DiversityNursing Blog

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

Health Care Workers Are Facing a Mental Health Crisis During The COVID-19 Outbreak

Posted by Erica Bettencourt

Tue, May 05, 2020 @ 11:25 AM

mentalhealthMany Nurses and Doctors said in interviews with TIME, that fighting COVID-19 is making them feel more dedicated to their chosen career, and determined to persevere and help their patients. But, many also said they were struggling with negative feelings.

Healthcare workers are afraid of spreading the virus to their families, frustrated about the lack of PPE, and feel they can’t do enough for their patients. First responders are tired from long shifts, and are extremely sad for their dying patients, of which many are passing away alone. This is heartbreaking.

Dr. Jay Kaplan, an emergency room Physician and wellness specialist at LCMC Health system in New Orleans, lets his staff know they aren't alone. He listens as Nurses and Doctors share their fears and problems.

Kaplan tells them it’s okay to get sad or angry over the coronavirus. He reads them his poems. He shares that one day he came home and cried to his wife because he was  overwhelmed by the rate of dying patients.

“We need to break the culture of silence and let people know it’s okay not to have it all together all the time,” he said.

Kaplan’s “wellness visits” are a key strategy in preventing healthcare workers from spiraling into depression and post-traumatic stress disorder during the pandemic. Many hospitals across the U.S. are launching similar initiatives.

Mount Sinai hospitals in New York City ramped up initiatives, such as a 24/7 mental health crisis line and one-on-one counseling. It also launched a wellness and resilience center that will track staffers' mental health long term.

Dr. Deborah B. Marin, Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai and Director of the new center said,  “This multi-disciplinary center will consider the physical, emotional, mental and spiritual needs of our entire health care community, including those on the frontline and in supporting roles. Working closely with every department across the health system, our aim is to not only address  but to also prevent the development of mental health issues before they occur by intervening early, offering resilience training and treatment for every health care working in need. It’s important that we launch now as this crisis continues to evolve and take a toll on our community.”

Several healthcare workers in the TIME interviews said, among all the uncertainty and fear, they have found some relief in support from their families, communities, and one another.

We’re offering this article during Nurses Week as a reminder to all to be as patient, kind and loving to our Nurses, Healthcare workers, first responders, grocery store employees and all the people out there working to keep us safe. Thank you!

Topics: mental health, first responders, mental health nursing, COVID-19, coronavirus, healthcare workers

Student Creates Face Masks For The Deaf Community

Posted by Erica Bettencourt

Fri, Apr 17, 2020 @ 09:29 AM

masksAs COVID-19 continues to impact communities around the world, people are coming together to help one another now more than ever.  

Ashley Lawrence, a 21-year-old in Kentucky, noticed that since so much of the population now are opting to wear protective face masks, those who are deaf or hard of hearing and rely on lip reading are struggling to access critical information. 

So she and her mom set to work sewing masks using plastic fabric and bed sheets, experimenting with various attachments for people who use cochlear implants and hearing aids and can’t wrap mask straps around their ears.

deafmasks

On the DHH Mask Project GoFundMe page Lawrence said she would distribute the masks for free to those who request them so they can provide them to their Doctors if they need medical attention.

Lawrence also said they were no longer accepting donations as they had met their goal, saying she was “completely overwhelmed” by the response.

For anyone who wants a mask, she suggested emailing dhhmaskproject@gmail.com. However, she noted they are struggling to meet the high demand.

“I felt like there was a huge population that was being looked over,” Lawrence told local news station LEX18. “We’re all panicking right now and so a lot of people are just not being thought of. So I felt like it was very important that, even at a time like this, people need to have that communication.”

And for anyone who wants to make face masks for their own community, Ashley said she would post a YouTube tutorial soon and would be willing to email the sewing pattern upon request.

According to Huffington Post, the Deaf Society advocates for sign language interpreters to be present for any interactions between DHH people and medical personnel, but these face masks could add further dimension to these interactions by allowing clients to see medical staff’s facial expressions and read their lips.

