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Johns Hopkins Nursing Research News—June-July 2011


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Posted: 7/6/2011

ResearchTexting for Healthier Pregnancies and Babies—Johns Hopkins School of  Nursing (JHSON) faculty members Elizabeth Jordan, DNSc, RNC, and Ellen M. Ray, CNM, RN, have harnessed the power of 51-character, mobile phone text messaging to promote healthy pregnancies and babies. The free National Healthy Mothers, Healthy Babies Coalition Text4Baby program, provides new and expectant mothers timely text messages on topics ranging from  prenatal vitamins and exercise to breastfeeding and immunizations. In the June/July 2011 Nursing for Women’s Health cover story, Jordan and Ray note that with growing cell phone use, texting now can reach young, low-income and minority women. Jordan observes, “Text4Baby is a prime opportunity to capture the attention of women who haven’t registered for prenatal care, who lack insurance or a regular healthcare provider, or who use the emergency room for care…one of the first messages reminds the reader to make an appointment for prenatal care, giving a phone number to call.” Text4Baby is supported by public-private partnerships among government, corporations, academic institutions, and professional organizations.  At last count, the program has over 400 outreach partners in 50 states. [“Text4Baby: Using text messaging to improve maternal and newborn health.”]

Retraining to Improve Advanced Cardiac Life Support—When a heart attack happens, early intervention can be lifesaving. CPR and advanced cardiac care training are the critical tools for that intervention, and new technologies, such as sophisticated cardiac patient simulators, are the increasingly common mechanisms for training doctors, nurses, and rapid rescue teams. However, JHSON professor Pamela R. Jeffries, DNS, RN, FAAN, ANEF, and colleagues caution that more exploration is warranted regarding the staging of ACLS training the efficacy of such training.  In a small research study, the researchers found that whether taught traditionally or using high-tech simulations, within three to six months most clinicians don’t retain advanced cardiac life support (ACLS) skills. As a result, they might fare poorly on mandatory, biennial ACLS certification exams. But, according to Jeffries, not everyone may need either the advanced training or the certification. She notes, “More frequent updates in ACLS skills, particularly those using promising real-life simulations, may best be reserved for hospital rapid rescue teams routinely involved in cardiac emergencies.  In contrast, most nurses and physicians would benefit from regular updates in managing the first five minutes following a cardiac event.” [“Advanced cardiac life support instruction: Do we know tomorrow what we know today?” Journal of Continuing Education in Nursing, June 2011.] 

Helping Sexual Violence Victims Stay on Preventive AIDS Meds—In sub-Saharan Africa, victims of rape or intimate partner violence are at risk not only for the physical and emotional trauma of the event, but also for HIV. The implications can be lethal, unless anti-viral medications are made available and taken appropriately. According to a review of 10 years of research, JHSON doctoral candidate Jessica E. Draughon, MSN, RN, and associate professor Daniel J. Sheridan, PhD, RN, FAAN, found that, despite guidelines advocating use of preventive anti-HIV medications, patients don’t always comply. Draughon and Sheridan recommend clinicians take more time to explain the importance of the medications and give patients the full course of medications up front. According to Draughon, “Nurses on the front lines of care are ideally positioned to support people through the full course of care.” [“Non-occupational postexposure prophylaxis for human immunodeficiency virus in sub-Saharan Africa: A systematic review, Journal of Forensic Nursing, June 2011.]

In Search of Colorblind Health Care: Impact on Patients and Providers—Writing in the Journal of the National Black Nurses Association [July 2011] JHSON faculty members Fannie Gaston-Johansson, PhD, RN, FAAN, and Deborah E. Jones, PhD, RN, research nurse Mary Ellen Haisfield-Wolfe, PhD, RN, and colleagues explore the sensitive issue of racial/ethnic disparities in both patient care and the careers of nurses and physicians.  Their findings, based on an analysis of Institute of Medicine-conducted focus groups of Africa-American and Latino physicians and nurses, reinforce the literature detailing ongoing disparities in care that confront many ethnic, minority patients.  According to Jones, “Trust between clinician and patient may play a role in health disparities in access to and care for some minorities. We need to build better personal relationships with minority patients, spending more time with patients, really hearing what they have to say, and getting them increasingly involved in self-care practices as partners in their health.” The analysis also disclosed the importance of mentors and role models for young African-American and Latino physicians and nurses, and the value of increased, regular training in cultural competence and diversity awareness for all clinicians. Jones suggests, “Such efforts can promote the retention of high-quality minority nurses and physicians who, in turn, can help reduce clinical care disparities.”  [“Physicians’ and nurses’ experiences of the influence of race and ethnicity on the quality of healthcare provided to minority patients, and on their own professional careers.”]

Other Nursing Research News Focuses on Older Adults—JHSON faculty members Sarah L. Szanton, PhD, MSN, CRNP, Jennifer A. Wenzel, PhD, RN, CCM, and colleagues found the stress-reduction practice of “mindfulness”—being aware of oneself in the here-and-now—appears to help older, low-income women manage depression and anger, and reduce anxiety about pain, medical procedures and social or economic difficulties. [“Examining mindfulness-based stress reduction: Perceptions from minority older adults residing in a low-income housing facility”, BMC Complementary and Alternative Medicine, May 2011.]  In a controlled study of 460 older adults, Douglas A. Granger, PhD, Director of the JHSON Center for Interdisciplinary Salivary Bioscience Research, and colleagues explored how a lifestyle-focused intervention can lower risks for physical and mental decline in cost-effective ways for an ethnically diverse, aging population. [“Effectiveness of a lifestyle intervention in promoting the well-being of independently living older people: Results of the Well Elderly 2 randomized controlled trial,” Journal of Epidemiology and Community Health, June 2011].