Aim:The purpose of this article is to summarize research targeting hypertension and healthcare access among adults living in rural Haiti.Background: Hypertension is a significant public health problem that impacts one in five persons globally. It is the leading cause of cardiovascular-related conditions such as stroke and myocardial infarction and accounts for most global non-communicable disease-related deaths. Limited healthcare access and social determinants of health are known contributors to poor health outcomes among persons with hypertension.Among Haitians, there are stark health disparities between those who live in urban versus rural areas.Design: A discursive review.Results: Several issues are identified as barriers to proper hypertension prevention and management. However, after examining the effective interventions, we found that social determinants of health such as transportation costs, lack of field care facilities close to patients, roadway conditions, political disturbance, and ineffective leadership and policies are major barriers to controlling hypertension in Haiti. Although Haiti has received help from international organizations, strengthening its internal infrastructure is paramount in improving healthcare access. Discussion:The review concludes that Haitians living in rural parts of Haiti are less likely to receive healthcare to manage non-communicable diseases such as hypertension. Similar to other developing countries, a heightened awareness is needed to address the lack of healthcare access for those living in rural communities.Impact to Nursing Practice: Nurses and other healthcare professionals working with populations in Haiti should become aware of the barriers and facilitators that promote sufficient healthcare access. To achieve this goal, nurses must understand the social determinants and other factors that serve as barriers for achieving access to quality care for this vulnerable population.
Background and objectives: Sickle Cell Disease is a painful genetic disorder characterized by abnormal hemoglobin that affects 1-in-365 African American births. Individuals with Sickle Cell Disease often experience frequent hospitalizations, resulting in 30-day readmission rates 2.5 times higher than those without Sickle Cell Disease. Discharge education programs have shown to improve 30-day readmissions and improve health outcomes.Methods: This advanced practice nurse-led initiative incorporated components of the Re-Engineered Discharge (Project RED) protocol, which included patient and medication education, specific discharge teaching, and post-discharge follow-up phone calls over a 12-week period. A pre/posttest design was used to evaluate 30-day readmission. Analyses included descriptive statistics and Fisher’s exact test.Results: Of the (N = 10) participants, eight (80%) were female, with a mean age of 31.08 (± 4.33) and all were African Americans. Although not statistically significant, there was a 48% reduction in 30-day readmissions rates between the pre/post intervention periods.Conclusions: The utilization of an enhanced discharge teaching protocol is a practical solution to increase patients’ readiness for discharge and to reduce 30-day readmission rates. Project RED discharge teaching protocol is an effective strategy for nurses to employ to improve patient outcomes and quality of care for persons with Sickle Cell Disease.
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