Provide one example, with supporting evidence, of organizational support for clinical nurse involvement in community healthcare outreach.
AND
Provide one example, with supporting evidence, of organizational support for nurse leader involvement in community healthcare outreach.
Example 1 - Introducing an Innovative Program with Community Partners: Introduce the DASH Diet
Introduction/Background
Cardiovascular disease is one of the leading causes of death in the USA. In Ontario County, one of the top two key health priorities is the reduction in hypertension rates. Hypertension increases the risk of many other diseases including heart disease and stroke. Coronary Vascular Disease is the leading cause of death in Ontario County.
There are a number of ways to reduce the risk of cardiovascular disease or to manage the symptoms associated with this illness. One such strategy is centered around managing dietary intake of foods that exacerbate or increase the risk of developing cardiovascular disease. Thompson has a very active cardiac rehabilitation team and they are always seeking ways to bring "heart healthy" messages to the community. This dedicated group of clinical nurses used their network of contacts in the community to bring a new and exciting program to fruition. The support of Ellie Fralick, a Thompson Board member, was instrumental in establishing community partnerships and sponsors to get the program off the ground. The cardiac rehabilitation team worked with local partners to develop a series of events at the Wine and Culinary Center to bring education and hands-on experience in making delicious low fat, low sodium heart healthy foods. The goal is to inspire people with hypertension, and those at risk, to develop skills to increase their dietary compliance. Thompson supported the clinical nurses in this process paying for their time to attend both the planning meetings (6 one hour meetings) and for attendance and participation at the events (2 hours per nurse per event).
Participants and their roles: Mary Allhusen, RN-BC, Clinical Nurse, Assisting participants with 'hands on' portion of the program Heather Williams, RN, Clinical Nurse, Assisting participants with 'hands on' portion of the program Kathy Roeland RN, Clinical Nurse, Assisting participants with 'hands on' portion of the program Judith Flamini, LPN, Licensed Practical Nurse, Assisting participants with 'hands on' portion of the program Marie Rusaw, Director of Cardiopulmonary Services, Assisting participants with 'hands on' portion of the program Ellie Fralick, Board Member, Program Sponsor Chef Jeff Christiano, Chef at the Wine and Culinary Center, Teaching the recipes in the hands-on kitchen Ginny Clark, VP Community Affairs, Constellation Brands, Program Sponsor Randy Jacques, Director of Wellness at Thompson Health, Administrative Support for Program Development Darcy Prunoske, Registered Dietician at Thompson Health, Education Peter Rogers, General Manager New York Wine and Culinary Center, Program Sponsor Amy Slentz, PR and Marketing Wine and Culinary Center, Program Sponsor
The program centers around the implementation of Dietary Approaches to Stop Hypertension (DASH diet). The DASH diet is based on evidence from research sponsored by the National Heart, Lung, and Blood Institute (NHLBI) that following the DASH diet lowers blood pressure in individuals experiencing high blood pressure, and reduces blood lipid levels. Both of these outcomes reduce the risk of developing cardiovascular disease.
Four classes were planned over a 6 month period (Exhibit SE9.1a)
Exhibit SE9.1a
Exhibit SE9.1a DASH Diet
Class one : Introduction to Heart Healthy Eating (April 10th 2014) Class two: Hands on Cooking with Chef Jeff Christiano (April 24th 2014) Class three: Creating and using the DASH Pantry (May 1st) Class four: 10 Principles of Healthy Cooking (Sept 11th).
All the classes take place at the New York State Wine and Culinary Center where interactive education is held in either a "demonstration kitchen" and lecture theater or in the "hands on" kitchen which has six workstations that each accommodate 4 participants.
The classes were advertised in the Canandaigua and Rochester press, the Thompson Health Wellness newsletter, at the Mended Hearts support group, in the cardiac rehabilitation gym, and through flyers and mailings (see Exhibit SE9.1a). Participants could sign up for one or all of the classes available. Underwriting from community partners allowed the classes to require a nominal fee of $10 instead of the usual fee of $75 for Culinary Center classes. The events were a resounding success and tickets sold out very quickly. The evaluations have been positive:
Evaluation
Each session was evaluated using a self-report questionnaire. Questions were rated on a 5 point Likert-type scale (1=poor to 5-=excellent).
