DiversityNursing Blog

Health Care Cultural Considerations

Posted by Erica Bettencourt

Sat, Aug 29, 2020 @ 01:22 PM

diverseheadsIn our growing diverse society, health care workers need to understand that applying only traditional westernized medical practices isn't appropriate for many patients and families. Health professionals must have an awareness of different cultural practices and spiritual beliefs in order to reduce racial and ethnic disparities in health care.

According to the American Hospital Association, cultural competency in health care describes the ability of systems to provide care to patients with diverse values, beliefs and behaviors, including the tailoring of health care delivery to meet patients' social, cultural and linguistic needs.

There can be language barriers so make sure you know your patient’s preferred method of communication and arrange an interpreter. Non-verbal communication may differ across cultures. Don’t make any assumptions without knowing the person's customs.

Many cultures have special dietary considerations. Hospital staff should be educated about food culture, which is a term used to describe the non‐nutritive, yet nonetheless significant, aspects of food, such as when food is eaten and how it is served.

For example, Jewish patients do not eat pork or shellfish. Muslim patients also do not consume pork. Muslims will eat only permitted food (halal) and will not eat or drink anything that is considered forbidden (haram). Halal food requires that Allah's name is invoked at the time the animal is killed. Lamb, beef, goat and chicken, for example, are halal as long as a Muslim kills them and offers a prayer. Fish and eggs are also halal. Buddhist are mostly vegetarian, though Buddhists may eat meat if it has not been killed for them specifically.

Health care workers should use effective communication to increase their understanding about the patient's spiritual beliefs and practices. Your workplace should offer spiritual counselors like a chaplain or a rabbi. It is a good idea to have a non-denominational prayer and meditation room which can serve as an inclusive sacred space for staff and patients of all religious backgrounds.

Management should take an active role in promoting culturally competent workplace training courses and resources.

Our calendar of cultural dates is a great tool to assist staff with respectful scheduling and diversity celebrations.

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Topics: cultural competence, culturally competent care, racial health disparities, cultural considerations, ethnic disparities in health care

This Ballerina Is Shedding Light On Racial Bias In Healthcare

Posted by Erica Bettencourt

Mon, Aug 24, 2020 @ 11:16 AM

ingridsilva Ingrid Silva, a ballerina of The Dance Theatre of Harlem, is using the current closing of theaters and performance venues to expose racial bias in healthcare. In the past, Ingrid received praise and recognition for creating a line of ballet shoes in an array of skin tones for dancers of all races and cultures.

Silva founded a nonprofit organization called EmpowHer. EmpowHer NY is a social catalyst that ignites the conversation about women who break through the glass ceiling imposed by society and live authentically according to their truth.

Recently EmpowHer and The Bloc teamed up to create a video called 'The Call Project'.

According to Forbes, this project is an experiment where actress Corin Wells made multiple calls to a 24-hour Nurses health hotline. Wells used a white-coded name and voice as well as a Black-coded name and tone. The results showed that 77% of her “black” alias calls ended with a recommendation to go to an urgent care facility, a protocol for minor health issues. However, her “white alias,” using the same script, was advised to go to the ER, which is protocol for any patient with urgent symptoms of an appendicitis.

Empowher believes, "When it comes to getting proper healthcare, it shouldn’t matter what your name is or how you sound like. Your pain shouldn’t be underestimated because of biological myths that are not only scientifically false but also fantastical in nature."

The goal of this experiment is to address racial biases in healthcare and to make unconscious bias training mandatory for hospitals and healthcare to ensure quality healthcare.

Silva said, “It’s been past time for us to speak up on this matter for the black community worldwide. This is our way of saying enough already!”

You can join the movement in the fight for equality in healthcare. EmpowHer is offering a petition to make unconscious bias training a mandatory requirement for hospitals across the country. You can sign the petition here.

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Topics: racism, racism in healthcare, racial health disparities, Racial Bias In Healthcare, Racial bias

Tips for Preventing PPE-Related Skin Damage

Posted by Erica Bettencourt

Thu, Aug 13, 2020 @ 04:06 PM

GettyImages-1217962206Personal Protective Equipment (PPE) is essential for protecting healthcare workers on the frontlines of the COVID-19 pandemic. However, with prolonged use of PPE, comes skin damage.

According to a study by the Journal of American Academy of Dermatology, 97% of staff working in two different COVID-19 units reported PPE-related skin damage. The incidence increased when PPE was worn continuously for longer than six hours, and especially with N95 masks and goggles.

