Discussion: Diversity and Health Assessments
May 2012, Alice Randall wrote an article for The New York Times on  the cultural factors that encouraged black women to maintain a weight  above what is considered healthy. Randall explained�from her  observations and her personal experience as a black woman�that many  African-American communities and cultures consider women who are  overweight to be more beautiful and desirable than women at a healthier  weight. As she put it, �Many black women are fat because we want to be�  (Randall, 2012).
Randall�s statements sparked a great deal of controversy and debate;  however, they emphasize an underlying reality in the healthcare field:  different populations, cultures, and groups have diverse beliefs and  practices that impact their health. Nurses and healthcare professionals  should be aware of this reality and adapt their health assessment  techniques and recommendations to accommodate diversity.
In this Discussion, you will consider different socioeconomic,  spiritual, lifestyle, and other cultural factors that should be taken  into considerations when building a health history for patients with  diverse backgrounds. Your Instructor will assign a case study to you for  this Discussion.

CASE STUDY:

EB is a 68-year-old black female who comes in for  follow-up of hypertension. She has glaucoma and her vision has been  worsening during the past few years. She lives alone and is prescribed  four hypertension medications (Hydralazine 50 mg PO Q8H, Metoprolol XL  200 mg PO Q12H, Lisinopril 40 mg PO daily, and HCTZ 25mg PO daily ). She  brings in her medication bottles and she has some medication bottles  from the previous year full of medications. She is missing one  medication she had been prescribed and says she may have forgotten it at  home. Her BP in clinic today is 182/99 with HR of 84.

To prepare:
� Reflect on your experiences as a nurse and on the information  provided in this week�s Learning Resources on diversity issues in health  assessments.
� By Day 1 of this week, you will be assigned a case study by your  Instructor. Note: Please see the �Course Announcements� section of the  classroom for your case study assignment.
� Reflect on the specific socioeconomic, spiritual, lifestyle, and  other cultural factors related to the health of the patient assigned to  you.
� Consider how you would build a health history for the patient.  What questions would you ask, and how would you frame them to be  sensitive to the patient�s background, lifestyle, and culture? Develop  five targeted questions you would ask the patient to build his or her  health history and to assess his or her health risks.
� Think about the challenges associated with communicating with  patients from a variety of specific populations. What strategies can you  as a nurse employ to be sensitive to different cultural factors while  gathering the pertinent information?
Post an explanation of the specific socioeconomic, spiritual,  lifestyle, and other cultural factors associated with the patient you  were assigned.

Explain the issues that you would need to be sensitive to  when interacting with the patient, and why.

Provide at least five  targeted questions you would ask the patient to build his or her health  history and to assess his or her health risks.

NOTE: THIS IS THE LINK TO DOWNLOAD THE BOOK

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Create a 1-2-page resource that will describe databases that are relevant to EBP around a diagnosis you chose and could be used to help a new hire nurse better engage in EBP.

Evidence-based practice (EBP) integrates the best evidence available to guide optimal nursing care, with a goal to enhance safety and quality. EBP is crucial to nursing practice because it incorporates the best evidence from current literature, along with the expertise of the practicing nurse. The concern for quality care that flows from EBP generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise. To gain the knowledge, you require a good understanding of how to search for scholarly resources, as well as identify which databases and websites are credible for the purposes of implementing evidence-based changes in practice.
Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the course competencies through the following assessment scoring guide criteria:

Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
Explain why the sources selected should provide the best evidence for the chosen diagnosis.
Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
Describe the best places to complete research and what types of resources one would want to access to find pertinent information for the diagnosis within the context of a specific health care setting.
Competency 4: Plan care based on the best available evidence.
Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis.
Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
Describe communication strategies to encourage nurses to research the diagnosis, as well as strategies to collaborate with the nurses to access resources.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for providing patient-centered, competent care based on current evidence-based best practices. You will be required to do research, analysis, and dissemination of best evidence to stay abreast of these best practices. Understanding where to go to find credible sources and locate evidence, as well as which search terms to use, is the foundation of incorporation of best practices.
Scenario

You are supervising three nurses working on the medical-surgical floor of a local teaching hospital. This hospital is nationally recognized as a leader in education and has a computer lab with an online library where staff has access to medical research databases (that is, CINAHL, PubMed, Medline, and Cochrane library) and online sources of all hospital policies, procedures, and guidelines, and computers at nurse workstations that also have access to these resources. (For this scenario, use the University Library to simulate the hospital’s online library.) You have given the nurses their patient assignments and you have all participated in shift report. A new nurse who just completed orientation and training a week ago approaches you and tells you that one of the assigned patients has a diagnosis he or she is very unfamiliar with. Knowing that patient-centered care based on best practices is imperative to positive patient outcomes, you want to assist this nurse to find research that can be utilized to provide the best care for this patient. Describe how you would communicate with this nurse to encourage him or her to research the diagnosis. Assume you will assist in the quest to locate evidence, then describe where you would go within the facility and what resources you would look for. These resources may include websites, journals, facility policies or guidelines, or any other sources of online information.

