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March Nursing News and Research Briefs


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Posted: 3/12/2007

Community Partnerships Benefit Nursing Students and Underserved Children-Service learning community partnerships are central to educating future nurses and providing much-needed health care services to underserved children. In Baltimore, MD, one such community partnership program annually screens over 1,000 children enrolled in Head Start for height, weight, hearing, vision, and blood pressure, and also provides health screening and treatment services to a faith-based elementary school.  In “Developing Community Partnerships in Nursing Education for Children’s Health,” published this month in Nursing Outlook, Johns Hopkins University School of Nursing (JHUSON) faculty members Kathryn Kushto-Reese, MS, RN, Maureen C. Maguire, MSN, RN, JoAnne Silbert-Flagg, MS, RN, Susan Immelt, PhD, RN, and Sarah J. M. Shaefer, PhD, RN describe how the collaboration between JHUSON, Head Start, and the elementary school extends interactive learning into the community while at the same time meeting societal needs. The Service Learning community partnership collaboration includes all JHUSON students in pediatric rotations, with 240 to 300 nursing students currently participating. In addition to the screenings, the program has helped the elementary school initiate a variety of health projects, including a walking program, increased physical activity, anti-substance abuse classes, and an anti-bullying program.

New DNA-based Prenatal Test Could Reduce Invasive Procedures-A new diagnostic test employing fetal DNA could reduce invasive procedures such as amniocentesis and chorionic villus sampling (removal of tissue from the uterus) to determine if birth defects exist.  In “A Non-invasive Test for Prenatal Diagnosis Based on Fetal DNA Present in Maternal Blood: A Preliminary Study,” now available online in The Lancet, JHUSON baccalaureate student Kara Franz and others members of a research team at the private biotech firm where she once was employed, describe a new methodology for isolating  fetal DNA to diagnose chromosomal abnormalities.  Franz and her former co-researchers note that “such testing has been hindered by the inability to distinguish fetal DNA from maternal DNA and distinguish the number of fetal chromosomes in the mother’s blood sample.  The study focused particularly on trisomy 21, the chromosomal abnormality associated with Down Syndrome. In a test of 60 pregnant women, with a median age of 34 and average length of pregnancy 17+ weeks, the test results were correctly established through amniocentesis or newborn reports in 58 of 60 samples.  Of the two incorrectly identified samples, one was a false positive and one a false negative. With further refinement, the test could become a useful compliment to available prenatal tests.

Fostering Evidence Based Nursing Requires Top-Level Support, Partnerships–Making clinical decisions based on the best available research and experiential evidence-evidenced based nursing practice (EBP)-is associated with better care outcomes for patients and a higher perception of autonomy by nurses.  As more schools of nursing teach and encourage EBP, JHUSON faculty member Robin P. Newhouse, PhD, RN, cautions that postgraduate education to train clinicians alone is insufficient to change skills, attitudes, and behaviors.  She urges that health care organizations-with the active, continued involvement and support of nurse-leaders in those organizations-create environments where EBP can flourish. In “Creating Infrastructure Supportive of Evidence Based Nursing Practice: Leadership Strategies,” published this month in Worldviews on Evidence-Based Nursing, Newhouse points out that EBP can only become everyday practice if leaders plan strategically and provide the organizational structure and processes needed to support it.  In a second article, “Collaborative Synergy – Practice and Academic Partnerships in Evidence-Based Practice,” in the March Journal of Nursing Administration, Newhouse describes how an academic institution might negotiate a student clinical placement contract with a health care organization where one of the outcomes of the partnership is an EBP project such as an integrative review or the development of practice guidelines.  Conversely, the partnering health care organization can influence the content of courses through discussions with academic leaders about important clinical and administrative practice issues that can be incorporated into EBP assignments in academic classes. Newhouse concludes: “Academic and clinical partnership in EBP can result in a win-win for health care organizations and universities, developing nurse leaders, nursing administrators, and educators.”

Electronic Personal Health Records Hold Promise for Consumers but Face Challenges-Electronic Personal Health Records (PHRs)-health records under the direct control of the consumer-will play a key role in the rapidly evolving electronically enabled health care environment. According to JHUSON professor Marion Ball, EdD, FHIMSS, author of “Personal Health Records: Empowering Consumers,”  appearing in the Winter issue of Journal of Healthcare Information Management, “Consumers want to be more engaged in their own health care and are seeking information online. Despite intense concerns about confidentiality and security, they have high expectations.”  PHRs now have joined Electronic Health Records (EHRs)-records maintained by health care providers-as a major area of interest for the health care industry. However, if PHRs are to fully reach their potential those developing them will have to assure confidentiality and security of data, capture and integrate provider information on a continuing basis, and keep records up-to-date and relevant. In addition, they must solve the problem of translating clinical information, often in technical jargon, into a form accessible to the lay person, and find a means of funding the costs of operations. 

In Other Nursing News

JHUSON Senior Associate Dean Anne B. Belcher, PhD, RN, presented “Spiritual Expression and Spiritual Care: A Comparison of Oncology and Non-Oncology Nurses” at the American Psychosocial Oncology Society’s Annual Conference this month in Austin, TX.  Belcher notes that according to nursing surveys, “oncology nurses are still often as reluctant as their non-oncology counterparts to initiate spiritual assessment and care, in spite of an increasing emphasis in oncology nursing education and publications on spiritual care.”

Mary F. Terhaar, DNSc, RN, was a Guest Editor of the Month for the February issue of eNeonatal Review, which focused on transportation of newborns.  In “Commentary,” JHUSON faculty member Terhaar identifies three key transport themes: configuration and preparation of systems and teams, transport of special populations, and stabilization prior to transport. She also emphasized the need for collaboration between diverse disciplines to ensure the best chance of survival and the best long term outcomes for acutely ill newborns.