Hand irritation is common when frequently using gloves. The hands become irritated from constant sanitizing and hand washing. Also gloves trap moisture and heat, causing side effects such as eczema and dermatitis on hands. 

Pat hands dry or allow hands to air dry instead of rubbing to avoid further irritation. Also use warm water instead of hot because frequent use of hot water can lead to excessively dry skin. Moisturize but make sure the skin fully absorbs it before putting gloves back on. 

Nurses wearing air tight N95 and N99 masks for many hours often end up with red indentations on their faces. On the other hand, Nurses who wear non airtight masks have reported getting acne and evidence of skin irritation from pressure or chafing of the mask over the bridge of the nose.

Make sure your mask isn't too tight and is fitted comfortably on your face. You should relieve pressure regularly. If possible, try removing your mask, goggles, and or face shield at least every four hours. Relieving pressure for a few minutes to allow for normal blood flow can prevent lasting skin damage.

The Wound, Ostomy and Continence Nurses Society (WOCN) suggests applying an alcohol-free barrier film if you know you’re going to be wearing your PPE for a long time.

Nurses have experienced ulceration on or behind the ears from the elastic loops that stretch around the ears. According to Nurse.org, Nurses are sewing buttons onto their surgical caps so they can fasten their face masks directly onto the buttons instead of their ears.

Healthcare workers wearing isolation gowns experience overheating and extreme sweating, which can lead to a red, itchy rash, known as intertriginous dermatitis.  

According to Nurselabs.com, to prevent this condition make sure that you dry off well after your bath or shower. Avoid tight and chafing clothing and wear moisture-absorbing underwear. You can also use talcum powder, or even corn starch, to help keep the area dry.

One last tip to help keep your skin healthy, stay hydrated and consume healthy, high protein meals and snacks.

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Topics: PPE, personal protective equipment, skin damage

New Carolyn Jones Emergency Nurse Documentary

Posted by Erica Bettencourt

Fri, Aug 07, 2020 @ 02:03 PM

incaseofemergencyFilmmaker, Carolyn Jones released The American Nurse in 2012, Defining Hope in 2017, and now In Case of Emergency: Without You, We Don’t Stand A Chance.

Jones teamed up with the Emergency Nurses Association (ENA) to create a documentary that celebrates emergency Nurses and the impact they have on patients across the country.

ENA President Patricia Kunz Howard said"Emergency Nurses do amazing things every single day. They put their patients first without any thought of reward or recognition. With Carolyn's unique style and approach to storytelling, this documentary will pay a proper tribute to that selflessness by showing the world the complicated, yet rewarding, work that defines emergency Nursing and the people who are committed to care."

“When COVID hit, we realized that it is all nurses that we can’t live without,” said Jones. “The role you play is really critical for us in finding our way to a better way of living. I applaud each and every one of you.”

In another interview discussing her new project, Carolyn said, "I want Nurses to feel elevated and come out of this idea that no one else wants to know what they are doing. The public will never understand it until Nurses tell them what goes on. I hope that some Nurses will rise to the surface and find their voices. They are the best story tellers I’ve ever encountered. That’s what I love about interviewing Nurses – boom, the story is right there.”

In celebration of Emergency Nurses Week, the film will be premiered virtually on October 14, 2020. 

TRAILER In Case of Emergency: Without You, We Don’t Stand A Chance 

 

Topics: ER nurse, Carolyn Jones, emergency nursing, COVID-19 study, emergency nurses, nurse documentary

Nurses Showing The Faces Behind The Masks

Posted by Erica Bettencourt

Fri, Jul 31, 2020 @ 03:06 PM

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Healthcare workers across the country are fighting tirelessly against COVID-19. They're wearing head to toe PPE around the clock. They're hot and frustrated while wearing it, and… they also lose their identity. Patients just see masks, suits, gloves, and goggles. Hospital staff wants this to change.

"Share Your Smile" and the "Button Project" are just 2 examples of a small, but positive movement. To look less intimidating to patients, healthcare heroes are attaching large photos and buttons of their faces, to their PPE.  

The goal of these projects is to eliminate or reduce a level of fear and anxiety for patients, especially children, who find comfort in seeing the smiling faces of healthcare team rodmembers.