You may choose the diagnosis for the patient in this scenario. Choose something you would find interesting to research or that applies to a clinical problem you would be interested in addressing. Create a list of at least five sources that could be used to find evidence, with the best source listed first, and explain why the sources you chose are best to find evidence for the diagnosis you chose and the clinical scenario. You are only evaluating the sources of evidence (database, website, policy database or website, et cetera). You are not actually completing a search and selecting evidence. Consider the following examples: a nursing journal in CINAHL may not be the best source of evidence for information on how to administer medications through a central-venous catheter, whereas a hospital policy database found on a website may not be the best source of information on caring for a patient with a rare chromosomal abnormality.
Preparation

To help ensure you are prepared to complete this assessment, review the following resources related to the school library. These resources will provide you an overview of the types of tools, resources, and guides available in the library. This may be useful in forming a better understanding of the library to apply to the hypothetical situation laid out in the scenario of this assessment.

BSN Program Library Research Guide.
Evidence-Based Practice in Nursing & Health Sciences.
Databases A-Z: Nursing & Health Sciences.
Get Critical Search Skills.

Remember, it is also appropriate to look toward databases and resources outside of the school library, such as organizational policies, professional organizations, and government health care resources.

You are encouraged to complete the Evaluating the Credibility of Evidence activity. This activity offers an opportunity to practice evaluating the credibility of evidence. These skills will be necessary to complete Assessment 1 successfully and is for your own practice and self-assessment. Completing this activity is also a way to demonstrate course engagement.
Instructions

The purpose of this assessment is to understand where to find evidence that can be applied to clinical scenarios and to learn effective communication and collaboration with clinical staff during the process of evidence location. As a baccalaureate-prepared nurse, you will not only use research for self-improvement in your clinical role, but you will also serve as a mentor to supervised nursing staff. Therefore, you will need to be able to communicate and collaborate effectively to guide them toward resources to find research, as well as support them through the initial evidence location process. In doing so, nurses can gain access to evidence that can be analyzed and utilized to stay current on best practices. This allows them to provide safe, patient-centered care and improve patient outcomes.

For this assessment:

Describe your role as a baccalaureate-prepared nurse supervising clinical staff nurses with regard to communication and collaboration in locating evidence for application to a nursing practice scenario.
Compile a list of five online databases or other online sources (that is, websites, journals, facility policies or guidelines, et cetera) that can be used to research evidence to apply to this scenario and describe to which of these you would direct a nurse colleague to search for evidence.
Describe where you might go in the clinical setting to complete this research and how you would access the desired, relevant research within research databases or other online sources.

Be sure to address the following in this assessment, which correspond to the grading criteria in the scoring guide. Please study the scoring guide carefully so that you will know what is needed for a distinguished score.

Describe communication strategies to encourage nurses to research the diagnosis, as well as strategies to collaborate with the nurses to access resources.
Describe the best places to complete research and what types of resources you would want to access to find pertinent information for the diagnosis within the context of a specific health care setting.
Identify five sources of online information (medical journal databases, websites, hospital policy databases, et cetera) that could be used to locate evidence for a clinical diagnosis.
Explain why the sources of online information selected should provide the best evidence for the chosen diagnosis.
Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Note: While you are not selecting and evaluating specific evidence to help with the clinical diagnosis, you should still be citing the literature and best practices to support your description of your communication and collaboration approach. Additionally, it is appropriate to cite best practices related to EBP and evaluating databases to support your explanation as to why you selected the five sources of online information that you did.
Submission Requirements

Your assessment should meet the following requirements:

Length of submission: 1–2 pages (not including the reference page) informal description of communication, collaboration, and evidence location process, including a list of databases or other sources with description of why they are appropriate for clinical scenario diagnosis (that is, something that would be useable in professional practice for other nurses). Be sure to include an APA-formatted reference page at the end of your submission.
Number of references: Cite a minimum of three sources of scholarly or professional evidence that supports your findings and considerations. Resources…