Running head: HEALTH CRISIS AMONG BABIES AND WOMEN OF COLOR Health Crisis among Babies and Women of Color Owusu Benedicta Capella University June 27th 2021 1 HEALTH CRISIS AMONG BABIES AND WOMEN OF COLOR 2 Assessing the Problem: Health Crisis among Babies and Women of Color Introduction Racial disparities have influenced the poor pregnancy outcomes among African Americans. Although the country has achieved much in racial equity, still many African Americans cannot access timely care. The increased institutional racism exacerbates the problem. Implementation of the Affordable Care Act was a promise to address the issue. However, a decade has passed with the marginalized people suffering from these poor outcomes. The country requires proactive action and plans that address the problem. Besides, the nursing profession has propagated for equitable healthcare through cultural awareness training. With these competencies, Curtis et al. (2019) affirm that nurses can value the diverse patients' needs to provide feasible interventions. Nursing leadership should be at the forefront of advocating for policy change that will result in equitable healthcare. Since nurses serve patients directly, they understand their concerns which is the appropriate way of suggesting patient-centered initiatives. The paper will focus on the burden of these racial disparities among women and babies of color. It will also guide the actions that address the problem in the healthcare and policymaking arena. Definition of the Patient and the Problem I devoted my volunteer experience to assess a patient from the African American ethnic group. Patient X was a 28-year-old African American in her first trimester of pregnancy. X reports that the economic burden has made it hard for her to update her insurance. Her casual work in the nearby laundry does not earn her much that could take care of the entire family and still pay for premiums. She admits that the costs of the insurance premiums are high. As a result, she does not visit the antenatal care adequately as recommended. Two years ago, she delivered HEALTH CRISIS AMONG BABIES AND WOMEN OF COLOR 3 her first baby at 35 weeks of pregnancy. She is naïve that the current situations and stress could risk her to another poor outcome. Poor pregnancy outcome is a national health crisis. Women and babies of color have double the risks of this problem. According to the March of Dimes.Org (2021), women of color are three times whites to die from pregnancy-caused complications. Additionally, they are more than 50% at risk of giving birth prematurely. The issue also affects their babies. The organization further reports that African American babies are more than two times whites to die before attaining their first year. Multifaced concerns cause these disparities. However, Prather et al. (2018) affirm that institutional discrimination and racism increase the burden. A hospital that does not effectively address the needs of all races can induce discrimination among marginalized communities. The issue can reduce patient satisfaction and increase the stigma in access to facilities. Also, the bias policies can segregate the provision of care based on racial factors. Individual issues and behavior can also increase the risks of poor pregnancy outcomes. As Byerley & Haas (2017) report, the increased smoking among African American women can risk poor pregnancy outcomes. Therefore, practical solutions need to address these multifaced issues. Evidence-Based Nursing Actions to Address the Problem Cultural awareness is the issue of priority in nursing care and education. Accordingly, the nursing departments need to provide employees with cultural diversity and inclusivity training. These training roles are to curb the institutional racism that can arise from a lack of ethnic understanding. In addition, the institutions should launch models that teach the providers practical approaches to dealing with patients from diverse backgrounds. For instance, March of Dimes.Org (2021) initiated a program that aimed to address these segregations. The program leveraged maternal and child research primarily within the marginalized communities. HEALTH CRISIS AMONG BABIES AND WOMEN OF COLOR 4 According to Madeira et al. (2018), cultural diversity training help in limiting the perceptions of the cycles of discrimination. Also, training creates a harmonious environment to care for patients and facilitates uniformity in the process regardless of race. Here, the providers should regard safe and effective care to all patients. Fundamentally, nurses can leverage health behavior education strategies to help the community to live healthily. For instance, a report of the increased tobacco abuse among African American Women can widen the gaps in the poor health outcomes. Tobacco can increase the risks of preterm births and also heighten the chances of fatal growth cessation. With community mobilization and cessation programs, nurses can empower the community to live healthily. Byerley & Haas (2017) research suggested increased effectiveness of the tobacco cessation programs and education in minimizing the health burdens. The instruction can also enlighten the community on healthy behaviors such as the increased uptake of immunizations and supplementation of folic acid. The uptake of the folic acid supplementation has reduced the burden of spina bifida and anencephaly. On the other hand, effective implementation of these strategies can face some barriers in healthcare. For instance, limited educational