Kelly Ranson, BSN, PHN, RN, CCHP, a nursing graduate student at California State University, Dominguez Hills, in Carson, Calif., turned her award-winning class assignment into a program where she works, Kern Valley State Prison, Delano, Calif.
As chief nurse executive for the level-4 high-security facility for the past five years, Ranson immediately knew she wanted to focus on the inmate population when CSUDH Assistant Professor of Nursing Lauren Outland, DrPH, APRN, MPH, CNM-BC,assigned the project in her health promotion and disease prevention course, according to a news release.
The resulting project was Improving Glycemic Control Among Incarcerated Men, which Ranson designed to help inmates control their diabetes, a national epidemic the complications of which she has seen firsthand behind prison walls.
The inmate population is experiencing the same health problems as the rest of the country, Ranson said in the release. I was thinking there had to be something we could do to improve the health of diabetic inmates, and I knew that we could also reduce the cost of their care if we could figure out a program for them.
Ranson, who expects to graduate from CSUDH this fall with an MSN, nurse administrator option, received an A on her assignment in Outlands class. The project also took first place at the 2014 CSUDH Student Research Day in the Health, Nutrition and Clinical Science category, according to the release.
While still enrolled in Outlands course, Ranson began working to get approval to implement the program at Kern Valley State Prison. She presented a draft program to Warden Martin Biter and prison CEO Michael Hutchinson. Both agreed to implement the program.
Ranson explained how the program would benefit the health of diabetic patients, and how teaching them to manage their diabetes better could also be a significant cost savings for the people of
She was concerned inmates from the general prison population would try to take advantage of those who were in the IGCAIM program.
To prevent this, Ranson met with the Inmate Advisory Committee, which is made up of inmates who have the respect of other inmates, and can influence their decisions and how they treat each other.
We still have to be careful about not treating our patients differently because the other inmates will try to manipulate them, but the support of the IAC has helped them stay with our program, Ranson said in the release. At Kern Valley State Prison not only does Ransons program enable incarcerated patients to carry glucometers to monitor their own blood glucose levels, but also each participant is given intensive education and must meet frequently with nursing and other health staff.
In the program, inmates are taught extensively about their diabetes and low-impact ways to manage their blood sugar, such as exercising more, drinking more water and managing what they eat, Ranson said in the release. Nobody in prison gets a special diet. They all eat the same thing. So we teach them creative ways of managing what they should and shouldnt eat.
Entering the IGCAIM program is voluntary, and so is remaining in it. Inmates who are not willing to comply with the programs guidelines, or converse and work with us; those who behave improperly, mess with their needles or glucometers, and/or sell their supplies are dropped from the program, she said. But if they do behave we work with them extensively and help them learn how to treat their disease and avoid amputations, blindness, and early death.
Up and Running
Since the project was implemented more than a year ago, it has proven successful. Ranson was recently accepted to present her process at the World Congress on Public Health in Kalkota, India, which will take place in February.
Many inmates participating in the program have reduced their A1Cs. If someone has an A1C less than nine there is a great likelihood that he or she will never develop those awful consequences associated with diabetes. Inmates who have A1Cs of nine or greater are encouraged to join our program, Ranson said in the release. Overall, we have had a lot of success. In fact, some people are no longer taking insulin. They now control their blood sugar just through our recommended dietary choices