The effect of a faith community nurse network and public health collaboration on hypertension prevention and control

Implementation of a Faith Community Nursing Transition of Care Program in the USA: A Propensity Score Matching Analysis

Faith community nursing (FCN) is a specialty nursing practice that integrates spiritual and religious practices into patient care. This study aimed to quantitatively assess the impact of the standardized FCN transition of care (TOC) program on the rate of hospital readmission and length of stay (LOS) through propensity score matching and difference-in-differences methods. Compared with those in the non-FCN group (n = 409), patients in the FCN group (n = 66) had a reduced likelihood of hospital readmission at 30, 90, and 180 days after discharge (by 8.8%, 9.0%, and 9.5%, respectively). Additionally, the FCN group exhibited a shorter LOS by 0.31, 0.53, and 0.87 days at 30, 90, and 180 days, respectively. The present study thus demonstrated the successful implementation of the FCN TOC program in a hospital setting, which reduced both the hospital readmission rate and LOS after discharge.

Challenges of Faith Community Nursing in a Midwestern Healthcare System

ABSTRACT

Faith community nurses are positioned to play a vital role in addressing whole person health in multiple settings. A steady decline of nurses completing faith community nurse (FCN) training in a midwestern healthcare system sparked the system's hospital leadership to re-evaluate the FCN training and outreach program. To inform future education programs, an online needs assessment survey was deployed to FCNs. Focus groups were used to understand the FCNs' experiences in their role. The findings highlight a need for comprehensive educational programs, support networks, and funding mechanisms to support faith community nursing practice.

Wearable cuffless blood pressure monitoring devices: a commentary

Hypertension is a growing public challenge as a leading risk factor for cardiovascular disease and all-cause mortality. Reducing overall cardiovascular risk through early screening, initiation of treatment and ongoing monitoring remains a priority in the comprehensive management of hypertension and its complications. Community nurses are ideally positioned to play a crucial role in the early detection of hypertension and providing support for its management. Wearable cuffless devices have the potential for continuous remote blood pressure monitoring. However, there is not enough literature on the validity and usability of wearable cuffless blood pressure devices to justify their use in clinical practice. This commentary critically appraises a systematic review designed to assess the validity, features and clinical usability of wearable cuffless devices, and expands on its findings and their relevance to community nursing and future research.

Team-Based Approach in Hypertension Management: A Quality Improvement Project

BACKGROUND/LOCAL PROBLEM

Hypertension is a major risk factor for heart diseases and stroke among Americans; only 25% have this under control nationwide.

METHODS

This quality improvement project evaluated the outcomes of team-based care in hypertension control by registered nurses and certified nurse practitioners in a primary care setting. Pre/post-data analysis of blood pressure (BP) control, and BP knowledge, was done.

INTERVENTION

The team provided education and counseling based on knowledge assessment during visits and used unattended automated blood pressure measurement (uAOBPM) techniques to measure BP.

RESULTS

There was a significant reduction in systolic and diastolic BP control ( P < .001). There was a statistically significant increase in disease knowledge score pre- and postintervention ( P < .001).

CONCLUSION

The team-based care approach improved patients' BP control and knowledge of the disease. The uAOBPM technique could be incorporated into clinical settings for accurate BP measurements.

Health coaching for hypertension control in primary care patients with uncontrolled hypertension in Egypt

BACKGROUND

Health coaching effectively improves hypertension self-care activities and the control of blood pressure (BP) in hypertensive patients. Studies on the effects of health coaching on patients in primary care with uncontrolled hypertension in developing countries are limited. In this study, the effectiveness of health coaching on hypertension self-care and BP control was assessed in patients who have uncontrolled hypertension compared to standard care in Egypt.

MATERIALS AND METHODS

Our quasi-experimental study included control and intervention groups. The intervention group included 70 participants who received health coaching sessions (face-to-face and by telephone) besides the standard care, whereas the control group included 71 participants who only received the standard care. The study was conducted between July 2020 and November 2021. The participants were recruited from three primary healthcare settings in the Port Said Governorate. Personal and medical history, BP measurements, and hypertension self-care activity level effects (H-SCALE) were obtained. Paired-t-test was used to assess the changes in BP measurement, and H-SCALE score before and after receiving the health coaching. McNemar's test was used to assess changes in controlled BP and optimal hypertension self-care activities between control and health coached groups. Multiple logistic regression analysis assessed the predictors of better BP control.

