SE10EO Nurses participate in the assessment and prioritization of the healthcare needs of the community.

Provide one example, with supporting evidence, of an improvement in an identified healthcare need that was associated with nurses' partnership with the community. Supporting evidence must be submitted in the form of a graph with a data table that clearly displays the data.

Nurses at all levels of the organization are involved in community outreach activities. As a community hospital, connections with the community are very important. As noted in SE9, we have a dedicated Manager of Family and Wellness, Tina Culver, BSN, RN, CWPC. Tina's role involves coordinating and supporting community activities.

FF Thompson Hospital's nurses play an integral role on the Ontario County's Health Collaborative. Tina has a significant role in the local community planning for health initiatives. FF Thompson supports her attendance at meetings of the Ontario County Health Collaborative. The Collaborative's vision is to improve the health of Ontario County residents. The committee’s mission statement is as follows:

The Ontario County Health Collaborative is an initiative that facilitates opportunities in Ontario County for improving access to health care and reducing the rates of chronic diseases in our communities. This coalition recently completed a community health assessment (Ontario County Community Health Assessment 2013-2017) that found Ontario County to place above the state average for cardiovascular risk factors. For example, cerebrovascular mortality rates were significantly above the state and regional average. Congestive heart failure mortality was also of concern. Obesity was chosen as a community priority due to the high rates of obesity and its effect on heart disease, diabetes, and other chronic diseases. The study found that of 578 Ontario County residents studied, the average Body Mass Index (BMI) of households was 30.6 which is considered obese.

Tobacco and alcohol use continue to be challenges for Ontario County. The percent of adults who smoke cigarettes(20%) is higher than both the New York State and upstate New York rates.

Leading Causes of Death by County, New York State, 2011

Source: Vital Statistics Data as of March, 2013 New York State Department of Health - Bureau of Biometrics and Health Statistics
Leading causes of death in Ontario County mimic that of New York State and upstate New York with the top two causes of death being heart disease and stroke.

Table SE10EO.1 Leading Causes of Death in Ontario County and New York State

Tina collaborates in developing objectives, identifying partners, strategies/ interventions, along with time frames. The newest Community Health Assessment and Community Health Improvement plan was published in 2013. The plan will be implemented and evaluated over the next several years (2013-2017). This relationship, supported and encouraged by FF Thompson, with the Ontario County Health Collaborative allows Tina to ensure that the programs FF Thompson develops are aligned with the local community needs.

The Ontario County Health Improvement plan identifies a top priority in the region as heart disease. Tina works closely with other members of the FF Thompson's team including Jeanna Savage, Director of Community and Governmental Relations to develop programs designed to improve the health and wellness of the local population. In 2011, FF Thompson sponsored its first Day of Dance event at a local school. After the first event, it was postulated that a move from the school to East View Mall in Victor could help raise the profile of the event and help meet the goals of the program.

FF Thompson Hospital’s Spirit of Women program now holds the Day of Dance for Heart Health in partnership with Finger Lakes Cardiology Associates, local dance and fitness studios, and East View Mall as a community outreach initiative to assess cardiovascular risk factors and to provide education and wellness information on how to reduce those factors. Extensive clinical and statistical studies have identified several factors that increase the risk of cardiovascular disease, the number one cause of death in the United States and the number one cause of death in Ontario County, New York. In many cases, heart disease can be prevented with education and the reduction and/or elimination of risk factors.

The Day of Dance aims to:

1. Assess the individuals in the community for cardiovascular risk factors by providing screening for Cholesterol levels and counseling
2. Educate individuals in the community about the prevention, reduction and elimination of those risk factors by counseling and referring
3. Provide individuals in the community with referrals to programs and services at to help them eliminate or reduce risk factors
4. Promote dancing as a fun exercise to help reduce many of the risk factors associated with heart disease
5. Educate women about heart disease and the unique signs and symptoms that occur in women. According to the American Heart Association, heart disease death rates among men have declined steadily over the last 25 years, while rates among women have fallen at a slower rate.
   
