Boone Health SPRING 2018
LEADING THE WAY
Boone Nurses Bring the Boone Touch to the Bedside. PG 12 P G . 1 4 T I P S F O R A H E A LT H Y G A R D E N
The American Heart Association and Boone Hospital Center are now accepting applications to select 10 women to participate in the Go Red For Women’s Go Red Challenge. This exciting opportunity will incorporate the American Heart Association’s Go Red curriculum, which focuses on developing skills to help today’s busy women lead longer, healthier lives. The Go Red Challenge is a nutrition program that will makeover your heart. The package includes: • Health screenings by Boone Medical Group, prior to the program beginning and upon completion, to measure success! • Nutritional planning assistance from registered dietitians and health educators from Boone Hospital Center. • Free 3-month membership to the WELLAWARE Fitness Center • Free orientation to the WELLAWARE Fitness Center, where professionals will help design a program for each participant • Free session of 1 group fitness class at WELLAWARE Fitness Center (a total of 6 or 8 classes, depending on which class the participant chooses)
Application Deadline: April 27, 2018 Program Start Date: May 21, 2018 Program End Date: August 6, 2018 For more information, contact: Leanne Geiss (573) 446-3000 Leanne.Geiss@heart.org Go Red Challenge Brought to you by:
APPLY AT: BOONE.ORG/RED OR HEART.ORG/COLUMBIAGORED
Table of Contents 12
President
Jim Sinek Director of Marketing and Public Relations
Ben Cornelius
Marketing Coordinator
Jessica Park
Multimedia Marketing Specialist
Madison Loethen Photography
Sadie Thibodeaux Anastasia Pottinger Kelly Cline Contributing Writers
Nicole Flood Rebekah Hall Kelsie Knerr, RD, LD
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Please submit comments or feedback to bcc1170@bjc.org or call 573.815.3392 1600 East Broadway Columbia, MO 65201 573.815.8000
For a FREE subscription, call 573.815.3392 or visit myBooneHealth.com and click on the subscription link on the right side of the page.
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A Note from Jim
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Caring in Motion
6
Hospital Headlines
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The Bionic Woman
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Boone’s Study Group
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Get to Know a BHC Doctor
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Infertility Treatment
25
Get to Know a BHC Nurse
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Positive Outcomes
26
When Nature Gets
14
Let’s Get Digging
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Leg Strength Exercises
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The Lentil
30
Foundation News
Under Your Skin
MyBooneHealth.org
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Three years in a row.
A NOTE FROM JIM
at a department level to give our leadership and staff actionable feedback. The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is conducted by the Centers for Medicare & Medicaid Services, and it is designed to measure patients’ perceptions of their hospital experience. The survey’s goals are to provide consumers an objective way to compare hospitals on multiple topics, to incentivize hospitals to improve quality of care, and to enhance accountability in health care though public reporting and transparency.
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n an ever-changing environment like health care, hospitals must constantly adjust in order to keep up. While our priorities may change, at Boone Hospital Center, our mission of improving the health of the people and the communities we serve remains unchanged. Here are some of the areas Boone Hospital Center will focus on in 2018 so that we can continue to be an excellent place to work and receive health care. EMPLOYEES Boone’s greatest asset has always been our employees. Boone Hospital Center was recognized by Nurse.org as one of the top hospitals for nurses to work for in Missouri. We want to make sure we maintain that standard for all of our staff. To do this, we’re focusing on turnover and employee engagement. Maintaining a low turnover rate builds a more experienced staff, which results in more efficient work, more familiarity with teammates and, ultimately, better patient care. Our employee engagement is determined using results from a semi-annual anonymous survey completed by our staff. The survey allows our employees to evaluate Boone on things such as leadership, communication, development opportunities and equality in the workplace. While we have traditionally scored very high on our employee engagement, we always look for ways to improve and ensure Boone is a great place to work. PATIENT SATISFACTION Happy and engaged employees contribute to an excellent patient experience. To evaluate patient satisfaction, we look at both system-wide and nationwide survey results. The BJC HealthCare system partners with Professional Research Consultants to conduct post-care follow-up calls to randomly selected patients. The results are reported
QUALITY OF CARE Now that we have happy, engaged employees creating excellent experiences for our patients, we need to make sure the clinical care we deliver is top-notch. We evaluate this using many tools, one of which is the Best-In-Class (BIC) Scorecard. We use this scorecard to monitor monthly progress on important areas across the organization. We intentionally select the most difficult metrics of care which represent opportunities for improvement related to quality, safety, or operational goals. Key stakeholders monitor BIC trends and create targeted action plans to implement national best practices and drive local improvement. STEWARDSHIP To deliver the excellent care that Boone Hospital Center is known for, we must strategically invest in our staff, technology and facilities. Health care is currently an incredibly challenging environment — reimbursement rates are dropping, regulations are constantly changing, supply costs are constantly increasing, and competition is coming from many angles. A small sampling of our recent efforts includes: • Opening Boone Medical Group primary care and specialty care clinics throughout mid-Missouri • Reducing our supply costs • Recruiting highly skilled physicians, including three general surgeons, cardiologists, intensivists and more • Being the first hospital in the BJC HealthCare system to implement the Epic electronic medical record system • Building partnerships with other health care facilities, such as the Siteman Cancer Center • Developing new services, like outpatient pulmonary rehabilitation
Jim Sinek President, Boone Hospital Center
MyBooneHealth.org
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HOSPITAL HEADLINES
DAISY Award Hospital Partner
B
oone Hospital Center is now a DAISY Award Hospital Partner. The DAISY Award is a nationwide program that rewards and celebrates the extraordinary clinical skill and compassionate care given by nurses every day. The DAISY Foundation was established in 2000 by the family of J. Patrick Barnes, who died of complications of an auto-immune disease at the age of 33. DAISY is an acronym for diseases attacking the immune system. Nurses who are selected for a DAISY Award personify a remarkable patient experience at Boone Hospital Center. Awardees consistently demonstrate excellence through their clinical expertise and extraordinary compassionate care, and they are recognized as outstanding role models in our nursing community. Each DAISY Award honoree is recognized at a public ceremony in their unit and receives a certificate, a DAISY Award pin and a hand-carved stone sculpture titled “A Healer’s Touch.” Additionally, everyone in the unit receives a special treat. Our first DAISY Award was given to Emily Wood, RN, with Boone Family Birthplace. Get to know Emily more on page 25.
Lee Pfefer Memorial 5K THURSDAY, MAY 3 AT 6 P.M. STEPHENS LAKE PARK $30 early registration $35 on-site registration Register at boone.org
Emily being surprised by the award in her unit.
Kids on Track
Emily with the family who nominated her.
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We are excited to announce the return of Kids on Track in May 2018! This annual program gives kids 12 years old and younger a 26.2-mile challenge to help keep them physically active over their summer break. This year, Kids on Track will hold programs in Ashland, Boonville, Centralia, Columbia, Hallsville, Mexico, Moberly and Osage Beach. For more information, please visit boone.org/ kidsontrack or email erin.wegner@bjc.org.
PEPSI Challenge
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n July 2017, a clinical team gathered to address Boone Hospital Center’s patient satisfaction scores related to staff responsiveness, specifically answering the call lights in a timely manner and assisting with bathroom help. The team reviewed literature, evidence-based practices and work that had been done previously through Rapid Improvement Events (RIEs), and as a result, they decided to re-implement hourly PEPS (pain, elimination, positioning and safety) rounds. The use of purposeful hourly PEPS rounds increases patient care staff ’s time at the bedside. The results were clear – between July and October 2017, BHC patient responsiveness scores rose until they reached the maximum level. To celebrate this remarkable improvement, we thanked every patient care staff member involved in improving the score by giving them a PEPS-I! PepsiCo kindly donated 720 cans of Pepsi and Diet Pepsi, which were distributed to units on Friday, February 2. Thank you to our caregivers for making a difference!