RESULTS

Health coaching resulted in more controlled BP (51.4%, P < 0.001) compared to the delivery of only usual care (11.3%, P = 0.008). The intervention showed a significant promotion in hypertension self-care activities, including medication usage (P < 0.001), low-salt diet (P < 0.001), and weight management (P < 0.001). The H-SCALE score mean change was the only predictor for BP control (odds ratio 1.057, P = 0.048) in the intervention group after 6 months.

CONCLUSION

Intervention including traditional health coaching and phone calls is a beneficial modality for the promotion of hypertension self-care and improvement of BP control in primary care patients with uncontrolled hypertension.

Person-Centered Models for Cardiovascular Care: A Review of the Evidence: A Scientific Statement From the American Heart Association

Cardiovascular disease remains the leading cause of death and disability in the United States and globally. Disease burden continues to escalate despite technological advances associated with improved life expectancy and quality of life. As a result, longer life is associated with multiple chronic cardiovascular conditions. Clinical guidelines provide recommendations without considering prevalent scenarios of multimorbidity and health system complexities that affect practical adoption. The diversity of personal preferences, cultures, and lifestyles that make up one's social and environmental context is often overlooked in ongoing care planning for symptom management and health behavior support, hindering adoption and compromising patient outcomes, particularly in groups at high risk. The purpose of this scientific statement was to describe the characteristics and reported outcomes in existing person-centered care delivery models for selected cardiovascular conditions. We conducted a scoping review using Ovid MEDLINE, Embase.com, Web of Science, CINAHL Complete, Cochrane Central Register of Controlled Trials through Ovid, and ClinicalTrials.gov from 2010 to 2022. A range of study designs with a defined aim to systematically evaluate care delivery models for selected cardiovascular conditions were included. Models were selected on the basis of their stated use of evidence-based guidelines, clinical decision support tools, systematic evaluation processes, and inclusion of the patient's perspective in defining the plan of care. Findings reflected variation in methodological approach, outcome measures, and care processes used across models. Evidence to support optimal care delivery models remains limited by inconsistencies in approach, variation in reimbursement, and inability of health systems to meet the needs of patients with chronic, complex cardiovascular conditions.

What Are the Characteristics of the Parish Nursing Research Literature and How Can it Inform Parish Nurse Practice and Research in Canada? A Scoping Review

BACKGROUND

Parish nursing is a specialized branch of professional nursing that promotes health and healing by integrating body, mind and spirit as a practice model. Parish nurses contribute to the Canadian nursing workforce by promoting individual and community health and acting as system navigators. Research related to parish nursing practice has not been systematically collated and evaluated.

PURPOSE

This review seeks to explore, critically appraise and synthesize the parish nurse (PN) research literature for its breadth and gaps, and to provide recommendations for PN practice and research.

METHODS

A scoping review was conducted using Levac and colleagues' procedures and Arksey and O'Malley's enhanced framework. The CINAHL, ProQuest and PubMed databases were comprehensively searched for original research published between 2008 and 2020. The final sample includes 43 articles. The Mixed Methods Appraisal Tool was used to critically assess literature quality.

RESULTS

There is a significant gap in PN research from Canada and non-U.S. countries. Methodological quality is varied with weak overall reporting. The literature is categorized under three thematic areas: (1) practice roles of the PN, (2) role implementation, and (3) program evaluation research. Research that evaluates health promotion program interventions is prominent.

CONCLUSIONS

More rigorous research methods and the use of reporting checklists are needed to support evidence-informed parish nursing practice. Building relationships among parish nurses, nursing researchers and universities could advance parish nursing research and improve evidence-based parish nursing practice. Research into the cost effectiveness, healthcare outcomes, and the economic value of PN practice is needed.

