‘I understand the importance of cultural safety but do not really know enough about how to implement it’: A qualitative exploration of health practitioners’ knowledge, attitudes and practices of providing culturally safe care for Aboriginal and Torres Strait Islander infants and families in neonatal intensive care units

Abstract

Purpose: Culturally safe care in neonatal intensive care units (NICUs) is crucial for Aboriginal and Torres Strait Islander infants and their families. Despite national efforts to improve culturally safe care, there is inconsistency in the way that health practitioners engage and translate cultural safety into their clinical practice. Currently, there is limited literature on Aboriginal and Torres Strait Islander health in NICUs to inform evidence-based practice. This study sought to explore health practitioners’ knowledge, attitudes and practices in delivering culturally safe care to Aboriginal and Torres Strait Islander infants and families in NICUs. Methods: This paper presents the qualitative findings of an online, cross-sectional, descriptive survey conducted with health practitioners from two New South Wales NICUs. Two open-ended questions were thematically analysed. A total of 164 complete open-ended responses were provided for question one and 103 for question two. Participants were recruited via flyers located in participant workspaces over a six-month period. Main findings: Five themes were identified. Theme one: Staff are aware of the term cultural safety and their role in delivering culturally safe care. Theme two: Staff lack confidence and find it difficult to deliver culturally safe care. Theme three: Truth telling: culturally safe care is not always upheld in practice. Theme four: Education is important, but staff want experiential learning to be able to enact cultural safety in practice. Theme five: Systemic change is necessary: policies and guidelines need to be created, and Aboriginal leadership needs to be prioritised. Principal conclusions: Health practitioners in NICU settings have reported a lack of confidence and support to deliver culturally safe care to Aboriginal and Torres Strait Islander infants and their families. This study highlights the need for experiential learning, face-to-face education, and an increase in representation of Aboriginal and Torres Strait Islander leadership in health services. Further research is recommended at both a local and national level to inform policy and practice of culturally safe care in NICUs.