Pub Date : 2021-05-03DOI: 10.14574/OJRNHC.V21I1.656
Jody Toerber-Clark, Marion M. Jamison, M. Scheibmeir
Purpose: Nurse practitioners (NPs) are rendering health care services in rural areas in increasing numbers, yet little is known about clinical skills and patient care management activities performed by these advanced practice nurses in the rural environment. The purpose of this descriptive study of rural NPs was to identify skills and patient care management activities that they have performed and considered critical to Kansas rural practice. Sample: A convenience sample of 208 nurse practitioners (NP) in rural and frontier Kansas were emailed a survey that asked about skills and activities they perform in their rural practice. Sixtythree responded for a response rate of 30%. Findings: The analysis produced a list of 26 skills and 37 patient care management activities critical to Kansas rural NP practice. Most of the skills/procedures were learned after graduation. Almost all the respondents reported additional training/certifications in advanced life support and trauma. The majority of respondents were family nurse practitioners who practiced in a variety of rural settings. “I grew up in a rural setting” and “Autonomy of practice” were the two top factors that influenced their decision to practice in a rural setting.
{"title":"Workforce Demands of Rural Nurse Practitioners: A Descriptive Study","authors":"Jody Toerber-Clark, Marion M. Jamison, M. Scheibmeir","doi":"10.14574/OJRNHC.V21I1.656","DOIUrl":"https://doi.org/10.14574/OJRNHC.V21I1.656","url":null,"abstract":"Purpose: Nurse practitioners (NPs) are rendering health care services in rural areas in increasing numbers, yet little is known about clinical skills and patient care management activities performed by these advanced practice nurses in the rural environment. The purpose of this descriptive study of rural NPs was to identify skills and patient care management activities that they have performed and considered critical to Kansas rural practice. Sample: A convenience sample of 208 nurse practitioners (NP) in rural and frontier Kansas were emailed a survey that asked about skills and activities they perform in their rural practice. Sixtythree responded for a response rate of 30%. Findings: The analysis produced a list of 26 skills and 37 patient care management activities critical to Kansas rural NP practice. Most of the skills/procedures were learned after graduation. Almost all the respondents reported additional training/certifications in advanced life support and trauma. The majority of respondents were family nurse practitioners who practiced in a variety of rural settings. “I grew up in a rural setting” and “Autonomy of practice” were the two top factors that influenced their decision to practice in a rural setting.","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"21 1","pages":"49-66"},"PeriodicalIF":0.0,"publicationDate":"2021-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47636377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-03DOI: 10.14574/OJRNHC.V21I1.684
P. Fahs
{"title":"The International Rural Nursing Conference is Coming to You in 2021","authors":"P. Fahs","doi":"10.14574/OJRNHC.V21I1.684","DOIUrl":"https://doi.org/10.14574/OJRNHC.V21I1.684","url":null,"abstract":"","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"21 1","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2021-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44448987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-11DOI: 10.14574/ojrnhc.v20i2.601
Khalid Bandar Almasloukh, P. Fahs
Background: Although equine assisted activities and therapies (EAAT) are rapidly increasing, as are cancer survival rates, little is known about the engagement of cancer survivors in EAAT. One may conceptualize equine or horse related activities as occurring in rural areas; however, the rural status of EAAT centers are not fully reported.Purpose: To explore the rural status of EAAT centers, and whether EAAT is provided for cancer survivors and the more common service for post-traumatic stress disorder at those centers.Method: A quantitative descriptive analysis was conducted of publicly available data after an exempt status decision of an Institutional Review Board. Services using EAAT for those with terminal illnesses, post-traumatic stress disorder and cancer survivors were examined. Rural status was evaluated for all organizational members (N = 784) of Professional Association of Therapeutic Horsemanship International (PATH Intl.). Roy adaptation model was used as a theoretical framework in this project.Findings: All types of the organizational members, cluster in urban areas more than rural areas. Significant relationship (p = 0.039) was found between rural status and type of membership, where more urban than rural centers were premier accredited center members. Most of the contacted and responding centers stated that they do provided EAAT for cancer survivors (n = 204); however, only (n = 26) centers have programs specifically designed for cancer survivors.Conclusion: There are not only less EAAT rural than urban centers, but rural centers also tend to have lower quality level membership based on PATH Intl. standards. Although EAAT is provided for cancer survivors, identifying effective ways to provide EAAT and standardization of programs for cancer survivors is recommended. DOI: http://doi.org/10.14574/ojrnhc.v20i2.601
