the policy, the physician is charged with the responsibility of helping patients to understand their medical conditions as well as treatment options they have before making their advanced directive. This is in line with CLAS standards on engagement, continuous improvement, and accountability (Messias, 2003). The requirement is for copies of such an advanced directive to be placed with the patient’s family, lawyer, doctor, and anyone else named as the patient’s health care agent. The hospital respects the individual choices in advanced directives as being varied due to cultural differences and accommodates them to the extent that they are consistent with the Center’s philosophy, mission, and capabilities. The policy allows for communication and language assistance as outlined in CLAS standards (Messias, 2003). This is a case where a patient with no living will or legal guardian, or available health care agent is assisted by a healthcare representative. The representative makes health care decisions for the patient if they are unable to communicate or make such decisions for themselves (Marshall, 2008).

Conclusion

In fulfilling the CLAS Standards in Health Care, Springfield Medical Center demonstrates cultural competence by designing a culturally inclusive advanced directives policy. The medical center does not make it mandatory for one to have an advance directive, but as a matter of policy, patients are asked if they have one during admission (Murphy & Others, 2009).

References

King, N. M. P. (2006). Making sense of advance directives. Washington, D.C.: Georgetown University Press.

Marshall, S. K. (2008). Advance directives. Buffalo, N.Y.: W.S. Hein.

Messias, D. (2003). What nurses need to know about the national standards for culturally and linguistically appropriate services (CLAS) in health care. South Carolina Nurse (Columbia, SC: 1994), 10 (3), p. 23.

Murphy, R. C. & Others (2009). Advocating for advance directives [electronic resource]: guidelines for health care professionals/by Rebecca Cowell Murphy.