From left to right: Rebecca McGuire, RN; Rob McEver, RN; Anne Balsley, RN; Kelly Canote, RN; and Stephanie Dorado, RN.
2018 Skin Cancer Screening
Appointments are necessary. To schedule an appointment, call 1-800-872-9008 Tues., Apr. 3
8:30 AM – 3:30 PM
Linn Co. Health Department, 635 S. Main St., Brookfield, MO
Wed., Apr. 25
9:00 AM – 3:00 PM
Hometown Homecare, 101 Furr St. Fayette, MO
Wed., May 16
8:00 AM – 5:30 PM
1701 E. Broadway, Columbia, MO (BMP 3 Mobile Health Unit)
Wed., May 30
8:00 AM – 5:30 PM
1701 E. Broadway, Columbia, MO (BMP 3 Mobile Health Unit)
Wed., June 27
8:00 AM – 5:30 PM
1701 E. Broadway, Columbia, MO (BMP 3 Mobile Health Unit)
Sat., July 21
8:00 AM – 5:30 PM
1701 E. Broadway, Columbia, MO (BMP 3 Mobile Health Unit)
Wed., Aug. 8
7:00 AM – 4:30 PM
Boone Electric Co-op, 1413 Rangeline St. Columbia, MO
Wed., Aug. 29
8:00 AM – 5:30 PM
1701 E. Broadway, Columbia, MO (BMP 3 Mobile Health Unit)
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Clinical researcher Suzin Cunningham (nee Dopplick) and senior clinical researcher Mihaela Popescu.
Boone’s Study Group Boone Hospital Center’s clinical research office upholds our mission of improving health care.
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n 2015, Mihaela Popescu joined Boone Hospital Center as the senior research coordinator of the brand-new Clinical Research Office, or CRO. She then immediately discovered that Boone Hospital was no stranger to research. “I found documents showing research going back to the ’80s,” Mihaela says. “It was amazing to learn how many projects had been done.” Clinical research has been led for decades by nurses at Boone Hospital Center and by physicians on Boone Hospital Center’s medical staff, including Tony Spaedy, MD, a cardiologist with Missouri Heart Center. “We started doing clinical research at Boone Hospital 24 years ago,” Dr. Spaedy says. Missouri Heart Center has two full-time cardiac research nurses in their office, and many patients in their clinical studies
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receive interventions and care at Boone Hospital. Some of Missouri Heart Center’s studies have contributed to advances in medications for congestive heart failure and cholesterol and lipid disorders; new advances in pacemakers and defibrillators; and new methods for treating patients with blocked arteries. “Involvement in clinical research has given us and our patients access to new medications, devices and treatment options that we wouldn’t have otherwise,” Dr. Spaedy says. “The research studies frequently help us learn better ways to treat patients and have significantly improved care over the years.” As clinical research leads to advances in medicine, those advances in turn lead to more clinical research. But before a study can begin at Boone, it must receive approval from hospital administration and be approved by an institutional review board, or IRB. Mihaela and research coordinator Suzin Cunningham
What are clinical research studies? In some studies, such as clinical trials, participants might try a new medication, medical device, procedure or therapy. Multiple phases of clinical research are required for these interventions to receive FDA approval. Research may also be done on a medical intervention after it has been approved and prescribed. Volunteers in these studies may benefit by receiving early access to the latest medical breakthroughs. Not all research studies require volunteers to receive medical interventions. In some studies, they follow a special diet, exercise program, or other lifestyle changes. Observational studies collect data on participants’ current lifestyle or medical care, but don’t require them to change medications or behaviors. Genetic studies seek to understand the relationship between a person’s genetic make-up and their likelihood of developing a disease. These studies are also used to develop specialized treatments. Quality of life studies, like the Cancer Experience Registry for cancer survivors, can improve understanding of how a disease affects a person’s emotional health, family and social life, finances or career. Clinical research data may include medical images such as MRIs, lab test results, or survey responses. Some studies collect data from volunteers over weeks, months or years to measure changes over time. Volunteers must be informed of what the study requires. Clinical research studies also need healthy people to participate. Researchers compare data from healthy volunteers to data from volunteers who have a health condition or receive an intervention. By participating in a research study, you can contribute to medical knowledge and help future patients. While clinical research studies are not without risks, guidelines have been established to protect volunteers’ rights, safety and welfare. By law, you must be fully informed of potential risks and benefits of being in a research study before agreeing to participate. You cannot be forced into participating, and study sponsors cannot deliberately mislead volunteers. If you are asked to participate in a clinical trial, you can and should ask questions about the study, what you would be required to do, and potential benefits and risks. To learn more about participating in clinical research, visit clinicaltrials.gov and look under Patients and Families.
make it easier for our physicians, nurses, and patients to take part in research studies. Clinical research studies are used to better understand how diseases are acquired, prevented, or treated in human subjects. Studies can take place at multiple locations, in inpatient and outpatient settings, and may be sponsored by academic institutions, hospitals, organizations, physicians or pharmaceutical companies. The investigator submits a protocol, which details how the study will be conducted, for review and approval by an IRB. An IRB includes doctors, researchers and other community members. Boone Hospital uses the IRB at Washington University School of Medicine in St. Louis to review, approve and monitor studies to ensure the welfare and rights of study subjects. For example, study participants, or volunteers, must be properly informed of risks and benefits before they agree to participate in a study. Volunteers can’t be exposed to unnecessary risks, and their identity and personal health information must be kept confidential. A clinical research study may touch multiple areas of the hospital, including inpatient units, radiology, laboratory, and medical billing. Boone’s CRO ensures that these departments are involved in the internal review process. All studies must be approved by Boone Hospital Center administration, including the chief medical officer and chief nursing officer. “If a study involves any procedures in the hospital, we have to be careful from the beginning,” Mihaela says. The Clinical Research Office also assists physicians interested in clinical research by helping them understand IRB requirements or acquire the training required to do research with human subjects. “We really want to collaborate with more physicians,” Mihaela says. “They have many great ideas, and we want to support them.” Once a study is approved and under way, the CRO coordinators follow the protocol requirements to ensure selected volunteers are eligible and study procedures are properly followed. Currently, Mihaela and Suzin support ongoing studies in the stroke center and oncology. They’ve also helped physicians conduct studies with Boone Hospital cardiology and orthopedics patients. The CRO also assists with evidence-based research done by nursing staff to improve patient care quality at Boone. Mihaela has been impressed by the enthusiasm and willingness to participate in research by nurses, physicians and patients at Boone. She says it’s definitely a team effort to get a research study going. She looks forward to further collaboration with nurses and physicians, advancing knowledge to improve health care and building upon the strong tradition of clinical research at Boone Hospital Center. By Jessica Park
MyBooneHealth.org
