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.
Bariatric Program Helps Obese Get HealthyGaspar Rosario, RN
Gaspar Rosario, RN, MSN, APRN-C, Clinical Nurse, NYU Program for Surgical Weight Loss, New York City
Alarming statistics from the CDC on obesity in America led to the creation of the NYU Program for Surgical Weight Loss, a certified bariatric center of excellence. The program is unique because a third of the staff has undergone a bariatric procedure. Being a Lap-Band patient helps Rosario understand patients firsthand and the best way to treat them with respect and dignity while providing care. One of the doctors also is a Lap-Band patient who has lost 110 pounds and kept it off. In turn, the patients appreciate the team for its expertise, experience, and care.
The weight-loss team has performed nearly 7,000 bariatric surgeries to date and works to meet the medical, surgical, and emotional needs of severely obese patients. The program offers gastric banding, gastric bypass, sleeve gastrectomy, and biliopancreatic diversion duodenal switch procedures as treatment for morbid obesity.
The staffs commitment to conquering obesity also is evident in their encouragement of Rosario to open a private practice in New Jersey called Access Wt-Loss Care LLC. Through their support, Rosario seized the opportunity and increased patient access to Laparoscopic Adjustable Gastric Banding follow-up care and adjustment by creating weekend hours.
Conference Strikes Back at StrokeMillie Hepburn, RN
Millie Hepburn, RN, MSN, ACNS-BC, Neuroscience Clinical Nurse Specialist,
The University Hospital of Columbia and Cornell, NewYork-Presbyterian/Columbia, New York City
The progress of stroke survivors often is measured in inches, not miles. So in 2005, the Strike Back at Stroke conference was created to reunite clinicians with former patients in celebration of transcending a stroke experience. This free, annual conference provides survivors with relevant information about community support organizations, recreational activities, survivor networks, state-of-the-art assisting devices, and education in relevant advances in the science of stroke care. Area hospitals, rehabilitation centers, and the American Stroke Association partnered to create this conference. A call for nominations for stroke Survivor of the Year and Stroke Hero of the Year someone who supported stroke recovery proved to be a hit. During the conference, the nominations are read to clinicians and families who applaud the heroism and perseverance to transcend stroke. One nominee even received a standing ovation and tears from the crowd when it was announced he passed his driving exam and had driven for the first time to the conference. New York City Mayor Michael Bloomberg has dedicated the annual conference as Strike Back at Stroke Day, which draws about 500 attendees.
Nurse-Family Partnership Decreases Infant MortalityRoberta Holder-Mosley, RN
Roberta Holder-Mosley, RN, CNM, Deputy Director, Bureau of Maternal, Infant, and Reproductive Health, Nurse-Family Partnership, New York, N.Y.
As deputy director of Nurse-Family Partnership, Holder-Mosley helps families improve maternal and child health, build a secure and nurturing relationship between parent and child, and reach education and employment goals. The program is a nationwide home-visiting program for first-time mothers in which the mother-to-be is voluntarily seen by a bachelors-prepared RN free of charge once every two weeks, from early pregnancy until the child is 2. It is implemented within all five boroughs of New York City by the Bureau of Maternal Infant and Reproductive Health within the NYC Department of Health and Mental Hygiene. Holder-Mosley says the partnerships primary target population is low-income, first-pregnancy mothers who reside in ZIP codes with a high rate of infant mortality.
NFP nurses use a reflective rather than directive approach to care while helping clients create a plan to reach their personal goals. The nurse acknowledges and praises the client as she successfully takes small steps toward reaching her goals and gains greater confidence in her ability to make critical decisions for herself and her family. Long-term follow-up shows NFP clients have 72% fewer convictions among mothers, a 48% reduction in child abuse and neglect cases, and a 59% reduction in arrests among children, Holder-Mosley says.
Program Treats World Trade Center RespondersMickie Brown, RN
Mickie Brown, RN, Joan Cropley, RN, MSN, Clinical Coordinators, World Trade Center Medical Monitoring and Treatment Program, Mount Sinai School of Medicine, New York City
Studies show many 9/11 responders suffer from numerous conditions after working at Ground Zero. Exposure to the dust and debris from the World Trade Center has been connected to numerous diseases, such as asthma and other respiratory conditions. To serve the health needs of this unique population, The World Trade Center Medical Monitoring and Treatment Program was created. Patients consist of first responders, workers, and volunteers who restored essential services or provided cleanup services.
The patients are unique because they do not routinely seek medical care. The WTC program introduces them to a healthcare setting and evaluates not only for 9/11-related conditions, but also general health parameters. Patients also often are unaware they are hypertensive, diabetic, etc.
After the initial visit, patients return annually for follow-up assessment. If they demonstrate 9/11-related health problems, treatment is initiated and follow-up care is provided by the WTC program, where the patient receives ongoing care.
Nurses also establish a safe and trusting atmosphere during the administration of the comprehensive health questionnaire. This is unique because the nursing staff spends more quality time with the patient than in other healthcare settings. The nurse acknowledges symptoms, offering tools to allow the patient to regain control of his or her health outcomes.
Documentaries Inspire Smokers to Kick the HabitPat Folan, RN
Pat Folan, RN, Director, Center for Tobacco Control, Pulmonary Medicine, North Shore University Hospital, Manhasset, N.Y.
To give smokers enrolled in North Shores cessation program more information about strategies for quitting, the Center for Tobacco Control team, directed by Folan, collaborated on the documentary 4,000, which represents the 4,000 chemicals found in each cigarette. The 30-minute film chronicles the challenges and successes of moderate-to-heavy smokers who have been counseled and coached by hospital staff through the quitting process. North Shore developed the documentary because educational films explaining the effectiveness of combination therapy to treat tobacco dependence could not be found elsewhere. Community participants have said the inspirational stories of smokers in the film have given them hope and confidence in their ability to kick the habit.
A second documentary, I Could Have Been Five Feet, highlights the smoking cessation efforts of an adolescent who smoked from ages 12 to 19 and believes her 4-foot-10 stature is a direct result of smoking. The teen suffered several bouts of bronchitis, was suspended from school, and was eventually released from the schools varsity swimming team because of smoking. The documentary star and a staff member also visited local schools to encourage students to avoid smoking. I Could Have Been Five Feet has been distributed to more than 450 schools on Long Island.