NUR 513 Topic 3 DQ 1 Identify a population that you will likely serve as an advanced registered nurse that you think is particularly vulnerable to issues of health disparities/inequity

NUR 513 Topic 3 DQ 1 Identify a population that you will likely serve as an advanced registered nurse that you think is particularly vulnerable to issues of health disparities/inequity

Identify a population that you will likely serve as an advanced registered nurse that you think is particularly vulnerable to issues of health disparities/inequity. Discuss the contribution of your particular specialty to health promotion and disease prevention for this population. How do issues of diversity and global perspectives of care contribute to your understanding of health equity as it relates to this population?

GINA

Re: Topic 3 DQ 1

As an informatics nurse, my target population would be pediatrics. Children have been deemed a vulnerable population in our healthcare system because they cannot consent on their own and must deal with circumstances beyond their control (economic, financial, access to healthcare, abuse, exploitation, etc.). Because of the factors mention, there is an increased health risk associated with the lack of pediatric research (Presidential Commission for the Study of Bioethical Issues, 2016). Pediatric populations are understudied because of the legality of consent, the willingness to participate in research, and being able to have the cognitive ability to understand any perceived risk associated with the research. Health determinates and measures of health within a population are critical indicators of how healthcare needs to evolve in terms of preventative measures and education (DeNisco & Barker, 2016). This makes the quantification of the effectiveness of preventative health measures, programs, and education necessary (DeNisco & Barker, 2016). An informatics nurse can play a significant role in quantifying data, the improvement of technologies, and the distribution of health services (AMIA, 2020).

In terms of diversity and the global perspective, the United States continues to experience population growth and increasing diversity due to immigration. I work in California and predominantly work with Hispanic/Latino, Asian, and Middle Eastern ethnic minorities. I’m sure we’ve all experienced how this can create barriers to access to health care and how we deliver nursing care. DeNisco and Barker point out that minorities who are low income and/or have language barriers often have less access to healthcare and have poorer health outcomes (2016, p.580). Health disparities among minorities become an even bigger issue when dealing with the already vulnerable pediatric population. In terms of health equity, we have made strides with things like the Affordable Care Act to help eliminate some disparities, but unfortunately, we have a long way to go. Western medicine is very focused on the physician model of care, where everything is diagnosis-driven. However, as our nation evolves, it speaks to the greater need for cultural competence and sensitivity and caring for the patient as a whole, including cultural and spiritual needs, not just their diagnosis (Watson, 2008).

References

American Medical Informatics Association (AMIA). (2020, April 14). Nursing informatics in the times of COVID-19: Achievements, challenges, and new ideas. AMIA COVID-19 Webinar series. 

DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.

Presidential Commission for the Study of Bioethical Issues. (2016). Vulnerable populations in safeguarding children: Pediatrics medical countermeasure research.

Watson, J. (2008). Nursing: The philosophy and science of caring (Rev. ed). Boulder, CO: University Press of Colorado.

 

RESPOND  HERE (150 WORDS, 2 REFERENCES)

This is insightful, Gina; nurse informatics play significant roles in the management of pediatric care. Given that children are vulnerable to diseases and different complications, there is always the need to rely on the previous data and information to initiate

effective care (American Nurses Association, 2015). Additionally, given that children cannot provide consent to the treatment processes, there is always the need to help them deal with circumstances beyond their control. Children often need quality care, and this calls for specialized interventions coupled with research and evidence-based practices. Therefore, informatics nurses, with their high-level technical roles, are able to use data and technology to monitor, the program carefully, and develop effective patient care initiatives to enhance treatment and general care for the patients (Grover, Sharma, & Mehra, 2020). Pediatric studies are critical, especially when it comes to the enhancement of primary care. However, in reality, pediatric populations are understudied due to the legality of consent and lack of cognitive abilities to understand any form of perceived risk associated with the research processes.

References

American Nurses Association. (2015). Nursing informatics: Scope and standards of practice. Retrieved from: =

Grover, S., Sharma, N., & Mehra, A. (2020). Stigma for Mental Disorders among Nursing Staff in a Tertiary Care Hospital. Journal of neurosciences in rural practice, 11(2), 237–244.