{"title":"Rural Status of Equine Assisted Activities and Therapies and Cancer Survivors","authors":"Khalid Bandar Almasloukh, P. Fahs","doi":"10.14574/ojrnhc.v20i2.601","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.601","url":null,"abstract":"Background: Although equine assisted activities and therapies (EAAT) are rapidly increasing, as are cancer survival rates, little is known about the engagement of cancer survivors in EAAT. One may conceptualize equine or horse related activities as occurring in rural areas; however, the rural status of EAAT centers are not fully reported.Purpose: To explore the rural status of EAAT centers, and whether EAAT is provided for cancer survivors and the more common service for post-traumatic stress disorder at those centers.Method: A quantitative descriptive analysis was conducted of publicly available data after an exempt status decision of an Institutional Review Board. Services using EAAT for those with terminal illnesses, post-traumatic stress disorder and cancer survivors were examined. Rural status was evaluated for all organizational members (N = 784) of Professional Association of Therapeutic Horsemanship International (PATH Intl.). Roy adaptation model was used as a theoretical framework in this project.Findings: All types of the organizational members, cluster in urban areas more than rural areas. Significant relationship (p = 0.039) was found between rural status and type of membership, where more urban than rural centers were premier accredited center members. Most of the contacted and responding centers stated that they do provided EAAT for cancer survivors (n = 204); however, only (n = 26) centers have programs specifically designed for cancer survivors.Conclusion: There are not only less EAAT rural than urban centers, but rural centers also tend to have lower quality level membership based on PATH Intl. standards. Although EAAT is provided for cancer survivors, identifying effective ways to provide EAAT and standardization of programs for cancer survivors is recommended. \u0000DOI: http://doi.org/10.14574/ojrnhc.v20i2.601 ","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"213-240"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43122752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-11DOI: 10.14574/ojrnhc.v20i2.618
Robin J. Brown, H. Mennenga, Alham A. Abuatiq, L. Burdette, L. Horsley, Christina Plemmons
Abstract Purpose: Primary care in rural areas of the U.S. urgently need competent healthcare providers, especially registered nurses (RNs). Registered nurses are ideal team members to help meet the primary care needs in rural communities, yet RNs are underutilized in primary care settings and rarely practice to the full scope of their license in these settings. The purpose of the project was to conduct a needs assessment with rural primary care practice partners to address the need for RNs in primary care. Sample: A needs assessment was sent to nurse leaders at 13 rural primary care facilities via an online survey in December 2018. Methods: This descriptive exploratory study utilized an online needs assessment survey to gather information from 13 rural clinical practice partners regarding their knowledge, interest, and use of RNs in primary care. Results: Twelve of the 13 rural clinical practice partners completed the needs assessment survey. A majority of the clinical partners indicated they felt knowledgeable about the RN full scope of license and expressed a high interest in the expanded role of the RN in primary care. The clinical practice partners reported interest in providing independent RN chronic and acute care visits, care management, medication management, and collaborative provider and RN visits. Conclusion: Conducting a needs assessment and collaborating with rural primary care practice partners to address the need for RNs in primary care is the first step in developing policies and utilizing RNs to the full scope of their license. Keywords: primary care, rural, registered nurses