resources among the hospitals in remote areas can limit the coverage. Moreover, effective education requires planning and promotive technology. In the era where healthcare has embraced telehealth, the marginalized can still lack sufficient technology coverage that supports virtual care. Other practical approaches like simulations require equipment which can be unaffordable is some population. Besides, it is complex to expand the cultural competence in institutions that have promoted racism. For instance, some institutions offer care based on the type of insurance cover. These alignments lock out many people who could desperately need urgent care. HEALTH CRISIS AMONG BABIES AND WOMEN OF COLOR 5 How Government Policies Address the Problem The government has been on the frontline of the provision of equitable care to all. As Courtemanche et al. (2018) report, the ACA's implementation has helped improve population health. Now, people can access healthcare regardless of socioeconomics. However, the program has not solved the problem. A significant number of African Americans are still uninsured. Like patient X, many people attribute these trends to the increased premiums, which are unaffordable. Necessarily, the March of Dimes.Org (2021) has suggested a comprehensive approach to government extension of Medicaid. The extension will allow even people with little income to afford the premiums and access care. With the insurance cover, March of Dimes.Org (2021) reports that the mothers have more motivation to seek healthcare. Adequate antenatal visits reduce the likelihood of poor outcomes and help in the early prevention of avoidable complications. As Courtemanche et al. (2018) support, the burden of infant mortality rates is high among the insured. Besides, the state nursing board advocates for equitable and just care to all. For instance, California nursing state has formulated a compliance approach that penalizes institutions that propagate institutional injustice. Here, the providers need to provide safe and effective care regardless of the patients' insurance status. Therefore, the increased coverage and state policies will improve pregnancy outcomes among the poor and marginalized communities. The move affects the scope of nursing positively. It is disheartening to deny care to many patients since they cannot afford the treatment and prescription medications. With the extended Medicaid, nurses can execute their intervention to all patients regardless of their economic status. The action creates room for unbiased care, which is the promising approach that addresses institutional prejudices. It is not understandable to promise patients a priority, yet many mothers in resource-constrained regions cannot afford healthcare. HEALTH CRISIS AMONG BABIES AND WOMEN OF COLOR 6 Leadership Strategies that Address the Problem and Improves Outcomes Democratic leadership style helps the nurse leaders to consider diverse opinions in decision making. One of the practical skills of this kind of leadership is inclusivity. Here, the leaders value the idea of the subordinates in brainstorming the route cause of the issue. Lack of inclusivity will seclude a section of the workforce. The separation demoralizes employees as they feel the organization fails to involve in decision-making. With the inclusivity of diverse opinions, Sabatello's (2019) research suggests that the organization can understand the factors that influence health from the broad spectrum. It also promotes cultural competence as employees from the culture can recommend solutions that meet all the patients' demands. Sabatello (2019) indicated that inclusivity propagates for culturally appropriate services. According to the research, the patients feel more comfortable receiving care from the providers from their race, community, and language. For change management, organizations should improve the inclusion of employees from diverse backgrounds. Diversity improves cultural awareness. The move attracts the understanding of the facets from the insiders' experience. It enhances the provision of holistic care and improves patients' satisfaction. The initiative makes the patients feel comfortable in an environment that understands their values, norms, and perspectives, influencing behavior change. It also allows for the collaboration of the providers with diverse experiences to meet the patients' dynamic needs. HEALTH CRISIS AMONG BABIES AND WOMEN OF COLOR 7 References Byerley, B. M., & Haas, D. M. (2017). A systematic overview of the literature regarding group prenatal care for high-risk pregnant women. BMC pregnancy and childbirth, 17(1), 1-9. https://doi.org/10.1186/s12884-017-1522-2 Curtis, E., Jones, R., Tipene-Leach, D., Walker, C., Loring, B., Paine, S. J., & Reid, P. (2019). Cultural safety rather than cultural competency is required to achieve health equity: a literature review and recommended definition. International Journal for Equity in Health, 18(1), 1-17. https://doi.org/10.1186/s12939-019-1082-3 Madeira, A. F., Pereira, C. R., Gama, A., & Dias, S. (2018). Justifying treatment bias: The legitimizing role of threat perception and immigrant–provider contact in healthcare. Cultural Diversity and Ethnic Minority Psychology, 24(2), 294. https://doi.org/10.1037/cdp0000187 March of Dimes.Org (2021). Health crisis impacting babies and women of color. Retrieved on 28th June 2021 from https://www.marchofdimes.org/mission/health-disparities.aspx Prather, C., Fuller, T. R., Jeffries IV, W. L., Marshall, K. J., Howell, A. V., Belyue-Umole, A., & King, W. (2018). Racism, African