Re: Topic 3 DQ 1

 

The population that is vulnerable to issues of health disparities that I would like to focus on is patients with mental health disabilities. As an advanced registered nurse focusing on health care quality and patient safety, it is my duty to address mental issues related to safety in the same degree as physical ailments. There are a lot of patients with mental illness that do not seek medical care because of fear of rejection. Among the various factors, which influence help seeking, stigma, discrimination, social prejudice, and negligence are considered to be important factors which prevent mental health care and treatment (Grover, et al., 2020).

In order to address the health promotion and disease prevention for this population, it is important to first eradicate the stigma towards them. Stigma toward mentally ill people not only originates in general public but also among health care professionals (Grover, et al., 2020). An example is when we had a homeless patient come in the hospital frequently asking for anxiolytics to help calm down. Some staff thought of this person as “drug-seeking”, but in reality, he suffered from anxiety disorder and PTSD from a prior traumatic experience. This is a common misconception among psychiatric patients. In order to prevent worsening of symptoms, he should receive the appropriate care that he deserves. Incorporating quality of service such as medical screening evaluation performed by a qualified provider, educating him about his medical problems and prescribing medications appropriate for his symptoms and diagnosis are forms of health promotion. Prevention in this case includes suicide risk screening and providing resources for support groups.

 

Health equity should be globally addressed because every human deserves quality care and treatment. Though there may be diversities in socio-economic status, cultural background, religion, and ethnicity, there should be no room for inequity. It is every one’s fundamental right to achieve health and wellness. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care (Braveman, et al., 2017).

 

References

 

Braveman, P. (2017). What is health equity? Robert Wood Johnson Foundation. https://www.rwjf.org/en/library/research/2017/05/what-is-health-equity-.html

Grover, S., Sharma, N., & Mehra, A. (2020). Stigma for Mental Disorders among Nursing Staff in a Tertiary Care Hospital. Journal of neurosciences in rural practice, 11(2), 237–244. https://doi.org/10.1055/s-0040-1702916

 

RESPOND  HERE (150 WORDS, 2 REFERENCES)

 

This is insightful, Maria; there are increased cases of mental illnesses in the healthcare systems. In the United States, one in five adults suffers from mental health problems; in other words, over 43.8 million people are diagnosed with mental health problems every year (Hai et al., 2020). There are also serious cases of mental health problems where one in twenty-five people are affected in a given single year. Also, there are many patients with mental illness who do not seek medical care because of fear of rejection. Advanced registered nurses, with their research skills, are able to undertake evidence-based practice processes to identify the best strategies that can be employed to enhance the management of patients suffering from mental health problems. Also, advanced registered nurses have the capability of reducing the stigma associated with mental health problems. Stigma toward mentally ill people not only originates in the general public but also among health care professionals (Shim & Compton, 2018).

References

Hai, A. H., Lee, C. S., Oh, S., Vaughn, M. G., Piñeros-Leaño, M., Delva, J., & Salas-Wright, C. P. (2020). Trends and correlates of Internet support group participation for mental health problems in the United States, 2004–2018. Journal of psychiatric research, 132, 136-143. Retrieved from:

Shim, R. S., & Compton, M. T. (2018). Addressing the social determinants of mental health: If not now, when? If not us, who?. Psychiatric Services, 69(8), 844-846. Retrieved from:

 

Re: Topic 3 DQ 1

The United States’ current focus in healthcare continues to be the curative model; one focused on disease treatment and cure of illness. This tends to be a physician-taught acute care approach to addressing the health of humans. Adjusting the perspective, the holistic model provides a balanced approach to considering the mental, social, spiritual health of a person in addition to the physical health. Naturally, this leads the holistic practitioner to include preventative and maintenance care to the individual in addition to the curative portion of healthcare (Barker and DeNisco, 2016). One population that suffers tremendously from the curative approach is the uninsured population, which ranges from older adults to adolescents and newborns. Due to the scarcity of health insurance as it relates to one’s ability to spend money on this economic “good”, the uninsured populations of our nation do not always have access to the best medical treatment, be it preventative, curative or maintenance (Barker and DeNisco, 2016). This vulnerable population in the acute care arena is certainly worthy of much deep consideration and thoughtful, strategic planning to ensure access to health care services when the inequalities of the uninsured sometimes feel insurmountable.

