The Future of Nursing 2020-2030 Charting a Path to Achieve Health Equity (2021) / Chapter Skim
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Appendix G: Profiles of Nursing Programs and Organizations
Appendix G: Profiles of Nursing Programs and Organizations
Pages 433-470
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From page 433... ...
Nurses are increasingly using their expertise, their connections with communities and individuals, and their ability to collaborate across professional boundaries to address SDOH and give everyone an equal opportunity to live a healthy life. The following vignettes describe nurses' work in this area; the vignettes are divided into sections on • prioritizing SDOH, • strengthening the nursing workforce, • innovating in health care, • mental health and substance abuse, • community-based health and social care, • leading on gender equity, and • the power of leadership.
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To reduce this waste while simultaneously addressing the needs of patients and local communities living with food insecurity, she, along with Nicole Wynn, DNP, RN-BC, and a team of community leaders founded the Rush Surplus Project. The program began as a partnership between ROPH and the Oak Park River Forest Food Pantry (recently renamed Beyond Hunger)
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Those early experiences led Szanton -- now endowed professor for health equity and social justice and director for policy at the Center for Innovative Care in Aging at the Johns Hopkins University School of Nursing in Baltimore -- to co-create a program called CAPABLE (Community Aging in Place -- Advancing Better Living for Elders) , designed to help low-income seniors age safely in their own homes. Two key program components are an em
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Trinity Health -- a nonprofit Catholic health system -- is offering the program to complex care patients in Muskegon, Michigan. According to Szanton, if the nation is to leverage the strengths of an aging population, policy changes will be needed to (1)
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degree, and a doctorate. In 2001, Batheja, along with his mother and wife (a behavioral health professional)
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STRENGTHENING THE NURSING WORKFORCE Multi-Employer Training Fund: Reducing Educational and Income Disparities In 2018, the U.S. Bureau of Labor Statistics projected that within a decade, jobs in the health care sector would increase by 14 percent, outpacing other occupations.
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But recognizing the limitations of a single-employer training fund, Diane Sosne, RN, MN, president of SEIU Healthcare 1199NW (a union representing 30,000 health care employees in Montana and Washington State) , became one of the founders of the SEIU HealthCare 1199NW Multi-Employer Training Fund.
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Rhode Island Nursing Institute Middle College Charter High School: A Pipeline to Health Equity Although ethnic or racial minorities represent almost 40 percent of the U.S. population, they make up only about 20 percent of the nursing workforce.
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These college enrollment rates contrast with a 52 percent enrollment rate for economically disadvantaged students in all of New England and an average enrollment rate of 55 percent for the region's Hispanic and Black students. McCue and her colleagues have a vision of replicating this model and developing a national network of schools working together to prepare a diverse group of students to become the future nursing workforce and leaders in their communities.
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INNOVATING IN HEALTH CARE Complex Care Model: Partnering for Transformation Lauran Hardin, MSN, CNL, FNAP, FAAN, learned a valuable lesson about model design nearly a decade ago when a chief executive of Mercy Health Saint Mary's Hospital in Grand Rapids, Michigan, jokingly told her she was accountable for a $2.6 million revenue loss. As the hospital's complex care clinical nurse leader, Hardin had successfully reduced health care utilization by palliative care patients and had been asked by the administration to extend her work to patients with high utilization of services outside of palliative care.
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Examples include • contending with policies such as those that prevent former felons from obtaining public housing or employment, or assessing the effects of not having health insurance; • securing resources for long-term sustainability, including for staff care delivery, data analysis, and research; • developing new competencies, including care coordination, cross-sector partnership, data analysis, and a focus on population health; and • addressing myriad systems-level barriers, including messages that un dermine nurses' ability to become leaders in the area of complex care management. Hardin's model has been shown to reduce ED use, hospitalizations, lengths of stay, and costs while increasing primary care visits, stable housing, and health care coverage.
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They report feeling seen and heard, and having a sense of renewed hope." She adds that the initiatives are helping not just patients but also their families, their communities, and the entire health care system by improving relationships, social circumstances, and care coordination. She notes further that Adventist Health is developing metrics to better measure the impact of this work on community well-being as it moves further upstream to address specific SDOH.
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Cunningham has since expanded his research on resilience-building practices to Emory Healthcare in Atlanta, Georgia, where in 2019 he became vice president of practice and innovation. "We find ways to scale best practices in culturally appropriate ways," he says, "and make them available to a wider audience." The Pause is a secular practice implemented after the death of a patient, offering the care team 30 to 45 seconds of silence to honor the life that has ended and the clinicians and support staff who cared for that life.
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The Pause has been implemented in 23 locations within the United States and globally in settings that include hospitals, academic institutions, administrative offices, and community health settings. Cunningham describes it as "a grassroots movement" that can be disseminated in various ways, including via clinical training or at the bedside.
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Associated with such conditions as heart disease, stroke, liver disease, and cancer, alcohol use may also signal the presence of other risky behaviors, including tobacco use, drunk driving, risky sexual behaviors, and suicidal ideation. Lowe's creation of the Talking Circle (TC)
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The TC intervention is also recognized as an American Academy of Nursing "Edge Runner" evidence-based innovation. In addition to TC groups in Oklahoma, Lowe has implemented the Virtual Talking Circle intervention to help other Native American communities -- including those in Minnesota and North Carolina -- provide similar interventions through video conferencing with a facilitator.
