Achieving Health Equity Through Eradicating Structural Racism in the United States: A Call to Action for Nursing Leadership
Achieving Health Equity Through Eradicating Structural Racism in the United States: A Call to Action for Nursing Leadership
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DOI：
10.1111/jnu.12602
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发表时间：
2020-10-01
影响因子：
3.4
通讯作者：
Stacciarini, Jeanne-Marie R.
中科院分区：
文献类型：
--
作者：
Nardi, Deena;Waite, Roberta;Stacciarini, Jeanne-Marie R.
目的是倡导美国护理领导层采取战略行动，表明种族主义的存在、习俗和影响，这些种族主义已经在美国护理领导层和职业的结构中制度化。组织构建种族公平框架被用来检查优质医疗保健和公平健康结果的障碍，并提出以证据为基础的行动，以消除护理专业中根深蒂固的结构性不平等。方法通过对相关研究、数据、同行评议文献、政府报告和组织指南进行全面的文献回顾和综合，形成这篇文章。研究结果：美国护理领导层必须承诺根除护理领域的结构性种族主义，以便向更公平的医疗保健系统实现可持续的变革性变化。结论本文建议美国护理领导层通过消除各级直接和系统的护理实践和教育、床边和会议室的结构性种族主义来重申其对高质量卫生保健的承诺。临床相关性护理和保健中的结构性种族主义也作为健康的一个关键社会决定因素在全球范围内持续存在。它的消除符合国际医疗保健和护理的政策优先事项，但只有当高级领导人明确认识到它是健康的关键障碍，并承诺对其“系统”的运作方式进行变革性改变时，才能发生变化。这些建议也可以由全球护理在文化上加以调整，用于反种族主义工作。
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.