Week 3 Check-In: Course Project Part 1 (Graded)

NR 394 Transcultural Nursing

Week 3: Course Project Part 1Check-In

Directions: Prior to completing this template, carefully review Week 3: Course Project Part 1 Check-In Directions paying attention to how to name the document and all rubric requirements.

Your Name:

1. Choose a specific cultural/ethnic population that is in your area, clinical practice, or community but different than your own culture.

The chosen population for this project is Hispanics.

• Identify a health problem or need for health promotion from your chosen cultural population, based on the Leading Health Indicators (LHI) priorities from Healthy People. (See the HealthyPeople.gov Leading Health Indicators website link in the Assignment Guidelines for this assignment). This might include a specific age or gender. You will use the specific cultural focus to complete your assignment.

            The identified health issue is obesity. Obesity is defined as a disorder characterized by excessive body facts that increases the risk of getting health issues. According to Healthy People 2020 (2021), lack of proper diet, physical activity, and healthy body weight can be attributed to the dramatic increase in obesity. Today, nearly one in three adults has obesity and one in six children and adolescents are obese. Obesity is a risk factor for many serious health conditions and chronic diseases such as many forms of cancer, high blood pressure, high cholesterol, diabetes, heart disease and stroke, and osteoarthritis, which are among the top causes of death. Other than dire health consequences, obesity and overweight can also lead to increased medical costs and heavy burden on the health care delivery system. As such, the issue of obesity is timely and need to be focused on.

            According to (CDC 2021), ethnic groups such as Hispanics are disproportionally affected by obesity than other groups with about 44.8% of Hispanic adults having the highest age-adjusted incidences of obesity. CDC also reported that the incidence of Obesity is 40.0% among adults aged between 20 and 39, 44.8% among adults in the age range of 40 to 59 years, and 42.8 among the adults in the age range of 60 and above. As such, the focus of this course project will be adults aged between 40 and 59 years since they are the most affected age group (CDC, 2021).

• Ask at least one question of your instructor that could help you do your best on the Course Project Part 1 Assignment.

            Does the chosen topic sound appropriate in the course project? Is it necessary to include specific age for study given that individuals get more mature and also the occurrence of many life events in these years that can possible change variables?

Statement from instructor on cultural/ethnic population and health problem/need based on LHI priorities from Healthy People:

• Accepted
• Accepted with revisions needed
• Not accepted.

*Any required revision will not alter your grade for this assignment. *

References

CDC. (2021). Adult Obesity Facts. Retrieved 2021, from https://www.cdc.gov/obesity/data/adult.html

Healthy People 2020. (2021). Nutrition, Physical Activity, and Obesity. Retrieved 2021, from https://www.healthypeople.gov/2020/leading-health-indicators/2020-lhi-topics/Nutrition-Physical-Activity-and-Obesity

Hello Class and Julie!

Reflect on how to apply cultural awareness to communication in your current clinical practice.

As nurses, we need to be aware of ways we communicate verbally as well as non-verbally to our patients to eliminate fears as well as educate them.  Whether we are using  a visual aid to help an intubated patient communicate or a translation system to help a non-English speaking patient understand their care, we need to be open minded, adaptive and embrace the tools we have at our fingertips.   As part of our admission assessment, one of the first questions asked is, ”what is your preferred language”.  Oftentimes, a patient can come in and speak just enough English to answer questions but not fully comprehend.  By addressing this within the first few minutes of our interaction we can better serve and safely care for the patient. 

Share an example of miscommunication that occurred as a result of this diversity and whether an adverse outcome resulted.

Recently we received a Spanish speaking patient to our department for a fistulagram.  This patient was scheduled from her dialysis unit for a slow flowing AV fistula.  Our procedure is simple, local anesthetic, conscious sedation, access the fistula, inject contrast, evaluate and treat.  When she was greeted by the IR staff, she said, she did not understand English. I contacted the sending unit to inquire how they had been communicating to the patient (I was also frustrated that this was not communicated to me in the report.)  They said her son was with her but had left. We retrieved the MARTTI (My Accessible Real-Time Trusted Interpreter) and began communicating.  This patient believed that she was having a new fistula created and was planning to go into surgery.  I am not sure where the miscommunication happened: dialysis, sending unit, family as translator.  Needless to say, she was relieved to learn that her existing fistula would remain, not a new one created, we were simply going to fine tune her existing access. In this example, no adverse outcomes resulted, however, this patient was nervous and apprehensive awaiting what she thought was another lengthy surgery; the son left with the same assumption.  Her procedure took less than an hour, the findings provided to her by the doctor with the use of the MARTTI and she was sent back to her room, MARRTI in tow. 

Describe how the miscommunication could have been and will be prevented in the future.

One, the dialysis unit does not have a communication system, such as the MARTTI, they rely on family to communicate.  By having the proper translation system in place, the patient and family would have been kept abreast as to her plan of care.  However, our facility has the MARTTI medical translation system and was unfortunately not utilized initially.  The sending unit felt that the son had answered their questions and explained procedures (VS, IV insertion, obtaining history) clearly enough.  When the patient arrived to us, for informed consent, we must ensure that the patient understands the procedure and the risks.  We are not allowed to use family for this because they do not always know medical terminology and we do not know how the procedure is being translated.  We will continue to advocate for the use of the MARTTI and insist that it follow the patient from location to location so that everyone can clearly explain the care they are providing. I found the language service website thinkculturalhealth.hhs.gov interesting and a useful tool that we could use to learn strategies as well as provide effective communication.  I did not create an account to further evaluate this service however it is designed for healthcare providers as well administrators to provide positive outcomes for a diverse population. (https://thinkculturalhealth.hhs.gov/)

Thanks!
Erica Berger

Resource:

The guide. (n.d.). Retrieved March 09, 2021, from https://hclsig.thinkculturalhealth.hhs.gov/Default.asp