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Trust Your Journey with MissouriFertility A
t MissouriFertility (formerly MidMissouri Reproductive Medicine and Surgery Inc.), family matters. In the journey with infertility, every patient has a unique goal, and MissouriFertility strives to listen, educate and create treatment plans to help patients meet that goal. The dedication to patient care begins with an important priority: direct contact with their staff. You won’t find an automated phone system when you call to talk to your provider. “In the journey of infertility, information is power,” says Gil Wilshire, MD, FACOG and medical director of MissouriFertility. “There is a ton of advice, and most of it is not helpful if the patient doesn’t know what their diagnoses are. It is crucial to have an accurate diagnosis before picking a treatment.” Dr. Wilshire specializes in reproductive endocrinology and endoscopic surgery and is board-certified in Reproductive Endocrinology and Infertility by the American Board of Obstetrics & Gynecology (ABOG). He is a Fellow of the American College of Obstetricians and Gynecologists (ACOG). The recommended time to attempt pregnancy before consulting a reproductive endocrinologist is about year without getting pregnant. This shortens to six months for women over 35 or after a miscarriage. “My personal advice is to seek evaluation at any time if the couple is trying, miscarries, has missed periods, or a sense that something is wrong,” Dr. Wilshire says. “Nothing is lost an getting evaluation early.” When a heterosexual couple is trying to conceive, both partners are accurately evaluated. Male factor problems are very
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common, and semen analysis is very simple. “This test can let us know if there are issues in fertility or other health concerns such as a thyroid problem,” Dr. Wilshire says. “If we come across an issue, it might take three to nine months to correct if it is treatable, so delay in diagnosis and treatment should always be avoided.” Dr. Wilshire says conception takes the “holy trinity of fertility:” a viable egg, good sperm,
and a healthy uterus. “If we can get these three things together all at the same time, then pregnancy can occur,” he says. “There is a window of receptivity, and half of the battle is getting the timing right. That’s why we are open six days a week, and sometimes even seven: to make sure the timing is accurate to provide the best care for our patients.” A common way to help patients conceive is by giving the woman pills to ensure she
To learn more or set up an appointment, please visit missourifertility.com or call 573-443-4511
is ovulating. The ovulation process is then monitored with ultrasound. When the egg and uterus are ready, they trigger ovulation by way of an injection. The woman will generally ovulate a day and a half after the trigger. Intrauterine insemination, or IUI, is also frequently practiced. This involves placing sperm inside a woman’s uterus to help enable fertilization. “Approximately 80 percent of our pregnancies in the clinic come from ovulation induction and IUI – it’s safe and simple and relatively inexpensive,” say Dr. Wilshire. Dr. Wilshire says a common misperception is that all infertility treatments are expensive and painful. Generally speaking, many patients can find help through the treatments mentioned above or other adjustments to hormone levels. If patients find they have an issue with their eggs, sperm, tubes or genetics, then assisted reproductive technologies (ARTs) could be what they need. “For instance, if the woman has blocked or damaged fallopian tubes, or the man has a low sperm count number, then in vitro fertilization [IVF] would likely be what they
would need to do,” Dr. Wilshire says. IVF combines the egg and sperm outside of the uterus to create an embryo. Once the embryo is created, it is transferred to the uterus for implantation. With IVF, physicians are able to do genetic testing to determine which embryo has the best chance of implantation. “When women get older, many of their embryos are genetically abnormal,” Dr. Wilshire says. “We also see people with genetic conditions such as cancer syndromes, muscular dystrophy, cystic fibrosis and many others. For these couples, the ability to do genetic testing of their embryos is very valuable. Genetic testing is becoming a standard of care in IVF — it also gives us confidence to transfer single embryos where even a few years ago we would transfer two or three. This lessens the risk of high-risk multiples with IVF.” Even if you’re not actively trying to conceive, MissouriFertility can help those experiencing painful periods or painful intercourse. They specialize in several reproductive surgeries and also have expertise
in treating hormone imbalances in teenagers and women going through menopause. “Women are prone to various conditions that not only affect their fertility but their quality of life,” says Dr. Wilshire. “Endometriosis causes a lot of pain in addition to infertility. It is also common for ovaries to develop cysts and uteruses to grow tumors called fibroids. These conditions all require surgery, and we can do them through minimally invasive procedures that strive to preserve the ovaries and uterus.” Dr. Wilshire also says that about several times a month, he meets a young man or woman just diagnosed with cancer who is about to undergo chemotherapy or surgery that can have a devastating effect on their fertility. Fertility preservation is a crucial service the clinic offers. The ability to freeze eggs and sperm allows patients the opportunity to have a family in the future. “Our number one obligation is to our patients,” Dr. Wilshire says. “As a private clinic, we’re here for you and we strive for world class success rates, outcomes and patient satisfaction.” By Nicole Flood
MyBooneHealth.org
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Positive Outcomes
Boone Hospital Center knows that satisfied nurses mean satisfied patients.
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hen nurses rated Boone Hospital Center one of the best places to work in Missouri on Nurse.org, this was good news not just for the hospital, but for patients and families. When you or a loved one needs medical care, nurses make a big difference. That difference definitely stood out to Monica Smith, vice president of patient care services and ancillary operations and chief nursing officer, when she had first visited Boone Hospital for a job interview. “I had always known great things about Boone Hospital Center, but I was really sold when I walked in the door and felt the positive family atmosphere. People smiled at you and greeted you when you were going down the hallway,” Monica says. Research shows that patients benefit when they receive care from nurses who are educated, experienced and engaged. A compassionate nurse who has excellent communication, teamwork, and critical thinking skills can be a powerful advocate for your health. To improve patient care, Boone Hospital give nurses opportunities for lifelong learning, professional development, and a positive work environment. “If you have happy and engaged nurses who are positive when they come to work, they’ll want to go the extra mile to provide excellent care, and that will produce excellent outcomes for patients,” Monica says. With new technological advancements and research emerging every day, nurses must continue learning to stay up-to-date. Registered nurses need an associate’s degree in nursing, but Boone Hospital encourages nurses to earn their bachelors of science in nursing (BSN). Multiple studies show that patients have better outcomes and shorter stays at hospitals where more nurses have their BSN. About 57% of BHC’s 600plus registered nurses have their bachelors, masters or doctorate in nursing. Boone Hospital Center also has 109 nurses who have earned board certification in a specialty
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Nurse residency program coordinator Velvet Meers (right) with nurse Rachel Whelan.