Faith Community Nurses Key to Promoting Health in At-Risk Communities: An Integrative Review

ABSTRACT

An integrative literature review was conducted to identify recommendations to implement culturally congruent and spiritually connected approaches to health promotion in at-risk faith communities. Five themes emerged from an analysis of 48 articles meeting criteria for the review. Review results repeatedly highlighted the impact nurses-more specifically faith community nurses (FCNs)-can have on at-risk population outcomes and bridging the gap between minority communities and the healthcare establishment. Five recommended action steps provide program guidance to FCNs for promoting faith-based health in at-risk minority communities.

Ensuring Food Safety for Americans: The Role of Local Health Departments

(1) Background: Several agencies in the United States play a primary role in ensuring food safety, yet foodborne illnesses result in about 3000 deaths and cost more than USD 15.6 billion each year. The study objectives included analyzing local health departments’ (LHDs) level of engagement in food safety and other related services, and LHDs’ characteristics associated with those services. (2) Methods: We used data from 1496 LHDs that participated in the 2019 National Profile of Local Health Departments Survey, administered to all 2459 LHDs in the United States. Logistic regression analyses were performed to model multiple dichotomous variables. (3) Results: An estimated 78.9% of LHDs performed food safety inspections, 78.3% provided food safety education, 40.7% provided food processing inspections, and 48.4% engaged in policy and advocacy. The odds for LHDs to directly provide preventive nutrition services were 20 times higher if the LHDs had one or more nutritionists on staff (Adjusted Odds Ratio or AOR = 20.0; Confidence Interval, CI = 12.4−32.2) compared with LHDs with no nutritionists. Other LHD characteristics significantly associated with the provision of nutrition services (p < 0.05) included population size, state governance (rather than local), and LHD having at least one registered, licensed, practical, or vocational nurse. The odds of providing food processing services were lower for locally governed than state-governed LHDs (AOR = 0.5; CI = 0.4−0.7). The odds of performing food safety inspections varied by LHD’s population size, whether a nutritionist was on staff, whether it was state-governed (vs. locally), and whether it completed a community health assessment (CHA) within 5 years. (4) Conclusions: LHDs play a critical role in ensuring safe food for Americans, yet variations exist in their performance based on their specific characteristics. Adequate funding and a competent workforce are essential for LHDs to utilize evidence-based practices and engage in policymaking and advocacy concerning food safety.

The role of the nurse in the obesity clinic: a practical guideline

Obesity is a major public health problem, and its trend is increasing worldwide. Interventions to effectively treat obesity and its related diseases are advocated. Given the complexity of obesity management, nurses need specific core skills to work in the Obesity Clinic and can act as key players in the multidisciplinary team of the Obesity Clinic. To provide practical guidelines for nurses working in Obesity Clinic for effective management of obesity and its related diseases, the current evidence on the role nurses in the obesity clinic was reviewed. Nurses can play a pivotal role in the management of patients with obesity and associated diseases that may require a stricter follow-up than usual care. Given the complexity of the treatment of obesity and its comorbidity, nurses should receive a specific training for: 1) methods and tools to effectively treat obesity and obesity-related disease, 2) patients and families education on nutrition, lifestyle changes, and prevention/management of obesity-related diseases; 3) motivation of patients towards adherence to treatment to achieve their specific goals. This manuscript highlights the need of specific core skills for nurses working in the Obesity Clinic.

The State of Research on Faith Community Nursing in Public Health Interventions: Results from a Systematic Review

Though faith community nurses (FCNs) serve many roles in churches and communities, little is known about their roles or effectiveness in public health interventions. This systematic review summarizes the literature on recent faith community nursing interventions, examining trends, evaluating rigor, and proposing future research directions. Articles were downloaded from PubMed and CINAHL, and 24 studies were included. Interventions addressed various health outcomes. The FCNs participated in research by recruiting participants, developing study measures, and implementing programs. Results reported mainly process evaluation and provided few outcomes. Better evaluation is needed to understand the effectiveness of FCNs in public health research.