 

Topics: COVID-19, deaf community, face masks

HealthCare Workers Are Using Social Media To Lift Their Spirits

Posted by Erica Bettencourt

Fri, Apr 03, 2020 @ 12:45 PM

socialiconsNurses, Doctors, EMTs, and other healthcare workers are on the front lines of the COVID-19 battle. Even though they are going through the toughest time right now, they still manage to keep a good sense of humor. 

Take a look at how these healthcare workers are spreading positivity.

 

 

Thank you for staying so positive!

 

Topics: social media, COVID-19, coronavirus, nurses social media, tiktok nurses

What Nurses Need to Know about COVID-19

Posted by Erica Bettencourt

Thu, Mar 26, 2020 @ 11:34 AM

covid-19What Nurses Need to Know about COVID-19


Preparedness, Early Identification, and Notification

All Nurses and the health care team must receive the highest level of protection to provide care for the individuals and communities in which they serve. It is essential to develop and educate ALL staff on preparedness plans that provide infection control procedures and protocols used within the health care facility for the early identification, containment, and care of patients with symptoms associated with Coronavirus Disease (COVID-19) to prevent spread within the facility. Here are some tips:

  • Develop inpatient, ambulatory, and home care policies and procedures that are in line with current CDC guidelines for COVID-19.
  • Provide training to all personnel on screening and isolation procedures.
  • Provide updated training and guidelines on the use of Personal Protective Equipment (PPE), including the use of N-95 respirators, gloves, gowns, masks, eye protection, and face shields.
  • Display clear signage with instructions for access and use of PPE.
  • Ensure consistent use of proper hand hygiene, standard precautions, contact precautions, and airborne precautions, along with the proper use of a National Institute for Occupational Safety and Health (NIOSH)-Approved N-95 respirator or higher.
  • Clearly display signage for patients that lists symptoms and instructions to wear a face mask before entering the healthcare facility if symptoms are present.
  • Incorporate assessment questions to document a detailed travel and community exposure history when patients present with fever, cough, or respiratory illness. 
  • Identify, in advance, airborne infection isolation rooms (AIIR) or negative pressure rooms, for quarantine and screening.
  • Outline staffing protocols to facilitate care of patients with COVID-19 to minimize patient-to-patient and patient to health care worker transmission.
  • Develop a telephone triage protocol for patients to access from home to minimize community based transmission.
  • Have available for immediate notification of Patient’s Under Investigation (PUI) the infection control personnel at your facility and the local and state health department. Click here for additional Recommendations for Reporting, Testing, and Specimen Collection and the fillable COVID-19 PUI case investigation form.
  • For Patients Under Investigation (PUI), follow the Criteria to Guide Evaluation of PUI for COVID-19.

Isolation, Quarantine, Monitoring, and Hospitalization

The CDC recommends several steps for identification and maintenance of COVID-19 along with detailed guidelines for isolation precautions to prevent transmission. There should be a clearly displayed flowchart for early identification and assessment of COVID-19.

At this time, the modes of transmission include respiratory droplets from coughs and sneezes and transmission by touching the eyes, nose, or mouth after contact with an infected surface.

 Isolation Precautions to Prevent Transmission Guidelines

  • Have masks available for PUI to don before entering the healthcare facility.
  • Once identified, isolate the patient to airborne infection isolation rooms (AIIR) or negative pressure room and keep the door closed. Conduct the assessment in this room.
  • Healthcare personnel entering the room should use standard precautions, contact precautions, airborne precautions, and eye protection (goggles or a face shield).
  • Don Personal Protective Equipment (PPE) before entering the room.
  • Have guidelines for the proper use of PPE displayed throughout the healthcare facility.
  • Have infection control personnel available to provide just-in-time training on proper PPE use.
  • Notify your infection control personnel and the local and state health department of suspected cases.