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There is also evidence of improved academic performance, which Melnyk believes can reduce educational disparities. Melnyk reports further that the program has been well received by children and teens and that when one variation of the program -- COPE/Healthy Lifestyles TEEN -- was shown to diminish obesity and depression, the National Cancer Institute listed it as a research-tested effective obesity control intervention for teens with the highest level of dissemination capability.
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Others, including counselors, mental health providers, school nurses, and community health workers, are also using the model. COPE is also being used in young adults -- for example, in universities to help prevent suicide and reduce dropout rates, as two-thirds of students who leave college before graduation do so because of a mental health issue.
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The center is now pushing to make telemedicine part of the standard of care. Doing so, Gomez says, is crucial for homebound patients, those with mental health illnesses who are secluded in their homes, the elderly, and pregnant women on bed rest or too depressed to go to a health center.
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The idea of a primary care clinic -- the Pine Ridge Family Health Center (PRFHC) -- on site at Pine Ridge Manor soon took hold.
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Evidence on the impact of C2C on students and the residents of Pine Ridge is still emerging, but preliminary findings of an analysis commissioned by NCIPE include the following: • As of 2018, the clinic had 1,131 visits from 444 unique clients. The sources of referral are expanding, and include local hospitals, commu nity agencies and halfway houses, and other community health clinics.
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The faculty, she says, "views health care as an act of social justice," and the students, who are from the community, "go back and give back." Working in tandem with Breslin is Cindy Sickora, DNP, RN, vice dean of practice and engagement and clinical professor. Before joining UTHSCSA, she was the founding CEO of the Rutgers Community Health Center (a nurse-managed federally qualified health center)
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That is the future." For more information, see Collins, 2012; Parke et al., 2019; Sickora and Chase, 2014; UT Health San Antonio School of Nursing, 2020; UT Health San Antonio Wellness 360, n.d. LEADING ON GENDER EQUITY Ending Period Poverty: The Royal College of Nursing Takes Aim For the estimated 800 million girls and women menstruating daily worldwide, long-standing traditions, stigmas, and taboos related to periods can carry significant physical, social, and economic consequences.
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they don't recognize the embarrassment that girls experience when they don't have access to sanitary products." In 2017, Nursing Standard, the official journal of RCN, reported that school nurses were increasingly buying sanitary products to keep girls in school. At its June 2019 annual meeting, the RCN membership committed to pursuing three goals: • Raise awareness of the problem among nurses and midwives, as well as the public.
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"It was an offer I could not refuse," she says, adding, "I led and rolled out a comprehensive prevention, treatment, care, and support program that is still a model in Africa now, offering free access to services." Tlou was able to keep on shifting the patriarchal culture of Botswana and promote gender equity by linking HIV to policies harmful to women. At the time, she says, 90 percent of women had access to perinatal care.
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Cogan joined the Camden School District in 2001 and completed the necessary courses to become a certified school nurse. Beyond carrying out the standard tasks of her profession -- health screenings, teaching, ensuring vaccine compliance, and caring for children with chronic health conditions -- she describes her role as the school's "chief wellness officer." In this role, she advocates for children's health and welfare, including mental health; procures and manages grants for wellness initiatives for students and their families; provides health education; conducts outreach for displaced children and families; offers individual and small-group counseling; refers students and families to health and social services; arranges resources for teachers and other staff for managing challenging behaviors in the classroom; and encourages conflict resolution among students.
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Accordingly, at the School Nurse Certification Program at Rutgers University School of Nursing, Camden, where Cogan now teaches, she and two colleagues redesigned the certificate program into a master's program that incorporates a focus on population health, social determinants, adverse childhood experiences, leadership, and health equity. Cogan also has dedicated herself to mentoring, publishing her writings, and speaking at an increasing number of events and conferences.
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Both are in the Louisiana State Nurses Association Hall of Fame. Together, they engage in mutual mentoring as they address SDOH through their health system and a community-based initiative to make Baton Rouge a healthier place to live and work.
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Employees making less than $15 per hour can purchase a $25 box of food for just $10; Our Lady of the Lake subsidizes the difference. Barrett says both facets of the initiative -- addressing food insecurity and supporting a local farmer along with migrant workers -- are driven by her commitment to social justice.
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In 2018, Governor Jay Inslee appointed Sue Birch, MBA, BSN, RN, to serve as director of the Washington State Health Care Authority, the state's largest health care purchaser. Birch quickly reached out to other nurse leaders, several of whom had for some time been collaborating informally on shared interests: Eileen Cody, BSN, RN, who since 1994 has represented Washington's 34th district in the House of Representatives, chairing its Health Care and Wellness Committee; Patty Hayes, RN, MN, director of public health for Seattle and King County; MaryAnne Lindeblad, BSN, MPH, among the longest-serving state Medicaid directors in the country; Azita Emami, PhD, RN, FAAN, Robert G
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• Changing Nursing Education. The group's involvement with ACH aligns with Emami's efforts to focus nursing education on population health and provide students with opportunities "outside of hospital walls" to learn about SDOH and health equity and to acquire the skills to put that knowledge into practice.
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n.d. Pine Ridge Family Health Center.
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2018. A nurse-led intervention to address food insecurity in Chicago.
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2013. Achieving health equity through nursing workforce diversity.
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. Nurses' Institute Middle College shapes, trains nursing workforce.
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2019. Three decades of Mary's Center's Social Change Model: A community health center's approach to addressing the social determinants of health.
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2019. UK government launches new taskforce to put an end to period poverty.
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