護理的未來:健康公平

不論種族、國籍、民族、文化、性取向、性別、性別認同、年齡、教育和心理或身體能力如何,所有患者都應該獲得最高品質的醫療保健。

37131640948521974 

分享智慧

共同成長

Full text

In his Notes on Surgical Nursing, published in England in 1874, Dr J. H. Barnes wrote that a surgical nurse needs to “have an eye as well to the future as the immediate present.”1(p71) Although he was referring to the nurse’s need to anticipate what might be required during a surgical procedure, the same could be said about nurses’ need to look to the future and the evolution of the nursing profession.

A few years after I graduated with my bachelor’s degree in nursing, the Institute of Medicine (now the National Academy of Medicine) published The Future of Nursing: Leading Change, Advancing Health.2 This report recognized the importance of the role of nurses in improving health care, and provided recommendations to strengthen the nursing workforce through education and enhanced roles in practice and leadership. Ten years later, the National Academies of Sciences, Engineering, and Medicine has released a follow-up report, The Future of Nursing, 2020-2030: Charting a Path to Achieve Health Equity.3 While the former report spoke to strengthening the expertise of the nursing workforce, the 2021 report provides an agenda for using that expertise.3

Although it is not possible to thoroughly summarize this more than 500-page report here, the emphasis of the report is that nurses should be prepared for and engaged in “the complex but essential work of advancing health equity, addressing [social determinants of health], and meeting social needs of individuals and families.”3(pxv) According to the Robert Wood Johnson Foundation,

Health equity means that everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as poverty, discrimination, and their consequences, including powerlessness and lack of access to good jobs with fair pay, quality education and housing, safe environments, and health care. 4

Achieving health equity encompasses working to eliminate differences in health outcomes and access to health care that are based on systemic barriers, such as lower socioeconomic status, racism, and other forms of discrimination.3 The nine major recommendations from the 2021 National Academy of Medicine report are aimed at nursing organizations, government agencies, public health organizations, payers, education programs, employers, and nurse leaders to help prepare nurses for these efforts. The first recommendation reads, in part, “In 2021, all national nursing organizations should initiate work to develop a shared agenda for addressing social determinants of health and achieving health equity.”3(p13)

AORN’S EFFORTS

As a nursing organization, AORN is dedicated to improving health care equity through efforts to strengthen diversity, equity, and inclusion (DEI).5 The goals in AORN’s DEI plan are to increase diversity in the workforce, its membership, and its board of directors; to develop and implement programs that support communities of color; and to educate perioperative teams on the effects of health care disparities on outcomes of surgical care.5 The AORN National Committee on Education has been charged with exploring the significance of social determinants on health care of the perioperative patient and evaluation in the preoperative environment. There is a lot of work being done within AORN in regards to diversity, equity, and inclusion. For the most up-to-date look at this important work, please visit the AORN DEI web page at http://www.aorn.org/about-aorn/dei. This web page contains links to blogs, articles, position statements, and continuing education.

CONCLUSION

All patients deserve to receive the highest quality of health care regardless of race, nationality, ethnicity, culture, sexual orientation, gender, gender identity, age, education, and mental or physical ability. As patient advocates who work in many different types of communities, facilities, and roles, nurses are well positioned to collaborate with other medical professionals to improve health equity for all citizens. The resources AORN provides are important tools to help our members move equity initiatives forward.

全文翻譯(僅供參考)

在1874 年在英國出版的《外科護理筆記》中,JH Barnes 博士寫道,外科護士需要“既要著眼于眼前,也要著眼于未來”。

(p71)雖然他指的是護士需要預測手術過程中可能需要什麼,但同樣可以説護士需要展望未來和護理行業的發展。

在我獲得護理學士學位幾年後,醫學研究所(現為美國國家醫學院)出版了《護理的未來:引領變革,促進健康》一書。

2

該報告承認護士在改善醫療保健方面的作用的重要性,並提出了通過教育和增強實踐和領導作用來加強護理人員隊伍的建議。十年後,美國國家科學院、工程院和醫學院發佈了一份後續報告《護理的未來,2020-2030:制定實現健康公平的道路》。3雖然前一份報告談到加強護理人員的專業知識,但 2021 年的報告提供了使用該專業知識的議程。

3

儘管無法在此全面總結這份超過 500 頁的報告,但該報告的重點是護士應做好準備並從事“促進健康公平、解決[健康的社會決定因素]的複雜但必不可少的工作” ,並滿足個人和家庭的社會需求。” 3 (pxv)根據羅伯特伍德約翰遜基金會的説法,

健康公平意味著每個人都有公平公正的機會盡可能保持健康。這需要消除貧困、歧視等健康障礙及其後果,包括無力和無法獲得薪酬公平的好工作、優質教育和住房、安全環境和醫療保健。 

4

實現健康公平包括努力消除基於系統性障礙(例如較低的社會經濟地位、種族主義和其他形式的歧視)在健康結果和獲得醫療保健方面的差異。3 2021 年美國國家醫學院報告中的九項主要建議針對護理組織、政府機構、公共衛生組織、付款人、教育計劃、僱主和護士領導,以幫助護士為這些工作做好準備。第一條建議部分內容是:“到 2021 年,所有國家護理組織都應著手制定一項共同議程,以解決健康問題的社會決定因素並實現健康公平。” 3 (p13)

奧恩的努力

作為一家護理組織,AORN 致力於通過努力加強多樣性、公平性和包容性 (DEI) 來改善醫療保健公平性。5 AORN 的 DEI 計劃的目標是增加勞動力、成員和董事會的多樣性;制定和實施支援有色人種社區的計劃;並就醫療保健差異對手術護理結果的影響對圍手術期團隊進行教育。5AORN 國家教育委員會負責探索社會決定因素對圍手術期患者的醫療保健和術前環境評估的重要性。AORN 在多樣性、公平性和包容性方面做了很多工作。有關這項重要工作的最新資訊,請訪問 AORN DEI 網頁,網址為http://www.aorn.org/about-aorn/dei。此網頁包含指向部落格、文章、立場聲明和繼續教育的連結。

結論

不論種族、國籍、民族、文化、性取向、性別、性別認同、年齡、教育和心理或身體能力如何,所有患者都應該獲得最高品質的醫療保健。作為在許多不同類型的社區、設施和角色中工作的患者倡導者,護士有能力與其他醫療專業人員合作,以改善所有公民的健康公平。AORN 提供的資源是幫助我們的成員推進公平倡議的重要工具。

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