Indicators of safe and equitable hospital-based care for culturally and linguistically diverse children and families: A scoping review

BACKGROUND: Equitable access to health care is supported as families experience cultural safety, reducing inherent power imbalances. Current measures of cultural safety focus on First Nations Peoples; no framework or measure has been identified for families of multicultural background who access children's health services. AIM: To identify how culturally safe care is assessed, measured, and monitored for families of multicultural background who access children's hospital services. METHOD: This scoping review followed Joanna Briggs Institute Manual for Evidence Synthesis. The search included terms for: 'population' of multicultural families of children aged birth to 17 years; 'concept' of experience of cultural safety; and 'context' of hospital-based care. Databases included PubMed, Cochrane, Epistemonikos, Cumulative Index to Nursing and Allied Health Literature, MedLine, PsychINFO, Scopus, Proquest, and secondary search of references from included studies. Data were evaluated using thematic analysis, and narrative discussion aligned with the World Health Organization Framework for improving the quality of paediatric care. RESULTS: Seven manuscripts were included, and four themes identified: 'Resources', 'Effective communication', 'Shared decision making', and 'Feeling supported'. Central to experience of multicultural safety is respectful verbal and nonverbal communication, supported through self-reflection by staff, allocation of extra time for families to seek clarity, and availability of interpreters. IMPLICATIONS: Most important to families was an experience of being respected as nurses and care providers listened carefully and showed interest in family culture. We will translate findings by partnering with families to develop a tool to measure experience of multicultural safety in hospital-based care for children and families.