American women, and their sexual and reproductive health: a review of historical and contemporary evidence and implications for health equity. Health equity, 2(1), 249-259. https://doi.org/10.1089/heq.2017.0045 Sabatello, M. (2019). Cultivating inclusivity in precision medicine research: disability, diversity, and cultural competence. Journal of community genetics, 10(3), 363-373. https://doi.org/10.1007/s12687-018-0402-4 6/29/2021 Assessment 3 Instructions: Assessing the Problem: Technology, ... Course Navigation  Tutorials Rebecca SupportLuetke Log Out FACULTY 20 NEW  Kat Plotnikova Benedicta Owusu 7 COACH  Assessment 3 Instructions: Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations In a 5-7 page written assessment, determine how health care technology, coordination of care, and community resources can be applied to address the patient, family, or population problem you've defined. In addition, plan to spend approximately 2 direct practicum hours exploring these aspects of the problem with the patient, family, or group you’ve chosen to work with and, if desired, consulting with subject matter and industry experts. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form. Report on your experiences during the second 2 hours of your practicum. Introduction As a baccalaureate-prepared nurse, you’ll be positioned to maximize the use of technology to achieve positive patient outcomes and improve organizational effectiveness. Providing holistic coordination of patient care across the entire health care continuum and leveraging community resource services can lead both to positive patient outcomes and to organizational improvements. Preparation In this assessment, you’ll determine how health care technology, coordination of care, and community resources can be applied to address the health problem you’ve defined. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts. To prepare for the assessment: Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed. Conduct sufficient research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence. Review the Practicum Focus Sheet: Assessment 3 [PDF], which provides guidance for conducting this portion of your practicum. Note: Remember that you can submit all, or a portion of, your draft assessment to Smarthinking for feedback, before you submit the final version. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback. Instructions Complete this assessment in two parts. Part 1 Determine how health care technology, the coordination of care, and the use of community resources can be applied to address the patient, family, or population problem you’ve defined. Plan to spend at least 2 practicum hours https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_318139_1&content_id=_9986195_1 1/3 6/29/2021 Assessment 3 Instructions: Assessing the Problem: Technology, ... exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form. Use the Practicum Focus Sheet: Assessment 3 [PDF] provided for this assessment to guide your work and interpersonal interactions. Part 2 Report on your experiences during the second 2 hours of your practicum. Whom did you meet with? What did you learn from them? Comment on the evidence-based practice (EBP) documents or websites you reviewed. What did you learn from that review? Share the process and experience of exploring the effect of the problem on the quality of care, patient safety, and costs to the system and individual. Did your plan to address the problem change, based upon your experiences? What surprised you, or was of particular interest to you, and why? CORE ELMS Update the total number of hours on the NURS-FPX4900 Volunteer Experience Form in CORE ELMS. Requirements The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence. Analyze the impact of health care technology on the patient, family, or population problem. Cite evidence from the literature that addresses the advantages and disadvantages of specific technologies, including research studies that present opposing views. Determine whether the evidence is consistent with technology use you see in your nursing practice. Identify potential barriers and costs associated with the use of specific technologies and how those technologies are applied within the context of this problem. Explain how care coordination and the utilization of community resources can be used to address the patient, family, or population problem. Cite evidence from the literature that addresses the benefits of care coordination and the utilization of community resources, including research studies that present opposing views. Determine whether the evidence is consistent with how you see care coordination and community resources used in your nursing practice. Identify barriers to the use of care coordination and community resources in the context of this problem. Analyze state board nursing practice standards and/or organizational or governmental policies associated with health care technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form. Explain how these standards or policies will guide your actions in applying technology, care coordination, and community resources to address care quality, patient safety, and costs to the system and individual. Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of technology, care coordination, and community resources. Explain how nursing ethics will inform your approach to addressing the problem through the use of applied technology, care coordination, and community resources. https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_318139_1&content_id=_9986195_1 2/3 6/29/2021 Assessment 3 Instructions: Assessing the Problem: Technology, ... Document the time spent (your practicum hours) with these individuals or group in the Core Elms Volunteer Experience Form. Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence. Apply APA style and formatting to scholarly writing. Additional Requirements Format: Format your paper using APA style. Use the APA Style Paper Template. An APA Style Paper Tutorial is also provided to help you in writing and formatting your paper. Be sure to include: A title page and reference page. An abstract is not required. A running head on all pages. Appropriate section headings. Length: Your paper should be approximately 5–7 pages in length, not including the reference page. Supporting evidence: Cite at least five sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format. Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance. Competencies Measured By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria: Competency 4: Apply health information and patient care technology to improve patient and systems outcomes. Analyze the impact of health care technology on a patient, family, or population problem. Competency 5: Analyze the impact of health policy on quality and cost of care. Analyze state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form. Competency 6: Collaborate interprofessionally to improve patient and population outcomes. Explain how care coordination and the utilization of community resources can be used to address a patient, family, or population problem. Competency 8: Integrate professional standards and values into practice. Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence. Apply APA style and formatting to scholarly writing. SCORING GUIDE Use the scoring guide to understand how your assessment will be evaluated. VIEW SCORING GUIDE  https://courserooma.capella.edu/webapps/blackboard/content/listContent.jsp?course_id=_318139_1&content_id=_9986195_1 3/3 6/29/2021 Capella University Scoring Guide Tool NURS-FPX4900 u03a1 - Assessing the Problem: Technology, Care Coordination, and Community Resources Considerations Learner: Benedicta Owusu OVERALL COMMENTS RUBRICS CRITERIA 1 Analyze the impact of health care technology on a patient, family, or population problem. COMPETENCY Apply health information and patient care technology to improve patient and systems outcomes. NON_PERFORMANCE: Does not describe the impact of health care technology on a patient, family, or population problem. BASIC: Describes the impact of health care technology on a patient, family, or population problem. PROFICIENT: Analyzes the impact of health care technology on a patient, family, or population problem. DISTINGUISHED: Conducts an astute analysis of the impact of health care technology on a patient, family, or population problem. Cites credible and balanced evidence of the advantages and disadvantages of specific technologies. Provides clear insight into current technology use in professional practice, as well as potential barriers and costs. https://scoringguide.capella.edu/grading-web/learner 1/10 6/29/2021 Capella University Scoring Guide Tool CRITERIA 2 Explain how care coordination and the utilization of community resources can be used to address a patient, family, or population problem. COMPETENCY Collaborate interprofessionally to improve patient and population outcomes. NON_PERFORMANCE: Does not describe the value of care coordination and the utilization of community resources in addressing health care challenges. BASIC: Describes the value of care coordination and the utilization of community resources in addressing health care challenges. PROFICIENT: Explains how care coordination and the utilization of community resources can be used to address a patient, family, or population problem. DISTINGUISHED: Provides a convincing explanation of how care coordination and the utilization of community resources can be used to address a patient, family, or population problem. Cites credible and balanced evidence of the benefits of care coordination and the use of community resources. Provides clear insight into current use in professional practice, as well as potential barriers. https://scoringguide.capella.edu/grading-web/learner 2/10 6/29/2021 Capella University Scoring Guide Tool CRITERIA 3 Analyze state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources and document the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form. COMPETENCY Analyze the impact of health policy on quality and cost of care. NON_PERFORMANCE: Does not describe state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources. BASIC: Describes state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources. PROFICIENT: Analyzes state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources and documents the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form. DISTINGUISHED: Conducts an astute analysis of state board nursing practice standards and/or organizational or governmental policies associated with health technology, care coordination, and community resources. Clearly articulates the implications for ethical professional practice of applying standards and/or policy guidance or legislative requirements to the problem. Documents the practicum hours spent with these individuals or group in the Core Elms Volunteer Experience Form https://scoringguide.capella.edu/grading-web/learner 3/10 6/29/2021 Capella University Scoring Guide