{"title":"Collaborating with Rural Practice Patners to Address the Need for RNs in Primary Care","authors":"Robin J. Brown, H. Mennenga, Alham A. Abuatiq, L. Burdette, L. Horsley, Christina Plemmons","doi":"10.14574/ojrnhc.v20i2.618","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.618","url":null,"abstract":"Abstract \u0000Purpose: Primary care in rural areas of the U.S. urgently need competent healthcare providers, especially registered nurses (RNs). Registered nurses are ideal team members to help meet the primary care needs in rural communities, yet RNs are underutilized in primary care settings and rarely practice to the full scope of their license in these settings. The purpose of the project was to conduct a needs assessment with rural primary care practice partners to address the need for RNs in primary care. \u0000Sample: A needs assessment was sent to nurse leaders at 13 rural primary care facilities via an online survey in December 2018. \u0000Methods: This descriptive exploratory study utilized an online needs assessment survey to gather information from 13 rural clinical practice partners regarding their knowledge, interest, and use of RNs in primary care. \u0000Results: Twelve of the 13 rural clinical practice partners completed the needs assessment survey. A majority of the clinical partners indicated they felt knowledgeable about the RN full scope of license and expressed a high interest in the expanded role of the RN in primary care. The clinical practice partners reported interest in providing independent RN chronic and acute care visits, care management, medication management, and collaborative provider and RN visits. \u0000Conclusion: Conducting a needs assessment and collaborating with rural primary care practice partners to address the need for RNs in primary care is the first step in developing policies and utilizing RNs to the full scope of their license. \u0000 Keywords: primary care, rural, registered nurses \u0000 \u0000 ","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"179-193"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43443088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-11DOI: 10.14574/ojrnhc.v20i2.615
J. Mallow, Andrea Bailey, Karen Clark, Laurie A. Theeke
Understanding and predicting hospital readmission has been of interest for more than three decades. To strategically place readmission reduction resources where most beneficial, organizations use readmission risk-stratification tools. However, common tools used to assess 30day risk do not incorporate health disparity and it is unknown how modifying currently validated tools affects their predictive value. The aims of this retrospective study were to describe the population of people who are admitted and re-admitted for hospital care in a rural population and examine the effectiveness of a common risk stratification tool to predict 30-day readmission in a rural population experiencing health disparities. This retrospective cohort study examined data
{"title":"Assessment of Readmission in a Rural Medical Center","authors":"J. Mallow, Andrea Bailey, Karen Clark, Laurie A. Theeke","doi":"10.14574/ojrnhc.v20i2.615","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.615","url":null,"abstract":"Understanding and predicting hospital readmission has been of interest for more than three decades. To strategically place readmission reduction resources where most beneficial, organizations use readmission risk-stratification tools. However, common tools used to assess 30day risk do not incorporate health disparity and it is unknown how modifying currently validated tools affects their predictive value. The aims of this retrospective study were to describe the population of people who are admitted and re-admitted for hospital care in a rural population and examine the effectiveness of a common risk stratification tool to predict 30-day readmission in a rural population experiencing health disparities. This retrospective cohort study examined data","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"241-262"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43808441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-11DOI: 10.14574/ojrnhc.v20i2.634
A. Nance, L. Saiki, Elizabeth G. Kuchler, Conni J DeBlieck, S. Forster-Cox
Purpose: Hepatitis C incidence is higher among American Indian/Alaskan Native populations than any other racial or ethnic group in the United States. Chronic Hepatitis C complications include cirrhosis of the liver, end stage liver disease, and hepatocellular cancer. Direct acting antiviral treatment taken orally results in > 90% cure, yet rural primary care providers lack the training and confidence to treat and monitor patients with chronic Hepatitis C. Rural patients are reluctant to travel to urban areas for Hepatitis C treatment. Project ECHO is an innovative telementoring program where specialists mentor primary care providers via videoconferencing to treat
