Health equity: A concept analysis.

BACKGROUND: Although health equity is critically important for healthcare delivery, there are inconsistencies in its definitions or lack of definitions. PURPOSE: Develop a comprehensive understanding of health equity to guide nursing practice and healthcare policy. METHOD: Walker and Avant's concept analysis method was used to establish defining attributes, antecedents, consequences, and empirical referents of health equity. FINDINGS: Health equity defining attributes are grounded in ethical principles, the absence of unfair and avoidable differences, and fair and just opportunities to attain a person's full health potential. Health equity antecedents are categorized into environmental; financial or economic; law, politics, and policy; societal and structural; research; and digital and technology. DISCUSSION: Health equity's antecedents are useful to distinguish health disparities from health outcomes resulting from individual preferences. To achieve health equity, organizations need to focus on addressing the antecedents.

The Experiences of United States Emergency Nurses Related to Witnessed and Experienced Bias: A Mixed-Methods Study.

INTRODUCTION: The purpose of this study was to obtain a broad view of the knowledge, attitudes, beliefs, and lived experiences of emergency nurses regarding implicit and explicit bias. METHODS: An exploratory, descriptive, sequential mixed-methods approach using online surveys and focus groups to generate study data. Two validated instruments were incorporated into the survey to evaluate experiences of microaggression in the workplace and ethnocultural empathy. Focus group data were collected using Zoom meetings. RESULTS: The final sample comprised 1140 participants in the survey arm and 23 focus group participants. Significant differences were found in reported experiences of institutional, structural, and personal microaggressions for non-white vs white participants. Respondents who identified Christianity as their religious group had lower mean scores on items representing empathetic awareness. Respondents who identified as nonheterosexual had significantly higher mean total Scale of Ethnocultural Empathy scores, empathetic awareness subscale scores, and empathetic feeling and expression subscale scores. Thematic categories that arose from the focus group data included witnessed bias, experienced bias, responses to bias, impact of bias on care, and solutions. DISCUSSION: In both our survey and focus group data, we see evidence that racism and other forms of bias are threats to safe patient care. We challenge all emergency nurses and institutions to reflect on the implicit and explicit biases they hold and to engage in purposeful learning about the effects of individual and structural bias on patients and colleagues. We suggest an approach that favors structural analysis, intervention, and accountability.

Preterm Infant Incubator Humidity Levels: A Systematic Review.

BACKGROUND: Numerous scholars have reported that inconsistent levels of incubator humidity in the neonatal intensive care unit (NICU) require attention. Evidence synthesis was needed to identify optimal incubator humidity levels and duration to decrease transepidermal water loss (TEWL) and the potential for infection. PURPOSE: The purpose of this systematic review was to appraise and synthesize the evidence of preterm outcomes related to incubator humidity. The primary aim of this study was to determine how patient outcomes were impacted by incubator humidity levels and duration in premature infants born before 320/7 weeks cared for in the NICU. METHODS/SEARCH STRATEGY: The foundation of this systematic review was the Joanna Briggs Institute method for systematic reviews. Mefford's theory of health promotion for the preterm infant was used to address the wholeness of the preterm infant's body system. Evidence was classified using the Johns Hopkins evidence-based practice levels and quality of evidence. FINDINGS: Twelve studies met inclusion criteria. The evidence demonstrated that the practice of incubator humidity is warranted; however, it does not come without risks. Microbial growth was increased in high levels of incubator humidity. Unnecessary TEWL was prevented by lowering high levels of incubator humidity after the first week of life, improving skin barrier formation. IMPLICATIONS FOR PRACTICE: Incubator humidity of 60% to 70% in the first week of life was effective in preventing TEWL in infants born 26 weeks or more. IMPLICATIONS FOR RESEARCH: Future incubator humidity research is needed for infants born before 26 weeks.Video Abstract available athttps://journals.lww.com/advancesinneonatalcare/Pages/videogallery.aspx?autoPlay=false&videoId=39.

Survivors Perceptions of Recovery following Air Medical Transport Accidents.

Abstract Objective: Air medical transport (AMT) teams play an essential role in the care of the critically ill and injured. Their work, however, is not without risk. Since the inception of the industry numerous AMT accidents have been reported. The objective of this research is to gain a better understanding of the post-accident sequelae for professionals who have survived AMT accidents. The hope is that this understanding will empower the industry to better support survivors and plan for the contingencies of post-accident recovery. Methods: Qualitative methods were used to explore the experience of flight crew members who have survived an AMT accident. "Accident" was defined using criteria established by the National Transportation Safety Board. Traditional focus group methodology explored the survivors' experiences following the accident. Results: Seven survivors participated in the focus group. Content analysis revealed themes in four major domains that described the experience of survivors: Physical, Psychological, Relational and Financial. Across the themes survivors reported that industry and company response varied greatly, ranging from generous support, understanding and action to make safety improvements, to little response or action and lack of attention to survivor needs. Conclusion: Planning for AMT post-accident response was identified to be lacking in scope and quality. More focused efforts are needed to assist and support the survivors as they regain both their personal and professional lives following the accident. This planning should include all stakeholders in safe transport; the individual crewmember, air medical transport companies, and the industry at large.

The Experience of Women With Opioid Use Disorder Accessing Methadone Treatment.

ABSTRACT: The number of women experiencing opioid use disorder (OUD) in Canada has increased exponentially. In Canada, healthcare is socialized and free for all citizens and, often, medications like methadone are free as well, yet few individuals with OUD access treatment services. The purpose of this study was to describe the lived experiences of Canadian women with OUD who were receiving methadone treatment. Interpretive phenomenology was used to investigate the treatment experiences of seven women with OUD. The conceptual framework of self-care of chronic illness was used to examine this phenomenon. Data were analyzed using a seven-step process of interpretive phenomenological analysis. Four major themes emerged: learning how to be you again, reaching out for help, finding your way to methadone, and going down the path of methadone. Women's experiences were influenced by family, friends, and healthcare providers. Accessibility and self-determination were important factors in entering and sustaining treatment. This study contributes to the discipline of nursing by providing accurate information regarding women's experiences with OUD and uncovering practice changes that can attract and retain women in treatment.