Health Systems Concepts (NUR 212)

Module Author(s)

• April Bradley (Central Piedmont Community College)

Course Description

This course is designed to further develop the concepts within the three domains of the individual, healthcare, and nursing. Emphasis is placed on the concepts of grief/loss, violence, health-wellness-illness, collaboration, managing care, safety, advocacy, legal issues, policy, healthcare systems, ethics, accountability, and evidence-based practice. Upon completion, students should be able to provide safe nursing care incorporating the concepts identified in this course.

Student Global Learning Outcomes

These mirror the SLO’s for the course.
● SLO 1: Assumes accountability for personal and professional behaviors that demonstrate cultural competence, incorporating the nursing standards of moral, ethical, and legal conduct.
● SLO 2: Communicate with members of the group to conduct an assessment and create a cohesive report of assessment. Collaborate as a group to provide population-specific care. Collaborate with the interdisciplinary team to provide high-quality care that overcomes barriers.
● SLO 3: Analyze data gathered and discover the holistic needs of a population by conducting a community assessment. Recognize the specific needs of a population and provide compassionate care through advocacy in nursing.
● SLO 4: Manage the care of a specific cultural population using efficient and effective nursing strategies.
● SLO 5: Use professional online resources such as journals and websites to gather data for the chosen health disparity related to the identified population.

Module Description and Activities

Description of Module:

One of the key objectives is vulnerable populations.  I would like to weave the idea of understanding our non-native English-speaking patients from Latin America and cultural competency throughout much of the course.

Global Learning Activities:

Student Global Learning Activity 1: Assessment of Health Equity in the Latin American Immigrant Population

Student Learning Objectives (SLO):

• SLO 1: Identify personal biases that can create barriers to providing equitable healthcare to non-native-speaking patients in the hospital setting.
• SLO 2: Communicate with members of the group to conduct an assessment and create a cohesive report of assessment. Collaborate as a group to provide population-specific care.  Identify barriers to providing high-quality care that overcome barriers within the interdisciplinary team.
• SLO 3: Analyze gathered data and discover the holistic needs of a population by conducting a community assessment. Recognize the specific needs of a population and provide compassionate care through advocacy in nursing.
• SLO 4: Manage the care of a population using efficient and effective nursing strategies.
• SLO 5: Use professional online resources such as journals and websites to gather data for the chosen health disparity.

Description:

The Joint Commission’s National Patient Safety Goals for 2024 include the improvement in healthcare equity.  As demonstrated in the Carolina Demography slides you reviewed regarding the immigrant community in NC as of 2021, there are over 870,000 immigrants in NC.  Of that population, 33% come from Mexico, Honduras, or El Salvador.  Around 440,000 NC residents are from Central or South America with the majority living in metropolitan areas like Charlotte.

Each group will be looking at social determinants of health (SDOH) outlined in Healthy People 2030 through the lens of the Latin American immigrant population living in the United States.  As a group, research the population and perform an assessment.  After you have performed your assessment, creatively present the findings. You can create a presentation, a video, or a poster, etc.  The final project does not have to be a written paper.

The final project should:

• Broadly describe the Latin American immigrant population including the factors that make them a vulnerable population in the United States. Consider all age ranges within the population.
• Explain relevant statistics and their significance.
• Discuss their social determinants of health, including the 5 domains identified by Healthy People 2030. How does each social determinant of health (SDOH) domain affect the vulnerable population’s health?
• Describe a health disparity affecting the Latin American immigrant
• Identify and discuss false assumptions about the Latin American immigrant population. What are the impacts of these assumptions on the population’s access to and practitioners’ delivery of healthcare?
• Identify resources and services available in the local Charlotte area community, in the state of North Carolina, and at the federal level. How can your population access these resources?
• Make sure to include authoritative APA references published within the last five years for all sources, including in-text citations.

Only one group member needs to upload your assessment into Brightspace.

Activity 1 Rubric for Grading:

