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Posted: 9/18/2006

The latest "Hopkins Nursing News and Research Briefs" covers organ donation after cardiac death, strategies to keep children safe from lead, school-based strategies to reduce violence, thorny issues in informatics, and a JHUSON "Leader to Watch."

Critical Care Nurses Play Important Role in Efforts to Increase Number of Organs Donated
Over 90,000 people are currently waiting for solid organ transplants and, on average, 17 people die each day waiting for one. In "Donation After Cardiac Death: Ethical Implications and Implementation Strategies" (AACN Advanced Critical Care, Vol. 17, No. 3, July-September 2006), Johns Hopkins University School of Nursing (JHUSON) Associate Professor Cynda Hylton Rushton PhD, RN, FAAN, explores processes and strategies for a new approach to collecting organs, Donation After Cardiac Death (DCD). As an alternative to the more commonly used neurologic criteria of determining death, DCD would greatly increase the number of potential organ donors identified.  The author notes that in all cases involving organ donation, many ethical issues are involved and great care must be taken to assure the donor and donor's family/surrogates preferences and wishes are respected.  Rushton points out that critical care nurses are ideally situated to collaborate with other health care professionals and implement proposals such as DCD while advocating for safe, ethical, quality care for patients. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=16931930

Research Studies Show New Ways to Identify, Reduce Lead in Homes with Children
Two recently published studies by JHUSON faculty member Patricia McLaine address the issue of lead in homes where children are at risk. "An Investigation of Dust Lead Sampling Locations and Children's Blood Lead Levels," published in the Journal of Exposure Science and Environmental Epidemiology (advance online publication), co-authored by McLaine, suggests the best locations for conducting sampling in a home for the presence of lead in dust and guides the collection of dust lead wipe samples.  The authors specify that when conducting the evaluation required by EPA in homes at risk for lead contamination among resident children, both entry floor samples from the living room and kitchen and a single central floor sample from the child's bedroom are highly predictive of the child's blood lead status. http://www.nature.com/jes/journal/vaop/ncurrent/full/7500514a.html  In "The Effectiveness of Low-Cost Soil Treatments to Reduce Soil and Dust Lead Hazards: The Boston Lead Safe Yards Low Cost Lead in Soil Treatment, Demonstration and Evaluation," (Environmental Research, Vol. 102, Issue 1, September 2006), also co-authored by McLaine, researchers found that low-cost yard work and soil interventions can reduce exposure to lead hazards in homes where lead from the yards can be brought into the home or blown in as dust. Costs of full abatement, such as replacing much of the yard's topsoil, are high, but other methods studied by the authors cost less than a third of full abatement, averaging $2,798, and included ground cover and ground treatment along with a contractor-developed individualized maintenance plan. Residents often implemented the recommended work within one year by watering lawns and gardens, mowing grass, adding plantings, and weeding.  Their work resulted in a reduction in soil lead concentrations comparable to the more expensive treatments used in the past.  http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=16500641&dopt=Abstract

Study Provides Guidance to School-Based Intimate Partner Violence Prevention and Intervention
In "Challenges in the Evaluation and Implementation of School-Based Prevention and Intervention Programs on Sensitive Topics" (American Journal of Evaluation, Vol. 27, No. 3, September 2006), JHUSON Associate Professor Joan E. Kub, PhD, APRN, BC, and co-authors describe the challenges of launching successful intimate partner violence prevention and intervention programs and evaluating school-based programs. The study focuses on lessons learned from three widely differing projects implemented in schools in West Los Angeles, CA; Baltimore, MD; and Arizona.   While all three programs were targeted toward youth in 8th and 9th grades, they presented significant differences in methods and approach.  The authors make numerous recommendations but stress the importance of flexibility and cultural awareness throughout the process and offer suggestions for maintaining ongoing communication and cooperation with schools and the community. http://aje.sagepub.com/cgi/reprint/27/3/320?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&author1=Kub&searchid
=1&FIRSTINDEX=0&sortspec=relevance&resourcetype=HWCIT

Thorny Issues in Nursing Informatics Confronted by JHUSON Experts
In publications out this month, two well-know JHUSON nursing and health care informatics experts explore issues and raise questions about developing technology and its use.   Marion J. Ball, EdD, asks provocative questions in "Skills and Competencies Needed in the Nursing Informatics Role," a chapter in Nursing and Informatics for the 21st Century. As co-author,  Ball addresses the need for academia to align information technology (IT) theory with practice and to identify the IT skills academic programs that should be "at the fingertips of the next generation" of nurses. Her key message in the chapter is that new curricula must educate and train nurses differently than in the past so that nurses are better prepared to work in increasingly interdisciplinary and technology-enabled environments and that they become involved at every level of the "informatics revolution."  In a foreword to E-Health & Medical IT Solutions 2006, Patricia Abbott, PhD, RN, BC, FAAN, makes the case that global connectivity is crucial to improving health care and delivery worldwide. She emphasizes the need for access to information in developing nations, especially in African nations that currently have only three percent of the world's telephone lines and where 80 percent of the population lives rurally. Abbott notes that in spite of these limitations, Africa is the world's fastest growing mobile market and both the United Nations and World Health Organization are working on advanced information and communications technology (ICT) and making a concerted effort to encourage the use of ICT throughout the continent. http://www.touchbriefings.com/pdf/1965/contents.pdf

Nursing Professor is a "Leader to Watch"
There are many kinds of nurse leaders. Some are very operational and internally focused. Others are operational but are also constantly looking for the answer to "what's next?" In the August 2006 issue of Nurse Leader, JHUSON Professor Maryann Fralic, DrPH, RN, FANN, a leader described as one who has the uncanny ability to look into the future and prepare current leaders for the next reality, shares how she learned those skills and her advice for tomorrow's leaders. http://download.journals.elsevierhealth.com/pdfs/journals/1541-4612/PIIS1541461206001492.pdf