19 minute read
Making Healthcare Smarter
By Debbie Lewis
As technology continues to advance, the impact on the delivery of healthcare has been profoundly changed. Data analytics, machine-to-machine communications, and the Internet continue to move the healthcare industry from a one-size-fits-all approach to tailored precision medicine, aiming to offer the right treatment to the right patient at the right time. As a result, higher education institutions have also had to adapt with more state-of-the-art technology, innovative curriculum, and learning experiences to prepare students for the ever-evolving world of healthcare.
It is a world where providers work as a team, exploring various facets of a patient’s genomic makeup, environment, and lifestyle to devise more thoughtful and effective personalized care.
“We now have the ability to analyze genetic material and markers, and determine what may work for one individual may not be the direction to go for another,” said Cynthia Russell, PhD, RN, FAAN, PCC, NBC-HWC, Dean of the School of Nursing and Allied Health Professions. “The customization of care that’s needed is going to be more refined, including anticipatory versus reactive guidance. Rather than moving strictly in a disease model, or a traditional medical model, where you address healthcare challenges as they arise, we can work with individuals to circumvent or decrease the impact of their genetic makeup, lifestyle, and social environment. It’s not 100 percent foolproof, but a particular pain medication may work for one
Celebrating a successful simulation – Bottom row (left to right): Purity Mwangi, Asia Scott, Jennifer Moylett, Daphne DaSilva, Lina Albarouki, Thalia Curtis, Cheryl Popovich Golestani, and Professor Jinsy Mathew; Middle row (left to right): Professor Gina Gordon, Professor Joeann Hall, Olivia Downie, Samantha Mcqueen, Chloe Austin, Gabrielle Gratton, Anees Fatima, Baljit Mann, Nejat Abdella, Brittany Jones, Dr. Mary Ellen Rush, and Dr. Cynthia Russell, Dean for the School of Nursing and Allied Health Professions; Top row (left to right): Brittany Slaughterbeck, Tecianna Velazquez, Vincent Guidos, Samantha Smith Beavers, Lindsay Gehman, Elora Brill, Lianna Ranna, Caitlyn Cahill, Menachem Scheiner, Mayke De Oliveira, Jake Tully, and Samuel Boateng
person and not the other. Or, someone could be living a healthy lifestyle and still have cardiac issues.”
The move towards precision medicine and precision health requires a comprehensive approach with the client at the center, explains Russell. For example, if a patient has mobility issues, you may have rehabilitation specialists, physicians, nurses, nutritionists, occupational and physical therapists, and environmental engineers all working together to develop a more personalized plan for better individual outcomes.
“It goes outside of traditional approaches, taking into account individual differences to create new models of care,” she said. “This is impacting our current practices and how we educate our students. We’re also moving from inpatient to ambulatory practices and shorter hospital stays. COVID-19 has taken us totally askew, because more patients are in the hospital, often with ventilators, for longer periods of time. So much is done in ambulatory centers and moving recovering patients to home, and arranging for home health visits. Hospitalizations are very expensive, and if we can maintain an individual’s care at home, that’s positive.”
In addition to precision medicine focusing on better outcomes for each individual, population health and social determinants such as zip code and level of education, continue to play a critical role in predetermining health outcomes. According to the National Heart, Lung, and Blood Institute (NHLBI), high blood pressure, a major risk factor for heart disease, is more common and not as well controlled in African American and Hispanic adults as it is in white adults. And, children from low-income families are more likely to have asthma. 1
“This disparity is showing up significantly now with COVID-19, and the higher rates of infection in racial and ethnic minority communities,” said Russell. “Healthcare providers are looking at the social determinants of health and the interrelationship of what it means if you didn’t complete high school and what you’re eating. For example, if you live in a food dessert, where dollar stores are pushing fresh grocers out of business, the population is subsisting on a less expensive, more processed food diet. We know the strong relationship between nutrition and health. Population health plays a significant role, and as the world continues to shrink, we can see what’s happened with this global pandemic.”
The trends of precision medicine, population health, and personalization are being supported by new data collection technologies, including electronic health records, the ability to analyze large amounts of data, and a more holistic approach to caring for patients. As a result, there are a plethora of new healthcare career opportunities, and Holy Family is paving a path to higher level degrees and advanced learning experiences. With the arrival of COVID-19, on-thejob training has kicked into overdrive for our graduates, while simulation training has played an ever-increasing role in help
Maria van Pelt ’92, Dean of the School of Nursing and Associate Dean for the Bouve College of Health Sciences at Northeastern University
ing students achieve their required clinical hours of experience. Whether preparing a future generation of nurses, radiologic technologists, or leaders in the promotion of health and wellness, the University continues to adopt more hands-on learning across various settings.
