Anne Derouin

Increasing HPV Vaccination Series Completion Rates via Text Message Reminders

Human papillomavirus (HPV) is the most frequently diagnosed sexually transmitted infection in the United States. It is associated with the development of cervical, anal-genital, and oral-pharyngeal cancers. The rate of HPV infection among adolescents and young adults in the United States remains high, and completion rates of an HPV vaccine series remain low. At an urban pediatric clinic, adolescent and young adult participants aged 11 to 22 years (n = 37) received text message reminders for their second and third dose of HPV vaccine over an 8-month study period. Of the participants receiving text message reminders, 14% completed the vaccine series at the optimal time, whereas 0% of an interested group (n = 43) and only 3% of a standard care group (n = 232) completed the vaccine series at the optimal time. Findings support the use of text message reminders to improve HPV vaccine series completion rates in a pediatric practice.

Living on the edge: the current phenomenon of self-mutilation in adolescents

The purpose of this article is to share current knowledge about adolescent self-mutilation (SM), and to discuss treatment approaches for affected teens and young adults. One in eight American teenagers experiences depression or anxiety. The growing phenomenon of SM is a particularly worrisome coping mechanism used by teens and young adults to deal with stress and sadness. The incidence of SM is increasing, and might be fueled by current trends in music and media that highlight violent and self-injurious behaviors. SM represents a “cry for help” by adolescents who are suffering. Self-mutilators who repeatedly cut themselves with razors, scissors, knives, or sharp glass are not attempting suicide, but are seeking to relieve extreme anxiety, tension, or pain. Medical literature regarding SM is limited, and evidence-based treatment approaches have not been documented; however, early discovery of SM and the development of a multifaceted treatment approach that incorporates the child, family, and trusted practitioners could be instrumental in managing SM. There is hope that antidepressant medications may also be beneficial. Research is needed to identify successful treatment approaches, and to discover the best ways to educate teens, families, educators, and community leaders about the prevalence of SM in our youth.

Beginning With the End in Mind: Cultivating Minority Nurse Leaders

In response to the need for increased racial and ethnic diversity in the nursing profession, the Duke University School of Nursing (DUSON) established the Making a Difference in Nursing II (MADIN II) Program. The aim of the MADIN II Program is to improve the diversity of the nursing workforce by expanding nursing education opportunities for economically disadvantaged underrepresented minority (URM) students to prepare for, enroll in, and graduate from the DUSONs Accelerated Bachelors of Science in Nursing program. Adapted from the highly successful Meyerhoff Scholarship Program model, the program is to cultivate URM nursing graduates with advanced knowledge and leadership skills who can address health disparities and positively influence health care issues currently plaguing underrepresented populations. The article discusses the MADIN II framework consisting of four unique components: recruitment of students, the Summer Socialization Nursing Preentry Program, the Continued Connectivity Program, and the Succeed to Excellence Program, providing a framework for other academic programs interested in cultivating a pipeline of minority nurse leaders.

Nurses on the Front Lines: Improving Adolescent Sexual and Reproductive Health Across Health Care Settings

The girl-child is hindered from achieving her full potential in life due to an “unknown burden”. The unknown unexpected burden comprises people, poverty, pregnancy, diseases, illiteracy and maltreatment. The purpose of the paper is to examine if the girl-child could be empowered to live an improved qualitative life through a school social work intervention and connecting the people who will support the girl-child. Are there problems in the life of a girl-child that prevent her from maximizing her educational opportunities? The intervention was conducted in two schools in Akinyele Local Government Area, Oyo State, Nigeria. All students (638) who attended the intervention workshop constituted the sample for the study. Data was collected through questionnaires administered after a presentation of the “unknown burden” of the girl-child to the entire school population. Data collected were analysed through frequency counts and percentages. Findings showed that the majority of the girls were aware of their burden, even though they do not know how to deal with it. In conclusion, the intervention was successful at giving the girl-child a forum to air her burden and help her to identify sources of support. Recommendations made included the establishment of the position of school social workers and the empowerment of the girl-child to be self-determined to succeed at school. Keywords: empowerment, connecting people, school social work, girl-child, intervention, unknown burden

Student-Faculty Lunch Program to Increase Mentoring and Facilitate Cross-Program Relationships in School of Nursing.

Let’s DU Lunch is a pilot program launched to explore the impact of a low-cost, student-faculty lunch program to increase mentoring and facilitate cross-program relationships. This program gave students the opportunity to go to lunch with a faculty member of their choice. A total of 71 students and 25 faculty participated. This program provided the opportunity for positive student-faculty interaction and mentoring and facilitated cross-program relationships.

Effectiveness of an on-site health clinic at a self-insured university: a cost-benefit analysis.

This study assessed the impact and cost-effectiveness of an on-site health clinic at a self-insured university. Health care costs and number of claims filed to primary care providers were trended before and after the clinic was established to determine savings. A retrospective chart review of all full-time, insured employees treated for upper respiratory tract infections (URIs) during a 1-year study period was conducted. On-site clinic costs for the treatment of URIs were compared to costs at outside community providers for similar care. Community cost norms for the treatment of URIs were provided by Primary Physicians Care, the administrator of insurance claims for the University. A cost-benefit analysis compared the cost of services on-site versus similar services at an outside community provider. Based on the results of this study, the Universitys on-site health care services were determined to be more cost-effective than similar off-site health care services for the treatment of URIs.