area, reflecting a high level of knowledge, skill and competency in their field. Boone Hospital Center and BJC HealthCare offer nurses countless learning opportunities. Boone Hospital Foundation funds caregiver education, sending nurses to national conferences and supporting free on-site courses. Employees studying for a nursing degree can apply for BJC nursing scholarships and tuition assistance to help complete their education. High-performing employees seek opportunities to advance in their career, and nurses are no exception. Boone Hospital Center offers talented, experienced clinical care nurses a career ladder through their Professional Nurse Development Program, or PNDP. Nurses must apply to join
the program, to be promoted within the program, and to renew their standing. “PNDP empowers nurses to engage at the hospital, community and national level, to be recognized for their professional practice, and to be compensated for it, too,” Monica explains. Nurses also appreciate recognition for a job well done. Boone Hospital has multiple opportunities for nurses to be recognized by colleagues, patients and families, including Employee of the Month, the hospital’s annual Professional Excellence in Nursing Awards, and, most recently, the DAISY Award program. Nurses who feel connected to the hospital’s mission and purpose are more invested in their roles as caregivers. Shared
Learn more at boone.org/nursing
decision-making gives nurses at every level a chance to make a difference and improve patient care. Unit councils give nurses a forum to recommend practice changes and discuss patient safety, work-life balance, professional development, patient education and other concerns. Unit councils report to core practice councils up to a coordinating council chaired by the chief nursing officer. All nurses have opportunities to serve on these councils and have their voices heard. “Shared decision-making empowers nurses to make decisions about their own practice,” Monica says. “Nurses at all levels, from the bedside to management, bring forward what’s important in their practice and make changes that impact care. Together, we can make a difference.” Nurses are more likely to support changes in their practice knowing their peers were involved in the decision-making. “It’s meaningful to be part of the bigger picture and to have the opportunity to make things better for your patients,” says Velvet Meers, BSN, RN. Velvet serves on the professional development professional practice council and coordinates Boone Hospital’s nurse residency program. Boone Hospital nurses also improve patient care by doing evidence-based practice, researching clinical evidence and best practices to propose and implement improvements to patient care. “We definitely encourage nurses to ask themselves why they’re doing something in their practice, and if it could be done better. If you have a burning question or think we might need to change practice, then you can research it and find evidence,” Monica says. Recently, evidence-based practice resulted in starting skin-to-skin care between mothers and newborns in the delivery room and has improved communication when transferring patients from the emergency department to other units. BHC’s Clinical Research Office assists nurses with their evidence-based practice research. Attracting and retaining the best nurses is necessary to build a strong patient care team, but the transition from nursing school to caring for patients in a hospital can overwhelm even the brightest graduates; in the United States, 1 in 5 new nurses leave their job during their first year. This rate,
however, has shown to be lower at hospitals with nurse residency programs. “Nurse residency helps the new graduate transition into professional practice and allows nurses to feel connected to their peers, while being professionally supported,” Monica says. Boone Hospital started its nurse residency program in 2017. Each cohort of new nurse graduates meets monthly for one year to expand their nursing school knowledge with presentations from Boone Hospital nurses and physicians. The program provides peer support and a space to discuss concerns and share experiences. The first cohort of nine nurses completed the program this January and all are still with Boone. Velvet says that the nurse residency program accustoms Nurse Lou Eleanor Keely, Boone County Hospital’s first administrator, led the hospital for over 20 years. new nurses to doing evidencebased practice and getting involved with shared decisionSince the county hospital opened its making. “They’re excited to be able to actively doors in 1921, nurses have led the way at make things better for our patients,” she says. Boone. The hospital’s first administrator, Lou Boone Hospital Center’s many prestigious Eleanor Keely, was a nurse. For over 20 years, designations and accolades reflect our high Keely led the new hospital through periods standards for nursing practice and quality of significant change and challenge. Barb care. In 2005, the hospital earned its first Weaver, the first woman elected to the Board of three Magnet® designations from the of Trustees, was a registered nurse. Another American Nurses Credentialing Center. nurse, Jan Beckett, currently serves as a The Magnet program recognizes health care trustee. Many of Boone Hospital Center’s organizations that meet the ANCC’s high leaders are nurses. standards for safe patient care and excellence in nursing practice. Hospitals must reNever content to rest on their laurels, apply for Magnet designation every 4 years. Boone nurses are always looking to the Boone Hospital is currently one of 471 future. In coming decades, the need for organizations worldwide to be recognized as nurses will rise as Baby Boomers age and a Magnet facility. require advanced care. Meanwhile, a third “Research has shown that Magnet of nurses currently working are over 50 and hospitals have lower rates of falls, pressure preparing to retire. The high demand for ulcer, and central line infections,” Monica nurses has resulted in a national shortage. explains. “There are better patient Whatever the future brings, one thing is outcomes in Magnet hospitals because the certain – Boone Hospital Center nurses will rigorous criteria to become Magnet makes continue to lead the way in providing the us set higher standards, which is what our patients deserve.” best patient care. By Jessica Park
MyBooneHealth.org
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Let’s Get
How gardening can empower children and foster healthy relationships with food. 14
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Spring is here, which brings warmer weather and all things green. Gardens are slowly coming back to life. This is a great time to introduce to children to gardening, which gets them out in the sunshine and gets their hands dirty. It also helps teach kids about time passing and how it takes time for food to get from the ground to their plates, says Kelsie Knerr, a clinical dietitian at Boone Hospital Center. “It’s such a blank slate for any kind of learning about the ecosystem and how time passes and how things change over time,” Kelsie says. Kelsie spent her first year after college volunteering for FoodCorps, an organization that works to connect children with healthy foods in their schools. The program recognizes the importance of teaching children about gardening and healthy foods at a young age, and the program also works to impact entire communities. Kelsie says it’s important to show kids how food takes time to grow, and this process is to be appreciated. “It’s so empowering to be able to grow something and have a part in growing it,” Kelsie says. “Kids need that boost of confidence that they did something and have some power or control over it.” There are many resources available online,and in your community,to help get children involved with gardening. Here are a few different ways to get children interested in gardening:
Visit the
Plant seeds that
Create a
farmer’s
are fun for kids
“soil food”
market.
to hold.
bowl.
The farmer’s market is a great place to teach kids about seasonality and help them be more connected to their food.
Smaller seeds can seem daunting or boring to children, so try using big seeds that will be fun for kids to hold and play with, like butternut squash seeds.
Children can collect produce scraps and egg shells from family meals and save them in a kitchen bowl to compost for “soil food.” This encourages children to nurture and “feed” a garden, just as it’s important for them to feed themselves.
Test your soil. Children can help their parents gather soil for a soil testing kit, which can then be submitted to MU Extension’s Soil and Plant Testing Laboratory. For more information on soil testing, visit soilplantlab.missouri.edu.
Grow plants that are fun to pick. A great way to make gardening appealing to children is to give them the opportunity for handson learning. Children can pick peas or raspberries, dig carrots or potatoes out of the soil, or cut lettuce, chives and different herbs.
Make portable garden beds. Milk crates can be turned into raised beds that are easy to transport. “Starting stuff inside lets your kid watch it grow before the season really starts,” Kelsie says.
Let children design their own gardens.
Get cooking!
Children can gain a sense of ownership from designing the layout of their own garden. Let them decide what they want to plant, where in their garden they want to plant it and how they want their garden to look. There are lots of online tools that use pictures to help kids design their own gardens, and many feature printable garden
Let kids practice cooking recipes with the ingredients they’ve grown in their gardens and contribute to family meals. This shows them how important the growing process is and fosters an appreciation for farm-to-table cooking.
planning activities.
Make a garden journal and photo album. Encourage children to write down their observations about their gardens and track the changes as it grows. This can also be documented with a photo album by letting kids take pictures of the garden as it changes. They can then look back to the beginning of their gardens and really see the impact of time on their plants.
When beginning to teach children about gardening, Kelsie encourages families to do what feels manageable. “I encourage people to keep it simple and start small,” Kelsie says. “Know that you don’t have to go crazy your first time around — just go with what you’re comfortable with.” Children can greatly benefit from tending a garden. It helps empower them, teach them patience, and form a healthy and enthusiastic relationship with the foods they eat. By Rebekah Hall
MyBooneHealth.org
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Learn to Love
THE LENTIL How this hearty “superfood” can improve your diet.
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Spring 2018
A “superfood” can be loosely defined as a food that is nutrient dense or provides a benefit to your health. Often, a “superfood” is a trending food or food group that gains popularity on social media because of specific health “benefits” the food asserts to provide. The term “superfood” is not recognized in the medical community or the field of nutrition science because its claims are difficult to measure, says Jennifer Anderson, RD, CDE, a registered dietitian at Boone Hospital Center. “Nutrition science is a hard science to study because we don’t eat foods in isolation,” Jennifer says. “And most of the time, foods aren’t one nutrient, so it’s hard to say whether [the benefits are] from that one nutrient or a combination of the nutrients.” Anderson adds that the “superfood” claim can be skewed because of the size of the study conducted. “A lot of the research is done either in animals or through in vitro, and in large amounts — way more than most people would consume at one time.” Jennifer says fruits and vegetables could all be considered “superfoods” because they’re very nutrient dense. While the term “superfood” can incentivize more people to consume certain fruits and vegetables, one shouldn’t rely on this label for its scientific accuracy. A recently trending “superfood” is the versatile and nutritious lentil. Lentils are a small, round vegetable and come from the larger legume family in many colors and sizes. They range from yellow, orange, and red to green, brown, and even black! Jennifer says the lentil is a satisfying, adaptable legume. “It’s a really healthy food,” she says. “It provides carbohydrate plus protein, and a good majority of the carbohydrate is from fiber, which is very satiating and has a lot of good benefits in itself.” Lentils also contain potassium, iron, folate and other important nutrients. This vegetable is a great source of plant-based protein and can be prepared in many different ways. It can be eaten by itself with a little seasoning and oil, or it can be added to other dishes to bulk up the meal. Curries and soups are good places to use lentils, and their earthy flavor and texture provide a filling alternative to larger beans or grains. You can introduce lentils into your diet by adding them to stews and soups, eating them with rice, or tossing them with other vegetables and spices. A quick internet search will yield hundreds of delicious lentil recipes, and due to their size, they’re kid-friendly too! “They’re smaller, so I feel like kids can gravitate toward them a bit more because they’re not as overwhelming as a bean,” Jennifer says. As with any other new food, the key to getting children to engage with lentils is by exposing the vegetable to them early on. Jennifer says it’s important for children to see their parents eating the food so they become familiar with it. This helps them become more willing to try new things and makes new foods less scary. Lentils make a delicious addition to soups, salads, stews and rice dishes, and they can also be enjoyed on their own in a variety of ways. Some may classify the lentil as a “superfood,” but this versatile vegetable can be enjoyed regardless of this label. By Rebekah Hall
l a u n n A 14th
DATION
FOUN L A T I P S O H OONE
c i s s a l golf c B
14 Y A M , Y MONDA
B AT @ THE CLUTHORNE OLD HAW
TO REGISTER OR FOR MORE INFORMATION:
573.815.2800 yvonne.gibson@bjc.org boone.org/foundation
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WELLAWARE
Level up with Lentils These legumes are tasty, easy to cook and packed with nutrients.
