The University of Vermont Medical Center recently celebrated the 50th anniversary of the Midwifery Service, the second-oldest hospital-based midwifery program in the United States. Since the program’s start in 1968, more than 13,000 births have been managed by certified nurse-midwives, who have helped with nearly 20 percent of deliveries at the Burlington hospital.
Certified nurse-midwives assist with the maintenance of healthy pregnancies and provide education, counseling, prenatal care, hands-on assistance during labor and delivery, and postpartum support to mothers who opt-in for midwife care.
Marti Churchill, CNM, who is currently leading the program says that nurse-midwives are regularly sought after because studies show better outcomes associated with deliveries attended by nurse-midwives. “No pregnancy happens in a vacuum,” Churchill shared with the UVM Medical Center Newsroom. “We attend to the mother’s psychosocial and emotional health and assess how she takes care of herself, her access to healthy food, how is she treated in her workplace, her housing situation — everything that can have an impact on a positive outcome.”
The UVM Medical Center Midwifery Service was founded by Dr. John Maeck, chair of the Obstetrics and Gynecology Department at the Medical Center Hospital of Vermont, in tandem with Clair Lintilhac, a retired nurse and English-trained midwife. Lintilhac went on to provide financial support of the program once it expanded in 1978; that support has continued today through the Lintilhac Foundation. The Midwifery Service has continued to grow and include research sabbaticals, a lactation clinic, and a perinatal mental health service.
The program also includes a weekly Maternal Fetal Medicine clinic, which provides mothers with high-risk or complicated pregnancies to receive care from both midwives and physicians. Kelley McLean, MD, is medical director of the Midwifery Service and knows that their patients are hardpressed to find the same kind and quality of care elsewhere for their pregnancies.
“I’m not aware of any other clinic like it in the country,” McLean said. “It is great to see these patients benefitting from a range of expertise in an integrated fashion.”
For more information about the UVM Medical Center Midwifery Service, click here.
The University of Nebraska Medical Center College of Nursing recently received a $91,500 grant from Women Investing in Nebraska (WIN) for geriatric and dementia services. The grant was given specifically to the UNMC Geriatric Cognitive and Mental Health Project for Rural Nebraska.
The project is being managed by UNMC assistant professor Dr. Nancy Meier, who teaches adult gerontology and psychiatric mental in the nurse practitioner programs. She explained that many older patients have to travel further for specialized services, which limits their access to care. “One of the reasons for my applying for this grant is that in the 11 Panhandle counties, almost 20 percent of the population is 65 or older,” Dr. Meier told the Scottsbluff Star-Herald. “That means almost 1 in 5 individuals living in the Panhandle are over the age of 65, yet there is really a lack of providers who have specialty in being able to evaluate them from a psychiatric standpoint, as well as geriatric.”
The grant will help Dr. Meier and other UNMC nurse practitioners get trained on performing geriatric assessments and psychiatric evaluations on patients in their own homes, in order to help access to care and help the nurse practitioners better see and understand their patients’ living situations, backgrounds, and other important details.
“I work with them to provide the details on what I think is the problem,” Meier shared with the Scottsbluff Star-Herald. “We are very specific into the needs of that older adult. Our goal is that they will be able to stay longer at home. Our goal is to be able to help them take care of the problem or give them a reference to another provider, such as physical therapy, occupational therapy or the right resource so that they are healthy and stay healthy.”
This grant from WIN is a huge boost for the program, which will also provide caregiver assessments, dementia education, and mobile services. This comes in addition to a four year, $2.6 million grant gifted in July to the UNMC College of Nursing by the U.S. Health Resources & Services Administration, aimed at improving engagement of registered nurses in patient management.
For more information about the grant awarded to the UNMC Geriatric Cognitive and Mental Health Project for Rural Nebraska, click here.
We’re starting a new feature for DailyNurse.com called Research of the Week! We’ll be sharing relevant and interesting research articles from our journals at Springer Publishing Company that we hope you find useful and helpful in your career.
This week we’re featuring The Design and Testing of the Psychometric Properties of the Person Engagement Index Instrument to Measure a Person’s Capacity to Engage in Health Care, from the Journal of Nursing Measurement. Author Ellen Swartwout, PhD, RN, NEA-BC, FAAN, provided some insight as to why the person engagement index is so crucial for patient care. Read more below:
Previous research has identified patient and family engagement as an essential element to optimize self-care management and improve patient outcomes1. Although much has been written about the importance of patient and family engagement, clinical care delivery models, processes and tools to translate patient engagement strategies into practice are needed2. In the July 2018 issue of the Journal of Nursing Measurement, the article entitled, “The Design and Testing of the Psychometric Properties of the Person Engagement Index (PEI) Instrument to Measure a Person’s Capacity to Engage in Health Care” discusses the development and testing of an instrument to measure a person’s capacity to engage in their health care3. The instrument was created based on review of the literature and underwent clinical expert review and validation prior to cognitive testing among adult medical-surgical patients. After cognitive testing, instrument items were revised to reflect patients’ feedback and tested in a multi-site research study involving four healthcare systems with five unique inpatient medical-surgical units. The PEI was developed for use in the assessment phase of the Interactive Care ModelTM — a five phase care delivery model for clinicians to use with people to engage them in their health care journey4.
