Oftentimes, social or economic disadvantages prevent a person from living their healthiest life. Last year, the American Diabetes Association (ADA) announced grant funding to support projects that focus on the impact of such health disparities on those with diabetes.
Louise Reagan, MS, APRN, ANP-BC, an assistant professor at the University of Connecticut School of Nursing, received one of those grants — called the Health Disparities and Diabetes Innovative Clinical or Transitional Science Award — as her research focuses on people with diabetes who are reentering society from prison.
Reagan says her team has found that people living with diabetes in prison lack critical knowledge and skills regarding managing their diabetes. As these individuals transition to the community, they are required to self-manage diabetes independently and are not prepared to do so.
Diabetes survival and self-management skills include knowing what foods to eat, how to control blood glucose (sugar), when to take insulin, how to manage sick days, and how to access health care. These skills are critical for incarcerated individuals, as their rate of diabetes diagnosis is almost 50% higher than the general population.
“I wanted to figure out what we could do to reach persons with diabetes at this critical transition period when they’re just getting out of prison and into the community, and how we could help them self-manage their illness,” Reagan says. “The Connecticut Department of Correction (CDOC), a community collaborator and advocate for the needs of persons transitioning from prison to the community, and my team don’t want citizens returning to the community from prison to end up in the emergency room being treated for hypoglycemia or dangerously low blood glucose when it can be prevented.”
Reagan worked as an advanced practice registered nurse in Hartford for 16 years, treating underserved populations with multiple comorbid diseases, including diabetes. This clinical work exposed her to the challenges that people released from prison or living in supervised community housing post-prison release face in self-managing their illness when reentering the community, and inspired her research.
She says many social barriers prevent patients from adequately caring for their own health. It can be challenging to provide diabetes education to recently released patients due to their multiple housing locations, desire for anonymity, and limited access to clinical care.
Additionally, she says, the priorities of people recently released from prison are often to avoid reentering prison, to find a job, and reestablish social and family relationships rather than manage their diabetes and other aspects of their health.
“Patients have many other competing needs when integrating into their societal roles,” Reagan says. “The Diabetes LIVE JustICE research provides an opportunity to help them with their health.”
Her study — called Diabetes Learning in Virtual Environments Just in Time for Community reEntry (Diabetes LIVE JustICE) — examines the feasibility and acceptability of a mobile app that provides diabetes education, support, and other resources in a virtual environment to people recently released from prison living in supervised community housing or on parole. Reagan’s goal is to improve health outcomes and reduce health inequities for this vulnerable population.
Reagan’s app, called LIVE Outside, contains live sessions with diabetes educators and instructive games to inform users about self-care.
Over the course of 12 weeks, Reagan will be measuring users’ diabetes knowledge, stress, and self-care after using LIVE Outside and comparing it to typical diabetes care education.
The mobile app is a culmination of projects Reagan has been working on since completing her postdoctoral fellowship at New York University. There, she served as a project director for an R01 study using a personal computer-based virtual environment called Diabetes LIVE, which promoted diabetes education to community-dwelling individuals.
Reagan’s proceeding research project with the CDOC, Diabetes Survival Skills (DSS), was an in-person intervention run within CDOC-managed correctional facilities. However, this project experienced attrition as individuals reentered society and could no longer participate, she says.
With collaboration and support from the Connecticut Department of Correction, Reagan anticipated taking in-person DSS interventions beyond prisons to supervised housing facilities to reach recently released individuals. This intervention, however, was put on hold due to the COVID-19 pandemic.
This forced Reagan to get creative with her work, leading to her innovation and the ADA grant.
“I was thinking about my work, and I wondered, ‘what if we use a virtual environment and adapt it to a mobile environment?’ ” Reagan says. “We could adapt the virtual app, use my program from the Diabetes Survival Skills, and blend them into a mobile app.”
Given the need for diabetes self-management education during the critical transition from prison to the community, the CDOC was excited to work with Reagan again to develop a remote mobile option for the people with diabetes under their care. Reagan then collaborated with her colleagues from Diabetes LIVE — Constance Johnson (UTHealth Houston), Allison Vorderstrasse (University of Massachusetts Amherst), and Stephen Walsh (UConn School of Nursing) — to combine DSS and Diabetes LIVE into a mobile app.
Diabetes LIVE JustICE was created and Reagan applied for the ADA grant to propel her innovation forward.
