Managing nursing care in multicultural nursing care environments.

Background Today's nurse managers are challenged to effectively lead culturally diverse nursing teams and to improve care in multicultural nursing work environments. Cultural competence has been described as a central tool to improve supportive work environments in organizations, to successfully lead a culturally diverse workforce and to plan and provide culturally congruent care to patients. Aim To identify nurse manager's interventions that improve culturally competent nursing work environments. Methods It was conducted an integrative literature review according to recommendations of Whittemore & Knafl. Indexed papers were searched in EBSCO's databases, including CINAHL and MEDLINE, and ScienceDirect. It was included qualitative, quantitative and mixed- -method design studies, literature reviews and text and opinion articles, published between 2012 and 2022, identifying nurse leader or manager's interventions that improve culturally competent work environments in all settings where nursing care is provided. Data were collected using a data extraction tool. Results A total of eleven papers were included identifying nurse managers' interventions related to patients care and interventions targeting nurses' relationships improvement, at the organizational, unit and nurse levels. Literature advocates that nurse managers must identify barriers, know the nurses' levels of cultural competence and use this information to plan and organise nursing care in their units, and to develop recruitment and retention strategies to facilitate adequate staffing, in number and competence, to provide quality of care to people from different cultural backgrounds. Leadership skills are also needed to value cultural diversity, to attend the needs of healthcare workers and challenge the cultural and professional boundaries. Dialogue and collaboration should be encouraged in multicultural teams in order to decrease discrimination and improve union between people. Conclusions and implications for knowledge development Cultural diversity in the nursing work environments tends to be the rule rather than the exception, which deserves the research attention. This integrative review allowed to comprehensively access the state-of-the-art on the nurse manager's role in improving culturally competent nursing work environments, understand its implications for nurses and patients care, and inform the practice. Nurse managers should participate in policy development at the organisational level, should improve the coordination and organization of nursing care and resources in their units, and should devote for training and development of nurses for improved levels of cultural competence, leading to mutual understanding and respect, and to the delivery of culturally congruent nursing care. Nurse managers need to engage in the process of becoming culturally competent to better understand patients' needs and to lead effectively their culturally diverse teams. It is recommended to conduct studies that explore the effectiveness of the identified interventions. [ABSTRACT FROM AUTHOR]