Lentils are a part of the legume family. Other common legumes include peas, chickpeas, beans, soybeans and peanuts. Lentils are cheap and pack many vitamins and minerals, like folate, manganese, iron, phosphorous, copper, vitamin B1 and potassium. The energy from lentils sticks with you and keeps you satisfied due to their high protein and fiber content. Lentils aren’t complicated to cook. To save time, you can cook them in bulk for the week and freeze what you don’t use. This recipe for Mediterranean Lentil Salad is very flexible – add whatever vegetables you like! I often add grape tomatoes, cucumbers and red onion. Also, try the Greek salad dressing, with or without lentils, with your favorite summer garden veggies! Recipe by Kelsie Knerr, RD LD, Boone Hospital Clinical Dietitian
NUTRITIONAL FACTS Calories: 295 Total Fat: 20g Saturated Fat: 3g Monounsaturated Fat: 12g Polyunsaturated Fat: 5g Sodium: 274mg Potassium: 514mg Total Carbohydrates: 22g Dietary Fiber: 8g Sugars: 4g Protein: 10g Vitamin A: 137% Vitamin C: 85% Calcium: 6% Iron: 18%
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BOONE HOSPITAL CENTER
Spring 2018
Find this recipe and others at boone.org/food
Mediterranean Lentil Salad (Serves 5) SALAD
• 1 cup dried lentils, cooked per package instructions • 1 bell pepper, diced • 2 large carrots, peeled and diced • 1/2 cup feta cheese • Greek Salad Dressing (see below) GREEK SALAD DRESSING
• ¼ cup red wine vinegar • 2 cloves garlic, minced • 1 teaspoon dried oregano • 1 ounce feta cheese • ½ teaspoon salt • Ground pepper to taste • 3 tablespoons vegetable oil • 3 tablespoons extra virgin olive oil INSTRUCTIONS
1. Cook lentils per package instructions (simmer until soft all the way through).
2. In a blender or with a whisk, combine vinegar, garlic, oregano, feta, salt and pepper (optional: two tablespoons of breadcrumbs).
3. Slowly pour in the oils, mixing until the dressing is light and airy.
4. Mix together diced carrots and bell peppers, extra feta cheese, cooked lentils and the Greek salad dressing. Enjoy!
MyBooneHealth.org
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Caring in Motion Boone Hospital’s patient transport team can be found wherever they’re needed.
Amber McLelland (center) with patient transport teammates Jamie Spry (left) and Terrill Brown (right).
A
s Boone Hospital Center patient transporter Amber McLelland enters a patient’s room, she greets him by his name and introduces herself, letting the patient and his wife know she’s there to take him to radiology for his CT scan. She makes sure the patient is comfortable, with enough blankets and his IV securely in place. After telling the patient’s wife they’ll return in about 10 minutes, Amber guides his wheelchair and wheeled IV drip stand out of his room to the elevators. On the elevator ride down, Amber asks the patient about his day.
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BOONE HOSPITAL CENTER
Spring 2018
“Sometimes a patient needs somebody to talk to,” she explains later. “We try to comfort them, and we always try to ask if there’s anything about their care they’d like to talk about.” The primary role of the transport team is to safely transport patients to and from their room for in-hospital transfers, tests and procedures, helicopter transports, and more. They help patients into a family member’s vehicle after they’re discharged. A transporter needs to be mindful of the patient’s condition and safely move them if they’re receiving oxygen or IV medicine.
Transporters can be reached with a Vocera pager or accept assignments using a secure iPod. They use an app that shows which patients require transport, their current location, and intended destination. Assignments are given based on priority and location. Nurses and physicians can use the same system to see which transporter is with a patient and where they are. Boone Hospital’s 11 transporters also respond to safety codes and intervene to help patients, visitors, and co-workers. They all receive on-the-job certification from the American Red Cross in basic
life support to provide CPR or AED resuscitation if needed. They are trained to use fire extinguishers and safely move patients in the event of a fire. They learn how to use patient lifts so they can help nurses safely move patients into and out of bed. And, to move patients efficiently, patient transporters must learn the layout of the hospital. “I’m Boone GPS!” Amber says. “If I see a visitor who looks lost, I take them where they need to go.” After letting the radiology staff know their patient has arrived, Amber helps the radiology techs assist him out of his chair and get him comfortable and properly positioned on the CT scanner flatbed. This not only helps the patient and radiology techs, but it also reduces wait times for other patients. “You’re not going to see me, but I’m going to wait for you,” Amber tells the patient before leaving the room. For a short test or procedure, transporters often wait so patients make a round trip with the same person. Amber has been with Boone Hospital for three years and been a transporter for two. She likes working with a close-knit group and having a physically active job. “Everything we do is hands-on,” she says. “If we can’t get a ceiling or handheld lift for a patient, we lift them. You have to be able to physically manage the job. You need to have a lot of forearm strength!” Comfortable shoes help, too – on a single shift, Amber walks anywhere from seven to 25 miles. People skills are also crucial to be a successful transporter. Transporters need to communicate with nurses to coordinate the safe movement of patients, and they need to communicate with patients to provide help and comfort. Amber says, “A quiet, 15-minute walk to X-ray is a long time for a patient!” On the return trip, Amber’s patient tells her that he and his wife would go out dancing when they were younger. She asks what kind of music they danced to. Country music, he says. She asks who his favorite country musicians are. “Do you know Waylon Jennings?”
Patient transport Amber McLelland wears a transport team scrub top that she designed with input from her coworkers.
-Amber asks. “He and I were born in the same town.” “Personal interaction is what makes the job,” says patient transport supervisor Jana Thompson. “Transporters help our patients know that they’re seen as people.” Jana says that, in addition to providing comfort to patients and visitors, transporters provide valuable support to nurses and techs. They also reduce delays in care, whether someone is waiting for a test, a blood transfusion, or a room for an admission.
“They’re an integral part of the care we provide,” she says. “This is an awesome
group of people!” “That was fast!” the patient’s wife exclaims when her husband and Amber return. Amber meets with his nurse to help him safely return to bed. Amber sees her role at Boone Hospital Center as lending a helping hand to anyone in need. “Whether it’s a patient, staff, or visitors, I’m here.” By Jessica Park
MyBooneHealth.org
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The Bionic Woman
Norma Long is now back to enjoying her retirement after undergoing the groundbreaking transcatheter aortic valve replacement, or TAVR, procedure.