“My team and I had been talking about making this app mobile,” Reagan says. “The grant allows us to put all our work together to collaborate on this new idea.”
Reagan says she is grateful to have received this grant and for the strong collaboration with and involvement of the CDOC.
“When I received notice that the project was going to be funded, it was just an unbelievable feeling,” she says. “For me, this grant meant I had the opportunity to help underserved populations with their health, and I am so grateful for that. I feel so thankful that we can offer something to these people that sometimes don’t have anything.”
This research is supported by an American Diabetes Association grant #11-21-ICTSHD-05 Health Disparities and Diabetes Innovative Clinical or Translational Science Award. To learn more about the grant program, visit professional.diabetes.org. To learn more about the UConn School of Nursing, visit nursing.uconn.edu and follow the School on Facebook, Instagram, Twitter, or LinkedIn.
When you think of being a nurse, do you envision yourself wearing scrubs and treating patients in a hospital? Perhaps you think of taking patients’ vitals and administering medications, or moving between beds to care for the sick. While nursing often involves this discipline of bedside care, you might not have imagined working in a prison, despite the vital role nurses have in this field.
UConn School of NursingPh.D. student Anne Reeder, BSN, MPH is gaining expertise in this nontraditional area because she says she wants to help reduce inequities in the correctional health care system.
“I worked in a mid-sized jail in Colorado from 2011 to 2015, which was one of the most challenging, yet rewarding, experiences,” Reeder says. “I started asking questions about some of the inequities I saw and realized I wanted to study this topic formally and structurally.”
Reeder has a background in both nursing and public health. She earned her Bachelor of Science in Nursing in 2010 from Michigan State University, and then went on to earn her Master of Public Health in 2014 from the Colorado School of Public Health. Now, she is advancing her studies in both nursing and American Studies through UConn’s School of Nursing and The Graduate School, respectively.
“One of my primary goals is to elevate the voices of people who are incarcerated.”
Reeder’s research focuses on correctional health care, specifically mental health care, health services administration, and quality of care. She says there are often barriers when people who are incarcerated attempt to access health care inside correctional facilities. There is a lack of both physical and human resources, which makes high-quality, community-equivalent health care difficult, she says.
“One of the myriad reasons for the lack of access and quality disparity is the Medicaid Inmate Exclusion Policy, which significantly limits the use of Medicaid dollars for people who are incarcerated,” Reeder says. “Another reason is the stigma and social bias associated with incarceration.”
Reeder’s research aims to expose and decrease inequities in the correctional health care system by centering the material and social needs of people who are incarcerated.
“I am currently working on an integrative review that examines reentry programs for people with mental illness who are leaving U.S. jails,” Reeder says.
She has made two preliminary findings from the integrative review: there is a lack of conclusive evidence regarding the efficacy of existing jail reentry programs for people with mental illness and there is a disconnect between existing reentry models and the implementation research needed to demonstrate model efficacy.
As she continues to study the U.S. correctional health care system, Reeder hopes to implement research-based programs aimed at improving the quality of care for incarcerated individuals within its institutions.
“One of my primary goals is to elevate the voices of people who are incarcerated,” Reeder says, “so that they may more meaningfully direct their health care in correctional facilities.”
It happens to everyone, but nurses grit their teeth and bear with it every day. “It” is, of course, the profligate, Gaia-trashing cousin of the Missing Sock Phenomenon: The Redundant Glove Problem.
This is the dream: Your mask is on, and you reach out to grab a disposable glove. A single glove separates itself from its mates as you pull it out of the box. You pull it on, reach out, and swiftly extract another SINGLE GLOVE from the box. The other gloves remain inside the box and patiently wait for hands that want them. There are no wasted, now-useless single gloves littering the floor, and we have entered a world that doesn’t incessantly force health care workers to squander essential supplies.
New grad—Nurse of the Week Ellen Quintana, RN—is the nurse who just might make this dream a reality.
Luckily, when Ellen was still a freshman, she could not easily dismiss her first encounter with the Redundant Glove Problem (or RGP) during a chem lab class at University of Connecticut School of Nursing. As she told UConn Today’s Mikala Green, “No one could get just one glove out of the box, and there were gloves everywhere. We were told that once they fell out, we couldn’t put them back; it was really wasteful.”
