NR 394 Discussion Presentation of Course Project: Part 3

NR 394 Discussion Presentation of Course Project Part 3

My focus population is Adult Hispanics. The Hispanic population in the county I work in is 43.4% compared to the National average of 18.5%. I care for a large number of Hispanics in my current practice. Working in ambulatory cardiology I chose a Leading Health Indicator that has a significant impact on cardiac health. Uncontrolled hypertension and its impact on the Hispanic community. The LHI goal is 60.8% of those diagnosed with hypertension to be controlled. The current rate of controlled hypertension is only 48%.

Hypertension is the leading cause of heart disease and stroke in the United States. Both Hispanics and White non-Hispanic have a similar rate of hypertension, but Hispanics are not well controlled. Only 20% of Hispanics with known hypertension have blood pressure readings at goal. Additionally, Hispanics have the highest rate of obesity in the U.S. which causes additional concern about the development of Metabolic Syndrome.

There are some barriers to care when it comes to my specific community and population. The level of poverty and lack of health insurance is higher in my community. This is going to prevent those that want care from seeking care. There is also a lack of education in addition to cultural beliefs on health that can impact care. There is a belief in fatalism within the Hispanic culture which essentially means they feel they have no control over their health outcomes. They are destined to have certain medical conditions and there is nothing that can be done about this. Education and community outreach are essential in disproving this belief. Hispanics also are reluctant to seek care due to language barrier and often feel discriminated against. Best practice when caring for non-English speaking patients is to offer an interpreter without the patient needing to request this as it is not uncommon for Hispanics to feel shame in having to make this request. Taking this element away will help create a connection with the patient and help them feel they are receiving patient-centered care. Asking open-ended questions about what barriers each patient may have in their care will help provide culturally competent care.

Just wanted to say your poster looked great, so organized and concise. Uncontrolled hypertension is one of the most common ER visit chief complaints that I have come across in my community. Like you said, it is essential that we are able to educate our patients in their hypertension diagnosis, and medication compliance. Just today, I had a patient come in with stroke symptoms who said he stopped taking his blood pressure medications because “I felt like I did not need it anymore”. It is essential we educate our patients on how medications work and why we must be compliant with them.

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I enjoyed reading your post as I am Hispanic myself and come from a family that has a history of HTH. My grandparents treated HTN as you stated, believing that it is just part of their lifestyle and that there was nothing they could do about it. Moreover, the fact that Hispanics have the highest rate of obesity which can cause HTN, is appalling. I am glad you brought up the fact that providing an interpreter before the patient and/or family requests one is best practice. I agree that many individuals in the Hispanic community feel ashamed to ask for an interpreter and will oftentimes simply nod their heads to information being discussed. This is neither safe nor culturally competent when providing care. I appreciate your post!

Cultural population selected and why

I selected the community in which the hospital I work at primarily serves which is the lower income community, and minorities. I choose this population because I wanted to research how I could better serve this community to reduce hospitalizations, length of stays, and reduce poor prognosis of diagnosis.

Health issue selected and why

The health issue I selected was increased diagnosis of chronic kidney disease in patients in lower income or minority communities because this is a highly preventable diagnosis in our community with few changes.

Highlight three or more key points from your poster

Patient education regarding small lifestyle changes such as eating better, medication education, and getting adequate exercise could make a world of difference when it comes to preventing CKD.
1. Early screening and treatment of hypertension, obesity, and diabetes to prevent progression to CKD.
1. Access and awareness of resources within the community.

I enjoyed reading about your topic! I think this is a great to have researched as CKD stems from uncontrolled HTN and DM. I see many individuals within the hospital setting that are newly diagnosed DM with HTN and are in for acute kidney injury. It is imperative to provide the proper teaching to these patients, but more importantly address insurance issues and lack of primary care providers that can provide early diagnosis and prevent progression of further medical conditions. I work in an underserved community with vulnerable patient population such as homeless, substance abuse, minorities, and incarcerated. This population is often overlooked and should be addressed. Thank you for sharing.

The issue that I am addressing is Drug and Alcohol abuse. More specifically, death by drug overdoses in African American people. Drug and alcohol abuse effect many different people and cultures. In my community, there has been a significant increase in drug overdose deaths in African Americans. According to Franklin County Corners Office (2020), African Americans made up 20.9% of drug overdose deaths in 2018. I have done extensive research and discovered that the Franklin County Corners Office is overwhelmed with drug overdose deaths, they are three years behind on collecting data.