PREPARING FOR THE FRONT LINES
In addition to entering an evolving, dynamic field, today’s health care professionals are pioneers, meeting a global pandemic head-on in every community. As Dean of the School Nursing and Associate Dean for the Bouve College of Health Sciences for Northeastern of University, Maria van Pelt ’92, PhD, CRNA, FAAN, has been preparing the next generation of healthcare professionals, while taking care of COVIDpatients and helping other nurses take care of themselves.
As a certified nurse anesthetist, during the COVID-19 pandemic surge, van Pelt worked a 12-hour shift one day a week in the ICU at Massachusetts General Hospital, helping her patients and other nurses get through this public health crisis. Van Pelt is a longtime advocate, educator, and researcher in the development of policies addressing support protocols for healthcare professionals in the aftermath of adverse events. At Mass General, she helped develop and implement a clinician peer support program that trains healthcare professionals to provide peer support to clinicians during and after adverse events, which now includes the COVID-19 pandemic. She is now on the advisory committee that is actively expanding the program institution-wide.
In a May article, Nurses are Taking Care of COVID-19 Patients. Who’s Taking Care of the Nurses?, 2 van Pelt says that those caring for COVID-19 patients could be especially at risk for post-traumatic stress disorder, depression, and increased substance misuse.
“My biggest message is going to be to practice self-compassion, and that it’s okay not to be okay,” says van Pelt. "As healthcare professionals, we’re innately ingrained to care for others, and show compassion and provide support, because that’s what our profession does. But all too often, healthcare professionals put their own health on the back burner to care for others.”
Van Pelt was inducted in October 2019 as a fellow of the American Academy of Nursing (AAN), joining more than 2,600 nursing leaders who make up the Academy. The AAN states in a news release, “Van Pelt’s professional passions for patient safety, education, and anesthesia care professional wellness, as well as her leadership on national and international committees, and national consultancy with more than 30 organizations to review their safety programs, make her a perfect addition to the 2019 Class of AAN Fellows.”
In addition to working as a Clinical Coordinator for the Radiologic Science Program at Holy Family, Samantha Cepparulo ’12, ’13, MS, RT (R) (ARRT), is a CT Technologist in the Emergency Department at Chestnut Hill Hospital in Philadelphia. The first two positive COVID-19 cases in Pennsylvania were in neighboring Montgomery County, so the hospital was one of the first to receive suspected COVID-19 patients.
“We didn’t have a lot of information, other than what we were seeing in Italy,” said Cepparulo. “Tests were taking a week to come back, so CT scans became an important early diagnostic tool. A lot of patients who confirmed positive were having blood clots. The CT techs realized this three weeks prior to the news. CT got so busy scanning for blood clots, helping doctors make informed decisions about patient care. I ended up working 20 to 25 hours a week on top of online teaching for Holy Family. I believe in our motto, teneor votis, which means I am bound by my responsibilities. My patients, hospital, and co-workers needed help, so I needed to help.”
One of her patients was in the hospital for four weeks. Fortunately, he was able to receive a standing ovation from the Chestnut Hill staff when he left the hospital COVIDfree. Cepparulo says CT scans played a critical role in his care.
“This patient was on my table so many times,” she said. “There are so many pieces we still don’t understand about COVID-19. From his initial scan, we were able to identify pneumonia patterns to get a better image of where the pneumonia was lingering. With his clots, we needed to keep checking. Then we began scanning for other clues to determine why he was septic. I personally scanned him at least six times, because COVID-19 kept throwing a wrench at us.”
Cepparulo is proud of the fundamental role her profession plays helping patients get better and live longer lives, and also for the opportunity to share her knowledge and ex
perience with her students.
RADIOLOGIC SCIENCES BRINGS TECHNOLOGY TO THE TABLE
Cepparulo, together with colleagues, Shana Narita, PhD, RT (R) (ARRT), Program Director for the Radiologic Science program, and Mark Ness, MA, Ed., RT (R) (ARRT), Faculty for the Radiologic Science Program, are among the recipients of the 2020 Ray and Mildred Taylor Awards. The awards are presented annually to fund research initiatives such as the trio’s work exploring radiologic examination advances. The team will conduct research in the lab
with Holy Family students to enhance their learning, research, and publishing experience. One project will measure the impact of moving an X-ray beam further from the patient to increase beam restriction and reduce focal radiation intensity so it doesn’t reach the patient, reducing the overall absorbed dose. A second project will measure the benefits of shielding gonads from the anterior versus posterior side of patients undergoing chest X-rays.
