Search

Cultural safety is increasingly recognised as imperative to delivering accessible and acceptable healthcare for First Nations Peoples within Australia and in similar colonised countries. A literature review undertaken to inform the inaugural Caring for Australians with Renal Insufficiency (CARI) guidelines for clinically and culturally safe kidney care for Aboriginal and Torres Strait Islander peoples revealed a timeline of the emergence of culturally safe kidney care in Australia. Thirty years ago, kidney care literature was purely biomedically focused, with culture, family and community viewed as potential barriers to patient 'compliance' with treatment. The importance of culturally informed care was increasingly recognised in the mid‐1990s, with cultural safety within kidney care specifically cited from 2014 onwards. The emergence timeline is discussed in this paper in relation to the five principles of cultural safety developed by Māori nurse Irihapeti Ramsden in Aotearoa/New Zealand. These principles are critical reflection, communication, minimising power differences, decolonisation and ensuring one does not demean or disempower. For the kidney care workforce, culturally safe care requires ongoing critical reflection, deep active listening skills, decolonising approaches and the eradication of institutional racism. Cultural safety is the key to truly working in partnership, increasing Indigenous Governance, respectful collaboration and redesigning kidney care. [ABSTRACT FROM AUTHOR]

Context The 'inaugural' Caring for Australian and New Zealanders with Kidney Impairment (CARI) guidelines for First Nations Australians provide recommendations on caring for First Nations Peoples with chronic kidney disease (CKD). Informed by targeted national community consultations, the guidelines include the historical context, detailed advice on culturally safe kidney healthcare, screening and referral of CKD. Public awareness and education initiatives, self- management programs, and models of care are all reported on. Objectives The CARI guidelines were developed in response to significant challenges and inequities experienced by First Nations Peoples over many years. Specific recommendations and suggestions aim to improve clinicians' understanding of historical and contemporary factors contributing to the social and health inequities underpinning the over-representation of First Nations Peoples with CKD. These guidelines provide comprehensive support for health professionals in all service and care environments to better respond to the care needs of First Nations Peoples. Key findings The CARI guidelines highlight the need to provide culturally safe clinical care and explicitly cite the need to address institutional racism and improve cultural safety training for all renal service providers. They specifically recognise the importance of kinship, and equitable access to transport and accommodation services. They also focus on keeping people on Country where possible, including increased nurse-supported and Aboriginal health practitioner-supported dialysis services. Conclusion The CARI guidelines provide recommendations on how to improve clinical kidney care delivery for and with First Nations Peoples by ensuring more responsive models of care. [ABSTRACT FROM AUTHOR]

The article focuses on the development of evidence-based clinical practice guidelines for First Nations Australians with chronic kidney disease (CKD) and their integration into clinical practice. Topics include community consultation to address institutional racism in kidney health care, the importance of social and cultural aspects in care, and recommendations to improve clinicians' understanding and health equity for First Nations Australians with CKD.