The vision of those scattered unwanted gloves bothered her. Quintana even surveyed her professors and found that the RGP plagued them as well. Looking ahead at a nursing career that would undoubtedly contribute a mountain of wasted “extra” gloves to the world’s landfills, Quintana realized this was more than a mere annoyance and started to analyze the problem. Even amid the intensity of her BSN program, she pursued a solution. The box opening, she determined, was the pain point—the “weak link” that allows those feckless gloves to flow so promiscuously. An adjunct faculty member suggested the freshman apply for the U Conn Idea Grant Program; she did, and her RGP-Killer project was awarded a grant!
Quintana soon found mentors, who helped her restructure her academic schedule to permit her to continue her nursing studies while concurrently developing her idea. She also partnered with the University of Connecticut Engineering and Design program and performed “pull tests” on proposed models. By spring 2020, she had acquired a partner (Kelsey MarcAurele U Conn NUR ’22), and their concept—now known as ReduSeal, a product in the making—won $10,000 at a university-wide innovation contest (second place). That summer, ReduSeal was also a finalist at the Johnson & Johnson Nurses Innovate Quickfire Challenge, and this year—not long before her graduation—Quintana became one of the few nurses to receive a patent when the US Patent Office awarded her a non-provisional patent for ReduSeal. At commencement, the U Conn School of Nursing presented her with the Regina M. Cusson Student Healthcare Innovations Award.
Ellen Quintana is scheduled to begin work this August as an Emergency RN at Hartford Hospital. And her RGP-killer, ReduSeal, is on its way to a career as well. She told U Conn Today, “I want to strategically license the product so hospitals can save money, reduce waste, and hopefully save time for nurses. Nurses shouldn’t have to clean up gloves.” Amen to that.
Be sure to check out the U Conn Today article on Ellen Quintana. It details the steps she took to develop her product and the resources that the School of Nursing and U Connecticut employed to support her project and her studies.
In Texas, Pennsylvania, Tennessee, and many other states, nursing students are saying, “Would you please roll up your sleeve?”
U Tennessee nursing students prepare Covid-19 vaccine doses.
Being a nursing student during a pandemic may be lacking in some respects, but at schools of nursing around the United States, students are helping to save lives and play an historic role. Some are keenly aware of their position. In Philadelphia, PA, Alondra Torregrossa, a nursing junior at Temple University’s College of Public Health, helped vaccinate 250 health workers at the Temple U Hospital as members of the media looked on. She said, “To be there as a student nurse felt like being a part of history,” but added, with a nurse’s passion for accuracy, that “I wasn’t too nervous, because I had a recently done flu shot clinic on the Health Sciences Campus.”
At Temple’s nursing program—like many others—students leapt at the chance to take part and gain more in-person experience with patients. Undergrad program director Joelle Hargraves remarked, “The opportunity for nursing students to participate was priceless. They eagerly volunteered to be part of an interprofessional team and witnessed how nurse leaders formulated and implemented a seamless plan for immunizing essential health care providers.”
“Despite the hospital being inundated with COVID-19 cases, the vaccination clinic is a glimmer of hope.”
The University of Connecticut School of Nursing called upon their students as well, and during the first two weeks of January they administered jabs to UConn Health staff and monitored them for adverse reactions. 20 students pitched in, but Dean Deborah Chyun said, “We initially had 85 undergraduate and graduate students express interest in volunteering, as well as a handful of faculty. Due to scheduling, not all were able to participate, but that level of caring speaks volumes about our students.”
In normal conditions, students rarely provide vaccinations even during clinicals, but Covid jab duty is now offers a precious opportunity to practice nursing. For example, “There was one occasion where an individual felt dizzy post-vaccination and required further evaluation,” says Amanda Moreau, a clinical coordinator and instructor with the U Conn School of Nursing. “The student played a crucial role in identifying that the individual did not feel well and initiated the proper protocol to call for additional medical assistance…”
After helping give shots to 200 U Connecticut Health workers, needle-wielding student Rebekah Gerber reflected, “It was easy to get lost in the procedure in the moment, but as I reflect back, I realize that these vaccines will save so many lives. It is an honor to have played a very small role in distributing the vaccines.”
Nursing students at University of Tennessee administered 400 shots in a single day. “They had the chance to talk with patients, answer questions they might have about the vaccine itself or side-effects, and even deal with some folks who might be nervous about getting the injection,” according to Victoria Niederhauser, the UT College of Nursing Dean.