Narita said, “Healthcare is moving rapidly toward simulation, and we were moving in that direction prior to COVID-19. It’s all about how we are going to prepare students for clinical practice in real life. Clinical, as we know it, will change and it’s going to force all of healthcare education to prepare from a clinical standpoint, especially when they don’t have the opportunity to do faceto-face.”
Holy Family uses advanced Shaderware software in its Radiologic Science courses, where students can work in a virtual radiographic room and learn how to properly position an avatar patient for diagnostic X-ray examinations.
“The benefits of live simulation and the ability to conduct virtual reality simulation provide the best of both worlds to create valuable learning scenarios for our students,” said Narita. “Our students experience three different clinical sites using various types of imaging technology, and that
Raphina (Tuan) Bracewell ’22 truly prepares them to enter the workforce and be productive rather quickly. In fact, after our graduates are working in the field, we survey their employers. One of the very consistent compliments we get is about the quality of our grads–how well-prepared and skilled they are. It’s great feedback.”
According to Ness, Holy Family is one of a handful of programs in the Delaware Valley that rotates its students to multiple clinical sites for face-to-face clinical instruction.
“Our students are motivated to go on to pursue lifelong learning,” said Ness. “We do a great job of instilling that in our graduates. They come to us to earn an Associate degree and this leads to additional post-primary certifications and advanced degrees. In the past five years, over 90% of our graduates have found great careers, and many are in leadership roles.”
NURSES PREPARE FOR THE WORST TO DELIVER THEIR BEST
At Holy Family, simulations take many shapes and forms, allowing students to practice new activities before they are put to the test in real-world situations. In January, 30 students in the University’s Fast Track Second Degree Nursing Program participated in a hazardous material (HAZMAT) simulation at our Newtown location, supervised by Detective Joseph Rovnan, who serves with the Philadelphia Police Department’s Counter-Terrorism Operations.
“This is the second time we’ve created this hands-on simulation, so our students can get a richer understanding of community health needs and emergency situations where nurses would play a critical role,” said Joeann Hall, MS, RN, Simulation Laboratory Coordinator for the School of Nursing and Allied Health Professionals.
The students were divided into two groups—responders and victims—so they could immerse themselves, and gain a 360-degree viewpoint of their function and appreciation for individuals being cared for in an emergency. At the sound of the alarm, a fictitious bombing took place, complete with smoke machines, to replicate a real situation. Responders, dressed in yellow vests and hats, jumped into action to help victims and prioritize them for the order of care. Each victim received a colored wristband, with red raising a top priority flag, followed by yellow, green, or black.
Students were impressed by the reality of the situation, including the real-world distractions that can deter the primary objective of caregiving when so much is happening at once. For example, Hall, playing the role of a news reporter, interrupted the process by trying to interview nurses as they were taking care of the injured population.
The University’s reputation for high quality instruction sets Holy Family students apart when they go to compete in the job market.
Raphina (Tuan) Bracewell ’22, born in Monrovia, Liberia, came to the US at age 20 because her mother believed she would have a better opportunity. She chose Holy Family because the core values lined up with her beliefs—family, integrity, and respect for the human family. Bracewell says that her handson training and coursework helped her stand out and secure a full-time, paid summer internship at Independence Blue Cross (IBX).
She is working at the company’s Philadelphia headquarters and also at clinical sites, educating members and clients about the Health Protection and Promotion Act, and setting up medical appointments with registered nurse coaches.
Russell explains the IBX internship is a best-in-class opportunity, and the relationship with IBX is an important one for the University. Holy Family has a strong partnership with the Independence Blue Cross Foundation’s Nurses for Tomorrow program, which awards scholarships to deserving nursing students.
“I’m very excited and happy that IBX chose me for this position,” said Bracewell. “I’m grateful to God because he made this possible, and I’m grateful to Holy Family for the rigorous curriculum that prepared me. The professors come every day to give us nothing but their best. I’m going for a Bachelor of Science in Nursing degree and then further to achieve my master’s or PhD. I’m very passionate about helping people, and a career in nursing will help me be of service to the human race. I feel it’s my calling.”