Criteria	Level 4 (4 pts)	Level 3 (3 pts)	Level 2 (2pts)	Level 1 (1 pt)
Summary of Immigrant Population (IP) and Statistics	Comprehensive identification and summarization of IP, including why this population is important to research and clear, relevant statistics	Comprehensive identification and summarization of IP, minimal information for one of the following: why this population is important to research or clear relevant statistics	Minimal identification or summarization of IP and/or excluding one of the following: why this population is important to research and relevant statistics	Incomplete identification and summarization of IP, why this population is important to research, and relevant statistics
Social Determinants of Health	Discussion of 5 identified IP SDOH	Discussion of 3-4 identified IP SDOH	Discussion of 1-2 identified IP SDOH	Unclear discussion of IP SDOH
Health Disparity	Clear, thorough identification of one health disparity	Identification with a basic description of one health disparity	General identification of one health disparity lacking a description	Unclear/no identification of one health disparity
False Assumptions	Thoroughly discusses specific false assumptions and their impact on access and delivery of healthcare	Briefly discusses specific false assumptions and their impact on access or delivery of healthcare	Discusses general false assumptions related to many populations and/or omits impact on access and/or delivery of healthcare	Vague discussion of false assumptions and their impact on access and/or delivery of healthcare
Resources	Identifies relevant resources available to IP at the local/ state/ federal level and clear discussion on how to access	Identifies relevant resources available to IP at the local and state/federal level with unclear discussion of how to access	Identifies relevant resources available to IP 1-2 levels (local/ state/ federal level with discussion of how to access	Identifies relevant resources available to IP 1-2 levels (local/ state/ federal level with little or no discussion of how to access
Mechanics of Writing	0-1 errors in spelling and grammar, the format is clear, professional, and organized	2-3 errors in spelling and grammar, but the overall format is clear	4-5 errors in spelling and grammar, and the overall format is disorganized	Greater than 5 errors in spelling and grammar in posts; the format is extremely hard to read and disorganized
APA	Authoritative references published within the last five years and in-text citations are listed in the correct APA format	Authoritative references published within the last five years are listed in APA format with minor errors	References and in-text citations are listed in APA format with major errors and/or references are not published within the last five years and/or references are not authoritative.	References and in-text citations are not listed in APA format. and/or references are not published within the last five years and/or references are not authoritative.

 

Follow up for Activity one will be the progression of additional activities based on the findings of the Population Assessment.  See Activity 2.

 

Student Global Learning Activity 2: Cultural Violence Infographic Description

Student Learning Objectives (SLO):

• SLO 1: Assumes accountability for personal and professional behaviors that demonstrate cultural competence incorporating the nursing standards of moral, ethical, and legal conduct.
• SLO 3: Provides compassionate and coordinated care while respecting the client’s preferences, values, and needs.
• SLO 4: Demonstrates critical thinking and interactive decision-making while prioritizing culturally competent client concerns and needs.
• SLO 5: Integrates best current evidence with clinical expertise and client/family preferences and values for delivery of optimal health care.

Description:

You will develop an infographic presented both in English and in Spanish related to one of the concepts of violence impacting the Latin American immigrant population here in the United States.  Your infographic should provide information that would help the intended audience of immigrants from Latin America find local resources in the Charlotte area that would provide culturally appropriate care.

You can use Google Translate to help you with your infographic.  One way to help ensure your translation is accurate is to translate from English to Spanish and then reenter the Spanish translation and see how it converts back to English.  You will not be graded on the accuracy of the Spanish as long as the meaning is similar.

Infographics should be creative, informative, and easy to read. APA references are required and should be authoritative and within the last five years.  Submit these on a separate document.

Possible topics:

• Assault
• Elder abuse
• Child abuse
• Sexual abuse
• Intimate partner violence
• Human trafficking
• Workplace violence

Assessment for Activity 2: Cultural Violence Infographic Rubric

Criteria	Level 4 (4 pts)	Level 3 (3 pts)	Level 2 (2pts)	Level 1 (1 pt)
Content	Content provided in infographic clearly addresses one of the topics of violence including relevant statistics on how it directly impacts the population.	Content provided in infographic addresses one of the topics of violence including relevant statistics on how it generally impacts the population.	Content provided in the infographic addresses violence, but the topic is vague or does not address a specific audience, or statistics are not used.	Content provided in the infographic addresses violence, but the topic is vague or does not address a specific audience and statistics are not used.
Community-based Resource	Provides clear and distinct information on how to access a culturally appropriate Charlotte area resource for assistance.	Provides general information on how to access a culturally appropriate Charlotte area resource for assistance.	Provides unclear information on how to access a Charlotte area resource for assistance or local resource is not culturally appropriate	Provides information on how to access a national resource for assistance
Audience	Information is clearly targeted to the specific audience and includes both English and Spanish text.	Information is targeted to a general audience and includes both English and Spanish text.	Information does not identify with the audience or does not include both English and Spanish text.	Information does not identify with the audience and does not include both English and Spanish text.
Resources	Resources used to create the infographic are authoritative and give a clear understanding of how the depicted type of violence impacts the target population.	Resources used to create the infographic are authoritative and give a general understanding of how the depicted type of violence impacts the target population.	Resources used to create the infographic lack authority or do not give a general understanding of how the depicted type of violence impacts the target population.	Resources used to create the infographic lack authority and do not give a general understanding of how the depicted type of violence impacts the target population.
Quality	The quality of the infographic exceeds expectations—information is presented in a creative and visually appealing way.	The quality of the infographic meets expectations – information is presented creatively but lacks visual appeal.	The quality of the infographic does not meet expectations – information is difficult to read and/or lacks visual appeal.	The quality of the infographic does not meet expectations – information is difficult to read and lacks visual appeal.

