Every morning starts the same way for Veteran Kenneth Tutt, age 79. At 8:00am he makes a phone call to Nurse Practitioner Rhonda Weinhold. Weinhold is a VA Home-Based Primary Care (HBPC) provider. She has been working with Tutt for four years. Together they review his weight, blood pressure and sugar levels. “There is no doubt in my mind I would not be here if it was not for this program,” said Tutt.
Home-Based Primary Care is a VA program bringing primary health care into Veterans’ homes. HBPC provides integrated, patient-centered care for Veterans with complex medical needs. Veterans in the program are assigned a primary care provider like Ms. Weinhold, based at the Staunton, Va., community-based outpatient clinic. “The families, the caregivers in the home, they really depend on us,” she says. “A lot of our patients consider us part of the family.”
“So Many Medications!”
Recently, Weinhold began something new for Tutt and several other patients that has helped to reduce their medications and resulted in higher satisfaction with their quality of life. Not long ago, she attended a VA Geriatric Scholars Program class, which inspired her to develop a medication management program to review patient medication prescriptions. The idea came in part from a HBPC routine: setting up monthly medication boxes. “We love doing it, but we noticed our patients were on so many medications. We just thought, are there medications we could potentially get rid of that actually might be doing more harm or that are not needed?”
She teamed up with HBPC team member Jena Willis, Doctor of Pharmacy (PharmD), to develop the idea. The review, it turns out, often results in a reduction of medications. Weinhold says it is good because, “Research shows the more medication patients are on, especially for the elderly population, the greater the risk for falls.” In fact, Tutt admits to having fallen at home a few times in the past. They consolidate the medication de-escalation recommendations, adding them to each patient’s electronic health record. Tutt, like most HBPC patients, takes a lot of medications for a variety of health conditions.
asked veterans, “How do you feel about trying to get off some medicine?” Tutt
thought, “It was a terrific idea.” The project has helped Tutt feel he’s got a
better chance of being the person he’s always been. “I’ve been an outdoor
person all my life,” said Tutt, who served in the Navy from 1958 to 1970. “I
garden, I raise flowers. I’ve had to cut back, but I’m still mobile.”
HBPC: Keeping Patients Safe in their Homes
“Our goal with Home-Based Primary Care is patient safety,” said Weinhold. “We’re there to keep them safe in the home and to keep them in the home as long as possible.” As they fine-tuned their process, Weinhold brought others onboard. It was a team effort. Three registered nurses met in person with 80 patients over six months. “We were able to reduce the number of medications an average two medicines per patient,” said Weinhold.
After their success in Staunton, they were able to coordinate with Salem VA Medical Center (VAMC) pharmacy residents’ grand rounds presentation on the de-escalation of therapy for the medical department there. The Salem VAMC is Staunton’s Community-Based Outpatient Clinic’s parent facility. The residents added the information to their presentation as an introduction to the rest of the medical facility. “The most rewarding thing is providing improved quality of life for our patients, whether it’s three more days, three more years, or 30 more years,” said Willis.
Maureen Jerrett is a contract
writer for VA Geriatric Scholars Program
University of Virginia (UVA) School of Nursing Dean Emerita Dorrie K. Fontaine was recently selected for the 2019 Elizabeth Zintl Leadership Award. Fontaine will be honored at a reception on October 15. She is known for her focus on creating a healthy work environment, fostering interprofessional education, and furthering efforts of inclusion and diversity in nursing.
The award was first given in 1998 to honor the memory of Zintl, an accomplished writer and journalist who served as chief of staff to the UVA president until her untimely death in 1997 at age 45. According to news.virginia.edu, the award recognizes a female employee who has given an “unusually high degree of service to the University, within and beyond the expectations of the position” and “whose excellence in work makes a direct and significant impact on the core academic enterprise.”
Fontaine retired from her position as Dean on July 31. She is taking a sabbatical this year and helping colleagues co-edit a book titled, “Caring for Ourselves, Caring for Others: A Self-Care Handbook for the Student Nurse.”
Fontaine is a former trauma and critical care nurse. She founded UVA’s Compassionate Care Initiative in 2009 with a mission of alleviating human suffering through developing compassionate caregivers and systems. The initiative nurtures students, faculty, staff, and clinicians to become resilient and know that caring for themselves provides a foundation for the safe and exceptional care of others. Fontaine is also a past president of the American Association of Critical-Care Nurses, the largest specialty nursing organization in the world, and past president of the Virginia Association of Colleges of Nursing.