While the definition of a career in healthcare continues to expand and evolve, the calling for healthcare students and professionals remains constant. In May, Holy
Reaching Higher and Higher: Dr. Princess Gayles-Jones
Princess Gayles-Jones MSN ’18, DNP ’20 knew she wanted to become a nurse ever since she opted in 11th grade for the Health Profession Liaison program at Trenton Central High School in Trenton, NJ. Through the program, she began an 11-year relationship with the St. Francis Medical Center in Trenton, where she practiced nursing in every area and found her calling on the correctional health floor, working with the prison population. Her extensive career experiences and a resolute pursuit of education paved a path to this spring when Gayles-Jones earned her hood and gown, and a coveted Doctor of Nursing Practice (DNP) degree, from Holy Family University.
“I love correctional nursing because that population is more humble,” said Gayles-Jones. “They know they’re in a transition phase and they’re more receptive to care. It gives me a sense of fulfillment that I could be a catalyst to make a change in someone’s life through kindness and care. “
While earning her master’s degree at Holy Family, Gayles-Jones was a full-time Department Nurse Manager for the New Jersey Department of Corrections, working concurrently at the Edna Mahan Correctional Facility for Women and the Annandale Youth because it was a new program, and a collaborative process between Correctional Facility. In her role, she managed nurses across the the instructors and the students. system caring for male youth offenders, ages 18 to 35, who were Classwork included papers, reflections, basic coursework, and on good behavior. exams. During the evenings, she would shadow her preceptor,
“The money is good but the environment can be harsh, so some a nurse leader working on the job. She was fortunate to have an nurses know it’s not for them,” said Gayles-Jones. “For me, I like unofficial mentor in Marina Boykova, PhD, RN, a nurse educator how correctional care is more than just one dimension of nursing. at Holy Family. During her master’s program, Gayles-Jones studied Since it’s a system unto itself, you need to bring everything to those statistics with Boykova, and was able to draw on her professor’s you care for.” expertise and coaching when it came time to do her own statistical
After receiving her master’s degree in 2018, Gayles-Jones analysis for her DNP. consulted with her three children, ages 14, 11, and two at the time, Gayles-Jones credits her positive experience at Holy Family before making a decision to go for two more years of school to with the rigorous curriculum, high-quality professional training, achieve her DNP. and close collaboration with her professors across the School of
“I knew my kids were still young, and it was going to be now or Nursing and Allied Health Professions. never,” said Gayles-Jones. “I needed to do this not only for myself, “Reaching my DNP dreams—and all that has entailed—means but for them as well.” everything to me,” she said. “It’s my last goal and I achieved it.
As Director of Nursing at an assisted living facility in Princeton, My family’s so proud of me. It’s a surreal feeling.” NJ, Gayles-Jones was already working 40 hours per week. ReturnGayles-Jones hopes to one day become a Chief Nursing Officer ing to school added another 40 to 50 hours, plus the time she spent at a correctional facility, and now with her DNP in-hand, this, too, taking care of her family. She chose to continue at Holy Family has become more achievable.
Family graduated its first class of Bachelor of Science in Health Promotion and Wellness students, who will go on to help clients make evidence-based, positive lifestyle decisions as part of today’s proactive healthcare movement. Princess Gayles-Jones MSN ’18, DNP ’20 became the first Holy Family graduate to achieve both her Master of Science in Nursing (MSN) and Doctor of Nursing Practice (DNP) degrees, coming closer to her ultimate goal of becoming a Chief Nursing Officer in a correctional facility.
“What I appreciate about Holy Family students is that there’s a deep commitment to caring for the community,” said Russell. “Many of our students are first-generation-to-college, working to put themselves through school while also helping to take care of their families. Our second-degree students see themselves advancing in terms of responsibilities and leadership. They combine drive, perseverance, delayed gratification, and the ability to put that all in perspective in pursuit of a goal. That’s one of the things that drew me to Holy Family. We are impacting the trajectory of our students’ lives and creating a pathway to so many opportunities.”
1 Health Disparities and Inequities, National Heart, Lung and Blood Institute https://www.nhlbi.nih.gov/science/ health-disparities-and-inequities
2 Nurses are Taking Care of COVID-19 Patients. Who’s
Taking Care of the Nurses? https://news.northeastern. edu/2020/05/05/nurses-are-taking-care-of-covid-19- patients-whos-taking-care-of-the-nurses/
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