Purpose and scope
The purpose of this best practice guideline (BPG) is to provide nurses and other members of the interprofessional team with evidence-based recommendations on foundational, inclusive care practices for 2SLGBTQI+ people. This BPG is also to be used to enhance the safety of health-service organizations and academic organizations for 2SLGBTQI+ people through the adoption of evidence-based practices. Safe and inclusive environments enable nurses and other members of the interprofessional team to optimize health outcomes for those receiving care.
The BPG addresses foundational inclusive care practices, chronic disease prevention and management, health promotion and health care for 2SLGBTQI+ people. The BPG is to be used by nurses and other members of the interprofessional team across the continuum of care (e.g., acute care, long-term care, rehabilitation, primary care and in all domains of practice (e.g., clinical, research, education, policy, and administration).
The 2SLGBTQI+ acronym stands for Two-Spirit, lesbian, gay, bisexual, trans, queer and intersex people. To learn more about the terminology used by RNAO, please see the glossary in appendix A of the BPG.
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Registered Nurses’ Association of Ontario (RNAO). Promoting 2SLGBTQI+ health equity. Toronto (ON): RNAO; 2021.
Recommendations
Recommendation 1.0: The expert panel recommends that health providers use 2SLGBTQI+ inclusive language and a person-centred history taking approach, and ensure privacy and confidentiality during interactions with all persons, to be inclusive of 2SLGBTQI+ people.
Recommendation 1.1: The expert panel recommends that health-service organizations implement 2SLGBTQI+ inclusive forms, documentation and signage.
Recommendation 2.0: The expert panel recommends health-service organizations create safer spaces for 2SLGBTQI+ people through a multi-component approach.
Recommendation 2.1: The expert panel recommends schools create safer spaces for students that include gender-sexuality alliances.
Good Practice Statement: The expert panel recommends that health providers assess 2SLGBTQI+ people for factors that may place them at increased risk of particular health conditions. Health providers are to follow established screening guidelines as available and based on a persons’ current anatomy.
Recommendation 3.0: The expert panel recommends health providers ensure the comfort and safety of lesbian and bisexual women and trans and non-binary people during cervical cancer screening.
Recommendation 3.1: The expert panel suggests health providers promote access to HIV-STBBI screening for 2SLGBTQI+ people in collaboration with 2SLGBTQI+ community partners through:
- media campaigns and/or
- outreach settings
Recommendation 4.0: The expert panel suggests health-service organizations implement specialized 2SLGBTQI+ clinical groups for health promotion and chronic disease prevention and management.
Recommendation 4.1: The expert panel recommends health-service organizations implement group-based interventions for 2SLGBTQI+ people that address the social determinants of health. These group-based interventions should be inclusive of and promote access to underserved 2SLGBTQI+ people including: Two-Spirit, Black, Indigenous and People of Colour, older adults, youth, migrants and people with disabilities.
Recommendation 5.0: The expert panel recommends academic institutions integrate 2SLGBTQI+ affirming health content into curricula for all students entering health professions.
Recommendation 5.1: The expert panel recommends that health-service organizations provide 2SLGBTQI+ affirming continuing education for all health providers.