To learn more about Dorrie K. Fontaine, Nursing Dean Emerita for the University of Virginia School of Nursing who was recently selected for the 2019 Elizabeth Zintl Leadership Award, visit here.
The University of Virginia has named Pamela F. Cipriano, PhD, RN, FAAN, the interim dean of the School of Nursing. She is currently a member of the school’s research faculty and has served two terms as the president of the American Nurses Association from 2014 until December 2018. She will assume her new position on August 1 and serve as interim dean until a permanent successor is named.
Cipriano has held a 40-year career in nursing with a focus on improving the quality and safety of services and the work environment for all staff. She has extensive experience as an academic medical center executive and previously served nine years as the chief clinical officer/chief nursing officer in the UVA Health System where she was responsible for inpatient and outpatient clinical services. The Health System was named an American Nurses Credentialing Center “Magnet” designation in 2006 under Cipriano’s leadership.
Cipriano is well known for being an advocate for quality and growing nursing’s influence on health care policy and efforts to advance the role and visibility of nurses. She served as a public sector adviser in the US delegation to the 69th World Health Assembly in 2016 and currently serves as the first vice president of the International Council of Nurses.
UVA President Jim Ryan tells news.virginia.edu, “I want to thank Pam Cipriano for her incredible service, and for her willingness to step into this new role. Pam is a nationally recognized leader in nursing, and she’s been a strong advocate for nurses and patients alike for decades. While it will be difficult for anyone to follow Dorrie Fontaine, I know Pam will do a fantastic job, and I look forward to working with her.”
To learn more about Pamela Cipriano who has been named interim dean of the University of Virginia School of Nursing, visit here.
The University of Virginia (UVA) School of Nursing recently received a Health Professions Higher Education Excellence in Diversity Award from INSIGHT Into Diversity magazine, which covers diversity in higher education. This was the first time UVA’s nursing school has been honored and they were among 35 health professions schools nationwide to receive a 2018 HEED Award.
Lenore Pearlstein, INSIGHT Into Diversity’s publisher, tells News.Virginia.edu, “The Health Professions HEED Award process consists of a comprehensive and rigorous application that includes questions relating to the recruitment and retention of students and employees – and best practices for both; continued leadership support for diversity; and other aspects of campus diversity and inclusion.”
Since establishing an initiative on Diversity, Inclusion, and Excellence Achievement (IDEA) in 2014, UVA’s nursing school has shifted its recruitment, admissions, and retention strategies to welcome more underrepresented and first-generation applicants, established affinity groups for students of color, initiated expansive diversity training for faculty and staff, and urged professors to incorporate diverse perspectives and inclusive content into their courses.
UVA nursing faculty and graduate teaching assistants attend trainings across a variety of diversity-related topics, and all nursing students take part in cultural humility training and a plethora of regular activities to drive the school’s message of inclusivity. In 2018, nearly a third of enrolled students are from groups underrepresented in nursing, and more than 17 percent are male.
To learn more about UVA Nursing’s Health Professions Higher Education Excellence in Diversity Award from INSIGHT Into Diversity magazine, visit here.
Eastern Mennonite University has recently grown its nursing program, in order to increase admissions and help with the nationwide nursing shortage. The Lisa Haverstick Memorial Nursing Laboratory was expanded and upgraded to allow the school to admit 16 more nursing students each academic year.
“We always have a wait list of qualified people who are unable to get into our program,” EMU Associate Professor Laura Yoder shared with VirginiaBusiness.com. With the expansion of the Nursing Laboratory, the average graduating class for the undergraduate nursing program will increase from 48 to 64 students, easing the wait list.
EMU has offered nursing degrees for over fifty years, including undergraduate and graduate nursing degree programs and a doctoral program in nursing practice. Yoder shared that the private liberal arts college sees nursing as a calling, considering both the nurse-patient relationship and the faculty-student relationship throughout their nursing programs.
“We’re very concerned about values and what it means to think about the common good, and doing health care in a way that serves those who are in need and have difficulty accessing care,” Yoder said. “Many EMU nursing students serve low-income patients, refugees and immigrants.”
The nursing program expansion costs roughly $245,000. With $90,000 already raised, EMU anticipates raising the rest of the funds by the end of 2018.