   Goal
   Increase the number of participants screened for high cholesterol as a marker of risk of cardiovascular disease.
   Cholesterol screening aims for early identification of patients at risk. David Carlson, MD reviews all cholesterol test results and blood pressure screenings. Follow-up letters are sent to the primary care providers of each patient and to individual patients with their test results.
   Each year at the Day of Dance, FF Thompson Hospital’s nurses oversee and perform hundreds of cardiovascular risk assessments that include: blood pressure screening, body fat percentage, cholesterol testing, sleep risk, depression, and stroke risk factors. In addition to assessing risk, a major focus of this event is to educate and counsel the community about risk factors and how they can reduce or eliminate many of them focusing on lowering blood pressure and cholesterol, smoking cessation, weight and BMI management, stress reduction, increase in exercise and healthy eating. The volume of participants grows year over year .
   
   

Participants and their roles:

Jeanna Savage, Director of Spirit of Women and Governmental Relations, Event coordinator, Women's Health information
Tina Culver, BSN, RN, CWPC, Manager of Community and Wellness, Wellness education
Mary Allhusen, RN-BC, Clinical Nurse, Cardiac Rehab Blood Pressure Screening
Kathleen Roeland, BSN, RN, Clinical Nurse, Cardiac Rehab, Blood Pressure Screening
Jane Hallstead, MS, RN, CDE, Diabetes Educator, Nursing Administration, Diabetes risk assessment and nutritional counseling
Stacy Marotta, MS, RN, NP, Nurse Practitioner, Finger Lakes Cardiology, Cardiovascular risk assessments and blood pressure screening
Kim Bagley, MS, ANP-C, Nurse Practitioner, Finger Lakes Cardiology, Cardiovascular risk assessments and blood pressure screening
Kathryn Tucker, BS, RN, JD, Quality Improvement Coordinator, Quality Department, Official Nurse on duty
Hazel Robertshaw, PhD, RN, CENP, Vice President Patient Care Services/CNO, General helping hands
Mary Ellen Fiorelli, RN, Breast Nurse Navigator, Diagnostic Imaging, Women's Health information
Sarah Gallagher, BSN, RN, CCRN, Quality Improvement Coordinator, Quality Department, Stroke Education
Hazel (Beth) Wilcox, RN, Quality Improvement Coordinator, Quality Department, Stroke Education
David Carlson, MD, Physician, Urgent Care/Healthworks, Review of Laboratory results and follow up
Wendy Blakemore, MS, BSMT (ASCP), Director of Laboratory Services, Cholesterol Screening
Summer Killian, LIS Coordinator, Cholesterol Screening
Angela Gage, Lab Clinical Service Technician, Cholesterol Screening
Jacob Daily, Lab Clinical Service Technician, Cholesterol Screening
Morgan Giles, Lab Clinical Service Technician, Cholesterol Screening
Nicole Wetmore, Chief Supervisor of Pre-Analytical Operations, Cholesterol Screening
Catherine Guatery, LPN, Clinical Nurse, Urgent Care/Healthworks, General helping hands
Sue Gantz, Office Manager, Planning Committee Member
Sandy Lesperance, Wellness Center Assistant, Aromatherapy and Wellness
Linda Rowsick, RD, Dietician, Patient Care Services, Diabetes risk assessment and Nutritional Counseling
Elaine Jackson, Director of Corporate Communications, Healthy eRecipe information
Michael Eve, Sleep technician, Sleep center, Sleep apnea risk assessment and information
Laura Reifsteck, Patient Care Technician, Sleep apnea risk assessment and information
Carol Drake, Director of Rehabilitation Services, Fitness information

Data requirements
The data collected show the number of cholesterol tests performed. Participants also receive a blood pressure reading and have access to a cardiology provider (MD or NP) from Finger Lakes Cardiology group to discuss their risk factors and potential follow up recommendations. All screenings provided are free of charge.
Graph SE10E0.1 Impact of moving the event to the local Mall to increase the number of community members screened.

Outcome
Access to screening was significantly increased; numbers doubled from 2011-2014.