Nurse leaders’ recommendations for implementing LGBTQ+ inclusive practices in health systems: A qualitative descriptive study

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Abstract

Background

Discrimination against lesbian, gay, bisexual, transgender, queer or questioning, and other sexual and gender diverse (LGBTQ+) individuals in healthcare settings remains a priority issue. Nurse leaders, who oversee the largest healthcare workforce, are critical in implementing inclusive practices to address LGBTQ+ discrimination, yet implementing LGBTQ+ inclusive practices and effective strategies is inconsistent. This qualitative descriptive study explored nurse leaders’ perceptions of LGBTQ+ inclusive practices across the United States to inform recommended strategies within health systems.

Methods

Twenty-one nurse leaders (e.g., chief nurse executives) from diverse healthcare settings (e.g., children's hospitals and public health centers) in 12 states across the United States participated in semi-structured interviews from October to December 2023. Interview transcripts were analyzed using content analysis to (1) describe nurse leaders’ definitions of LGBTQ+ inclusive practices and (2) identify effective strategies for their implementation.

Results

Nurse leaders defined LGBTQ+ inclusive practices to include delivering culturally responsive and competent care, fostering safe and affirming environments, integrating inclusivity into daily interactions and organizational culture, and supporting the needs of both LGBTQ+ staff and patients. Key implementation strategies included fostering a flexible organizational culture through open communication; a diverse workforce; and inclusive mission statements, policies, and strategic plans. Supportive infrastructure involved effective LGBTQ+ training and adapting electronic health record systems to include information on sexual orientation and gender identity. Active and interdisciplinary engagement from staff and leadership, as well as systematic data collection on patient and staff experiences, were essential for driving inclusivity. The advocacy highlighted included legislative support, discourse within the nursing profession, and the incorporation of LGBTQ+ inclusion into healthcare regulations and accreditation standards. Additionally, multisectoral partnerships with LGBTQ+ health experts and external organizations, along with multilevel evaluations, were recommended to develop tailored interventions and promote LGBTQ+ inclusive practices.

Conclusion

Implementing LGBTQ+ inclusive practices in healthcare is a multifaceted effort influenced by strategies at various levels. Promoting a supportive organizational culture, establishing comprehensive support structures, encouraging active engagement, and fostering community partnerships can address the needs of LGBTQ+ individuals more effectively. Future implementation efforts should tailor strategies to accommodate variability across healthcare settings and regions, ensuring that practices are both adaptable and sustainable.
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护士长对在卫生系统中实施 LGBTQ+ 包容性实践的建议:定性描述研究
背景在医疗机构中,对女同性恋、男同性恋、双性恋、变性人、同性恋或有疑问者以及其他性取向和性别多样化(LGBTQ+)的个人的歧视仍然是一个需要优先解决的问题。护士长监督着最庞大的医疗保健队伍,他们在实施包容性实践以解决 LGBTQ+ 歧视问题方面至关重要,但实施 LGBTQ+ 包容性实践和有效策略的情况并不一致。这项定性描述性研究探讨了美国各地护士长对 LGBTQ+ 包容性实践的看法,以便为医疗系统内的建议策略提供参考。方法2023 年 10 月至 12 月,来自美国 12 个州不同医疗机构(如儿童医院和公共卫生中心)的 21 名护士长(如护士长)参加了半结构化访谈。我们采用内容分析法对访谈记录进行了分析,以(1)描述护士长对 LGBTQ+ 全纳实践的定义,(2)确定实施这些实践的有效策略。结果护士长对 LGBTQ+ 全纳实践的定义包括:提供符合文化要求且胜任的护理、营造安全且肯定的环境、将包容性融入日常互动和组织文化,以及支持 LGBTQ+ 员工和患者的需求。主要实施策略包括:通过开放式沟通培养灵活的组织文化;多元化的员工队伍;包容性的使命宣言、政策和战略计划。支持性基础设施包括有效的 LGBTQ+ 培训和调整电子健康记录系统,以纳入有关性取向和性别认同的信息。员工和领导层积极的跨学科参与,以及对患者和员工体验的系统数据收集,对于推动包容性至关重要。宣传重点包括立法支持、护理行业内的讨论,以及将 LGBTQ+ 纳入医疗保健法规和评审标准。此外,还建议与 LGBTQ+ 健康专家和外部组织建立多部门合作关系,并进行多层次评估,以制定有针对性的干预措施,促进 LGBTQ+ 的包容性实践。促进支持性的组织文化、建立全面的支持结构、鼓励积极参与以及促进社区合作关系可以更有效地满足 LGBTQ+ 个人的需求。未来的实施工作应调整策略,以适应不同医疗机构和地区的差异,确保实践的适应性和可持续性。
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来源期刊
CiteScore
5.80
自引率
0.00%
发文量
45
审稿时长
81 days
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