RNSystematic ReviewJournal of clinical nursing2026

Which Cultural Safety Strategies Are Making a Difference? Exploring Hospital Initiatives for First Nations Peoples in Australia. A Scoping Review.

Kate Fowler, Mary O'Loughlin

PMID 40970593

WHAT IT FOUND

First Nations staff and interpreters were reported to reduce self-discharge and improve communication; the review mapped hospital strategies rather than testing whether they work.

Key findings

01First Nations staff and interpreters were reported to reduce self-discharge and improve patient identification.

02Strong executive leadership and organisational support were identified as essential to delivering culturally safe patient care.

03The review did not assess study quality, and six studies did not evaluate the strategy's effect on First Nations inpatient cultural safety.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

This is a scoping review, so it maps what has been tried; it does not show whether any strategy caused better patient care. No quality or risk of bias assessment was done, so weak studies count alongside stronger ones. Many strategies were reported by study authors, and six studies did not assess the effect on First Nations inpatient cultural safety. Cultural safety outcomes are hard to measure; some studies used administrative proxies such as self-discharge rather than asking patients directly. First Nations researchers were not part of the author team, although a local Aboriginal health leader reviewed the findings.

Declared interests

The authors declared no conflicts of interest.

The easy way to misread this

Do not read this as proof that these strategies work. Some were described without evaluation, and the review did not judge study quality.

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Which Cultural Safety Strategies Are Making a Difference? Exploring Hospital Initiatives for First Nations Peoples in Australia. A Scoping Review. — Applied Evidence