Nurses as agents of disruption: Operationalizing a framework to redress inequities in healthcare access among Indigenous Peoples.
Health equity is a global concern. Although health equity extends far beyond the equitable distribution of healthcare, equitable access to healthcare is essential to the achievement of health equity. In Canada, Indigenous Peoples experience inequities in health and healthcare access. Cultural safety and trauma- and violence-informed care have been proposed as models of care to improve healthcare access, yet practitioners lack guidance on how to implement these models. In this paper, we build upon an existing framework of equity-oriented care for primary healthcare settings by proposing strategies to guide nurses in operationalizing cultural safety and trauma- and violence-informed care into nursing practice at the individual level. This component is one strategy to redress inequitable access to care among Indigenous Peoples in Canada. We conceptualize barriers to accessing healthcare as intrapersonal, interpersonal, and structural. We then define three domains for nursing action: practicing reflexivity, prioritizing relationships, and considering the context. We have applied this expanded framework within the context of Indigenous Peoples in Canada as a way of illustrating specific concepts and focusing our argument; however, this framework is relevant to other groups experiencing marginalizing conditions and inequitable access to healthcare, and thus is applicable to many areas of nursing practice.
['Horrill|Tara C|TC|0000-0002-8803-5624', 'Martin|Donna E|DE|', 'Lavoie|Josée G|JG|', 'Schultz|Annette S H|ASH|']
D054625:Healthcare Disparities D006801:Humans D000081034:Indigenous Peoples D009729:Nursing D009936:Organizational Innovation
nursing healthcare access Indigenous peoples health equity cultural safety trauma- and violence-informed care health services accessibility