The psychometric properties of the instrument were tested among 338 medical–surgical adult inpatients and found that four subscales comprised the total scale. Using exploratory factor analysis, four factors explained 63.9% of the total variance. The total and subscale reliability testing (Cronbach’s α) all exceeded the .70 threshold. The overall scale Cronbach’s = .896 and the four subscales corresponding Cronbach’s α were: Engagement in Health Care = .885, Technology Use in Health Care = .854, Proactive Approach to Health Care = .728, and Psychosocial Social Support = .880.
The results of the study indicate that the PEI is a valid and reliable instrument among the inpatient medical –surgical to measure a person’s capacity to engage in their health care. The importance of creating evidenced-based tools and resources to foster engagement and partnerships between clinicians and those they serve is an important step towards implementing patient engagement strategies. There are currently clinical and research cohorts of healthcare organizations using the PEI in clinical practice demonstration projects and formal research studies to test its use among various populations and settings.
You can read more about Dr. Swartwout’s research on the PEI here. To subscribe to the Journal of Nursing Measurement, click here.
- Hibbard, J. H., & Greene, J. (2013). What the evidence shows about patient activation: Better health outcomes and care experiences; fewer data on costs. Health Affairs, 32(2), 207–214.
- Carman, K.L., Dardess, P., Maurer, M.E., Workman, T., Ganachari D., & Pathak-Sen, E. A Roadmap for Patient and Family Engagement in Healthcare Practice and Research. (Prepared by the American Institutes for Research under a grant from the Gordon and Betty Moore Foundation, Dominick Frosch, Project Officer and Fellow; Susan Baade, Program Officer.) Gordon and Betty Moore Foundation: Palo Alto, CA; September 2014. www.patientfamilyengagement.org.
- Swartwout, E., El-Zein, A., Barnett, S., & Drenkard, K. (2018). The design and testing of the psychometric properties of the person engagement index instrument to measure a person’s capacity to engage in health care. Journal of Nursing Measurement, 26(2), 278-295.
- Drenkard, K., Swartwout, E., Deyo, P., & O’Neil, M. Interactive Care Model: A framework for more fully engaging people in their healthcare. Journal of Nursing Administration, 2015; 45(10), 503-510.
Concordia University Texas School of Nursing students are now utilizing a medical van to better serve their community. Their mobile Medical Missions Van operates as a pop-up clinic that provides free, basic healthcare to two counties and has plenty of space for medical supply storage and seating for clients and nurses.
Students first put the van to use last month to help individuals living under an Austin bridge, setting up foot-washing stations while a local ministry provided fellowship and food. Though these community healthcare activities are strongly helped by the use of the mobile medical clinic, nursing students have been working on projects like these since 2015, as part of their requirement for their Community Health course.
Concordia’s Nursing program director Dr. Greta Degen, RN, told CTX Blog: “The biggest impact the van has is that it allows Concordia nursing students to become the first stop for people in the community who are wrestling with a medical issue. Students can use their nursing knowledge to screen and educate individuals on their health issue or medication before needing to go see a doctor or visit an emergency room.”
Mobile medical clinics like this are used globally, especially in areas devastated by war, natural disasters, and humanitarian crises. The clinics provide a way for healthcare professionals to get medical treatments and supplies to people cut off or isolated from communities, and are especially helpful in areas lacking in public transportation.
To learn more about Concordia University Texas School of Nursing and their mobile Medical Missions Van, visit CTX Blog.
Earlier this week, Johnson & Johnson started a challenge for all U.S. nurses to participate in and contribute. The “Nurses Innovate QuickFire Challenge” is designed for nurses to submit ideas for new devices, health technologies, protocols and/or treatment approaches. Participants can receive up to $100,000 in grants from this challenge, and also receive mentoring and coaching access through Johnson & Johnson Innovation, JLABS.
Innovation in patient care has a long and linear history with nursing, from figures like Florence Nightingale, Nurse Jean Ward, and Nurse Rebecca Koszalinkski. The combination of nurses’ patient experience and insight and resourcefulness provides them with a unique perspective in the healthcare field, allowing them to have significant and crucial input in addressing health challenges.
Yet a nationwide survey showed Johnson & Johnson that nearly half of Americans (41%) are unaware of the role that nurses play in developing new medical tools and solutions. However, the majority (66%) believe that all medical professionals are capable of coming up with lifesaving ideas, and 75% of those surveyed believe nurses should have platform to submit ideas and inventions for improving patient care.
Investing in nurses is part of Johnson & Johnson’s storied history, as the company has provided funding for scholarships, employment opportunities, and more since their start in 1897. Previous efforts to help nurses include the “Campaign for Nursing’s Future,” which took care of a nursing shortage and increased the nursing workforce by more than one million.
The challenge is open now through February 1, 2019. Applicants should meet the following criteria:
- Uniqueness of the idea
- Potential impact on human health
- Feasibility of the idea
- Thoroughness of approach
- Identification of key resources and plan to further idea
For more information about the Johnson & Johnson Nurses Innovate QuickFire Challenge, visit nursing.jnj.com/home.