Promoting Awareness in Nurses: Developing Culturally Competent Hair Care Education to Eliminate the Equity Gap for BIPOC Children in Inpatient Settings

Problem A survey that was administered to staff members on nine units at a pediatric hospital assessing their awareness of hair care for Black, Indigenous, and people of color (BIPOC) indicated a lack of awareness. This impacts the fundamentals of nursing care, which encompasses cultural sensitivity and promoting health equity. In this survey, 12.18% (n=52) of the 427 patients on the nine participating units between December 12, 2023, and January 19, 2024, identified as BIPOC. Although this was the case, the survey sent out on December 12, 2023, to staff members on nine units which included 491 nurses, with 104 responses (response rate of 21.18%), 76.92% being RNs (n=80), revealed that 51% (n=52) had never ordered BIPOC hair products for patients on their units. Furthermore, 41.7% (n=43) of respondents revealed discomfort/uncertainty related to taking care of BIPOC children's hair. In addition, 48.5% (n=50) were unaware of the project site’s policy related to BIPOC haircare or did not know how to find it. This has the potential to negatively impact the overall well-being of BIPOC children and their experience at the hospital. Purpose The purpose of this evidence-based practice (EBP) scholarly project that fulfills the DNP degree was to implement a quality improvement project using a backward design educational approach on inpatient pediatric units and evaluate its value in increasing the awareness of hair hygiene practices for BIPOC patients, usage of BIPOC hair products, and accessibility of the project site's policy. Method This project followed the project site's framework for quality improvement by using the SMART goal format: specific, measurable, achievable, relevant and time bound. The specifics of this project were based on increasing the awareness of nurses with regards to hair hygiene practices for BIPOC patients. It was measured through using a: (1) pretest/posttest project design using a "Hair Care for BIPOC Patients" survey, (2) assessing the number of times the project site's policy regarding BIPOC hair hygiene had been accessed by staff, and (3) gathering data from the materials department at the project site regarding ordering of relevant products. Results The post intervention survey was distributed through the project site’s REDCap and the two areas in the survey related to, (1) awareness of BIPOC hair care products at the project site, and (2) how to find the project site’s BIPOC hair care policy, showed a 5% or greater increase. The remaining areas fell short of the desired 5% increase, with the number of individuals who responded “yes” to the question “If these products exist, have you ever used them?” showing a decrease of 9.60% (n=52). Regarding the ordering of BIPOC hair products across all nine units, eight stayed close to the baseline number, with one unit showing an increase (n=30). In terms of the number of staff members hospital-wide who accessed the BIPOC hair care policy, the number of times the policy was accessed remained steady for the pre-intervention months of January and February 2024, decreasing briefly in the first intervention month of March 2024 before increasing steadily during the two remaining intervention months of April and May 2024. Conclusion This DNP scholarly project helped raise awareness of BIPOC hair care hygiene practices at the project site. However, for sustainability of this initiative, more work needs to be done to increase the use of BIPOC hair care products. In addition, awareness of the project site’s BIPOC hair care policy may have increased, but greater work must be done to increase the use of the policy in nursing care. Keywords: Hair hygiene, BIPOC, inpatient, nursing care, backward design, nursing education and health equity