NURS 6512 Week 2 Diversity and Health Assessments
In May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).NURS 6512 Week 2 Diversity and Health Assessments
Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the health care field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and health care professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.
In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.
Case 1
JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”
Case 2
TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion. She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.
Case 3
MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.NURS 6512 Week 2 Diversity and Health Assessments
To prepare:
Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
Select one of the three case studies. Reflect on the provided patient information.
Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.
Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
By Day 3
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!
Read a selection of your colleagues’ responses
By Day 6
Respond on or before Day 6 to at least two of your colleagues who selected a different patient than you, using one or more of the following approaches:
Suggest additional socioeconomic, spiritual, lifestyle, and other cultural factors related to the patient.NURS 6512 Week 2 Diversity and Health Assessments
Critique your colleague’s targeted questions, and explain how the patient might interpret these questions. Explain whether any of the questions would apply to your patient, and why.
Diversity. It is a word that means something different to each and every person. The changing demographics and economics of our growing multicultural world and the long-standing disparities in the health status of people from culturally diverse backgrounds have challenged health care providers and organizations to consider cultural diversity as a priority. However, health care providers must realize that addressing cultural diversity goes beyond knowing the values, beliefs, practices and customs of African Americans, Asians, Hispanics/Latinos, Native Americans/Alaskan Natives, and Pacific Islanders. In addition to racial classification and national origin, there are many other faces of cultural diversity. Religious affiliation, language, physical size, gender, sexual orientation, age, disability (both physical and mental), political orientation, sociology-economic status, occupational status and geographical location are but a few of the faces of diversity. This article will discuss the concept of cultural competence, describe a model of cultural competence that can be used in the delivery of health care services to address the many faces of diversity, and present a mnemonic to help in asking questions whose responses will facilitate culturally competent care.
Diversity is becoming a key word in health care. Hospitals and health care systems are focusing on providing care that addresses the diversity of their patient populations. Hospitals also are working to increase the diversity of their leadership team, board and staff and building a culture of diversity and inclusion. This collection of case studies from the field highlights diversity initiatives at six hospitals across the country.
The healthcare business landscape is changing. In the wake of the Patient Protection and Affordable Care Act (ACA), newly insured individuals are seeking health care outside of the emergency department setting, bringing an increasingly diverse patient population into the healthcare system. Newer payment models, including value-based purchasing and pay-for-performance programs, create new imperatives for hospitals and healthcare systems to contain costs while improving patient outcomes and ensuring the quality of care for all populations.The increased emphasis on quality and cost-containment means that many healthcare organizations are seeking to develop and implement innovative approaches to service that incorporate new performance measures. With guidance, more healthcare organizations can expand upon their progress in this area, improving healthcare services, quality, and health outcomes, while having broad community impact. A key area of focus for these hospitals and healthcare systems is organization-wide cultural competence and workforce diversity, or cultural effectiveness. NURS 6512 Week 2 Diversity and Health Assessments Achieving cultural effectiveness is predicated upon successfully targeting seven elements – leadership, institutional policies and procedures, data collection, community engagement, language and communication access, staff cultural competence, and workforce diversity and inclusion.1 Research demonstrates that management practices and administrative policies designed to build a culturally effective organization can improve patient and employee satisfaction, the quality of clinical care delivered, and patient health outcomes.2 High performance in the areas of staff cultural competence and workforce diversity can result in an enhanced bottom line resulting from patient satisfaction-based performance incentives. Increased workforce diversity and cultural competence can also lower costs as a result of increased employee retention, more efficient use of interpreter services, and a reduction in unnecessary care and avoidable readmissions that can follow when communication and cultural understanding improve.3 For these reasons, it is just as important to understand the needs of the various racial and ethnic groups that contribute to the rapidly increasing diversity in an organization’s catchment area as it is to understand the differing needs of the baby boomer and millennial market segments to which organization are trying to respond.Although all seven elements contribute to success in becoming a culturally effective organization, this brief focuses on specific indicators and approaches that tie service, quality, and outcomes to the implementation of organizational strategies to improve workforce diversity and cultural competence. In addition to providing an overview of research in the field, the brief includes case studies and resources to facilitate the creation of a strategic plan.NURS 6512 Week 2 Diversity and Health Assessments