The role that nurse-driven programs play in the efficiency of the American healthcare system has been a hot topic on the national front. Nurses play a leading role in U.S. healthcare, heading up programs on the local level that help prevent disease before it happens and creating customized programs for unique populations.
In honor of National Nurses Week, Nursing Spectrum reached out to nurses who reach out to their communities to improve patient outcomes.
Nurse Teaches, Recruits Child Asthma ProgramFelesia Bowen, RN
Felesia Bowen, RN, NP, Pediatric Nurse Practitioner, Advanced Practice Nurse, Pediatric Pulmonology, Children’s Hospital of New Jersey at Newark Beth Israel Medical Center
A one-woman show, Bowen recruits and teaches children with pulmonary problems through an asthma education program for children ages 8 to 12 called Open Airways. In the program, children learn about the disease, diagnosis, triggers, medications, relaxation techniques, and more. Children who have been admitted to the ED, PICU, or the pediatric unit are invited to participate as well as children who have been to the pediatric pulmonology clinic.
To measure the programs effectiveness, children complete surveys and a spirometry test at the beginning, end, and three weeks after the program is over. With a focus on prevention and minimizing morbidity through education, Bowen visits schools and community centers to speak with students, parents, and nurses about asthma and demonstrates how to effectively use medication, devices, and asthma action plans. She says its common for children and parents to not know about asthma action plans even though its required by state law.
Bowen hopes to show there are measurable, positive health outcomes from asthma education. If children learn to recognize their symptoms and manage them, she predicts to see a decrease in lost school days, unscheduled provider visits, and use of the ED for asthma exacerbation.
Outreach Program Educates, Screens Mount Kisco CommunitySue Gamache, RN
Sue Gamache, RN, MSN, Community Educator, Northern Westchester Hospital, Mount Kisco, N.Y.
The Community Health Outreach Program offers health education and screenings to the Mount Kisco community. Gamache serves as the nurse liaison between Northern Westchester Hospital and the community agency, training staff on health screening and education protocols, tracking data, and more.
The program helps the underserved, such as the uninsured, underinsured, immigrants, seniors, and the working poor, by conducting health events at community centers, food pantries, social service centers, and places of worship. We offer screenings for diabetes, hypertension, stroke, osteoporosis, elevated cholesterol, and clinical breast exams. I feel the real value of the screenings is the one-on-one time and individualized education that every participant receives from a nurse, says Gamache.
With the rising incidence of obesity, prediabetes and heart disease, Gamache and members of the outreach program are focused on prevention. We have seen some of our repeat participants reducing cholesterol levels, blood pressures, and glucose findings, and we guide people to whatever other community health resources they need. With more and more people becoming uninsured, prevention education and screenings play an important role in reducing individual and agency costs, she says.
The program, funded by grants, pays for hospital staff to work at the events.
Parish Nursing Combines Faith and HealingSally Munson, RN
Sally Munson, RN, Community Health Nurse Educator, Parish Nurse, Nurse Liaison for Health and Healing, Mountainside Hospital, Montclair, N.J.
The Parish Nurse/Congregational Health program was developed to combine health, healing, and tools of modern healthcare with ancient faith traditions. To administer the program, an RN coordinator was funded by the hospital to act as a liaison to what has grown to encompass 16 community congregations.
As a nurse liaison, Munson provides resources and consultation for local churches and gives each faith community the freedom to tailor the program to their congregations needs. She also provides educational programs, offers health screenings for diabetes, stroke, blood pressure, and cholesterol, and assists with congregational health fairs to reach out to the community.
The nurse liaison role acts as mentor and support person to each healing ministry. She even compiled a how-to booklet called Steps to Starting a Health & Healing Ministry. She says its helpful for each parish to formulate a questionnaire to assess its own particular needs. Munson then assists in implementing the individualized program. Parish nursing does not involve hands-on care as much as filling the role of support person, advocate, and educator.
Mobile Project Brings Healthcare to Underserved in Newark, N.J., AreaGloria J. McNeal, RN
Gloria J. McNeal, RN, PhD, Project Director, University of Medicine & Dentistry of New Jersey School of Nursing, Newark, N.J.