Studies show that African Americans are having an increase in drug overdose deaths. Reasons for this vary. The community is developing a generation of children that will be without parents. In order to stop the increase of drug overdose deaths, we must educated and empower. The stigma around addiction must stop. Understanding that addiction is a disease and meeting the addict where they are is important. Not everyone is ready to become sober. By educating clients about safe needle disposal /exchange, offering Narcan, and list of treatment facilities, gives the client the information they need in order to help guide them to sobriety.

In order to reach out to the African American culture, we as nurses need to come from a place of empathy and not judgement. Asking drug abuse questions with a nonjudgmental approach is imperative to helping the person in need. Educating ourselves and understanding how drugs effect the brain can help us as nurses, and understand why the addict is an addict. To save lives we must stop the stigma and impower the people.

Opioid use has impacted death rates among non-Hispanic Blacks more severely than any other population (SAMHSA, 2020). There has been a lot of education in recent years about substance use and the availability of Narcan in the community. However, I was not aware how the significant disparities between African Americans and other populations. Great poster and presentation.

SAMHSA. (2020). The opioid crisis and the Black/African American population: An urgent issue. Substance Abuse and Mental Health Services Administration.

I really enjoyed reading about your topic choice for your course project. Drug and alcohol abuse is certainly a major issue that we face in healthcare and can be very challenging. It’s always interesting to consider how health issues affect different populations and cultures. I couldn’t agree more that addiction is a disease with a huge stigma around it, and unfortunately many people still don’t view it as a disease. You brought up some really great points. It’s true that you can’t force someone to get sober and they’re not going to help themselves until they’re ready to do so. That’s why education is so important as well as readily available resources such as needle disposal and exchange and narcan. Preventing overdoses as well as many blood borne diseases that can be contracted from the use of dirty needles is not only important, but saves lives. You made a great point that especially when it comes to addiction, nurses should be empathetic and nonjudgmental in order to allow our patients to trust us.

Great presentation. Things are very hard right now for our children. I worry everyday about my children as well as others, especially ones that already struggle with mental illness. Being isolated can sometimes make things worse. I worry there are not enough resources out there with everything going on with covid. People are not noticing the things they would usually notice if the see the child in school or out in social settings. Its hard to see a change happening and sometimes it is to late. I pray things get better for our young ones, you are right awareness and access to resources for all ages is very important and key to early intervention.

Hispanic and Latino terms are often used interchangeably, however, the connotations are different. Hispanics are people with Spanish-speaking backgrounds. Latino reflects geographic region that includes Central, South America, and the Caribbean. “According to the 2008 U.S. Census Bureau population estimate, about 46.9 million Hispanics live in the United States (representing 15% of the total U.S. population). Among Hispanic subgroups, Mexicans rank as the largest (66%) followed by Central and South Americans (13%), Puerto Ricans (9.4%), Cubans (3.9%), and people of other Hispanic origins (7.5%)” (cdc.gov). Hispanics and Latinos are fast-growing populations in the United States. They are family-oriented and live in large, multigenerational households. They prefer traditional patriarchal structure when a male is the greatest authority and one is submissive. Hispanics and Latinos culture represents collectivism. They prefer group activities, shared responsibilities, and collective accountability. Despite lower income than whites, Hispanics live longer, and their life expectancy is75.1 for men and 82.6 years for women (cdc.gov). Hispanic and Latino patients represent 13.9 % of the population in McHenry County, Illinois where I currently work, and a third of the patient population hospitalized. I am very interested in their culture, I would like to understand the group, it is dynamics, and learn to speak Spanish to be able to provide culturally competent patient-centered care.

I chose “new cases of diagnosed diabetes in the population” from Healthy People 2030 Leading Health Indicators (health.gov) to provide information and support to the Hispanic and Latino populations. “Type 2 diabetes (T2D) affects more than 415 million people worldwide and is predicted to be the 7th leading cause of death in 2030. T2D is particularly prevalent in Latin Americans (14.4%, twice as high as for non-Hispanic whites in the US), where it is one of the leading causes of death. While different environmental and lifestyle risk factors in Latin America partially explain the increased prevalence of T2D, unique genetic influences also contribute” (Mercader & Florez, 2017). In my everyday practice, I take care of patients with diabetes and related complications. Pandemics and working on Covid units are a learning experience. I have noticed that the majority of Hispanic and Latino patients that I took care of who experienced complications due to the SARS-CoV-2 virus suffered from diabetes mellitus as well. It made me realize the need for education and management in the cultural group.

