DNP 825 TOPIC 3 DQ 2

DNP 825 TOPIC 3 DQ 2

Sample Answer for DNP 825 TOPIC 3 DQ 2 Included After Question

Describe a scenario in which a patient’s culture might impact health literacy. What measures would you employ to address this health literacy barrier? What kinds of quality improvements could your institution make to reduce similar health literacy barriers? How does increased health literacy contribute to better health outcomes for individuals in particular cultural groups? Provide relevant examples and literature to support your answer.

A Sample Answer For the Assignment: DNP 825 TOPIC 3 DQ 2

Title:  DNP 825 TOPIC 3 DQ 2

Many women of Middle Eastern descent have a challenging time accepting gynecological care from a male provider and/or obtaining a pelvic examination when in the Emergency Department (ED) for various obstetric and gynecological chief complaints. With recurrent incidents of patients declining to have a pelvic exam performed in order to receive the correct diagnosis and treatment, a new option has been given to these individuals.  Providers and nursing staff work together to offer patients a self-swab option for wet-mounts, urogenital cultures, gonorrhea and chlamydia.  Self-collected vaginal swabs have been compared to physician-collected swabs in order to distinguish the reliability and effectiveness of diagnosing sexual transmitted infections and reproductive tract infections. According to Khan et.al., (2019) self-collected swabs have shown similar predictive values in comparison to provider-collected results. This patient led intervention can assist community-based clinics that have less resources and can help women who do not feel comfortable with speculum exams. Within the ED, a patient with gynecological symptoms will be offered a speculum exam. If the patient declines, a provider will order all tests with a self-collected option. The nurse will be responsible for educating the patient on the number of swabs (typically three), how to obtain each swab, how to properly secure the swab containers, and where to place them after completion. This education must be geared towards the patient’s learning level and must be in the patient’s preferred language. The department has multiple interpreters on wheels to aid in translation, to ensure proper education is given and to ensure the patient has a full understanding of the testing process. This intervention assists not only women of Middle Eastern descent, but all women wanting to seek healthcare for conditions that are private and perceived as an uncomfortable situation. A self-collection option assists individuals to return for gynecological chief complaints with less hesitation and builds a more comfortable relationship between staff and patients. A quality improvement initiative to enhance use of self-collected vaginal swabs can ultimately improve efficiency, elevate standard of care, and increase patient satisfaction for women of all ages and ethnic backgrounds (Hazel, Dallaire, & Kottke, 2020).  

Hazell, M., Dallaire, J., & Kottke, M. (2020). 63. implementing self-collected vaginal swabs as routine patient care: A Quality Improvement initiative. Journal of Pediatric and Adolescent Gynecology, 33(2), 205. https://doi.org/10.1016/j.jpag.2020.01.137 

Khan, Z., Bhargava, A., Mittal, P., Bharti, R., Puri, P., Khunger, N., & Bala, M. (2019). Evaluation of reliability of self-collected vaginal swabs over physician-collected samples for diagnosis of bacterial vaginosis, candidiasis and trichomoniasis, in a resource-limited setting: A cross-sectional study in India. BMJ Open9(8). https://doi.org/10.1136/bmjopen-2018-025013 

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A Sample Answer 2 For the Assignment: DNP 825 TOPIC 3 DQ 2

Title:  DNP 825 TOPIC 3 DQ 2

Describe a scenario in which a patient’s culture might impact health literacy. What measures would you employ to address this health literacy barrier? What kinds of quality improvements could your institution make to reduce similar health literacy barriers? How does increased health literacy contribute to better health outcomes for individuals in particular cultural groups?  

A patient’s cultural influences shapes beliefs and attitudes, and consequently has an influence on health literacy. An example of this is seen in a scenario where an old woman of Mexican origin who only speaks Latino/Hispanic is escorted by her granddaughter to seek treatment for an infection on the left leg. The attending physician only speaks English language and explains to the patient that her leg could get worse if not treated as prescribed. The granddaughter could not translate the concept of infect in Hispanic/Latin language as explained by the doctor. The patient become frustrated and just indicated that she understood what the physician said. She indicated that she was to attend a Mexican traditional ceremony over the weekend and it would require her to be barefoot. The granddaughter translated this information to the physician, who restated that the patient should take the medication as prescribed and rest at home until she healed. The patient insisted that she understood, but in fact she had not understood the physician’s explanation. As a result, she opted to visit a traditional healer upon leaving the facility following which she discarded the prescribed medication and instead used the traditional medicine. As a result, the wound worsened and the leg had to be amputated a few weeks later. The physician ascribed the situation to the patient’s non-compliance.

An important measure for addressing the language barrier is linguistic competence. The patient has limited English proficiency and her native language is not English. Culture gives meaning to health education. As such, the health literacy must be understood and addressed in the context of culture and language. This would require that a translator be engaged. In dealing with patients who may not understood English language, it would be important to ensure that translation services are availed. In addition, it is important to apply tools for measuring the health literacy of the patients. This would help in ensuring that health information is presented in a language and vocabulary they can understand (Stanhope & Lancaster, 2020). Besides that, the medical personnel should be provided with opportunities to experience the patients cultures by providing them with workshops, presentations and hands-on experiences in selected cultures. This exposes them to what the cultures entail, thus improving their cultural awareness and improving their capacity to communicate (Truglio-Londrigan & Lewenson, 2018).

