1. Understanding and Eliminating Health Disparities in the LGBTQ+ Population
Jenna Indingaro
University of New Hampshire
Department of Nursing
Research Implications
Research in this topic is beginning to be explored in length recently due to the increasing popularity of the LGBTQ+ community.
Limitations of the literature overview includes:
Location of research survey
Personal experience and impressions on healthcare/biased
Limited data available on topic
Lack of healthcare provider involvement in research exploration
Clinical Implications
This is being brought to the attention of Winchester Hospital because the LGBTQ+ population is growing and becoming more prominent across the United States. Educating staff and developing standards of care in everyday practice will enable Winchester Hospital to be culturally competent with this population group.
Practice Recommendations
Leading clinical recommendations based off the literature and interviews with members of the LGBTQ+ community include:
Healthcare provider’s pronouns represented on hospital name badges
Modified introductions to patients
Addressing patient’s preferred pronouns when filling out the whiteboards in each room upon admission/transfer to the unit
Clinical Question
How would the implication of a hospital policy promoting practice recommendations and required education for staff on the LGBTQ+ community be beneficial for this population in the healthcare setting?
Problem
Negative healthcare encounters are commonly reported by lesbian, gay, transgender, and queer/questioning (LGBTQ+) patients. These negative experiences range from medical professionals using inappropriate gender pronouns and negative or inflammatory statements regarding patients' sexual experiences or lifestyle to outright refusal of treatment (Parameshwaran, Cockbain, Hillyard, & Price, 2017).
Goal
To illustrate how care providers can provide equitable care through anticipating LGBTQ+ vulnerability in their practice.
The expected outcome is that members of the LGBTQ+ community will be able to develop trust and a sense of comfort in their care providers, resulting in a better overall healthcare experience.
Members of the LGBTQ+ population report feeling comfortable when seeking medical advice and do not encounter discrimination or inadequate care from their care providers.
Clinical Implications
A study by Parameshwaran, Cockbain, Hillyard, and Price (2017) shows that 84.9% of participants reported a lack of LGBTQ+ healthcare education, with deficits in confidence clarifying unfamiliar sexual and gender terms, deciding the ward in which to nurse transgender patients, finding support resources, and discussing domestic abuse with LGBTQ+ patients.
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Coronary and Intensive Care. (2017). Retrieved from
Percent
(Parameshwaran, Cockbain, Hillyard, & Price, 2017)
A focus group was collected from Safe Zone members that identify as LGBTQ+. This group agreed that healthcare professionals wearing pronouns on their nametags would symbolize an understanding to sexual identity differences. Additionally, addressing the patient’s preferred pronouns is important “to indicate respect towards each patient and letting them know it’s safe to identify freely in the hospital setting (personal communication, March 20, 2019).”
This push to normalize pronoun identification is also seen as Searle explains that “when LGBTQ+ patients access healthcare services, heteronormative practices create a context that is often perceived as unsafe to disclose their identity (2019).” Heterosexuality is what our culture finds normal, natural, and what’s to be expected. By advocating for pronoun identification in all social settings, this heteronormative practice begins to dissipate into a more inclusive culture.
Epic’s “Sexual Orientation and Gender Identity Smart Form”
Patient gender identity
Patient sex assigned at birth
Patient preferred pronouns
Steps patient has taken in transitioning, if applicable
Patient’s future plans for transition, if applicable
Policy development that promotes a required one-time educational course on LGBTQ+ definitions, concepts, and terminology