The poster created for Transcultural Nursing NR 394 “Risk for diabetes among Hispanics and Latino population” is divided into five sections: cultural community, health issue, clinical impact, best practice tips, and references. In “Cultural community” I described the population, increased risk for type 2 diabetes, and healthy people indicator. “Health issue” talks about diabetes prevalence among the ethnic group. “Clinical impact” includes the patient’s experience. All patients need to be educated about a healthy lifestyle, the importance of a balanced diet, exercise, and weight management. Nurses can help hospitalized patients make healthy choices while ordering meals. All overweight, obese patients and those with elevated fasting glucose should have hemoglobin A1c checked and followed upon. Health professionals should understand cultural and ethnic predispositions; however, stereotyping should be avoided. “Best practice tips” focuses on understanding traditional cultural practices. Family plays an important role in adaptations. Traditional cuisine includes rice, beans, tortillas, and cooking oil. Those accultured to the mainstream behaviors demonstrate “higher fat and artificially sweetened beverage intake, as well as lower fruit and vegetable consumption. The introduction of processed foods and sweets has also been reported” (Mora & Golden, 2017). Also, many Hispanics and Latinos have limited English language fluency and low health literacy what limits their access to healthcare. It is a heterogeneous community with respect to socioeconomic, psychosocial, and environmental needs.

References:

Mercader, J., Florez, J., (2017). The Genetic Basis of Type 2 Diabetes in Hispanics and Latin Americans: Challenges and Opportunities. Frontiers in Public Health. 5 (12). doi: 10.3389/fpubh.2017.00329Links to an external site.

Mora. N., Golden, S., (2017). Understanding Cultural Influences on Dietary Habits in Asian, Middle Eastern, and Latino Patients with Type 2 Diabetes: A Review of Current Literature and Future Directions. Current Diabetes Reports. 12(17). DOI:10.1007/s11892-017-0952-6

https://www.cdc.gov/healthcommunication/pdf/audience/audienceinsight_culturalinsights.pdfLinks to an external site.

https://www.census.gov/quickfacts/fact/table/mchenrycountyillinois/PST045219Links to an external site.

https://health.gov/healthypeopleLinks to an external site.

My focus was on 65+ Turks living in the United States. There is an increase in Turks in the community I serve.

Hypertension was the health issue focused on due to heart disease being the leading cause of death in most racial and ethnic groups.

Most ethnic populations live in underserved areas and lack access to healthcare. Language barriers are an issue when it comes to compliance and many older adults are fearful of their neighborhoods and will not go far from home. Bringing the education and healthcare to their homes or their neighborhoods is a good way to manage hypertension and chronic conditions. MaschinoNR394CourseProjectPart3-1.pptx

I chose the Adult Filipino population because of the prominence in my area. I have many coworkers and patients that are Filipino, and I wish to learn more about the culture. Because of the prominence in my community, learning more about the Filipino culture will allow me to provide more culturally competent care in my workplace. The reason I chose cigarette smoking in the Filipino population is due to the prevalence of smoking in the Filipino culture that I see in my community. “Many Asian Americans emigrate from countries where smoking prevalence is high and smoking among men is the social norm” (CDC, 2020).

2. Health issue selected and why:

The health issue from the chosen Filipino population is cigarette smoking in adults. The Healthy People 2030 goals are related to evidence-based initiatives and represent high-priority public health concerns (Reduce current cigarette smoking in adults, n.d.). The issue identified is cigarette smoking in adults, with the objective to reduce cigarette smoking in adults. This habit can accelerate the disease process of many chronic diseases that the Filipino population may already be prone to. “Smoking harms nearly every organ in the body and increases the risk of heart disease, stroke, lung diseases, and many types of cancer” (U.S. Department of Health and Human Services, 2014). The health issue of cigarette smoking in adults was selected because this remains an ongoing problem despite the knowledge of the health issues cigarette smoking causes. In addition, Cigarettes are the most common tobacco product used in US adults. “More than 16 million adults in the United States have a disease caused by smoking cigarettes, and smoking-related illnesses lead to half a million deaths each year” (U.S. Department of Health and Human Services, 2014). I believe that more education needs to be provided to adults in addition to providing resources that are more readily available to assist people in quitting.

3.Key points from poster:

Cigarette smoking remains the leading cause of preventable disease and death in the United States.
1. Filipino Americans have significantly higher rates of cancer, diabetes and cardiovascular disease than Americans overall (Smith, 2018).
1. Research suggests that social networks influence smoking cessation and prevention in these populations. Social support can be a great tool in preventing and cessation of cigarette smoking.