NURS FPX 4900 Preconception Care Intervention Black Maternal Health Capstone
NURS FPX 4900 Preconception Care Intervention Black Maternal Health Capstone
Develop an intervention (your capstone project), as a solution to the patient, family, or population problem you’ve defined. Submit the proposed intervention to the faculty for review and approval. This solution needs to be implemented (shared) with your patient, family, or group. You are not to share your intervention with your patient, family, or group or move on to Assessment 5 before your faculty reviews/approves the solution you submit in Assessment 4. In a separate written deliverable, write a 5-7 page analysis of your intervention.
Please submit both your solution/intervention and the 5-7 page analysis to complete Assessment 4.
Health Crisis among Babies and Women of Color
June 27th 2021
Assessing the Problem: Health Crisis among Babies and Women of Color
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. NURS FPX 4900 Preconception Care Intervention Black Maternal Health Capstone
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 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. 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.
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.
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.
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
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