How to Educate Your Patients and Minimize Spread within the Community

Per the CDC, it is known that coronavirus is part of a large family of viruses that can cause illness in people and animals. It is known that COVID-19 is spread via respiratory droplets from coughs and sneezes. It is also possible to spread COVID-19 by touching your eyes, nose, or mouth after touching an infected surface. The CDC provides the following guidance to help prevent COVID-19 from spreading among people in homes and communities.

    • STAY HOME except to get medical care, do not use public transportation or taxis if sick.
    • Call first before visiting your healthcare provider. Notify them of your symptoms and the need for evaluation for COVID-19. Follow the instructions provided by your healthcare team.
    • Separate yourself from other people in your home, utilize a separate bathroom.
    • Wear a facemask as instructed if you are sick.
    • Use your elbow to cover your coughs and sneezes.
    • Wash your hands frequently with soap and water for at least 20 seconds.
    • Avoid sharing household items.
    • Monitor your symptoms.
    • For a full list of guidelines and recommended actions for preventing the spread of Coronavirus visit https://www.cdc.gov/coronavirus/2019-ncov/guidance-prevent-spread.html

COVID-19 - Nurses Online and Printable Materials

https://www.nationalnursesunited.org/nurses-response-covid-19-printable-materials

 

Coronavirus disease (COVID-19) Situation Dashboard

https://experience.arcgis.com/experience/685d0ace521648f8a5beeeee1b9125cd

 

What To Say To Patients About Coronavirus Video

https://youtu.be/Yk6VX_Bktik

 

Topics: virus, CDC, COVID-19, coronavirus, nurse resources, PPE, infection control

Telemedicine Being Used In The Fight Against COVID-19

Posted by Erica Bettencourt

Mon, Mar 23, 2020 @ 03:00 PM

telemedicine-1During this global health crisis, telehealth is an effective solution for the prevention and treatment of COVID-19. 

Telehealth allows patients, healthcare providers and health systems to safely communicate. Patients with symptoms, told to stay at home, can communicate with Nurses and Doctors through virtual channels, mobile apps, video conferencing and phone calls to reduce the spread of the virus to mass populations and the medical staff on the frontlines. 

Telemedicine carts are another way hospitals are using technology to help treat patients. The carts allow health staff to roll video cameras and other telemedicine equipment into a patient's room so they can be assessed without Nurses and Doctors physically being at their bedside. 

Dr. Todd Czartoski, Chief Medical Technology Officer at Providence Regional Medical Center Everett, said "We had people outside the room talking to the patient, evaluating them with the electronic stethoscope and keeping those communication lines open. The Hospitalists, Infectious Disease Doctor and other Specialists didn't have to gown up and go in and out of the room multiple times a day." 

This technique also minimizes the use of personal protective equipment (PPE), such as gloves and masks.

The Centers for Disease Control (CDC) recommends using telehealth tools to direct people to the right level of healthcare for their medical needs. They launched a COVID-19 chatbot called the Coronavirus Self-Checker to help screen Americans who are worried about the coronavirus despite not being sick or being at risk. This would free up healthcare resources for those who need them.

Health insurers are giving providers and patients incentives to use telemedicine delivery models. CVS Health said Aetna would waive copays for coronavirus testing, and all telemedicine visits would have a $0 co-pay until June 4, 2020.

Patients can check their provider’s website or check with their health insurer on how to access telehealth services. According to the Wall Street Journal, people can also go directly to sites from Teladoc Health, Amwell, PlushCare, Doctor on Demand and MD Live for virtual visits.

If needed, Doctors can send prescriptions directly to a local pharmacy via telehealth.

According to the New York Times, health systems are racing to adapt and even develop telehealth services that can serve on the front line for patients. “Telehealth is being rediscovered,” said Dr. Peter Antall, the Chief Medical Officer for AmWell, a company based in Boston that is working with health systems across the country. “Everybody recognizes this is an all hands on deck moment,” he said. “We need to scale up wherever we can.”

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Topics: telemedicine, telehealth, COVID-19, coronavirus

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