The participants were asked to rate the following:
Class 1 Evaluations Summary-Introduction to Heart Healthy Eating
97% of participants rated the Trainers Skills as excellent and 3% as very good.
100% of participants stated that they would recommend the program to others.
Class 2 Evaluations Summary-Hands on Cooking with Chef Jeff Christiano
100% of participants rated the Trainers Skills as excellent .
Class 3 Evaluations Summary- Creating and using the DASH Pantry
100% of participants rated the Trainers Skills as excellent.
Class 4 is scheduled for early September.
Exhibit SE9.1 Pre and Post class self-rating of knowledge
Exhibit SE9.2 Pre and Post class self-rating of knowledge
Exhibit SE9.3 Pre and Post class self-rating of knowledge
This innovative program has been a resounding success to date. The program meets Thompson's strategic objective concerning partnerships with the community, consistent with the community health assessment. Management of hypertension is one of the top goals of the community health plan and this program was designed to assist participants in following an evidence based approach to hypertension management through dietary modifications. Working together with community partners, clinical nurses at Thompson aim to improve the overall health of the community.
Example 2 - Organizational Support for Nurse leader involvement in Community Outreach activities
Tina Culver, BSN, RN, CWPC is the manager of Family Health and Wellness, a role that is focused on community outreach and educational activities (Exhibit SE9.4). Her role is focused on three main areas:
Exhibit SE9.4 Family Health and Wellness Manager Job Description
Exhibit SE9.4 2012 Manager Job Description.pdf
Tina is supported by the organization to provide community programming including:
Tina has a significant role in the local community planning for health initiatives. Thompson supports her to attend meetings of the “Ontario County Health Collaborative”. 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.
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 Hospital, with the Ontario County Health Collaborative allows Tina to ensure that the programs FF Thompson Hospital develops are aligned with the local community needs.
Exhibit SE9.5 is an excerpt from the Ontario County Health Improvement Plan 2013-2017. The plan outlines activities associated with the focus area of preventing chronic disease by reducing obesity in children and adults. The Thompson Get Up Fuel Up program was specifically designed to address healthy eating behaviors in school age children.
Exhibit SE9.5
Prevention Agenda Focus Area: Prevent Chronic Disease
Priority 1: Reduce Obesity in Children and Adults
Strategy Area
Objective
Activities
Partners
Timeframe
Measurement/ Evaluation
1. Reduce Obesity in Children and Adults
B. Prevent childhood obesity through early-care and schools
1 - B1. Attempt to have committee members on the Wellness Committees at each school district in the County.
OCHC/Hospitals
By June 2015
Adherence to wellness standards
1 - B2. Partner with local schools and after school programs to promote reducing screen time, healthy living, healthy eating and physical activity. Continue and expand the "Get Up! Fuel Up!” and “Food, Fun, Fitness” programs. Explore program with Midlakes. Explore homeschoolers and parochial schools.
OCPHD, Hospitals,
OCHC, schools, YMCA, Boys and Girls Club
Dec 2016 On-going
# of students reached
# of new students reached
1 - B3. Work with farms, food service directors and Seeking Common Ground to encourage use of local produce and farms in schools, restaurants, healthcare facilities, etc. Including promoting the use of the Ontario County "Local Food Guide" - CCE.
Cornell Cooperative Extension, OCHC, Hospitals, School Food Independence Committee, OFA
July 2014 On-going
# of schools, restaurants and health care facilities utilizing local produce
1 - B4. Create and annually update inventory of existing opportunities for physical activities available to community members at schools. Continue to encourage, develop and expand opportunities for physical activity for community members in school facilities.
OCHC, Schools
April 2014 – and annually thereafter
# of schools expanding use
C. Expand the role of health care, health service providers, and insurers in obesity prevention
1 - C1. Ensure providers are discussing obesity and providing resources – provide resource list to providers
Hospitals
July 2015 – On-going
EMR link to resources – measure use
From http://www.co.ontario.ny.us/DocumentCenter/View/3186