An Academic-Practice Partnership to Advance Million Hearts®

BACKGROUND

An academic-practice partnership between a college department of nursing, the YMCA, and one health system was developed to provide student learning opportunities in cardiovascular disease prevention, while advancing the goal of Million Hearts^®.

METHOD

Using The Ohio State University College of Nursing's Million Hearts Fellowship Module, students learned to provide Million Hearts screenings, educate and coach participants in the college and greater community, and deliver a free home blood pressure monitor. Pre- and postscores were obtained to assess change in students' knowledge and participants' blood pressure, lifestyle scores, and perceived stress scores.

RESULTS

A statistically significant improvement in mean participant blood pressure and lifestyle scores was observed.

CONCLUSION

This academic-practice partnership provided an opportunity for students to learn about prevention within a national, population health initiative and for participants to achieve measurable, healthy outcomes. The college's participation in a national Million Hearts consortium enabled practice partners to prioritize cardiovascular disease prevention in the community. [J Nurs Educ. 2021;60(2):103-106.].

Patient and Family Engaged Care: An Essential Element of Health Equity

In this paper, we emphasize and explore health equity as an integral component of a culture of patient and family engaged care (PFEC), rather than an isolated or peripheral outcome. To examine the role of PFEC in addressing health inequities, we build on the 2017 NAM Perspectives discussion paper "Harnessing Evidence and Experience to Change Culture: A Guiding Framework for Patient and Family Engaged Care." Informed by both scientific evidence and the lived experience of patients, their care partners, practitioners, and health system leaders, the paper by Frampton et al. introduced a novel Guiding Framework that delineates critical elements that work together to co-create a culture of PFEC, while also depicting a logical sequencing for implementation that facilitates progressive change and improvement toward the Quadruple Aim outcomes of better culture, better care, better health, and lower costs. In this paper, the authors highlight the need to integrate addressing health and health care disparities and improving health equity as core components of the framework to ensure the culture and policy changes necessary to meaningfully engage patients, health system staff, families, and communities.

The Progression and Ongoing Development of a Research Agenda for Faith Community Nursing

Research is critical to the growth of professional nursing in every practice area. Faith community nursing research evolved slowly in the years following publication of the first research in 1989. A faith community nursing research agenda was developed in 2008 and research priorities have been reviewed every 2 years since 2012 at a forum held in conjunction with the annual Westberg Symposium. This article reviews the progression and ongoing development of a research agenda for the specialty practice of faith community nursing. Recommendations for the development of future research for faith community nursing are discussed.

A systematic review of community nursing interventions focusing on improving outcomes for individuals exhibiting risk factors of cardiovascular disease

OBJECTIVE

To examine the role of community-based nursing interventions in improving outcomes for community-dwelling individuals exhibiting risk factors of cardiovascular disease (CVD).

DESIGN

A systematic review and narrative synthesis.

DATA SOURCES

Seven electronic databases (MEDLINE, CINAHL, Global Health, LILACS, Africa-Wide Information, IMEMR, and WPRIM) were searched from inception to 16 March 2018.

REVIEW METHODS

This review included outcomes from studies that were led by or delivered primarily by nurses for individuals exhibiting risk factors of CVD in community settings. At least two independent reviewers performed study selection, data extraction and risk of bias.

RESULTS

46 studies met the eligibility criteria. Community nursing interventions were found to be effective in improving clinical outcomes of symptom control, symptom awareness, symptom management, and social outcomes. Effective interventions were found to be facilitated by a community-centric approach, participant empowerment, reinforcement strategies, a targeted approach towards underserved populations, and home visits. These resulted in positive outcomes such as significant reductions in HbA1c for diabetic patients, attainment of blood pressure targets for hypertensive patients and greater improvement in self-reported dietary intake for patients with hyperlipidaemia.

CONCLUSION

Community-based nurse-led interventions can result in positive outcomes for patients with risk factors of CVD. However, the success of such interventions needs to be facilitated by appropriate funding, thoughtful intervention design and training opportunities for nurses.

IMPACT

Community-based nursing interventions are largely effective in improving clinical and social outcomes for community-dwelling individuals with risk factors of CVD.