Fowler, Kate, and O'Loughlin, Mary (2025) Which Cultural Safety Strategies Are Making a Difference? Exploring Hospital Initiatives for First Nations Peoples in Australia. A Scoping Review. Journal of Clinical Nursing, 35 (3). pp. 964-1001.

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Abstract

Aim To explore the barriers, facilitators, and outcomes of strategies that have been implemented to improve the experience of cultural safety for First Nations inpatients in the Australian hospital setting.

Design Scoping review.

Methods Guided by the Joanna Briggs Institute scoping review methodology and reported using PRISMA-ScR, six databases were searched with data extracted and synthesised.

Data Sources Cumulative Index to Nursing and Allied Health Literature (CINAHL), Emcare, Informit, Medline, ProQuest and Scopus databases. Searches were undertaken in March 2024.

Results Forty-three articles representing 39 studies were included. Strategies were categorised as governance, service delivery, hospital environment, clinician education, and First Nations workforce. First Nations researchers were co-authors in most studies, and emergent themes were grounded in First Nations priorities, with an emphasis on developing the First Nations health workforce. Findings included (i) First Nations health staff being identified as cultural brokers between First Nations patients and non-First Nations clinicians; (ii) experiences of cultural safety being amplified when First Nations and non-First Nations health staff worked together; and (iii) strong governance being critical to addressing institutional racism and enabling cultural safety.

Conclusions Embedding the voice of First Nations peoples in governance and an organisational commitment to strengthening the First Nations workforce are essential drivers for implementing cultural safety strategies in Australian hospitals.

Item ID:	88906
Item Type:	Article (Research - C1)
ISSN:	1365-2702
Keywords:	Cultural safety; Australia; Hospital
Copyright Information:	This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. © 2025 The Author(s). Journal of Clinical Nursing published by John Wiley & Sons Ltd.
Date Deposited:	07 May 2026 01:14
FoR Codes:	42 HEALTH SCIENCES > 4206 Public health > 420699 Public health not elsewhere classified @ 100%
SEO Codes:	20 HEALTH > 2003 Provision of health and support services > 200304 Inpatient hospital care @ 50% 20 HEALTH > 2002 Evaluation of health and support services > 200206 Health system performance (incl. effectiveness of programs) @ 50%
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