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BOONE HOSPITAL CENTER
Spring 2018
For more information, visit boone.org/heart
81-YEAR-OLD NORMA LONG is the epitome of class. She is always dressed to the nines and never has a hair out of place. She is not one to complain, and she is always thinking of others before herself. All of this stayed true even in the midst of her health crisis. Norma was diagnosed with leukemia in 2008. She says the diagnosis came as a shock. “I really felt fine when was diagnosed, maybe a little tired, but mostly fine. I couldn’t believe it,” says Norma. At one point, Norma was told she may not make it another year. However, Norma and her doctors pursed an aggressive chemotherapy treatment plan, and she was actually pronounced cancer-free after six chemo treatments. “Getting the news I was officially cancerfree was such a relief. I felt I could finally relax,” says Norma. Norma says the next few years were relatively uneventful. She and her husband, Walt, just enjoyed their retirement and spent a lot of time with their son, Kevin, daughter-in-law, Kristy, and grandkids, Amanda and Kolton. Then, in 2016, Norma experienced an unexpected heart attack. She was referred to Boone Hospital Center by her cardiologist, Henry Marquez, MD. Dr. Marquez had been Norma’s cardiologist for years, and he practices out of the Missouri Heart Center office in Sedalia. “All of my doctors and nurses were just wonderful. They were so comforting and explained everything that was going on,” says Norma. Norma underwent cardiac catheterization and received several stents to allow blood to flow more freely to her heart. Shortly after her stents, she began having heart rhythm issues and underwent a procedure to upgrade her pacemaker. “Dr. Marquez would call me the bionic woman while all of this was going on because I managed to feel pretty good and be pretty upbeat even though so much was going wrong with my heart,” says Norma. Norma even became known for her lovely appearance during her hospital stays. “I would get up early and do my hair and makeup before my doctors came in. I just wanted to look nice for them,” says Norma. Norma’s failing aortic valve continued to be a concern, and in late 2016, Norma’s doctors
recommended that she undergo the transcatheter aortic valve replacement, or TAVR, procedure. TAVR is a minimally invasive surgery that repairs a heart valve by wedging a replacement valve into the failing aortic valve’s place. Unlike traditional valve replacements, this procedure is done with catheters. Because this surgery is minimally invasive, it requires less of a hospital stay and has less risk for major complications. Norma’s procedure was done by Joss Fernandez, MD, and Michael Brown, MD. “Norma’s outlook on life is an inspiration to everyone. There are two types of people in this world: those who look for happiness and those who make it. I am glad we were able to apply this valve technique to help Norma extend the quality of her life,” says Dr. Fernandez. Norma says she was home in no time and is now feeling much better. She and Walt stay busy spending time with family, going to services at their church, Flat Creek Baptist, and meeting and having coffee with friends at McDonalds. “I am so grateful to be feeling better and enjoying life. I owe so much of that to my wonderful doctors and nurses,” says Norma. By Madison Loethen
“I am so grateful to be feeling better and enjoying life. I owe so much of that to my wonderful doctors and nurses.” MyBooneHealth.org
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GETTING TO KNOW A BHC DOCTOR
Dr. Mozow Zuidema
I
’m a ha rd wor kin g , s o c i a l , i n te l l e c tu a l , ca r i ng p er s on. I’m a l s o a fe m a l e ca rd i ol og i s t , de v o te d w i fe a n d aspi ri ng s up er m om : e ss e n ti a l l y a u n i c o rn .
What interests you in your specialty? My original interest in cardiology came at the age of 7, when my identical twin sister was diagnosed with a large ventricular septal defect. She had surgical correction and lives a healthy, normal life. I continue to love the field because it is varied and challenging, with diagnosis and treatment based on structural, electrical and physical science. As a cardiologist, I treat the number-one killer of men and women. To diagnose, treat and cure heart disease is very rewarding. How do you see health care changing in the next five to 10 years? Medicine has many technological advances, but the most profound change is that health care will increasingly be put back into the hands of patients, with mobile apps and cardiac monitoring devices to promote and encourage patients to be advocates for their own health improvement. It will truly be what most informed patients have been seeking. What advice would you give to someone who wants to be a doctor? Do it. But do it only for the right reasons: to help heal patients in the most compassionate, devoted way only a physician or surgeon can. Be ready to pay a high price for the rewards you will obtain. You will miss time for yourself, with your family, with your friends, and you will likely not be rich with money in the bank. You will be rich with gratitude from patients. What do you enjoy outside of work? Family, family, family. Is there really anything else? What advice would you give to a patient who has had an extended stay in the hospital? Be involved in your care, be patient, and ask questions from everyone: nurses, doctors, any providers. If you can’t be alert or awake, have a family member or friend present to be your advocate. Above all, trust your medical team. We are working hard to help you feel better.
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BOONE HOSPITAL CENTER
Spring 2018
GETTING TO KNOW A BHC NURSE
Emily Wood, RN
M
y career as a nurse began about three and a half years ago at Boone Hospital Center. Fortunately, I was given the opportunity to complete my obstetrics and pediatrics clinical rotation at the superb Boone Family Birthplace. It was at that point I knew, “I have to become a labor and delivery nurse here!” The amount of enthusiasm, teamwork and passion that I witnessed from each nurse within the department was incredibly gratifying. By the grace of God and many prayers, I landed my first job out of nursing school right here at Boone’s Women’s and Children’s Health department
Why did you get into the health care field? As a child, I vividly remember always feeling the burning desire to take on that caretaker role. Any time a friend or family member became ill or hurt, my mind would immediately start developing steps or interventions to make my loved one feel better again. This desire only became stronger as I got older. One of the biggest role models in my life just so happens to practice as a registered nurse, too. While in high school, I had the privilege to watch her delve into all the challenges of nursing school, pass her State Board of Nursing exam and begin her career as registered nurse. I was fortunate enough to witness first-hand the qualities one must embody to fulfill the role of a compassionate nurse. I am lucky enough to call my sister my role model.
mother and newborn during the first hour of life. The benefits that both mother and newborn gain are remarkable.
What interested you in your particular specialty? My love and interest for obstetrics started long before I decided to study nursing. Science was, undoubtedly, my favorite subject to study in high school. I always looked forward to learning the physiological process of pregnancy and dreaded the moment it was over. I was so intrigued that during my leisure time, I found myself continuing to browse for any literature related to pregnancy.
What do you see changing in the next five to 10 years? Over the next five to 10 years, I would highly anticipate the need for obstetrics–pediatrics nurses to increase dramatically. The number of teen pregnancies continues to rise and is expected to keep rising. In addition, I foresee Boone Hospital continuing to advance technologically while holding onto their mission of employing educated, compassionate and caring registered nurses.
Most rewarding and challenging aspect about my job: Not all situations or outcomes in labor and delivery end with the happiness of holding a new bundle of joy in your arms. There are also very challenging and devastating times of sadness and sorrow due to the loss of a child. Embodying and providing empathetic and compassionate care is essential and truly makes my job the most rewarding of all.
What do you enjoy doing outside of work? Outside of work, I love spending time with my family back home. I am the proud aunt of my 5-year-old nephew, Crew, and 2-month-old niece, Auley. We enjoy taking long trips to the beach and thrilling adventures to Disney World. Family is such an important part of my life, and I’m very grateful to call my co-workers at Boone family.
What has changed in your field since you started practicing? The field of obstetrics continues to evolve, as does the profession of nursing. During my three and a half years at Boone, I have been lucky enough to witness and experience change. One modification that is very near and dear to my heart was implemented almost two years ago with skin-to-skin contact happening between
What advice would you give to someone looking to become a nurse? For anyone aspiring to become a nurse, my best piece of advice is to choose your area of specialty wisely. If you are passionate about one area in particular, try to utilize the resources around you to gain additional knowledge and experience needed for affirmation. Along with clinical rotations, put in the extra effort and set up job shadowing experiences for additional hands-on time.
