1. Health Impacts Due to the Lack of Level I Trauma Centers in American Indian and Alaskan Native Communities
Laura Sandoval, Research Advisor: Angel Butron
DePaul University School of Nursing
Background
Findings
Nursing Implications
Methods
Research suggests that the lack of level I trauma centers within the Indian Health Service (IHS) should be investigated as a strategy to improve overall health status and provide economic opportunities for American Indians and Alaskan Natives (AI/AN).
Integrative literature review
Literature was retrieved from databases available at DePaul University
Search terms used were: American Indian, Alaskan Native, Native American, trauma centers, emergency services, traumatic injuries, critical care, disparities, inequality, and emergency health disparities
There were five common themes found throughout this integrative literature review:
The lack of funding for IHS
Children, diabetes, mental health and substance abuse patients utilize emergency departments (ED) the most
Improving the patient-provider relationship
Implementing culturally tailored care management
Facility and staff preparedness
Advocate to ensure that AI/AN communities receive quality emergency care
Address the cultural and spiritual needs of this vulnerable minority
Screen all AI/AN patients for PTSD, depression, and alcohol dependence
Improving communication between patient and provider through increased mutual understanding
Purpose
The purpose of this integrative literature review was to examine the effects of the lack of trauma I centers on AI/AN living on reservations.
Conclusion
The current literature has promising interventions and comprehensive solutions however, more research needs to be conducted to provide a better overall picture of the state of IHS facilities and capabilities.
Conceptual Framework
Healthy People 2020: Focuses on Injury and Violence Prevention
Neuman’s Systems Model: Focuses on human needs such as protection or relief of stress
Figure 1. Location of IHS EDs. Numbers correspond to site number on Figure 2.
Figure 2. Annual ED visits by IHS site.