San Diego respiratory therapist Robertino Rodriguez started the "Share Your Smile" idea. Rodriguez said, “Yesterday I felt bad for my patients in ER when I would come in the room with my face covered in PPE. A reassuring smile makes a big difference to a scared patient. So today I made a giant laminated badge for my PPE so my patients can see a reassuring and comforting smile.”

peggyThe movement is catching on amongst health care workers. Peggy Ji, an ER Doctor in Los Angeles, wrote on Instagram, "I was inspired by Robertino Rodriguez who works as a respiratory therapist in this COVID pandemic. I didn’t have a preprinted photo or a color printer so my polaroid will have to do. I wanted to bring a personal touch to caring for patients through my PPE. My hope is that our patients will know there’s a reassuring smile under this mask, and that we’re here for them."

 

Nurse Derek also posted a photo of himself and fellow coworkers on Instagram saying, "thought it was a beautiful way to bring ease to our patients during this stressful time. Thank you to all the healthcare workers out there for battling on the frontlines."

others

The Button project holds the same meaning and started at Monroe Carell Jr. Children’s Hospital at Vanderbilt.

Adelaide Vienneau, Director of the Children’s Hospital Family Resource Center (FRC) said, “When we were asked to take the lead on this project, I immediately said, ‘yes.' The FRC team likes finding solutions for staff and providing resources to assist patients and families in having the best possible experience during their health care visit. We are delighted with the anecdotal comments on how the photo buttons have been well-received.”

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Any time in the hospital as a patient is a scary time for the patient. The personal connection is so important, but difficult to achieve with all of the PPE. What a simple, yet creative way to put patients at ease to feel a more personal connection with the healthcare team.

What is your place of employment doing about this? Please share with our community. Thank you!

 

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Topics: nurses, hospitals, hospital staff, COVID-19, PPE, healthcare workers, personal protective equipment, share your smile, healthcare team

Nurses Invitation to Participate in National COVID-19 CHAMPS Study of Frontline Workers

Posted by Villanova University

Thu, Jul 23, 2020 @ 11:43 AM

CHAMPSThe M. Louise Fitzpatrick College of Nursing (FCN) at Villanova University invites nurses to participate in CHAMPS, the Caring About Health for All Study villanova.edu/CHAMPS. CHAMPS is one of a few national studies designed to understand the immediate and long-term effects of caring for COVID-19 patients on the health, lives and careers of all frontline workers, including nurses. We seek colleagues across the spectrum of nursing who share our concerns for frontline workers to join us in participating in CHAMPS to better understand and meet their emergent health needs.

The FCN launched CHAMPS in mid-May 2020, recognizing the importance of seizing the moment to understand how the pandemic has impacted the physical, social and behavioral health of those caring for COVID-19 patients. The initial study survey takes less than 20 minutes to complete. This study will enable the government, healthcare providers, insurance companies, and other stakeholders to understand the broader impact of COVID-19 on frontline workers. Ultimately, CHAMPS will inform public health strategies designed to mitigate these effects during future health emergencies.

The study will include data obtained through surveys and optional in-person interviews and will capture immediate and long-term impacts on frontline workers. Participants will be recruited throughout the United States and its territories with outcomes followed longitudinally (for those who choose to enlist in the longitudinal phase) through a registry.

The FCN seeks your help to:

Disseminate the online survey link among nurses who provided care to patients with COVID-19 and encourage their participation.

TO PARTICIPATE, go to villanova.edu/CHAMPS and click Enter Study.

The FCN believes that our country has an obligation to frontline workers to learn about the effects that their sacrifices have had on their lives. This will enable us to best support and plan for future health emergencies. Thank you for your consideration of this request.

CHAMPS Principal Investigators:

Donna S. Havens, PhD, RN, FAAN, Connelly Endowed Dean and Professor
Peter Kaufmann, PhD, Associate Dean for Research and Innovation
Janell L. Mensinger, PhD, FAED, Associate Research Professor and Biostatistician

For more information about CHAMPS, please contact Dr. Havens at donna.havens@villanova.edu .

Topics: CHAMPS, Villanova University, Caring About Health for All Study, frontline workers, M. Louise Fitzpatrick College of Nursing, COVID-19 study

MIT Designed An Effective And Reusable Face Mask

Posted by Erica Bettencourt

Wed, Jul 22, 2020 @ 12:44 PM

siliconemaskResearchers at MIT and Brigham and Women’s Hospital designed a new face mask that is believed to be as effective as N95 masks. 

There has been a dire need for N95 masks in hospitals across the nation. Essential workers were wearing the disposable masks more than once, often weeks at a time. 

Engineers and researchers hope to provide a solution to this shortage by designing a mask that can be safely reused. 