References

Stanhope, M., & Lancaster, J. (2020). Public Health Nursing: Population-Centered Health Care in the Community. Elsevier, Inc.

Truglio-Londrigan, M., & Lewenson, S. (Eds.) (2018). Public Health Nursing: Practicing Population-Based Care (3rd ed.). Jones & Bartlett Learning, LLC.

A Sample Answer 3 For the Assignment: DNP 825 TOPIC 3 DQ 2

Title:  DNP 825 TOPIC 3 DQ 2

According to the Centers for Disease Control and Prevention (CDC) (2022), personal health literacy is the degree to which a person not only can comprehend but apply the information thus enabling them to make an informed decision based on individual needs. The CDC further defines organizational health literacy as the ability of the organization or institution to enable people to find and use health information. Many Somalian refugees have been resettled in North Dakota. There has been a large gap in culturally sensitive care for these refugees, especially when they are seeking obstetric care. There are differences in healthcare expectations, what causes disease, and how the disease should be treated. Somali refugee women have poor health-seeking behavio, resultings in worse adverse pregnancy outcomes (Agbemenu et al., 2019).

           Women from Somalia believe the Quran can be used as a treatment and there are some religious prohibitions for treatment (Clarkson Freeman et al., 2013). Further if something ill-expected happens, the belief is that it is God’s will (Clarkson-Freeman et al., 2013). This has caused delays or apprehension to have a cesarean section (C-section). According to Narruhn (2018), Somalian women try to avoid a C-section while physicians encourage it to save the women’s lives.  With the language gap, when interpreters are used, females are less likely to share information with a male interpreter compared to a female counterpart.

           One intervention performed at the facility was to create a video spoken by a medical Somalian female interpreter. This video explains the birthing process in a culturally sensitive manner. It describes the reason for the different medical interventions and why they are being performed. Pregnant Somali women can view this video in the outpatient clinic to help with prenatal education. There is an I-pad that accesses medical interpreters. However, one cannot select the gender of the interpreter which can be challenging. By improving health literacy at the organizational level, individuals can make informed decisions thus enhancing their health literacy as well. The first step is to develop trust, remain non-judgmental, respect the culture, and develop an understanding of the culture that will help to reduce the uncertainties and concerns for the women and, ultimately, improve outcomes.

References

Agbemenu, K., Banke-Thomas, A., Ely, G. & Johnson-Agbakwu, C. (2019). Avoiding obstetrical interventions among US-based Somali migrant women: a qualitative study. Ethnicity & Health, 26(7). Doi: https://doi.org/10.1080/13557858.2019.1613519.

Centers for Disease Control and Prevention. (2022, February 2nd). What is health literacy? https://www.cdc.gov/healthliteracy/learn/index.html.

Clarkson Freeman, P. A., Penney, D. S., Bettmann, J. E., Lecy, N. (2013). The intersection of health beliefs and religion among Somali refugees: a qualitative study. Journal of Religion and Spirituality in Social Work, 32 (1), 1-13. Doi: https://doi.org/10.1080/15426432.2013.749141.

Narruhn, R. A. (2018). Administrator perspectives of patient-centered and culturally appropriate reproductive health care for women from Somalia. Journal of Obstetric, Gynecologic & Neonatal Nursing, 47(5), 641-653. Doi: https://doi.org/10.1016/j.jogn.2018.05.005.

Grading Rubric Accomplished Emerging Unsatisfactory Content Points Range:62.25 (41.50%) – 75 (50.00%) Responds clearly, thoroughly, and effectively to all aspects of the assignment. All content is accurate and/or supported. Points Range:57 (38.00%) – 61.5 (41.00%) Responds adequately to the assignment but may not be thorough. Points Range:0 (0.00%) – 56.25 (37.50%) Does not respond to the assignment. Focus and Detail Points Range:31.125 (20.75%) – 37.5 (25.00%) There is a clear, well-focused topic. Main ideas are clear and are well supported by detailed and accurate information gathered from scholarly sources. Points Range:28.5 (19.00%) – 30.75 (20.50%) There is a clear, well-focused topic. Main ideas are clear but are not well supported by scholarly sources and detailed information. Points Range:0 (0.00%) – 28.125 (18.75%) The topic and main ideas are not clear. Organization Points Range:18.675 (12.45%) – 22.5 (15.00%) The introduction is inviting, states the main topic, and provides an overview of the paper. Information is relevant and presented in a logical order. The conclusion is strong. Points Range:17.1 (11.40%) – 18.45 (12.30%) The introduction states the main topic and provides an overview of the paper. A conclusion is included. Points Range:0 (0.00%) – 16.875 (11.25%) There is no clear introduction, structure, or conclusion. Mechanics and APA Points Range:12.45 (8.30%) – 15 (10.00%) The assignment consistently follows current APA format and is free of errors in formatting, citation, and references. There are no grammatical, spelling, or punctuation errors. All sources are correctly cited and referenced. Points Range:11.4 (7.60%) – 12.3 (8.20%) The assignment consistently follows current APA format with only isolated and inconsistent mistakes and/or has a few grammatical, spelling, or punctuation errors. Most sources are correctly cited and referenced. Points Range:0 (0.00%) – 11.25 (7.50%) The assignment does not follow current APA format and/or has many grammatical, spelling, or punctuation errors. Many sources are incorrectly cited and referenced or citations and references are missing.

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