{"title":"Hepatitis C Treatment at a Rural Navajo Health Clinic Using Project ECHO","authors":"A. Nance, L. Saiki, Elizabeth G. Kuchler, Conni J DeBlieck, S. Forster-Cox","doi":"10.14574/ojrnhc.v20i2.634","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.634","url":null,"abstract":"Purpose: Hepatitis C incidence is higher among American Indian/Alaskan Native populations than any other racial or ethnic group in the United States. Chronic Hepatitis C complications include cirrhosis of the liver, end stage liver disease, and hepatocellular cancer. Direct acting antiviral treatment taken orally results in > 90% cure, yet rural primary care providers lack the training and confidence to treat and monitor patients with chronic Hepatitis C. Rural patients are reluctant to travel to urban areas for Hepatitis C treatment. Project ECHO is an innovative telementoring program where specialists mentor primary care providers via videoconferencing to treat","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"133-155"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46521526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-11DOI: 10.14574/ojrnhc.v20i2.619
Evelyn P Brewer, F. Weierbach, R. Fletcher, Katherine Hall, W. Nehring
Purpose: Research in rural areas presents special challenges for sampling and recruitment. Examples of considerations include smaller sampling population, privacy concerns, and the rural context. The purpose of this article is to discuss the results of sampling and recruitment strategies within this study. Sample: Nurses form a central hub of health care in rural communities. However, little is known about the lived experience of nurses serving in this capacity. This study explored stories of nurses in a six-county area of three adjoining states in rural South Central Appalachia. Method: Recruitment for the study was completed using state boards of nursing social marketing strategies and snowball sampling. Findings: Sampling and recruitment efforts enlisted 15 participants. The sample was deemed representative of the population as participants represented diverse employment contexts, education preparation levels, licensure duration, and multiple generations. Conclusions: Understanding implications of rural setting and cultural context are critical to successful recruitment and sampling. Privacy considerations may still be concerning, however, multiple de-identification strategies serve to help lessen this risk. Social marketing strategies failed to recruit the needed number of participants secondary to the fact that participants from only one state were recruited in this manner. Smaller population pool limitations were eased by snowball sampling, an approved recruitment method in qualitative research. Future researchers should be cognizant of the influence of rurality norms and cultural context on recruitment and sampling efforts. Social marketing proved less successful than snowball sampling strategies. Further research is needed to develop best practice for rural recruitment and sampling via social marketing. Finally, time and resource commitment for participation can be a barrier. Flexibility in scheduling interviews, location of interview sites, and the availability of audio/phone interviews served to facilitate agreement to participate. Key words: rural, nursing, Appalachia, research, sampling, recruitment
{"title":"Lived Experience of Nursing Appalachia","authors":"Evelyn P Brewer, F. Weierbach, R. Fletcher, Katherine Hall, W. Nehring","doi":"10.14574/ojrnhc.v20i2.619","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.619","url":null,"abstract":"Purpose: Research in rural areas presents special challenges for sampling and recruitment. Examples of considerations include smaller sampling population, privacy concerns, and the rural context. The purpose of this article is to discuss the results of sampling and recruitment strategies within this study. \u0000Sample: Nurses form a central hub of health care in rural communities. However, little is known about the lived experience of nurses serving in this capacity. This study explored stories of nurses in a six-county area of three adjoining states in rural South Central Appalachia. \u0000Method: Recruitment for the study was completed using state boards of nursing social marketing strategies and snowball sampling. \u0000Findings: Sampling and recruitment efforts enlisted 15 participants. The sample was deemed representative of the population as participants represented diverse employment contexts, education preparation levels, licensure duration, and multiple generations. \u0000Conclusions: Understanding implications of rural setting and cultural context are critical to successful recruitment and sampling. Privacy considerations may still be concerning, however, multiple de-identification strategies serve to help lessen this risk. Social marketing strategies failed to recruit the needed number of participants secondary to the fact that participants from only one state were recruited in this manner. Smaller population pool limitations were eased by snowball sampling, an approved recruitment method in qualitative research. Future researchers