UMDNJ, the Children’s Health Fund, and the Healthcare Foundation of New Jersey have partnered to create a university-based mobile healthcare project. McNeal, the project director, says the initiative provides 24/7 care to the medically underserved in the only nurse-faculty managed, interdisciplinary primary care center on wheels in the greater Newark, N.J., area.
Patients are seen by APNs with credentialing privileges from the UMDNJ University Hospital system to diagnose and treat conditions, with medical oversight by the projects medical director. Patients register on-site in the intake area of the mobile unit, are screened for third-party reimbursement eligibility, and evaluated for care by the APNs in well-equipped examination rooms. All patients are assessed, diagnosed, and treated regardless of ability to pay. Based on the clinical findings, the APNs provide medical treatment and schedule follow-up care or referral for specialty care, as needed.
The mobile unit travels daily and on designated weekends to scheduled sites in the New Jersey cities of Newark, Irvington, and Elizabeth. McNeal confers with the community site coordinator in the establishment of the scheduled site visits. Because of popular demand, the visit schedule has been increased from three to four days each week. The mobile clinic also serves as a clinical rotation and faculty practice site for nursing and medical students and faculty.
Spirit of Women Program Combines Health With Fun
Suzanne Juliano, RN, MS, Coordinator, Linda Lohsen, RN, BSN, Community Liaison, Holy Name Hospital, Teaneck, N.J.
By planning and implementing a unique entertainment segment, Juliano and Lohsen of the Spirit of Women membership program go beyond providing healthcare information. They combine important medical information with fun activities directed toward women. Health lectures and special events are offered monthly to address timely and diverse issues, such as gastric health, COPD and lung cancer, and autoimmune diseases. Two focuses they address annually are breast cancer and cardiac disease as it differs in women.
They also couple their informational sessions with activities that encourage community involvement. For example, they brought the issue of cardiac risk factors and lifestyle modification to the community in their Day of Dance program. At a mall, they offered participants the opportunity to speak one-on-one with a cardiologist, pharmacist, and nutritionist. Blood pressure, BMI, and risk assessments were measured, and people were counseled about their results. Since dancing is a fun way to improve cardiac health, local dance schools performed and offered interactive dance instruction in country and western, Zumba, and belly dancing. Taking the program to a mall helped them reach nearly 400 people who might not have come to the hospital for a health lecture.
The events blend real-world experiences with knowledge to help women take action to improve their health and their familys health. Spirit members turn to the nurses they know through the classes with concerns and requests for information, giving the nurses an opportunity to educate beyond the lectures. In addition, more than 50 nurse colleagues volunteered at the Day of Dance event.
RNs Conduct Bone Marrow Donation Drives to Boost Registry
Suzanne Bartlett, RN, Staff Nurse, Pediatrics, Blythedale Children’s Hospital, Valhalla, N.Y.
Pediatric patients with cancer, such as leukemia, often need bone marrow transplants. To increase the number of donors and educate the public, the Blythedale chapter of the Society of Pediatric Nurses began to conduct donation drives in April to register potential donors for the Be the Match Registry. Only about 30% of siblings will be a match, which means 70% of the time someone needs an unrelated donor, Bartlett says. The registry is in need of minorities and first-responder donations since minorities comprise only 17% of donations. Since the $52 one-time registration fee may be a hardship, minorities can be tested for free through 2010.
The chapter has two main goals: to run multiple drives throughout the year and to train nurses and lay people to become involved in the program to educate the public and run drives, Bartlett says. Fear stops people from deciding to donate, so everyone who registers must be sure they wont back out for that reason.
About 70% of the time, the stem cells needed for transplant can be collected through an IV. Before donation, the donor only would need to take Filgrastin. The donor gives blood, the stem cells are removed and saved, and the donor is given back any remaining blood. For the 30% of patients who need to donate marrow, there is no need for prior medication since they are sedated and the marrow is aspirated through a needle.
For information about becoming a donor, visit www.BAHBAD.org or e-mail Bartlett at [email protected] .