Tool CRITERIA 4 Support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence. COMPETENCY Integrate professional standards and values into practice. NON_PERFORMANCE: Does not support main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence. BASIC: Sources lack relevance or credibility, or the evidence is not persuasive or explicitly supportive of main points, assertions, arguments, conclusions, or recommendations. PROFICIENT: Supports main points, assertions, arguments, conclusions, or recommendations with relevant and credible evidence. DISTINGUISHED: Supports main points, assertions, arguments, conclusions, or recommendations with relevant, credible, and convincing evidence. Skillfully combines virtually error-free source citations with a perceptive and coherent synthesis of the evidence. https://scoringguide.capella.edu/grading-web/learner 4/10 6/29/2021 Capella University Scoring Guide Tool CRITERIA 5 Apply APA style and formatting to scholarly writing. COMPETENCY Integrate professional standards and values into practice. NON_PERFORMANCE: Does not apply APA style and formatting to scholarly writing. BASIC: Applies APA style and formatting to scholarly writing incorrectly and/or inconsistently, detracting noticeably from good scholarship. PROFICIENT: Applies APA style and formatting to scholarly writing. DISTINGUISHED: Applies APA style and formatting to scholarly writing. Exhibits strict and nearly flawless adherence to stylistic conventions, document structure, and source attributions. Supplemental Feedback https://scoringguide.capella.edu/grading-web/learner 5/10 6/29/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 1 Purpose Compose a text that articulates meaning relevant to the main topic, scope, and purpose of the prompt BEGINNING: This text is unrelated to the assignment prompt. DEVELOPING: This text is related to the assignment prompt but does not demonstrate an understanding of the main topic, scope, and purpose. SKILLED: This text responds to the assignment prompt and appropriately addresses the main topic, scope, and purpose. ADVANCED: This text presents a focused response to the assignment prompt and demonstrates a thorough understanding of the main topic, scope, and purpose. https://scoringguide.capella.edu/grading-web/learner 6/10 6/29/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 2 Organization Develop text using organization, structure, and transitions that demonstrate understanding of relationship between main and subtopics BEGINNING: This text does not include a thesis statement and is organized inappropriately for the assignment. DEVELOPING: The thesis statement in this text is unclear and/or the text is presented in paragraphs with unclear main idea(s) and/or transitional phrases. SKILLED: This text includes a thesis statement and is organized into paragraphs, with clear main ideas and effective transitional phrases. ADVANCED: This text reflects a strong thesis statement. Additionally, this text is organized with skillful transitions into paragraphs with clear main ideas, sufficient evidence, analysis, and linking information. https://scoringguide.capella.edu/grading-web/learner 7/10 6/29/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 3 Evidence Integrate into text appropriate use of scholarly sources and evidence BEGINNING: This text included plagiarized information. DEVELOPING: This text lacks synthesis of information from sources and/or the credibility of the sources is questionable, with many flaws in APA citation style. SKILLED: The included evidence was integrated and synthesized from outside sources, most of which are scholarly, with minimal flaws in APA citation style. ADVANCED: The evidence in this text was integrated and synthesized from credible, scholarly, and professionally sound sources, with minimal flaws in APA citation style. https://scoringguide.capella.edu/grading-web/learner 8/10 6/29/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 4 Tone Apply in text the standard writing conventions for the discipline, including structure, voice, person and tone BEGINNING: Text uses language inappropriate for the intended audience. DEVELOPING: This text does not meet writing conventions for the discipline and lacks appropriate voice, person, and/or tone for the intended audience. SKILLED: This text meets writing conventions for the discipline and there were minimal issues in appropriate use of voice, person, or tone for the intended audience. ADVANCED: This text exhibits strict adherence to writing conventions for the discipline and uses appropriate voice, person, and tone for the intended audience. https://scoringguide.capella.edu/grading-web/learner 9/10 6/29/2021 Capella University Scoring Guide Tool SUPPLEMENTAL CRITERIA 5 Sentence Structure Produce text with minimal grammar, usage, spelling, and mechanical errors BEGINNING: Text meaning is unclear due to errors in sentence structure, grammar, usage, word choice, spelling, or mechanics in 75% or more of text. DEVELOPING: Text meaning is interrupted due to sentence structure, grammar, usage, word choice, spelling, or mechanical errors in 25%-75% or more of text. SKILLED: Text conveys clear meaning with minimal issues in grammar, usage, word choice, spelling, or mechanical errors in 10%-25% of text. ADVANCED: Text complexity and concision conveys clear meaning, with grammar, usage, word choice, spelling, or mechanical errors in 10% or less of text. https://scoringguide.capella.edu/grading-web/learner 10/10
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