should be cognizant of the influence of rurality norms and cultural context on recruitment and sampling efforts. Social marketing proved less successful than snowball sampling strategies. Further research is needed to develop best practice for rural recruitment and sampling via social marketing. Finally, time and resource commitment for participation can be a barrier. Flexibility in scheduling interviews, location of interview sites, and the availability of audio/phone interviews served to facilitate agreement to participate. \u0000Key words: rural, nursing, Appalachia, research, sampling, recruitment \u0000 ","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"108-132"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47492606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-11DOI: 10.14574/ojrnhc.v20i2.633
Tracy P. George, Allison C. Munn, Tiffany A. Phillips, J. Hucks
Background: Tweet-format narratives have been used in medical education to capture student experiences. However, there is a lack of research on tweet-format narratives during experiential learning in nursing education. Purpose: The purpose of this project was to explore the usefulness of tweet-format narratives to capture nursing student experiences and to elicit reflection during a service-learning trip. Methods: Eight bachelor of science in nursing (BSN) students participated in a service-learning experience to Appalachia. A grounded theory approach with three data collection methods was
{"title":"Use of Tweet-Format Narrative Reflections During a Service-Learning Trip to Appalachia","authors":"Tracy P. George, Allison C. Munn, Tiffany A. Phillips, J. Hucks","doi":"10.14574/ojrnhc.v20i2.633","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.633","url":null,"abstract":"Background: Tweet-format narratives have been used in medical education to capture student experiences. However, there is a lack of research on tweet-format narratives during experiential learning in nursing education. Purpose: The purpose of this project was to explore the usefulness of tweet-format narratives to capture nursing student experiences and to elicit reflection during a service-learning trip. Methods: Eight bachelor of science in nursing (BSN) students participated in a service-learning experience to Appalachia. A grounded theory approach with three data collection methods was","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"156-178"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45436247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-11DOI: 10.14574/ojrnhc.v20i2.625
J. Cochran, Traci D. Jarrett, A. Baus
PurposeThe impact of intrauterine exposure of opioids and other addictive substances on pediatric patients is concerning for health care providers in rural WV. NAS patients must be identified, screened, and treated during the pediatric years to facilitate improved outcomes. The purpose of this research was to evaluate the ability of rural providers to use EHRs to identify, describe, and monitor aspects of NAS across the pediatric health span. MethodsThe research team used de-identified data of patients that had the NAS diagnosis from a rural clinic. One hundred fifty-five charts were evaluated. Demographics, clinical characteristics, and developmental milestone status were extracted from charts. ResultsThere were differences in characteristics across age groups. Reported secondhand smoke was higher among the 0-3 year olds. Normal BMI percentile was highest among 4-5 year olds. The Ages and Stages Developmental screening was abnormal more in those aged 6-19 years. Foster care was highest among the ages 0-3 years. The 4-12 age groups highest amount of no show visits. Respiratory illness was the most frequent diagnosis and was highest in the 4-5 age group. Eye and ear diagnosis were noted as a recurrent diagnosis in the 4-5 year old group. Diagnosis related to mental health were highest in the 6-18 age group. DiscussionThe EHR can be used to describe and track special populations such as NAS in rural areas. Tagging and tacking patients with NAS can help primary care providers manage care and anticipate age related health care needs. Tracking high risk populations assures that the patient care is maintained. Tracking no show rates assists providers in assuring that patient’s caregivers are compliant in necessary treatments and referrals. Child Protection can also be involved if medical neglect is noted. EHRs are useful in identifying high risk populations such as NAS to facilitate treatments and continuity of care. DOI: http://doi.org/10.14574/ojrnhc.v20i2.625
