NURS 510 Week 5 Discussion 2

Evidence-based practice is extremely important in nursing. Throughout your master’s program, you will complete research on various topics. Knowing how to construct a strong problem statement and complete a critical analysis of the available information to write a literature review is essential.

This week, you will write a problem statement and perform a literature review in preparation for your ethical issues debate presentation. Share your problem statement in this discussion so that you can review each other’s work and provide peer-to-peer feedback. Also, describe what you think are the most important learning takeaways from the literature review resources you reviewed.
Follow the instructions in the bullets below to find resources on problem statements and literature reviews:
• View:
o WCU Resources: Problem Statement, Literature Review
o What is a Problem Statement?Links to an external site.
o What is a Literature Review?Download What is a Literature Review?
o Evaluating Sources
o Five Steps to Conducting a Systematic Literature ReviewLinks to an external site.
o Writing a Literature Review

Solution

My topic- Access to Care for Undocumented Immigrants

Problem Statement
There is a dilemma between the need for humanitarian duty versus resource constraints or legal and ethical constraints that limit the ability of undocumented immigrants in the United States to access health care services, amid the fear of deportation. Although the principles of healthcare for all require immigrants to be provided with necessary medical care, many face delayed or inadequate treatment, especially in cases of non-emergency (Woofter & Sudhinaraset, 2022). These barriers have negative health implications such as increased morbidity and mortality, worsening of chronic diseases, and frequent use of emergency services. The lack of routine and preventive measures also increases the burden on the health sector and public health interventions. To overcome these challenges, there is a need to adopt policies and consider the ethical factors that will help meet the public health needs without violating the law.

Literature Review
Among the barriers that prevent undocumented immigrants from accessing health care are financial, legal, and structural hurdles. In their article, Brenner et al. (2021) pay much attention to the ethical challenges in relation to emergency care and the conflict between the legal requirements and the principle of non-maleficence. The EMTALA affords the right to emergency treatment, but many of these immigrants avoid seeking such treatment for fear of being reported to the immigration authorities (Brenner et al., 2021). Nwadiuko et al. (2021) found that despite the increased access due to local policies, the undocumented are still afraid to access services because of structural barriers and economic volatility. These studies call for developing health policies that will safeguard the vulnerable.

Sociocultural and systemic factors also play a role in the healthcare disparities of undocumented immigrants. In their article, Galvan et al. (2021) discuss the challenges undocumented Latino people have in accessing healthcare and attribute them to low income and prejudice. This supports the research done by Mona et al. (2021), in which they also used principal component analysis to establish that fear of detection, language barrier, and poor healthcare literacy also compounded the challenges. Although the contexts of the studies are different, the United States and Sweden, both show how legal precariousness is connected to healthcare and perpetuates structural barriers that hinder undocumented people from accessing healthcare services consistently.

The recent healthcare policy changes have affected the healthcare services for immigrants differently. Ayón et al. (2020) focus on the healthcare needs of the Latinx undocumented older adults and stress the importance of CBOs in addressing the barriers. According to them, despite localized efforts, exclusion from public health insurance programs hinders access to healthcare. Similarly, Porteny et al. (2022) also assess the impact of the ACA on immigrants, arguing that while the ACA enhances the level of health insurance coverage of documented immigrants, it leaves out the undocumented immigrants, thus compounding health disparities. These studies underscore the need for policy changes that include undocumented people in health care systems with regard to financial and ethical factors.

Key Takeaways from the Literature Review
The literature shows that legal, economic, and sociocultural factors contribute to the barriers to accessing health care among undocumented immigrants. Legal issues pose a moral challenge to healthcare professionals since they must work within the law while offering services. Also, most undocumented immigrants lack health insurance, and the fear of being deported hinders them from getting medical attention until it gets to a critical stage, where they have no other option than to seek emergency department services. Local programs and nonprofit organizations try to fill the gaps in the healthcare system, but the exclusion from public insurance programs is a major issue. To address these issues, there is a need for comprehensive policy changes that will respect ethical principles and the best interests of the public health while providing equal access to health care to all individuals, including immigrants.

References
Ayón, C., Ramos Santiago, J., & López Torres, A. S. (2020). Latinx undocumented older adults, health needs, and access to healthcare. Journal of Immigrant and Minority Health, 22, 996-1009. https://link.springer.com/article/10.1007/s10903-019-00966-7Links to an external site.

Brenner, J. M., Blutinger, E., Ricke, B., Vearrier, L., Kluesner, N. H., & Moskop, J. C. (2021). Ethical issues in access to emergency care for undocumented immigrants. JACEP Open, 2(3), e12461. https://www.sciencedirect.com/science/article/pii/S2688115224011676Links to an external site.

Galvan, T., Lill, S., & Garcini, L. M. (2021). Another brick in the wall: Healthcare access difficulties and their implications for undocumented Latino/a immigrants. Journal of Immigrant and Minority Health, 23, 885-894. https://link.springer.com/article/10.1007/s10903-021-01187-7Links to an external site.

Mona, H., Andersson, L. M., Hjern, A., & Ascher, H. (2021). Barriers to accessing health care among undocumented migrants in Sweden-a principal component analysis. BMC health services research, 21, 1-11. https://link.springer.com/article/10.1186/s12913-021-06837-yLinks to an external site.

Nwadiuko, J., German, J., Chapla, K., Wang, F., Venkataramani, M., Vaidya, D., & Polk, S. (2021). Changes in health care use among undocumented patients, 2014-2018. JAMA network open, 4(3), e210763-e210763. https://jamanetwork.com/journals/jamanetworkopen/article-abstract/2777033Links to an external site.

Woofter, R., & Sudhinaraset, M. (2022). Differences in barriers to healthcare and discrimination in healthcare settings among undocumented immigrants by deferred action for childhood arrivals (DACA) status. Journal of Immigrant and Minority Health, 24(4), 937-944. https://link.springer.com/article/10.1007/s10903-022-01346-4Links to an external site.

Porteny, T., Ponce, N., & Sommers, B. D. (2022). Immigrants and the affordable care act: changes in coverage and access to care by documentation status. Journal of Immigrant and Minority Health, 24(1), 86-94. https://link.springer.com/article/10.1007/s10903-020-01124-0

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