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African Women, Patient Safety, Kidney Donors: The Focus of Hopkins School of Nursing Awardees

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Posted: 11/17/2009

Several Johns Hopkins University School of Nursing (JHUSON) faculty members have received grants and fellowships to research the  reproductive needs for African women, patient safety, and kidney donations.

Mali Midwives, Addressing Africas Unique Needs
Assistant professor Nicole Warren, PhD, MPH, CNM, Department of Community Public Health, earned the Maryland Higher Education Commissions (MHEC) New Nursing Faculty Fellowship of $20,000 over three years. Warren joined JHUSON this semester after two years as assistant professor at Chicagos Loyola University School of Nursing. As a Peace Corps volunteer in Mali in 1994-1996, Warren first was exposed to midwifery and to midwives' crucial role in providing reproductive health care in developing countries. The experience was life-altering: Warren returned to attend JHUSON to train as a nurse and midwife and earn her MPH, traveling often to Mali. In 2005 she formed Mali Midwives, an organization that supports continuing education programs for matrons, auxiliary midwives who provide most of the country's reproductive health services. Warren's research interests include maternal mortality in Mali and the work environment of such front-line health workers. She is also interested in exploring the reproductive health needs of African immigrant women who have been affected by female genital cutting (or circumcision) and now received care in the West. Warren is working on a pilot study in Baltimore to explore the childbearing experiences of Somalia-born couples. "I'd like to find out, for example: Did they feel they were unnecessarily subjected to Caesarean section? When the fellowship came through, I thought, 'This money will allow me to do that study,'" Warren said. "I'd like to see this [fellowship] used in a way that contributes to what I bring to the classroom. I can use those tools in order to be a better teacher."


Patient Safety, an Ever-growing Concern in the Medical Profession
Associate professor Jo Walrath, PhD, MS, RN, director of the JHUSON baccalaureate program, received a $35,000 grant under the program, Retooling for Quality and Safety: An Initiative of the Josiah Macy Jr. Foundation and the IHI Open School for Health Professions Institute for Health Improvement. Her grant proposal was submitted collaboratively with the JHU School of Medicine. Walrath's pilot project will bring together undergraduate nursing students and medical students to study how to improve interprofessional communication and work together for patients' benefit. The project will take place during classes in early spring, with a goal of reaching all 109 traditional nursing and 120 medical students. Both schools already include patient quality and safety in their curricula. The students will jointly participate in case studies involving  communication strategies between professions.  Effective communication is a core competency of all medical professionals and is considered a key element in reducing medical errors that adversely affect hospitalized patients, Walrath explained. "This effort is aimed at interprofessional education and will provide these students the opportunity to come together early in their educational process," she said. "Nursing students often ask why nursing and medical students are trained in academic silos and then are expected to come together after their careers start to figure out how to work together. This is a tremendous opportunity for these students to have both schools committed to pilot interprofessional education."

Organ Donation, the Greatest Gift of All
Department of Health Systems and Outcomes assistant professor Laura Taylor, PhD, RN, Department of Health Systems and Outcomes, is studying how living kidney donors and caregivers gain support in the organ donation process. She received a $450,000, two-year grant from the National Institutes of Health's National Institute of Nursing Research (NINR). The grant will expand Taylors Living Donor Information Network for Caregiving (LINC), a Hopkins-based Web site for living kidney donors and their "informal caregivers," usually relatives. Taylor hopes to gain critical insight into how African Americans, in particular, utilize the Internet to gain information and seek emotional support.

Taylor has worked at Johns Hopkins Hospital since 1987 and cared for patients who have undergone liver, kidney, and pancreas transplantation since 1994. For the past decade, she has studied the linkage between organ donors, information technology and donors trust in the medical staff.

In the randomized controlled trial, donor candidates and their informal caregivers will be invited to join LINC, which features a discussion board, PDF files on kidney donation, video clips and Podcasts. The initiative was prompted, in part, by the disparity between African Americans constituting the majority of patients with end-stage renal disease but less than 12 percent of the living kidney donors last year. A 2007 Pew Internet study revealed differences in African Americans and Caucasians use of the Internet to access health information.

"What we really don't know is: What are African Americans seeking on the Internet?" Taylor said. "I hope to create educational resources that'll best meet the needs of the African-American population. Maybe, then, more African Americans will consider living kidney donations because they feel more confident in the information they're receiving."