The Role of Transcultural Nursing in Improving Patient Safety: An Integrative Review of Cultural Competence in Healthcare Settings
Abstract
Global concerns regarding patient safety are especially pertinent in today’s highly multicultural healthcare environment. Communication, decision making, and treatment adherence are influenced by culture. Miscommunication, lack of compliance with treatment plans, and higher risks for adverse events occur when there are differences in language, belief systems regarding health and wellness, and health-related practices among patients and healthcare workers (Divi et al., 2007; Flores, 2006; Schyve, 2007; Richardson et al., 2019). The development of transcultural nursing rooted in cultural competence provides an effective framework to provide culturally congruent and patient-centered care to help meet the needs of this population (Campinha-Bacote, 2011; Purnell, 2013). This integrative review is intended to explore the current literature related to the impact of transcultural nursing on enhancing patient safety within a variety of healthcare settings. A comprehensive search of four major electronic databases (PubMed, CINAHL, Scopus, and Google Scholar) was performed utilizing keywords associated with transcultural nursing, patient safety, and diversity. Articles published from January 1, 2010 through December 31, 2025 were included in the search results. Twenty-two peer-reviewed articles that addressed all three components (transcultural nursing, patient safety, and diversity) were selected for analysis using thematic synthesis and critical appraisal. Results showed that having cultural competence significantly enhances communication, decreases medical errors, increases treatment adherence, improves patient satisfaction, and builds trust between patients and their healthcare providers (Beach et al., 2005; Truong et al., 2014; Jongen et al., 2018; Kaihlanen et al., 2019; Govere & Govere, 2016). Three broad categories were identified based on the findings: (a) barriers to communication; (b) beliefs and practices relative to health and wellness; (c) cultural competence training; and (d) the relationship between cultural competence and patient safety outcomes. Additionally, subcategories included organizational support for cultural competence initiatives and cultural competence training programs at the educational level (Douglas et al., 2014; Seeleman et al., 2015; Jeffreys, 2016). Based upon the findings of this study, it appears that transcultural nursing plays a crucial role in ensuring both quality care and patient safety. Therefore, integrating cultural competence into clinical practice and the educational system, as well as incorporating cultural competence into healthcare policy, will be important steps toward providing safe, equitable, high-quality healthcare services (Alizadeh & Chavan, 2016; Degrie et al., 2017; Stubbe, 2020).