According to CNBC, the new MIT mask is made from silicone, with slots for just two small, disposable disks of the N95 material (which serve as filters). That means the masks themselves can be quickly and easily sterilized and reused.

Adam Wentworth, a Research Engineer at Brigham and Women’s Hospital said, "With this design, the filters can be popped in and then thrown away after use, and you’re throwing away a lot less material than an N95 mask." 

The mask is called iMASC, which stands for Injection Molded Autoclavable, Scalable, Conformable. The iMASC can be sterilized a couple of different ways. You can use a steam sterilize, put it in an oven, or soak them in both bleach and rubbing alcohol. 

In a study researchers had 20 healthcare workers wear the mask and perform a series of movements to see how it stayed in place. High ratings were given for fit and breathability. 

The study also showed the mask successfully filtered out a sugar solution in the air that was used to mimic aerosolized respiratory droplets.

According to FastCompany, researchers are beginning talks with the FDA about emergency use authorization, both for healthcare workers and the general public. The team is currently running both an environmental impact study and a cost-effectiveness study, and has estimated that its mask could cost just $15 and be used up to 100 times, making the cost per use likely less than a quarter, with the filter inserts less than a dollar.

There is no timeline yet as to when these masks will be available. 

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Topics: PPE, face masks, personal protective equipment, N95 masks, reusable masks, iMASC

Nursing Schools See Spike In Applicants Since Pandemic

Posted by Erica Bettencourt

Fri, Jul 17, 2020 @ 03:40 PM

BSN

One positive thing to come out of the COVID-19 pandemic is the renewed appreciation for healthcare workers, particularly Nurses. This appreciation is leading to an increase in Nursing school applications.

Donna Havens, PhD, RN, FAAN, Dean of Nursing at Villanova University M. Louise Fitzpatrick College said, “For the first time in my career, which has been a long one, folks truly get what Nurses do and they see how important and rewarding a career it is. Some would say Nurses are the glue, especially in hospitals and healthcare organizations." 

Havens believes another reason for the uptick in applications is from the record unemployment that has resulted from the pandemic. People in struggling occupations may look to Nursing as a rewarding and stable profession. 

Widener University spokeswoman Emily A Barrett said, "Historically speaking, economic downturns translate to an increase in Nursing programs due to industry stability and growth, which is projected to rise 15 percent by 2026 according to the U.S. Bureau of Labor Statistics."

Sandra Russo, Chair and Director of the Nursing program at Touro College in New York said, "This year, I have 20 students on a waiting list to get into my program, so the demand is much higher."

According to US News, the number of applications to Regis College's on-ground and online Nurse Practitioner programs are currently 10% to 15% higher than normal. 

Kevin Finn, Dean of Colby-Sawyer School of Nursing and Public Health said, the one thing he sees in common on the applications is a desire to help. 

The incoming Nursing class is 34% larger than last fall's. The college will have 90 students enrolled in its Nursing program in September, an increase from 62 students last year.

The University of Kansas School of Nursing said it’s currently at capacity on applications. In fact, they’ve increased their Salina branch because of so many people who now want to be a Nurse.

Nurses are in demand. Getting into Nursing school was already extremely competitive before the pandemic. Nursing schools may become even more selective with the increase in applications. Future Nurses should focus on boosting their credentials. 

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Topics: nursing schools, nursing school, nursing programs, nursing school applications, applying to nursing school

COVID-19 Racial Health Disparities

Posted by Erica Bettencourt

Wed, Jul 01, 2020 @ 12:33 PM

maskedpeopleCOVID-19 has shone a light on how systemic racism plays a role in health disparities among Black people. 

According to Scientific American, the overall death rate from COVID-19 is 2.4 times greater for African Americans than it is for white people. 

Camara Phyllis Jones, an Epidemiologist who recently served as president of the American Public Health Association said, “People of color right now are more likely to be infected, and we’re more likely to die. What we’re seeing here is the direct result of racism.”

Hypertension, obesity, diabetes and other risk factors for severe coronavirus complications, are more prevalent in minority populations.

According to an article from STAT, Black people in the U.S. are more likely than white people to live in food deserts, meaning they have limited access to fresh fruit or vegetables. They are also less likely to be able to access green spaces, and more likely to live in areas without clean water or air.

Household spread is the most common form of virus transmission. Many people of color live in overcrowded homes and communities so it's difficult to social distance. It is also difficult to find an outdoor place to social distance as there are fewer publicly provided resources, such as parks and bike lanes, for minority-dense neighborhoods.

