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Educational opportunities abound at convention
During the ANA Convention, June 29-July 2, 152 nurse researchers presented their posters and nursing research studies on topics ranging from acute care, alternative therapies and long term care to pain management, patient outcomes and quality of care, and women's health. The presenters were nominated by the Eastern Nursing Research Society, the MidWest Nursing Research Society, the Southern Nursing Research Society and the Western Institute of Nursing, as well as the American Academy of Nursing, the American Nurses Foundation Nursing Research Grant Scholars Program, and the Ethnic Minority Fellowship Program. Three of the presenters received top accolades as ANA's 2002 Research for Practice Award Winners when conference attendees chose their presentations as providing research findings most useful for current general nursing practice. First place: "Problems and Resources of American Indian Elders" Betty A. Ide, PhD, RN, Barbara Dahlen, MS, FNP, and Marcia Gragert, PhD, RN, took first place with "Problems and Resources of American Indian Elders." Nominated by Western Institute of Nursing, this research study involved a first-ever needs assessment of elders on the Standing Rock Indian Reservation. The information gained from this needs assessment will be used by tribal leaders in applications for other grants for programs to help meet these needs. Standing Rock Reservation is a vast area encompassing about 1,500 square miles and parts of North and South Dakota. The estimated population of elders is about 400, aged 50 years of age and over (the tribal designation). Diabetes is a major problem, with one of three adults over 45 having the disease. Interviews were completed with more than 140 elders identified through the Tribal Health Program and the community health representatives (CHRs) who serve the elders. The questionnaire addressed housing, transportation and employment conditions, use of medical services, perceptions of self-efficacy, family support, functioning health needs and problems, and available resources. The sample had a median age of 65 at the time of the study, is 65 percent female, includes 46.2 percent with less than high school education, 63 percent divorced/widowed/separated, and 26.9 percent unemployed. Nearly half have grandchildren in the household, and 34.5 percent live in three- to four-person households. Over a third live in government, single-family housing, 63.8 percent are renters, and 63.1 percent say their housing needs repairs. Nearly half see their health as fair or poor. Researchers found that those who had a high self-assessment also had a high emotional status, were trusting, and possessed good mobility, cognitive ability and social support. Those with low self-assessment had low economic and physical status. There were high estimates of perceived self-efficacy and family support among those interviewed. Participants named unemployment, someone bothered by stress, anxiety or depression, or someone with a drinking problem as their main family concerns. The assessment also revealed a high prevalence of chronic health problems, such as heart, high blood pressure, diabetes, vision and hearing problems, problems with teeth, and sleep disturbances. Access to health care was found to be abysmal: 55.8 percent of study participants are 50 or more miles from emergency care; 59.4 percent rely on a relative/friend for transportation; and 35.8 percent paid $11-20 for transport to care. The researchers noted that these findings are further complicated by geographic and environmental issues; weather and road conditions; closed satellite clinics; and a lack of providers to staff the satellite clinics. As a result of the needs assessment, program recommendations are to include a higher skill level for CHRs and assign more CHRs per district, reinstate transportation for CHRs with a minimum of four reliable vans, and repair satellite clinics and staff them with advanced practice registered nurses with an institution of telemedicine services and fly-in-service for emergencies and transport of specialists. In addition, the researchers state more ancillary health providers are needed, especially physical therapists, since American Indians have the highest rate of amputations in the nation, but the fewest physical therapists. Second Place: "Kangaroo (Skin-to-Skin) Care (KC) in Healthy Full Term Neonates: Effect on Pain from Hepatitis Vaccine Injection" Raouth Kostandy, MSN, RN, and Gene Cranston-Anderson, PhD, RN, FAAN, took second place with "Kangaroo ( Skin-to-Skin) Care (KC) in Healthy Full Term Neonates: Effect on Pain from Hepatitis Vaccine Injection." Nominated by the MidWest Nursing Research Society, the study was in response to the fact that with the advent of technology in neonatal care, painful procedures have become common even for healthy full-term neonates. The researchers noted that neonates are often under-treated pharmacologically, leading to testing of non-pharmacologic methods (e.g. relaxation) for pain reduction. The researchers reported that during KC, when mothers hold their diaper-clad infants prone, skin-to-skin and chest-to-chest, infants stop crying, relax and become sleepy. Thus, researchers theorized that KC may promote the kind of relaxation that would lessen infant reactivity to painful stimuli. This randomized trial, the first to test the hypothesis that KC will reduce pain from hepatitis B vaccine injections, is in the process of being completed. Thirty mother-full-term neonates dyads will be randomized 30 minutes before the injection to KC or standard care (bassinet) groups. Mothers will hold their neonates in KC until the mothers feel relaxed, which is when KC is most effective. Then mothers will rotate their neonates to the supine position for injection into the anterior thigh. Post-injection, mothers will rotate their neonates prone again for comforting. Heart rate, behavioral state and crying time will be measured pre-, during and post-injection. Currently, a sample of 10 mother and full-term neonates dyads has been enrolled and the research is in progress. Third Place: "Pediatric Professionals' Decision-making and Refused Treatment Options Near the End of Life" In third place was "Pediatric Professional's Decision-Making and Refused Treatment Options Near End-of- Life," presented by Gina M. Emge, MSN, RN, CCRN, Emma Jane Schneck, RN, Larissa Hutchins, RN, CCRN, Arnetta Woodson, RN, CCRN, Antoinette DeSales, RN, and Jane Barnsteiner, PhD, RN, FAAN, and nominated by the American Nurses Foundation Nursing Research Grant and Scholars Program. The presentation notes that professional guidelines regarding medical treatments at the end of life are available to aid in decision-making for the pediatric health care professional. The professionals' knowledge of these guidelines and the relationship between refusal of medical treatments for self (professional) and child are unknown. The researcher hypothesized that 1) knowledge of guidelines affects treatments refused by health care professionals for self and/or for child, and 2) refusal of treatments are similar for self and child. During the study, 300 pediatric professionals completed two tools that assessed knowledge of guidelines and identified refusal of treatments. The results were analyzed to determine the relationship between knowledge of guidelines and treatments refused. The response rate was 66 percent. Knowledge of guidelines regarding end-of-life issues was found to vary among professionals. All groups refused some end-of-life treatments for self, except pain medication. Fifty-four percent of physicians, 46 percent of nurses and 38 percent of respiratory therapist/social workers answered knowledge questions in accordance with guidelines. For child, 56-68 percent of professionals refused CPR, dialysis/chemotherapy, mechanical breathing and invasive diagnostic tests. All groups had significantly more refusals of treatments for self than for child. Professionals refuse 12-26 percent more treatments for self than for child. When subjects were analyzed individually, a positive association exists between knowledge of guidelines and treatments refused. The researchers concluded that these results indicate a need for education about professional guidelines for all groups. Differences between treatment preferences for self and child deserve further study. The impact of the likelihood of a full recovery on treatments refused also warrants exploration.
Upcoming continuing education opportunities Health & Safety Workshops * Regional Health & Safety Training Sessions -- "Caring for Those Who Care: Promoting Save Work Environment for Nurses." (Awareness Raising, Train-the-Trainer)
Magnet Program Workshops * ANCC, Institute of Research Education and Consultation ( IREC) -- "Magnetism Consultation Workshop"
American Academy of Nursing (AAN) * Annual Conference -- "Closing the Gap in Health Disparities"
New Independent Study Modules/Courses * ANCC IREC -- "Cardiovascular Review & Resource Manual Text"
* ANA/ANF -- "Working with Adolescents: A Time of Opportunity"
For more information, contact ANA Center for Continuing Education and Professional Development at (202) 651-7107. |
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