 

Follow-up will be conducted using a human-trafficking simulation.

Student Global Learning Activity 3: Final Student Project

Student Learning Objectives (SLO):

• SLO 1: Demonstrate professional behaviors in the development and presentation of the information reflecting a clear understanding of the Latin American immigrant population in North Carolina in relation to healthcare.
• SLO 2: Communicate effectively and relevantly with colleagues hearing the presentation. Collaborate as a group to accomplish the project and produce a high-quality presentation that improves health outcomes for the immigrant population.
• SLO 3: Use data and tools to assess the immigrant population. Reflect on the key concepts from the projects completed throughout the course. Design caring interventions for the immigrant population.
• SLO 4: Manage the care of the immigrant population in the health care setting utilizing the knowledge shared in the presentation.
• SLO 5:  Use professional online resources such as journals and websites to support your presentation development.  Share current Evidence-based practice (EBP) regarding the immigrant population with colleagues.

 

Description:

Each group will provide a virtual presentation of the course assignments as related to the Latin American immigrant population in North Carolina including a public service announcement (PSA) video.  Groups will collaboratively prepare, present, and upload the presentation by the scheduled date in the course calendar.  One group member should submit the final presentation to the designated Brightspace assignment submission area and final group presentation discussion board.

The presentation should include the following information:

• Immigrant Population Assessment: Brief review of the Latin immigrant population assessment including one domain of the social determinants of health and how it impacts the population.
• Embedded Public Service Announcement: Follow the steps below to create your PSA:

1. Choose a specific topic within the chosen social determinant of health discussed.
2. Gather information on your topic using evidence-based references.
3. Create and embed a 2 to 3-minute public service announcement video in your presentation. Include something memorable or ‘catchy’ that will capture your audience’s attention.  You should guide your audience to a health-promoting behavior.  Include resource(s) in the Charlotte area, where they are located, and how to utilize them. Each group member should have a speaking role in the video. PSA Example

• Ethical Issue: An explanation of a debated ethical issue the immigrant population faces regarding the chosen social determinant of health illustrating both sides of the argument.
• Cultural Competence: Share 3 key points for your colleagues to learn and apply when providing care for the population.

 

Post a link to your presentation to the final group discussion board.

Review 2 group presentations other than your own and provide feedback. How can you incorporate what you learned from the presentation into your nursing practice?  Posts should be a minimum of 150 words each.

Activity 3 Assessment – Final Group Project Rubric

NUR 212 Final Project – Presentation Rubric 

 

Component	Level 4	Level 3	Level 2	Level 1
Immigrant	Brief overview of IP assessment including description, statistics and chosen Social Determinant of Health (SDOH) and its level of impact.	Incomplete overview of	Incomplete overview of	Vague overview of IP
Population (IP) Assessment   15%		IP including lacking one of the following: description, statistics, chosen SDOH, level of impact.	IP including lacking two of the following: description, statistics, chosen SDOH, level of impact.	including lacking description, statistics, chosen SDOH, level of impact.
Public Service Announcement   PSA 50% of final  grade for project   35%	PSA video thoroughly addresses a health topic for the IP directly related to chosen SDOH.	PSA video generally addresses a health topic for the IP directly related to chosen SDOH.	PSA video vaguely addresses a health topic for the IP related to chosen SDOH.  Or health topic is not directly related to SDOH.	PSA video fails to address a health topic for the IP related to chosen SDOH.
PSA Resources   10%	PSA points IP to Charlotte area resources including location and how to access/utilize the resource.	PSA points IP to Charlotte area resources but is vague regarding location and/or how to access/utilize the resource.	PSA points IP to Charlotte area resources but does not discuss the location and/or how to access/utilize the resource.	PSA points IP to a non- local resource.
PSA Timing 5%	PSA is 2 to 3 minutes in length and all group members participated in the video.	PSA is longer/shorter than 2 to 3 minutes in length (+/- 30 sec) and all group members participated in the video.	PSA is longer/shorter than 2 to 3 minutes in length (+/- 30 sec) or all group members did not participate in the video.	PSA is longer/shorter than 2 to 3 minutes in length (+/- 1 min) and/or all group members did not participate in the video.
Ethical Debate   15%	Ethical issue explained thoroughly with both pro and con positions discussed.	Ethical issue explained, omission of pro or con positions discussed.	Ethical issue poorly explained, or omission of pro and con positions discussed.	Ethical issue vaguely discussed.
Cultural Competence 15%	Discussion of 3 key points of cultural competence	Discussion of 2 key points of cultural competence	Discussion of 1 key point of cultural competence	Vague discussion of key points of cultural competence
References 5%	Chooses a variety of authoritative information sources (2 or more). References listed in correct APA format.	Chooses 2 authoritative information sources. APA format with minor errors (1-3).	Chooses 1 authoritative information source. APA format with major errors (4-5).	Unprofessional information sources utilized. APA format not used for references.