The best advice to fighting the virus is to stay at home but, unfortunately essential workers don't have this option. Not only are fewer Black and Latino adults able to work from home, but they're also overrepresented in essential jobs.

These health disparities are further worsened by an unequal healthcare system. People of color often have unequal access to care, and when they do receive care it is often poorer quality.

The National Academy of Medicine (NAM) released a report that found “racial and ethnic minorities receive lower-quality health care than white people—even when insurance status, income, age, and severity of conditions are comparable.”

In order for things to change, the entire health care field, from medical schools to hospitals and even medical device manufacturers, need to work to unravel and address racism within the healthcare system.

Progress will take time and efforts must occur on every societal level. This involves a wide range of actions, like improving wages and closing pay gaps, improving access to health insurance, providing better access to fresh foods and green spaces, and ensuring more diversity in the health care system so healthcare workers can provide culturally competent care.

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Topics: racial health disparities, COVID-19

Improving Diversity and Inclusion in Healthcare with CLAS

Posted by Erica Bettencourt

Tue, Jun 23, 2020 @ 10:32 AM

CLASlogo1

Health systems are working to increase the Diversity of their leadership team, board and staff. Each hospital’s workforce should represent the diverse populations of the community they serve. Many hospital teams are building a culture of Diversity and Inclusion (D&I) to better engage all employees and provide high-quality, equitable care for all patients.

Part of building a culture that is mindful of D&I is being aware of the National CLAS (Culturally and Linguistically Appropriate Services) Standards. As stated in the case for National CLAS Standards “Culturally and linguistically appropriate services are increasingly recognized as effective in improving the quality of care and services. By providing a structure to implement culturally and linguistically appropriate services, the National CLAS Standards will improve an organization’s ability to address health care disparities.”

A Diversity Best Practice report says, Minorities continue to experience discrimination in healthcare and have worse health outcomes than white individuals. Cultural differences, language barriers, and high rates of unemployment and poverty have created major disparities in health status and health outcomes for minorities and other marginalized groups. Lack of diversity in the healthcare workforce, poor provider-to-patient communication, and health literacy challenges further contribute to the problem. 

The National (CLAS) Standards is a great strategy intended to advance health equity, improve quality, and help eliminate healthcare disparities, by providing a set of 15 action steps for healthcare organizations to implement.

The National CLAS Standards are as follows:

Principal Standard

  1. Provide effective, equitable, understandable, and respectful quality care and services that are responsive to diverse cultural health beliefs and practices, preferred languages, health literacy, and other communication needs.

Governance, Leadership and Workforce

  1. Advance and sustain organizational governance and leadership that promotes CLAS and health equity through policy, practices, and allocated resources.
  2. Recruit, promote, and support a culturally and linguistically diverse governance, leadership, and workforce that are responsive to the population in the service area.
  3. Educate and train governance, leadership, and workforce in culturally and linguistically appropriate policies and practices on an ongoing basis.

Communication and Language Assistance

  1. Offer language assistance to individuals who have limited English proficiency and/or other communication needs, at no cost to them, to facilitate timely access to all health care and services.
  2. Inform all individuals of the availability of language assistance services clearly and in their preferred language, verbally and in writing.
  3. Ensure the competence of individuals providing language assistance, recognizing that the use of untrained individuals and/or minors as interpreters should be avoided.
  4. Provide easy-to-understand print and multimedia materials and signage in the languages commonly used by the populations in the service area.

Engagement, Continuous Improvement, and Accountability

  1. Establish culturally and linguistically appropriate goals, policies, and management accountability, and infuse them throughout the organization's planning and operations.
  2. Conduct ongoing assessments of the organization's CLAS-related activities and integrate CLAS-related measures into measurement and continuous quality improvement activities.
  3. Collect and maintain accurate and reliable demographic data to monitor and evaluate the impact of CLAS on health equity and outcomes and to inform service delivery.
  4. Conduct regular assessments of community health assets and needs and use the results to plan and implement services that respond to the cultural and linguistic diversity of populations in the service area.
  5. Partner with the community to design, implement, and evaluate policies, practices, and services to ensure cultural and linguistic appropriateness.
  6. Create conflict and grievance resolution processes that are culturally and linguistically appropriate to identify, prevent, and resolve conflicts or complaints.
  7. Communicate the organization's progress in implementing and sustaining CLAS to all stakeholders, constituents, and the general public.

Topics: CLAS, Diversity and Inclusion, Culturally and Linguistically Appropriate Services

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