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通过消除美国的结构性种族主义实现健康公平:护理领导力的行动呼吁。

Achieving Health Equity Through Eradicating Structural Racism in the United States: A Call to Action for Nursing Leadership.

机构信息

Alpha, Psychotherapist, Cathedral Counseling Center, Chicago, IL; Professor, (retired) University of St. Francis, Joliet, IL, USA.

Nu Eta, Professor & Associate Dean of Community-Centered Health & Wellness and Academic Integration, Drexel University College of Nursing and Health Professions, Philadelphia, PA, USA.

出版信息

J Nurs Scholarsh. 2020 Nov;52(6):696-704. doi: 10.1111/jnu.12602. Epub 2020 Oct 1.

Abstract

PURPOSE

To advocate for strategic actions by U.S. nursing leadership that denote the presence, customs, and implications of racism that has been institutionalized within the structures of U.S. nursing leadership and the profession.

ORGANIZING CONSTRUCTS

A racial equity framework is used to examine the barriers to quality health care and equitable health outcomes and to present evidence-based actions to dismantle structural inequities embedded in the nursing profession.

METHODS

This article was developed through a comprehensive literature review and synthesis of relevant research, data, peer-reviewed literature, government reports, and organizational guidelines.

FINDINGS

A commitment by U.S. nursing leadership to eradicate structural racism in nursing must be made in order to effect sustainable transformative change toward more equitable systems of health care.

CONCLUSIONS

This article presents recommendations for nursing leadership in the United States to renew its commitment to quality health care through dismantling structural racism at all levels of direct and systems nursing practice and education, at the bedside, and in the boardrooms.

CLINICAL RELEVANCE

Structural racism in nursing and health care also persists globally as a key social determinant of health. Its elimination aligns with international health care and nursing's policy priorities, yet change can only occur when senior leaders clearly understand it as a key barrier to health, and commit to transformative change in how their "systems" work. These recommendations can also be culturally adapted by global nursing for use in antiracism work.

摘要

目的

倡导美国护理领导层采取战略行动,表明美国护理领导层和护理专业内部体制化的种族主义的存在、习俗和影响。

组织构建

采用公平性框架来审查医疗质量和公平性健康结果的障碍,并提出基于证据的行动,以消除护理专业中嵌入的结构性不平等。

方法

本文通过对相关研究、数据、同行评议文献、政府报告和组织准则的全面文献回顾和综合分析来撰写。

结果

美国护理领导层必须承诺消除护理中的结构性种族主义,以实现更公平的医疗保健系统的可持续变革。

结论

本文提出了美国护理领导层的建议,通过在直接和系统护理实践和教育、床边和董事会层面消除结构性种族主义,重新致力于优质医疗保健。

临床相关性

护理和医疗保健中的结构性种族主义在全球范围内也是健康的主要社会决定因素之一。消除它符合国际医疗保健和护理的政策重点,但只有当高级领导层清楚地将其视为健康的主要障碍,并承诺改变其“系统”的工作方式时,变革才会发生。这些建议也可以被全球护理界采用,用于反种族主义工作。

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