Bold Voices - June 2014 - (Page 7)

AT THE BEDSIDE Four tips guide hospitals in creating policies to prevent institutional racism while responding to the needs of patients. I nstitutional racism is a widespread, often-ignored problem that can damage a hospital's equity and compromise the well-being of patients, notes an article in BMJ. Nadeem Moghal, associate medical director at George Eliot Hospital in the United Kingdom, shares a firsthand account in "Allowing Patients to Choose the Ethnicity of Attending Doctors Is Institutional Racism," about parents who requested that only white physicians treat their child. For more than a year, the hospital agreed to the request based on clinical need, reports an article in FierceHealthcare. Although the decision was reversed, the episode points to the need for hospitals to revamp their policies and practices. Institutional racism can be quashed, Moghal writes, by standing up to racially motivated requests, with support from hospital leaders, and confronting the issue immediately. Reporting on a similar case at a Michigan hospital, another article in FierceHealthcare includes four tips from Boston-based health attorney David C. Harlow, when creating such policies: * Tell patients they have the right to refuse treatment but not to demand a certain type of treatment. * Disclose nondiscriminatory policies prominently to patients. * Train employees how to handle patient requests to be treated by a particular race. Specifically, allow health professionals to choose whether they agree to treat a patient with race-based demands. * Remind patients that allowing race-based demands increases the risk of a bad outcome, because it disrupts the institution's usual workflow. The American Medical Association's ethics code bars physicians from "refusing to treat people based on race, gender and other criteria," but there are "no specific policies for handling race-based requests from patients," adds the article in FierceHealthcare. Healthcare organizations, therefore, are encouraged to develop their own guidelines for handling racially motivated requests. Culture of Violence Becoming Normal Much work still required to protect nurses from workplace assaults. A culture of violence against nurses in the workplace continues to exist, along with a level of normalization of this phenomenon among healthcare and law enforcement systems that prevents interventions. "Nothing Changes, Nobody Cares: Understanding the Experience of Emergency Nurses Physically or Verbally Assaulted While Providing Care," in Journal of Emergency Nursing, states that much still needs to be done to protect nurses from workplace assaults. "Interventions on both personal and institutional levels should be developed to address high-risk situations to recognize and mitigate violence, rather than manage post-event sequelae." Some easily identifiable causes that may contribute to the risk of violence against nurses (including overcrowded emergency departments, limited behavioral health beds and an increasing number of patients who require these beds) are addressed in a related article in The Daily Briefing. Violence prevention programs, in partnership with the facilities' security teams, help employees recognize warning signs and know what to do if the risk of violence occurs, the article adds. Cue recognition is particularly important. Examples from the study note that several nurses who reported being victims of violence gave detailed cues in their narratives but were surprised when the violence occurred. 7 AACN BOLD VOICES JUNE 2014 Institutional Racism Can Damage Healthcare

Table of Contents for the Digital Edition of Bold Voices - June 2014

Another Angle
Pres Note Teaser
‘Take a Chance to Make a Change in Your Patients’ Lives’
New Mobile App Launched: AACN Bedside
AACN Research Grants Continue to Drive Evidence-Based Care
AACN Scholarships to Develop Training Skills and Professional Growth
Institutional Racism Can Damage Healthcare
Culture of Violence Becoming Normal
Nip Ethical Violations in the Bud
Up to Half of Prescribed Antibiotics Unnecessary, Inappropriate
Minimal Sedation, Early Mobilization May Reduce Delirium
Care Transition Programs Reduce Readmissions, Penalties
Unclear Relationship Between Hypothyroidism and Mild Cognitive Impairment
Women Have Unique Stroke Risks
Costs Increase Because of More Inpatient Constipation
Nursing-Supportive Work Environments Linked to Better Care
Smile, You’re on ReadyCam!
Automated EHR-Linked Checklist Greatly Reduces CLABSIs
Online Game Helps Students Identify, Manage Sepsis
Sepsis Detection System More Effective in Patient Diagnosis
In Our Journals
Test Can Predict Breast Cancer Outcomes
Spice It Up With Cinnamon
IHEs: Significant Cause of Preventable ED Visits
Certification Capsules
With Deep Appreciation for Your Generosity
Save the Dates for Progressive Care, Nurse Manager Fall Conferences
AACN Chapters Model Excellence
‘I Am a Critical Care Nurse’
President’s Note

Bold Voices - June 2014