{"title":"Characteristics of Neonatal Abstinence Syndrome (NAS) in a rural clinic population: Tracking with Electronic Medical Health Records (EHR)","authors":"J. Cochran, Traci D. Jarrett, A. Baus","doi":"10.14574/ojrnhc.v20i2.625","DOIUrl":"https://doi.org/10.14574/ojrnhc.v20i2.625","url":null,"abstract":"PurposeThe impact of intrauterine exposure of opioids and other addictive substances on pediatric patients is concerning for health care providers in rural WV. NAS patients must be identified, screened, and treated during the pediatric years to facilitate improved outcomes. The purpose of this research was to evaluate the ability of rural providers to use EHRs to identify, describe, and monitor aspects of NAS across the pediatric health span. \u0000MethodsThe research team used de-identified data of patients that had the NAS diagnosis from a rural clinic. One hundred fifty-five charts were evaluated. Demographics, clinical characteristics, and developmental milestone status were extracted from charts. \u0000ResultsThere were differences in characteristics across age groups. Reported secondhand smoke was higher among the 0-3 year olds. Normal BMI percentile was highest among 4-5 year olds. The Ages and Stages Developmental screening was abnormal more in those aged 6-19 years. Foster care was highest among the ages 0-3 years. The 4-12 age groups highest amount of no show visits. Respiratory illness was the most frequent diagnosis and was highest in the 4-5 age group. Eye and ear diagnosis were noted as a recurrent diagnosis in the 4-5 year old group. Diagnosis related to mental health were highest in the 6-18 age group. \u0000DiscussionThe EHR can be used to describe and track special populations such as NAS in rural areas. Tagging and tacking patients with NAS can help primary care providers manage care and anticipate age related health care needs. Tracking high risk populations assures that the patient care is maintained. Tracking no show rates assists providers in assuring that patient’s caregivers are compliant in necessary treatments and referrals. Child Protection can also be involved if medical neglect is noted. EHRs are useful in identifying high risk populations such as NAS to facilitate treatments and continuity of care. \u0000DOI: http://doi.org/10.14574/ojrnhc.v20i2.625 ","PeriodicalId":56353,"journal":{"name":"Online Journal of Rural Nursing and Health Care","volume":"20 1","pages":"194-212"},"PeriodicalIF":0.0,"publicationDate":"2020-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48068476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-12-10DOI: 10.14574/ojrnhc.v20i2.632
Theresa Garren-Grubbs, M. Letizia, M. Minton
Purpose: Evaluate the impact of an advance care planning (ACP) educational session utilizing PREPARE for Your Care for South Dakota farm and ranch women and its ability to increase engagement in ACP and documentation of medical wishes in the form of an advance directive. Sample: A convenience sample of women (n = 23) represented members of the farm and ranch community in South Dakota who were participating in the Power of Women as AgVocates Conference. Inclusion criteria for this study included being 18 years old or older, female, and conference participation. Exclusion criteria included men and those under the age of 18. Method: This was a cross-sectional investigation, consisting of three phases, and included comparisons of the same sample population before and after an ACP intervention at different time intervals (baseline, 1 week after the educational session and 3 months after the educational session). Increased engagement in ACP was evaluated using a pre-test, post-test design and utilized the 15-item Advance Care Planning Engagement Survey. Demographic information including age and highest level of education completed was collected. Findings: In total, 23 women participated in education session. The median age range was 35-44 years of age. There were statistically significant increases in self-efficacy and readiness to complete ACP reported by participants. The objectives of this education session were met. Per the participants, this was an effective format for ACP. Advance directive completion rates did not increase. Conclusions: The use of PREPARE for Your Care during an education session on ACP can increase self-efficacy and readiness to engage in ACP. The format of this program is appropriate for future use in community settings with the farm and ranch population. Keywords: Advance Care Planning, farm and ranch womenDOI: http://doi.org/10.14574/ojrnhc.v20i2.632
目的:评估利用PREPARE for Your care对南达科他州农场和牧场妇女进行预先护理计划(ACP)教育课程的影响，以及其提高ACP参与度和以预先指示形式记录医疗意愿的能力。样本:一个方便的女性样本(n = 23)代表了南达科他州农场和牧场社区的成员，她们参加了妇女作为农业倡导者的力量会议。本研究的纳入标准包括18岁及以上、女性和参加过会议。排除标准包括男性和18岁以下的人。方法:这是一项横断面调查，包括三个阶段，包括在不同时间间隔(基线、教育课程后1周和教育课程后3个月)对相同样本人群进行ACP干预前后的比较。ACP参与率的提高采用测试前、测试后设计进行评估，并利用15项预先护理计划参与调查。收集了人口统计信息，包括年龄和完成的最高教育水平。结果:共有23名妇女参加了教育课程。年龄中位数为35-44岁。参与者报告的自我效能和完成ACP的准备程度有统计学上的显著提高。这次教育会议的目标已经实现。与会者认为，这是ACP的有效形式。预先指示完成率没有增加。结论:在ACP教育课程中使用PREPARE for Your Care可以提高自我效能感和参与ACP的准备程度。这个项目的形式适合未来在有农场和牧场人口的社区环境中使用。关键词:提前护理计划，农牧妇女，endi: http://doi.org/10.14574/ojrnhc.v20i2.632
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