MyBooneHealth.org
25
When Nature Gets Under Your Skin Learn how to identify, treat and avoid these common warm-weather skin conditions.
Spring’s arrival means longer days, shorter sleeves, and the chance to resume your favorite outdoor activities, but it also means increased contact with elements that irritate your skin. This ranges from the sun to everything under it. Skin is our largest immune defense organ. It serves as a barrier between your body and the outdoors. “Your skin is monitored by circulating white blood cells, which provide your body's immune defense against the world's collection of infectious organisms,” says Lindall Perry, MD, a board-certified dermatologist with Central Missouri Dermatology. A dermatologist specializes in diagnosing and treating diseases of the skin, nails and hair. “For example, the skin recognizes bacteria, viruses and fungal elements, which can invade and cause your body harm,” Dr. Perry says. “When the skin is intact and you are healthy, we can co-exist with these organisms.” Broken and cut skin puts your body at risk of infections. Dr. Perry recommends keeping wounds coated with a topical antibacterial ointment. If an injury site becomes painful, red and swollen, see your physician. While most skin conditions aren’t life-threatening, they can be a symptom of a serious health condition or severe allergic reaction. If a rash covers your body, is painful, appears infected, or is accompanied by other symptoms, see your physician. If you develop a rash along with trouble breathing, swelling, dizziness, or nausea, seek emergency medical care.
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BOONE HOSPITAL CENTER
Spring 2018
Mosquito Bites
Poison Ivy
Mosquito bites often result in itchy red bumps or welts. While most mosquito bites aren’t serious, mosquitos can spread blood-borne diseases, like West Nile virus.
Poison ivy, oak and sumac rashes are caused by urushiol, an oil found in every part of these plants. An itchy, blistering rash appears where the urushiol touched your skin in hours to days after contact.
HOW TO TREAT
Don’t scratch. According to Dr. Perry, itching is caused when your cells release histamine in response to an irritant, such as mosquito saliva: “The act of scratching one’s itch causes more histamine to be released,” Dr. Perry says. “Therefore, we often recommend not to scratch your skin for fear you might create an injury, which could lead to an infection.” He often recommends over-thecounter, oral antihistamines to relieve mild itching — ask your physician or pharmacist for recommendations.
HOW TO AVOID
Keep mosquitos away with screens or netting. Remove standing water on your property, where mosquitos tend to lay eggs. Apply an insect repellant containing DEET before going outside. Mosquitos are most active at dawn and dusk. If you plan to travel to tropical locations, visit your doctor four to six weeks before you leave to discuss concerns and precautions.
SEE YOUR DOCTOR IF
You develop a fever, flu-like symptoms or severe headache, or if the bite becomes infected.
HOW TO TREAT
Don’t scratch or pick at the rash. Relieve itching with colloidal oatmeal baths, cool compresses, calamine lotion, hydrocortisone cream or an antihistamine pill. Avoid getting exposed again — your reaction could worsen. “You should expect to be hypersensitive to poison ivy for the rest of the summer if you get significant exposure early in the season,” Dr. Perry says. “Your body’s immune reaction is primed to deliver an exuberant response if second and subsequent exposures arise in a short period of time.”
HOW TO AVOID
Learn to identify these plants — poison ivy is common in Missouri. If you come into contact with the plant, immediately rinse your skin with lukewarm, soapy water. Urushiol can stick to clothing, pet fur, or sports and gardening equipment, so wash these items thoroughly. Don’t burn poison ivy, oak or sumac — the urushiol can become airborne and land on your skin.
SEE YOUR DOCTOR IF
Your rash doesn’t improve after two weeks; appears infected; or covers a large area of your body, face or genitals.
Athlete’s Foot
Sunburn
Heat Rashes
Athlete’s foot is a contagious fungal infection that causes itchy, flaking, cracked skin on the soles of your feet and between your toes. Most people get it by walking barefoot in locker rooms or showers, then the fungus grows in the damp, warm confines of their shoes. Athlete’s foot can be treated at home, but take precautions to avoid spreading it to your household.
Sunburns are caused by overexposure to ultraviolet radiation (UV) from the sun or indoor tanning lamps. Your skin turns red and painful and, in severe cases, may swell or blister. You may also feel fatigued or feverish. Sunburn is a sign of sun damage – over time, too much sun damage can cause premature aging and skin cancer, including melanoma.
Heat rashes, or prickly heat, are caused by blocked sweat ducts, usually during hot, humid weather or after exercising. The rash may appear as tiny clear or red bumps and typically affects skin folds or areas covered by clothes.
HOW TO TREAT
Many over-the-counter antifungal products can treat athlete’s foot. While treating the infection, keep your feet clean and dry. If you or someone at home has athlete’s foot, don’t share footwear or towels, and wear shower shoes or flip-flops around the house.
HOW TO AVOID
Wear shower shoes or flip-flops when walking around a locker room, shared shower or pool deck. Wash your feet with soap and dry them thoroughly every day. Keep your feet dry with wellventilated shoes and socks made of moisture-wicking fabric. Avoid wearing the same pair of shoes every day. Don’t share footwear.
SEE YOUR DOCTOR IF
Your infection worsens; doesn’t clear up or spreads to your toenails or other areas; or you have diabetes or a compromised immune system. According to Dr. Perry, diabetics are prone to neuropathy that causes numbness in the feet. They may not feel the pain caused by athlete’s foot or secondary infections. He recommends diabetics place a hand mirror on the floor and hold the foot over it to check the sole and toes for redness or fissures.
HOW TO TREAT
Treat sunburn as soon as you notice it — first by getting out of the sun! To reduce pain, apply cold compresses, creams or gels with aloe vera, or take an NSAID like ibuprofen. Sunburn is usually accompanied by dehydration, so drink plenty of fluids.
HOW TO AVOID
Don’t use tanning beds or sunlamps. Before going outside, apply a broadspectrum sunscreen, which blocks both UVA and UVB rays, with an SPF of 30 or greater. Reapply every two hours or sooner if you sweat or swim. Cover your skin with clothes and take shelter in the shade. Be aware that some prescription medications can increase your sensitivity to sunburns.
SEE YOUR DOCTOR IF
You have a second-degree sunburn with swelling and blisters. A history of severe sunburn is a risk factor for skin cancer. Examine your skin for any changes (new moles; irregularshaped or colored moles; bleeding moles; moles that grow larger). Dermatologists can screen for skin cancer and may offer treatments to improve the appearance of sundamaged skin.
Lindall Perry, MD, is with Central Missouri Dermatology. The practice sees patients in Columbia, Jefferson City, Boonville, Mexico and Moberly. For more information, visit centralmodermatologygroup.com or call 573.876.1616
HOW TO TREAT
Heat rashes usually clear up on their own. Take a cool bath or shower or briefly apply a cold compress for relief. Wash the affected area with a gentle soap and pat dry. Don’t put lotion on the rash. Try to keep your skin cool and dry.
HOW TO AVOID
Keep cool and hydrated in hot weather. Wear loose-fitting, lightweight, breathable clothes. If you exercise outdoors, avoid working out during the hottest time of the day.
SEE YOUR DOCTOR IF
The rash won’t go away or becomes infected. While sweating is normal, if you have problems with excessive perspiration, a dermatologist can help identify the cause and find solutions.
If you find unexplained or unusual redness, discoloration, welts, bumps, flakes, cracks, or anything else on your skin, a board-certified dermatologist has extensive training to diagnose and treat you. Your primary care provider can refer you to a dermatologist or you can refer yourself. “I recommend anyone seek the care of a dermatologist if they have any concerns with their skin, hair or nails,” Dr. Perry says. “We emphasize the importance of caring for our largest and most visible organ of our body — the skin. We are always glad to serve anyone who needs help with a skin issue.” By Jessica Park
MyBooneHealth.org
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WELLAWARE
Get a Leg Up
Try this leg-strengthening workout from WELLAWARE fitness instructor Heidi Salter!
