Better Healthcare

Winter 2013
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by Ruhan Memishi Figliulo

The work of professors in the School of Nursing does not stop in the classroom. Faculty members are tackling the nation’s most pressing health problems by researching ways to prevent some of the leading causes of death.

Assistant Clinical Nursing Professors Karen Larimer and Elizabeth Florez have partnered on several initiatives aimed at reducing the cardiovascular risk of the Latino population in the Chicago metro area. Heart disease is the nation’s leading cause of death. According to the American Heart Association (AHA), heart disease and stroke claim the lives of 26.6 percent of the more than 135,000 Hispanics or Latinos who die each year.

Working with the AHA’s Midwest affiliate, Larimer and Florez have implemented a program called Get To Goal, which counsels people at two Chicago-area facilities on behavior modification to reduce their blood pressure and get to their target pressure.

The program is helping an older Latino population through the Pilsen Satellite Senior Center in Chicago and younger Latino families through the St. Mary of Celle Family Strengthening Center in west suburban Berwyn. Get To Goal offers health mentoring and behavioral interventions, which consist of education classes on healthy diet and nutrition and how to incorporate exercise into your day. “If you can modify cardiovascular risks that people have, you reduce a lot of problems and diseases, such as the risk of stroke, diabetes and cancer,” Larimer says.

The challenge is to accomplish that while being culturally sensitive to the needs of the Latino population. “It’s not a one-size-fits-all intervention to modify behavior,” she explains. “They may not have the same diets, and they may not have the same beliefs about risks and about the perception of illness.” For example, when she asks people to identify the biggest health risk they face, everyone says diabetes. “But really the reason that most people die is from cardiovascular disease,” Larimer says.

Larimer and Florez have structured the intervention as a research protocol and will write up their results in late summer.

Making Hospitals Safer

Kim Amer, an associate professor of nursing, has been working on trying to reduce the number of people who succumb to the nation’s fifth-leading killer: accidents and unintentional injuries. More specifically, her research centers on developing safety standards to help hospitals prevent medical errors and adverse events that, she says, lead to 90,000 deaths each year in the United States.

A pediatric nurse by training, Amer became interested in hospital safety through her work with what is now the Ann & Robert H. Lurie Children’s Hospital of Chicago. She began her career at the hospital in 1982. More than two decades later, in 2006, as a DePaul faculty member, she had been doing some research at Lurie Children’s when she was asked to participate in a Robert Wood Johnson Foundation project called Transforming Care at the Bedside (TCAB). It is a national project involving a group of 10 hospitals charged with analyzing and addressing these safety issues. Lurie Children’s was the only children’s hospital chosen to participate.

When Amer got involved, it was two years into the project–about the time TCAB researchers were realizing that they needed to disseminate their findings to identify best practices for preventing safety breaches in areas such as medication administration and managing the stress of nurses who routinely work long shifts.

“They were finding good solutions to the national safety crisis,” says Amer, but that information needed to be shared with other medical institutions to prevent the loss of 90,000 lives each year. Some people think the figure is higher, according to Amer, referring to a recent study that estimates that some kind of mistake affects one in five hospital patients.

The Lurie Children’s team put together an article on its findings, which led to a book proposal, which ultimately resulted in Amer writing a textbook on the topic.

“There are actually very few textbooks or resources available out there right now for nursing students,” says Amer. Published in fall 2012 by Pearson Publishing, “Quality and Safety for Transformational Nursing: Core Competencies” will be used in nursing courses. “It also can be used by health care practitioners if hospitals or health care organizations need to get up to speed with knowledge about safety and quality,” Amer says.

In addition to preventing medication mistakes and reducing stress among overworked nurses, the book explores many other safety issues, including how to prevent infections from spreading and how to prevent falls after surgery or after a patient starts taking new medication. The book also suggests how to improve collaboration and communication between nurses and doctors and make sure that care is patient-centered.

A Comforting Space

Nursing faculty members also are addressing the growing concern of suicide by researching an alternative form of treatment for people suffering from mental illness, which is “one of the top disabling illnesses,” says Mona Shattell, an associate professor of nursing and a psychiatric nurse. “Our society stigmatizes people with mental illness or people with emotional problems,” says Shattell. “That’s why it’s so important to conduct research that helps people with these issues or helps develop better treatment or more awareness, less stigma and less discrimination.

“I think we call it ‘stigma’ because it’s a nicer word than what it really is, which is discrimination,” Shattell says. Mental health “affects everything–your physical health, your occupational functioning, your family life, academic accomplishments, life accomplishments” and whether you live.

Today, most people experiencing a mental health crisis end up in the emergency room or worse. Shattell and fellow nursing faculty member Barbara Harris, an assistant professor, are researching how offering an alternative environment may encourage treatment before it’s too late. Specifically, they are studying The Living Room, a crisis intervention treatment center operated by Turning Point, a Skokie-based mental health agency that receives state funding.

All are welcome to The Living Room, which is open three days a week from 3 p.m. to 8 p.m. and provides services free of charge. Even though it is connected to the Turning Point’s community mental health facility, The Living Room has its own entrance and looks like an actual living room with couches, chairs and a television. Patients, or “guests” as they are called, can drop in without an appointment and talk to a professional counselor and get a referral to a therapist or some other form of community-based care. They also can talk to peer counselors, who are other people with mental illness who have been trained as advocates.

The research team, which includes graduate students, has been trying to determine whether a setting like The Living Room serves patients better and at a lower cost than available alternatives. Preliminary findings look promising, but more research is planned.

Nurses have come a long way from the days when they were considered doctor’s helpers. Today, many have graduate degrees. They are the go-to health care providers in hospitals. They are advocates, researchers, counselors and so much more.

“It’s much more about holistic comprehensive care that really values the patient and the family,” says Amer, who firmly believes that research-based practice leads to excellent patient care. “That’s where we want to be–being able to guide patients through the difficult times by providing the best care that we can.”

For more about the School of Nursing's graduate programs, visit csh.depaul.edu/departments/nursing/Pages/default.aspx.