Building a Community of Health Professionals to Establish a Shared Learning Experience in Psychiatry and Substance Use Disorders for Health Professions Students

Caring for patients with psychiatric and substance use disorders requires collaboration among numerous healthcare providers in order to manage their complex medical, social, and psychological needs [1]. Typically, healthcare teammembers learn how to work together in the actual delivery of care [2]. Unfortunately, learning teamwork “by doing” can be difficult to achieve when it is perceived as competing with the demands of clinical practice, rather than in the spirit of intentionally working together. Despite the potential value of collaborative practice, numerous barriers challenge successful collaboration in clinical practice [2]. These barriers include professional concerns about autonomy and accountability, competition for financial resources, and procedural differences between disciplines. Introducing interprofessional education in the early stages of training is one strategy to improve health professions students’ appreciation of the value of collaborative practice [3–5]. Preparing learners to overcome barriers to team-based care, however, requires that the healthcare professionals from whom they learn model appropriate behaviors. Therefore, an interprofessional education course must also bring together diverse professionals who practice collaborative care. A course intentionally designed toward these goals would provide students with opportunities to develop skills in teamwork, reflect on their professional role, and resolve power struggles [2]. Creating a Community of Practice with key leaders from each student’s health professions program is one way to maximize student benefit from interprofessional education. A Community of Practice among key health professional leaders would create a shared vision for students’ learning and collaboration [6]. These leaders would represent the learning needs of their respective students, connect learning to relevant clinical applications, and lead the learning experience through barriers and challenges to successful execution [7–9]. Since a Community of Practice consists of individuals with a genuine passion for a topic who are interested in collaboration, one outcome could be the modeling of interprofessional behaviors, including sharing ideas and experiences, learning from one another, deepening expertise, exhibiting mutual respect, and building innovations [10]. Less well described in the interprofessional education literature, however, is the intentional development of a Community of Practice as a strategy to guide these training activities. Building upon an existing substance use course for health professions students [3], we developed a new course embedding the intentional modeling of an interprofessional Community of Practice. The purpose of this paper is to describe our deliberate process for using a Community of Practice framework to build a team of faculty from medicine, pharmacy, and nursing and to develop a psychiatry and substance use disorders course for medicine, physician assistant, pharmacy, and Accelerated Bachelor of Science in Nursing (ABSN) students.

Implementing a Parent Education Program in the Special Care Nursery

BACKGROUND Parents of preterm hospitalized infants, whose lengths of stay can range from a few days to several months, often experience emotional liability. Because the Neonatal Intensive Care Unit (NICU) or Special Care Nursery (SCN) is a stressful and intimidating environment, prompt attention should be given to reducing parental stress and increasing parental confidence in preparation to care for their child post-discharge. METHODS A quality improvement pilot project was designed to evaluate the parent education and support program, titled HUG Your Baby, in a Level II SCN for its ability to decrease stress and increase confidence for postpartum mothers of preterm infants born at less than 35 weeks gestation during the infants hospitalization. RESULTS The outcomes demonstrated a statistically significant decrease in maternal stress and a statistically significant increase in maternal confidence. DISCUSSION The HUG Your Baby program is an effective parent education and support program that would benefit NICU and SCN families.

Strategies to Address Individual Level Social Determinants of Health Designed to Cultivate the Next Generation of Minority Nurse Leaders Committed to Health Equity

In response to the need for increased racial and ethnic diversity in the nursing profession, the Duke University School of Nursing (DUSON) established the Academy for Academic and Social Enrichment for Leadership Development in Health Equity (Health Equity Academy). The aim of the Health Equity Academy is to improve the diversity of the nursing workforce by expanding nursing education opportunities for underrepresented minority (URM) students who are economically disadvantaged to prepare for, enroll in, and graduate from the DUSON’s Accelerated Bachelors of Science in Nursing program. The goal of this program is to cultivate URM nursing graduates with advanced knowledge and leadership skills who can address health disparities and positively influence health care issues currently plaguing underrepresented populations. The article discusses the Health Equity Academy framework, which consists of two unique components: the Pre-entry Immersion in Nursing and the Pathway to Success in Nursing (PSN). These two components are designed to address the nursing student individual level social determinants which could be potential barriers to success as well as provide support in their academic and professional development goals.

Evaluation of a Sickle Cell Disease Educational Website for Emergency Providers.

Sickle cell disease (SCD) is a complex multisystem debilitating disease. Despite its complexity, health care providers who are not SCD experts receive little formal education on SCD. An open-access, educational website, “Emergency Department Sickle Cell Disease: Crisis Management and Beyond,” was created to provide education about SCD to emergency department (ED) providers who are not SCD experts but who provide care for patients with SCD. Electronic surveys were used to conduct a formal evaluation of the accuracy and relevance of the websites content, as well as the effectiveness of the education modules in improving knowledge among health care providers. The evaluation consisted of (1) individual module pre- and post-knowledge assessment, (2) content validity assessment of educational modules, (3) overall website content assessment, and (4) overall website assessment (Health on the Net core principles). A convenient sample of ED providers, accelerated bachelor of science in nursing students, SCD experts, and website experts completed the anonymous surveys. Descriptive statistics and paired t tests were used to compare mean difference in post- minus pre-knowledge test scores. Knowledge scores statistically improved for nursing students (p value less than 0.0001). Emergency department providers showed a mean improvement of 3.2 points on the eight-item knowledge assessment. Both SCD experts and ED providers agreed that the module content was clear and easy to understand, accurate, comprehensive, relevant, and met module objectives. Participants agreed that the website was clear, easy to navigate, and visually appealing. Website experts stated that the website met much of the Health on the Net criteria. The website is a useful resource for providers and nursing students, especially those who serve or plan to serve in EDs.