 

Follow-Up: Culturally and Linguistically Appropriate Services (CLAS)

Students will follow up by completing the Culturally and Linguistically Appropriate Services(CLAS) in Nursing four CEU online course discussing cultural and linguistic competence.  They will take the Harvard Project Implicit, Hispanic IAT (Implicit Association Test) before starting the first cultural assignment in the course.  They will repeat this after completing the Culturally and Linguistically Appropriate Services(CLAS) in Nursing.  They will then reflect on how this has impacted their perception of the Latin community in regards to health and their practice as a nurse.

Culturally and Linguistically Appropriate Services (CLAS) – Instructions for Clinical Credit

• SLO 1: Professionalism – Assumes accountability for personal and professional behaviors that demonstrate the nursing standards of moral, ethical, and legal conduct when caring for a culturally diverse population.
• SLO 2: Teamwork & Collaboration – Utilizes a culturally competent approach to function effectively within nursing and inter-professional teams, fostering open communication, mutual respect, and shared decision-making to achieve quality client care including the utilization of linguistically appropriate services.
• SLO 3: Client Centered Care – Provides culturally competent, compassionate, and coordinated care while respecting the client’s preferences, values, and needs. Recognizes the client or designee as the full source of control and partner in all care decisions.
• SLO 4: Clinical Judgment – Demonstrates critical thinking and interactive decision-making while assessing, identifying, analyzing, and prioritizing client concerns and needs.
• SLO 5: Evidence-Based Practice – Integrates best current evidence with clinical expertise and client/family preferences, culture, and values for delivery of optimal health care.

About the Program:

As healthcare disparities among cultural minority groups persist in our country, culturally and linguistically appropriate services (CLAS) are increasingly recognized as an important strategy for improving the quality of care to diverse populations. This e-learning program will equip you with the knowledge, skills, and awareness to provide the best care for all patients, regardless of cultural or linguistic background.

• Course 1: An introduction to CLAS, Students will examine cultural identity, social determinants of health, and the role of CLAS in improving quality.
• Course 2: Self-awareness, the student will become more aware of their beliefs and values, as well as their privilege, power, bias, and stereotypes.
• Course 3: Awareness of a patient’s cultural identity, Students will learn how and why to get to know a patient’s cultural identity.
• Course 4: Providing CLAS in nursing practice, students will explore ways to deliver respectful, compassionate, high-quality care that responds to a patient’s experiences, values, beliefs, and preferences.

Assignment

This course provides 4 hours of continuing education credit for nurses and focuses on education to provide culturally relevant care to patients in the clinical setting.

You will complete this course and send the completion certificate along with a reflection to account for your clinical day on Week 10.

The course can be found at the following link: https://thinkculturalhealth.hhs.gov/education/nurses

• Got to this website and click Begin Program
• You will need to sign in to participate in the program.
• This is self-paced.

Do the following:

• Complete all four courses. There are pre and post-quizzes for each course along with content that will be filled in as you proceed.  Print your completion to PDF and submit it along with the reflection below in BrightSpace.
• Retake the Harvard Project Implicit, Hispanic IAT (Implicit Association Test).
• Write a 300-word reflection describing how the exercises throughout this semester including the Culturally and Linguistically Appropriate Services (CLAS) modules have impacted your view of providing culturally competent care to patients.
  • How has your viewpoint regarding health equity for non-native English-speaking patients changed?
  • What did you learn?
  • What barriers do you see to being a non-native speaker trying to navigate the healthcare system?
  • What do you think could be done differently in the health care settings now to better ensure equity for all patients?
  • What role can leadership play in ensuring equity for all patients?
  • What have you learned that will you implement as you start your role as an RN?

 

Resources and References Used in the Creation of the Module

See Student Global Learning Activities.