REMEMBER: Check with your physician before beginning an exercise routine. A health and fitness coach can help you make sure your form and posture are correct to prevent injury. If you’re a beginner, do standing exercises while holding onto the back of a chair for support. As you do these exercises, keep your torso straight and tall, maintaining the normal curve to low back, and pull your abdominals in tight. Keep breathing normally. Your movements should be slow and controlled to ensure correct posture and technique. For each repetition, count to 4. Start movement on 1, get to end point at 2, begin moving back on 3, end the movement on 4. These exercises can be done 2-3 nonconsecutive days a week. Start with one set of 8-12 repetitions and gradually increase to 2 or 3 sets. Give your ligaments, tendons and muscles time to build strength before progressing. If you’re sore in the days following any exercise, wait until you feel better before repeating. If needed, decrease the number of reps, resistance, depth of movement, or step height. Stop if you feel fatigue or pain in your joints. By Heidi Salter
WELLAWARE Fitness Center Boone Hospital Center 1601 E Broadway, Lower Level Columbia, MO 65201 573-815-3876
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BOONE HOSPITAL CENTER
Spring 2018
Sit to Stands (Q u a d r i ce p s ,
Ha ms t r i n g s , G l u te a l )
Sit in a firm chair with your feet shoulder-width apart and toes pointed forward. If your chair is too low, put a pillow on the seat. Use a chair with arm rests to assist with standing. Variation: Wall Squat. Stand with your back turned, one to two footlengths away from a wall. For balance, place a chair at your side and keep one hand on the chair. While sitting back against the wall with your legs straight, bend your knees slightly. Do not let your knees go past your toes. Straighten your legs back to starting position. Be careful to not bend down far. Make sure you can push yourself back up to starting position without any knee discomfort.
Ball Squeeze (A d d u ct or s / I n n e r
Th i g h )
Stand or sit and place a flexible ball or pillow between your thighs, just above your knees. Squeeze and hold for 5 to 10 seconds to strengthen inner thighs. If you’re standing, be sure to keep a slight bend in your knees. Adductors help pull your legs together, work to stabilize the hips, and are used in activities that require side-toside movement.
Forward Leg Raise with Quad Set ( Q u a driceps ) Lie on your back, with one leg bent at a 45-degree angle and the other leg straight. Pull the toe toward the knee of your straight leg without hyperextending your knee. Tighten your abdominals and lift your straight leg until your thighs are parallel. This exercise can also be done while standing or seated. If standing, keep a slight bend in the leg you stand on.
Side Leg Raise
Hamstring Curl
Hip Extension
(Abductors/ Outer Leg)
(Ha ms t r i n g s )
(G l u t e s , Ha ms t r i n g s )
Lie on your side with your bottom leg bent. Lift your top leg up (no more than 45 degrees). Keep your knee pointed forward. This can also be done while standing: Keep your abs pulled in tight and a slight bend in the leg you’re standing on. Abductors are stabilizing muscles for any side movements.
Hold onto the back of a chair for support as you stand on one leg, with a tall torso and your abs engaged. Keep the leg you’re standing on slightly bent at the knee so it is not locked. Keeping your thighs parallel, slowly bend the other leg by lifting your heel behind you, to about 45 degrees. Switch legs and repeat. For more resistance, try this with an ankle weight.
Hold onto the back of a chair for support as you stand on one leg. Keep the leg you’re standing on slightly bent at the knee, so it is not locked. Keep your torso tall and your abs tight. Bring your straight leg back by a very short distance without letting your hips tilt. For more resistance, try this with an ankle weight.
Leg-strengthening exercises can help you: • Accomplish activities like walking, running, climbing stairs, jumping, and getting up from a chair or the floor with greater ease.
• Protect your back by using your legs to lift, instead of your back.
• Protect your hip, knee and ankle joints, including tendons and ligaments.
• Burn more calories at rest.
March or Step Ups March in place. Hold onto back of chair if needed for balance. For more resistance, lift knees higher.
Step Ups (G l u t e s , Ha ms tri n g s) Can be done on a step platform or the base of a staircase. Step onto the first step with your right foot. Place your weight on the foot as you straighten your leg, without locking your knee, to work your quad. Repeat 8 to 12 times, then switch and repeat with your left foot. As this gets easier over time, try using a higher step.
• Increase your bone density.
• Tone muscles. MyBooneHealth.org
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FOUNDATION NEWS
Gifts That Keep Giving Whenever you buy a gift for a loved one (or yourself) at Boonique Gifts, Boone Hospital Center’s gift shop, you also give the gift of health to others! All proceeds from Boonique Gifts support Boone Hospital Foundation and fund many of our patient care and community health programs and services, including: • Sleep sacks that are sent home with every Boone Baby to aid in the prevention of SIDS and to give new parents peace of mind when laying their babies down to sleep. • Lifeline services, which allow qualifying home health patients to continue to live independently and feel safe at home. • Kids on Track, a summer exercise program that gives children and their families incentive to create and maintain healthy lifestyles. • Charging stations at the hospital, which make it easy for patients, family members and visitors to keep their phones and other electronic devices charged. • Video laryngoscopes in all Boone ambulances that aid EMTs so they can open patients’ airways more quickly and safely.
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BOONE HOSPITAL CENTER
Spring 2018
• Continuous Ambient Relaxation Environment (C.A.R.E.) Channel, which plays beautiful nature images set to soothing music. It is available in all patient rooms and family waiting areas and helps to create a healing environment and reduce pain, stress, and restlessness. • Stuffed animals for children facing surgery. • Rehab T-shirts, which are provided to stroke patients relearning how to dress themselves. • Heart pillows, which are provided to cardiac surgery patients and support the surgical chest incision. This allows them to experience less pain when coughing to clear their lungs after surgery. • Lung pillows for pulmonary patients. • Neonatal developmental positioning devices, like Bendy Bumpers and Prone Positioners, which promote musculoskeletal development in premature babies born between 23 and 36 weeks gestation and help decrease the pressure of babies’ bony knees and elbows.
Patients admitted to the hospital for surgery or a major test are often anxious. Research indicates that music and nature help reduce stress. For the past eight years, Boone Hospital Foundation has helped create a healing environment by funding the Continuous Ambient Relaxation Environment (C.A.R.E.) Channel, which plays in all patient rooms and family waiting areas. Combining peaceful scenes of nature video with beautiful music, the C.A.R.E. Channel is a welcome alternative to commercial television. A patient’s circadian rhythm is supported by sunrises shown in the morning and pictures of starfilled skies at night. The C.A.R.E channel can also mask hospital noises and reduce the negative impact of unavoidable distractions in the hospital. This highly effective, therapeutic tool significantly contributes to improved satisfaction and patient outcomes, and it helps create a healing environment for patients, families and caregivers alike.
2017 Distribution of Funds 8%
2018
CALENDAR OF EVENTS APRIL 25 & 26
Uniform Sale MAY 7-11
3%
National Nurses’ Week Honor a nurse with a Foundation gift during National Nurses’ Week. Call 573.815.2800 to make a donation.
4% 26%
MAY 14
Annual Golf Tournament JULY 24 & 25
Uniform Sale
45%
14%
JULY – AUGUST
Community Campaign SEPTEMBER 10-12
Common Goods Book Sale OCTOBER 22 & 23
Jewelry Sale NOVEMBER 3
Annual Gala MyBooneHealth.org
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Boone Hospital Center 1600 East Broadway Columbia, Mo 65201 573-815-8000
NONPROFIT U.S. POSTAGE
PAID
COLUMBIA, MO PERMIT 286