A U Conn nursing student remarked on the experience, “I was often asked to take pictures of individuals receiving their vaccines so they could document their participation in this historic experience and encourage others to receive their vaccines as well. Overall, the environment was positive and uplifting. Despite the hospital being inundated with COVID-19 cases, the vaccination clinic is a glimmer of hope.”
Nursing students, nursing schools, school nurses grounded after school closures, and retired nurses are all joining the fight against the rising pandemic.
Here are just a few
examples to be found across the United States:
Jackson, Mississippi
Seniors at
Belhaven’s School of Nursing are performing community outreach and
educating the public on how to protect themselves and others from the
virus. Students are teaching infection-control techniques, discussed
sanitation practices with the college’s operations team, and have
posted instructions in campus dorms on maintaining safe hygiene.
Senior Rebecca Rylander tells Jackson’s WJTV,
“There is a desperate need for healthcare workers amidst this
pandemic, and I want to help fill that need.”
Long Island, New
York
At nursing and
medical programs in Long Island, students barred from immediate
contact with patients are playing an active role behind the scenes
and on the front lines. While medical students at the Renaissance
School of Medicine in Stonybrook are conducting online research and
serving patients via telehealth sessions, the Barbara H. Hagan School
of Nursing and Health Sciences tells Newsday
that they have “alumni, graduate students and faculty working in
emergency rooms and testing sites, and undergraduates are working or
volunteering as nursing assistants.”
Darien, Connecticut
School nurses have
volunteered at Darien High School’s COVID-19 testing station. Lisa
Grant, a school district nurse at Hindley School, said “We had been
asking our director what we can do to help so when Darien signed up
for a site, we volunteered.” Yvonne Dempsey, of Ox Ridge School was
also ready to help out. Dempsey told the Darien
Times, “As nurses, we put ourselves out there any way we can. I
figured that’s something I can do in my free time with the schools
closed.” She adds, “Testing is the key — testing and isolation
as much as possible is the only way to stop the spread.”
Framingham,
Massachusetts, Caldwell, New Jersey, and elsewhere
In response to calls
from the American Association of Colleges of Nursing, nursing faculty
at colleges, universities, and community colleges are rushing to
donate supplies of everything from masks to isolation gowns, to hand
sanitizer. “This is a time when we all need to come together as a
community and work cooperatively to fight this pandemic for the
health and safety of everyone,” MassBay Community College President
David Podell told the Framingham
Source. Jennifer Rhodes, DNP, a faculty member at Caldwell
University’s School of Nursing and Public Health, remarked,
“As a former emergency room nurse, I cannot imagine what they are
experiencing on the front lines right now.”
Chapman, Nebraska
Retired nurses are
also answering individual states’ call for help. Nebraska
TV spoke to 61-year-old Mary Steiner, a former emergency response
nurse, has volunteered for the Central Nebraska Reserve Core. As she
waits to put to use her training in natural disaster and emergency
preparedness, Mary remarks, “If it’s something that becomes as
serious as what’s going on in New York City right now… They’re
wanting all hands on deck and so regardless of what my workplace
setting has been in the past I know they’re going to be able to use
me.”
Our Nurse of the Week is Jasmin Flores, a nurse from Hartford, CT, who was driving on the highway when she came upon an overturned jeep and three passengers who required lifesaving CPR, including a toddler. Flores was one of the only bystanders who knew how to administer lifesaving support which enabled her to save the toddler’s life.
Flores inspired the local University of Saint Joseph to hold a community training session on CPR. Students and members of the public practiced CPR on dummies and learned proper technique. Flores tells the Hartford Courant:
“I think CPR should be like a rite of passage, something that you learn like you learn how to ride a bike. Because, you don’t need anything but your hands and your good intentions to save somebody’s life. It’s that simple.”
As Flores came upon the overturned Jeep, she saw the backseat had detached and there was a child’s car seat rolling down the hallway. The father, who had also been injured, was struggling to get to the car seat while the driver lay motionless on the pavement. All three had been ejected from the vehicle.
Flores immediately rushed to help and when she felt no pulse on the two-year-old, she proceeded to administer CPR until police and medics arrived. The father survived, but the driver was later pronounced dead. The two-year-old has since been discharged from Connecticut Children’s Medical Hospital in Hartford and is recovering.
To learn more about nurse Jasmin Flores and the lifesaving CPR she administered to a toddler who survived a fatal accident, visit here.
