Janet Primomo

Changes in Political Astuteness After a Health Systems and Policy Course

Political advocacy, an integral part of the nursing role, requires knowledge of the policy process and skills. Few studies describe the influence of nursing education on political competence. This study examined political astuteness in graduate students before and after a required course in health policy. Students reported significantly higher political astuteness scores after the course. Academic preparation in health policy can increase the knowledge and skills that nurses need to effectively advocate for healthcare change.

Associations between asthma emergency visits and particulate matter sources, including diesel emissions from stationary generators in Tacoma, Washington

The objective of this research was to evaluate the effect of particulate matter air pollution, including emissions from diesel generators, on visits to emergency departments for asthma. Daily asthma case data from participating hospitals in the greater Tacoma, Washington area were obtained. Daily asthma emergency room visit data were available from six Tacoma hospitals from January 3, 1998 to May 30, 2002. Only emergency visits where the primary discharge diagnosis was asthma were included in the analysis. Air pollution, daily temperature and relative humidity data were obtained from the Puget Sound Clean Air Agency. An association between daily PM2.5 and emergency department (ED) visits for asthma at lag days 2 and 3 was observed. The relative risk for lag day 2 was 1.04 (95% confidence interval[CI]: 1.01, 1.07) and for lag day 3 was 1.03 (1.0, 1.06). A significant association between ED visits for asthma and increased use of diesel generators was not detected. The use of low-sulfur diesel oil may have mitigated potential adverse health effects. These data indicate that air pollution in a medium-sized coastal city may be sufficient to have a public health impact on asthma.

Use of a Silicone Nipple Shield with Premature Infants

Nipple shields have been used with premature infants to facilitate breastfeeding in certain circumstances. In this paper, clinical observations and chart reviews regarding nipple shield use by 15 premature infants are reported. Volume taken at the first breastfeeding was compared to the volume prescribed by the physician, based on caloric requirements for infant weight. Using test weights, we found that 60 percent of these infants consumed 50 percent or more of the prescribed amount with the first use of the nipple shield. The nipple shield was found to be useful in certain circumstances where mothers had attempted breastfeeding previously.

Changes in Political Astuteness Following Nurse Legislative Day

Political astuteness, including awareness, knowledge, and involvement, is necessary if nurses are to engage in policy advocacy—a vital aspect of the nursing profession. However, little is known about the effects of learning activities, such as legislative days, on political astuteness. The purpose of this research was to determine if political astuteness changed after participants attended a state nurse legislative day. Pre and post data were collected from participants in two studies (N = 80 and N = 34) using the Political Astuteness Inventory (PAI). Political astuteness scores were significantly higher after participants attended legislative day as compared to before. Age and educational rank were positively correlated with political astuteness. Experiential activities such as attending nurse legislative days that offer opportunities to learn policy advocacy skills can enhance knowledge of and participation in the policy process.

The utilization of geographic information systems to create a site selection strategy to disseminate an older adult fall prevention program

Abstract Public health programmatic interventions are increasingly required to address the prevention needs of aging populations. Falls in adults age 65 and older are the leading cause of injury hospitalization in the U.S., and a leading cause of international fatal injuries in older adults. This project used geographic information systems (GIS) to create a site selection strategy for the dissemination and pilot evaluation of a community-based fall prevention program for older adults in Pierce County, Washington. Potential site addresses (n = 84), 2000 U.S. census data for adults ≥65 years of age, and local road networks, which were converted into service areas using actual travel time, were entered in a GIS. Potential sites were then ranked by census densities of older adults who lived within 10 min travel time. Nine sites launched the program, with the goal recruiting 20 older adult program participants at each site (n = 180). At the end of 12 months, participation exceeded program goals (n = 331). GIS can be used to determine actual travel time, and may facilitate the selection of community-based prevention program sites to maximize accessibility and utilization by targeted populations.

Taking the lead in environmental health: defining a model for practice.

1. The link between the environment and health has become increasingly evident during the last half of this century. 2. The concept of environment has been central to nursing practice since its origins; however, nursings description of this concept has varied over the years. Occupational health nurses tend to place more emphasis on environmental aspects of health and safety than other nursing specialists. 3. An ecological systems model provides a convenient framework for describing the interrelationships and interactions that exist in the various levels of environmental systems. 4. This model can serve as means to guide the development of primary, secondary, and tertiary preventive strategies to address environmental and occupational health problems.

Community Health Needs Assessments: Expanding the Boundaries of Nursing Education in Population Health

BACKGROUND Conducting federally mandated community health needs assessments through academic-practice partnerships provides new opportunities for developing population health nursing competencies. OBJECTIVES The purpose of this article was to describe how a baccalaureate practicum experience within such an assessment process, involving health care system partners, re-affirms the importance of community and population health assessment in the development of future nursing leaders. RESULTS Student evaluations indicated an emerging appreciation for the social determinants of health, the power of partnerships, and the importance of diversity. Integrating health care and public health system perspectives on assessment meets both public health and nursing accreditation standards and extends student leadership experiences. Such integration also improves regional capacity for improving population health. CONCLUSIONS Federal mandates for community health needs assessments provide opportunities to advance leadership roles for nursing graduates throughout the health care system, and for confirming the importance of community assessment as an essential nursing competency.

A Comparative Analysis of Master of Nursing Students' Scholarly Inquiry

Although graduates of masters of nursing programs are expected to demonstrate competence in systematic inquiry, few reports describe how students obtain this skill. We conducted a comparative analysis of 118 scholarly projects from 2004 to 2009 with an earlier sample of 112 projects from 1996 to 2003. We examined changes in the method of scholarly inquiry, population type examined, and outcomes or products of inquiry. Data from a scholarly inquiry evaluation checklist were transcribed and analyzed. Literature review continued to be the most frequent method of scholarly inquiry, with few group differences noted between the time periods. Evidence-based clinical or practice projects increased as an inquiry method, as did health care providers as the population type. Papers of publishable quality and educational materials increased as outcomes of scholarly inquiry. Although this analysis is limited by incomplete data and a need to clarify checklist categories, the increased number of clinical-based projects supports a shift to evidence-based practice outcomes. The expansion in the number of educational scholarly projects is attributed to increasing enrollment in the nurse educator option. With new Essentials of Masters Education in Nursing and the transition of specialty preparation to the doctoral level, revisiting scholarly outcomes for masters degree students is recommended.