Six Creative Ways to Implement Interprofessional Education (IPE) and Practice - Without an Academic Medical Center on Campus

It seems logical that health professionals should be taught how to respectfully and effectively communicate across professional lines. However, coordinating this type of academic experience has its challenges. Associate Professor & Undergraduate Program Director at Montclair State University, Courtney Reinisch, shares her experiences with creating opportunities for interprofessional education and partnerships on campus

Transprofessional Education – An Asynchronous Approach

Creating an opportunity inter-professional educational for nursing students involves challenges in logistics and resources

Diabetes Self-Management Education in the Home

Purpose: Diabetes self-management education and home visits have been found to improve clinical outcomes in individuals living with diabetes. The purpose of this pilot project was to evaluate the feasibility and effectiveness of conducting self-management education in patients\u27 homes.Methods: Baseline biometric data was collected from a cohort of adult patients with diabetes. Home visits to 19 patients were conducted by doctoral students from Rutgers University School of Nursing. The visits included knowledge assessment, review of foods in the home, diabetes self-management education, and teaching the proper use of monitoring tools such as the glucometer and blood pressure monitor. Biomarkers were obtained post-intervention and were compared to baseline biomarkers. Descriptive lifestyle data was collected and opportunities for customized patient education were provided.Results: The biomarkers improved overall during the four months after the education intervention. The mean A1C reduced 12% (p=0.0107), the mean glucose reduced 12% (p=0.0994), the mean BMI reduced 2% (p=0.1490), the systolic pressure reduced 1% (p=0.4196), and the diastolic pressure remained stable. Specific goal setting further increased the improvement in the area the individual planned to address.Conclusions: This project supports prior studies that found that in-home educational programs can improve the self-management of diabetes and lead to improvement in health indicators. The benefits of the study included personal attention in ensuring the correct use of home health monitoring devices, building self-management confidence, and identifying treatment barriers that may not be easily discerned in a clinic setting

The Ethical Management of a Psychiatric Patient Disposition in the Emergency Department

This case examines the ethical issue of the disposition of a patient who presents in the emergency room with a psychotic disorder when a nurse practitioner is given the autonomy to determine disposition of a patient and the attending physician disagrees. Therein lies the dilemma of an NP lacking emergency psychiatric admitting privileges. The NP ethically needs to continue to act as a patient advocate to ensure patient safety and best outcomes

Diminished 11β-Hydroxysteroid Dehydrogenase Type 2 Activity Is Associated With Decreased Weight and Weight Gain Across the First Year of Life

Context: Low birth weight is associated with adverse metabolic outcome in adulthood. Exposure to glucocorticoid (GC) excess in utero is associated with decreased birth weight, but the prospective longitudinal relationship between GC metabolism and growth has not been examined. Objective: We have hypothesized that changes in GC metabolism leading to increased availability may impair growth. Design: This was a prospective, longitudinal study with clinical measurements and 24-hour urinary steroid metabolite analysis at 1, 4, 12, 26, and 52 weeks after delivery in mothers and their babies. Setting: The study was conducted with observations and samples collected in the volunteers' own homes. Participants: Healthy mothers and newborn babies/infants participated in the study. Interventions: There were no interventions. Main outcome measures: Urinary steroid metabolite excretion quantified by gas chromatography/mass spectroscopy across the first year of life in relation to change in weight was measured. Results: The total production of the GC metabolites quantified increased across the first year of life. Markers of 11β-hydroxysteroid dehydrogenase type 1 activity increased from the age of 3 months as did those of 5α-reductase activity. After correcting for confounding variables, low markers of 11β-hydroxysteroid dehydrogenase type 2 activity was associated with reduced absolute weight and decreased weight gain over the first year of life. In the mothers, 5α-reductase activity was low at birth and progressively increased to normal over the first 6 months postpartum. Conclusions: Increased GC exposure as a consequence of reduced 11β-hydroxysteroid dehydrogenase type 2 activity is likely to be a critical determinant of growth in early life. This not only highlights the central role of GCs and their metabolism, but also emphasizes the need for detailed longitudinal analyses