For the advanced practice registered nurse (APRN) who is a nurse administrator in the acute care arena, the uninsured patient population is a common customer in the hospital. With chronic conditions such as diabetes, heart failure and renal disease on the rise, and in turn, claiming the prize as the leading causes of death in the United States, nurse administrators are called to action now more than ever in effort to advocate and provide equitable care for these populations whilst maintaining a successful business model for the hospital to remain open and available to the public (Barker and DeNisco, 2016). To successfully promote health and wellness as well as disease prevention to the uninsured, the nurse administrator must not only address the acute needs of patients entering their facility, but plan for preventing these sometimes acute-on-chronic conditions prior to their arrival. According to the Office of Disease Prevention and Health Promotion (ODPHP), uninsured populations vary in age, race, and socioeconomic status. Still, this vulnerable population is more likely to make repeated visits to the emergency department, die prematurely, and have overall poor health status (2021). The nurse leader’s role is to advocate for medical provider accessibility for this population by ways of collaboration with policymakers, preventative services, and emergency medical services. Though access to care is often rooted in deeper disparities such as residential location, the nurse administrator may advocate for an innovation like telehealth visits, with hopes to remove barriers preventing quality care from being provided (ODPHP, 2021).

Issues of diversity and global perspectives of care contribute to my understanding of health equity as it relates to the uninsured population in many ways. First, the concept of social justice on an international level views access to all areas of healthcare as a social resource that is a right to all humans. This includes a social approach to addressing the skyrocketing costs of medical care, using public health problem-solving measures to combat widespread chronic health conditions, and at its core, a collective agreement to work toward the greater good of our society (Barker and DeNisco, 2016). Moving a step forward, emphasis on curative treatment and inpatient care does not impact total community health in a significant way, and therefore, a collaborative approach that involves all stakeholders – inpatient leaders, community health leaders, public policymakers, local leadership, and federal leadership – to come to the table repeatedly to discuss and execute the most meaningful way to improve the community’s quality of life, improve overall health and remain responsible stewards of fiscal resources (Barker and DeNisco, 2016).

 

REFERENCES

DeNisco, S. M. & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Burlington, MA: Jones & Bartlett Learning. ISBN-13: 978-1284072570

Office of Disease Prevention and Health Promotion (2021). Access to health services. https://www.healthypeople.gov/2020/topics-objectives/topic/Access-to-Health-Services

 

RESPOND  HERE (150 W0RDS, 2 REFERENCES)

 

This is insightful, Kristi; the uninsured population often has difficulties in accessing quality medical services. In most cases, they have to pay more for the services being delivered to them. Health insurance is essential as it gives an individual opportunity to plan for their treatment plans. In the United States, most uninsured populations have atleast one worker in their families. Also, families with low incomes are most likely to be uninsured (Van Der Steen et al., 2015). Given that medical plans do not favor other populations, it is always necessary to develop new strategies on how to ensure that different populations are covered in the insurance plans. Advanced registered nurses, with their advanced skills and knowledge in healthcare processes, are able to determine the best strategies on how to manage the population of uninsured patients. The uninsured populations vary in age, race, and socioeconomic status (Wouk et al., 2020). Still, this vulnerable population is more likely to make repeated visits to the emergency department, die prematurely, and have overall poor health status.

References

Van Der Steen, A., Knudsen, A. B., Van Hees, F., Walter, G. P., Berger, F. G., Daguise, V. G., … & Lansdorp‐Vogelaar, I. (2015). Optimal Colorectal Cancer Screening in States’ Low‐Income, Uninsured Populations—The Case of South Carolina. Health services research, 50(3), 768-789. Retrieved from:

Wouk, K., Morgan, I., Johnson, J., Tucker, C., Carlson, R., Berry, D. C., & Stuebe, A. M. (2020). A Systematic Review of Patient-, Provider-, and Health System-Level Predictors of Postpartum Health Care Use by People of Color and Low-Income and/or Uninsured Populations in the United States. Journal of Women’s Health. Retrieved from: