SON Nursing Education and Simulation Expertise Utilized in Kitui, Kenya

Patient safety and quality are at the core of healthcare education across the globe. Over the past year, School of Nursing faculty and Kenya Medical Training College (KMTC) health professionals focused on these concepts in the enhancement of a skills lab at KMTC Kitui’s Centre of Excellence for Family Planning and Reproductive Health Training in Kitui, Kenya, Africa. The skills lab was recently upgraded by Capacity Kenya to include state-of-the-art teaching tools and simulation equipment. UNC SON faculty lent their nursing education and simulation expertise to a skills training program in collaboration with KMTC faculty at the upgraded lab.

Carol Durham, director of the Education-Innovation-Simulation Learning Environment (EISLE), Darlene Baker, assistant director of ,  Sonda Oppewal, SON clinical associate professor, and Gwen Sherwood, associate dean for academic affairs communicated regularly via Skype with faculty in Kitui to develop the training program’s educational goals and discuss logistics. Darlene Baker and Sonda Oppewal then traveled to Kitui, Kenya, April 27– May 12, 2012 to assist in the implementation of the program.

Capacity Kenya and KMTC Kitui received USAID funding to create the Centre of Excellence for Family and Reproductive Health Training. The Centre aims to improve health outcomes in Northern Kenya in women’s health, reproductive health, and decreased maternal and infant mortality through strengthening the healthcare workforce. Capacity Kenya was created by IntraHealth International. Its mission is to improve healthcare in Kenya by enhancing the quality of training for healthcare workers in public, private, and faith-based organizations.

SON’s involvement in the project included assistance in outfitting the lab as well as facilitating a two-week training session for nurse lecturers at KMTC. Prior to the visit, UNC’s EISLE researched and made recommendations on simulation equipment to match the needs of the local constituency. IntraHealth purchased equipment including simple contraceptive displays, task trainers, and complex birthing simulators. The equipment was grouped into five categories for training: childbirth, maternal, infant, physical exam, and patient care skills.

The most complex piece of equipment new to the skills lab was Noelle, a human patient birthing simulator made by Gaumard Scientific. Noelle is used at UNC SON and other schools and hospitals to train nursing and medical students as well as professionals. The simulator connects wirelessly to a computer that can be programmed to take students through a range of scenarios that could accompany normal as well as complicated childbirth.  At KMTC Kitui, Noelle was renamed Mwende which means “loved one”. Mwende was accompanied by a newborn baby simulator that enabled students to practice newborn resuscitation, a skill which was impossible to practice before the simulator’s arrival.

Darlene Baker led the equipment training, guiding KMTC staff through all stages of use. The local staff helped open the boxes, gaining familiarity with the equipment before learning utilization procedures. To complete the learning cycle, the team went over storage and cleaning, or what Baker called, “long-term considerations for the sustainment of the equipment.”

“I went there to be the boots on the ground,” Baker said.

“My role was focused on facilitating the training process,” Sonda Oppewal said. “This included helping the group identify training expectations and guidelines, facilitating the faculty members’ involvement in developing simulations, and helping them consider ways to integrate the new equipment and simulations into the curriculum.” Dr. Oppewal also helped evaluate the training, and assisted faculty members in identifying ways the project could be evaluated over time and outcomes could be reported to Capacity Kenya. They also developed models to summarize their learning over the two weeks for the faculty to use as a resource.

Dr. Oppewal also followed up on work she and Associate Dean for Academic Affairs Gwen Sherwood did in 2010 with Capacity Kenya on creating an AHEC-like model for improving the healthcare workforce in Northern Kenya.  Dr. Oppewal met with the Nursing Council of Kenya and reported that a steering committee and subcommittees had been formed, and partnerships were being investigated to establish the Kenyan AHEC model.

About 15 KMTC Kitui nurse lecturers attended the sessions taught by the UNC team. The training schedule included time for each lecturer to practice using the simulators and to develop and practice teaching simulations. Next, lecturers practiced using the simulators and the simulations they developed as teaching tools with students. Thirteen students were arranged into groups for simulations the lecturers identified as having high priority for student learning: family planning, normal newborn delivery, newborn resuscitation, and normal newborn assessment.

For the lecturers, “It was an opportunity to provide hands-on experience with key patient care skills which previously had only been taught theoretically,” Baker said.

It was a collaborative experience, with KMTC lecturers coming up with their own ideas for simulation training. Baker said of the experience, “It opened my eyes to new ways to use equipment here.” Some of the equipment had never been used before by either UNC or KMTC instructors; these provided new learning experiences for the entire cohort.

Dr. Oppewal said the UNC team benefitted from seeing KMTC lecturers interact with their students. She noted the effectiveness of the Kitui lecturers’ method of having each student demonstrate and verbalize what they were learning, and the students’ recognition of the need for continual practice. “The lecturers were clearly invested in giving the best education possible to their students and the students were eager to learn all that they could.” Dr. Oppewal also remarked that the Kenyan practice of taking a midmorning tea break made room for spontaneous collaborations among colleagues.

By the end of the two weeks, the KMTC Kitui lecturers formed a Skills Lab Committee with the goal of making the skills lab available to the district hospitals and other KMTC campuses. The Committee expressed a desire to expand the skills lab program so that it could be used by nurses in continuing education.

Overall, Baker said the experience was inspiring. “People were already doing so much with so little, and now they have an opportunity to do so much more.”


UNC Provides Care, Supplies on Service Learning Trip to Honduras

A group of 22 students and volunteers from UNC School of Nursing and UNC School of Pharmacy went to Honduras on a service learning trip during spring break 2012. The group joined the efforts of Compassion Med International in providing medical screenings, care, and supplies to local populations.

The group was led by SON’s Jean Davison, clinical assistant professor and family nurse practitioner. Volunteers included SON’s Rhonda Lanning, clinical instructor and nurse midwife, Elizabeth Prata, family nurse practitioner from UNC Center for Latino Health, and Christine Walko, PharmD from the School of Pharmacy.

The group conducted over 100 health screenings on local children before seeing over 150 patients per day at four different clinical sites. In addition, triage staff cared for minor complaints and handed out anti-parasitic treatments and vitamins. All told, the group saw more than 1,000 patients over the course of their trip, and distributed 20 food packets that could feed a family of five for one week.

UNC’s MedWorld helped provide the group with medical supplies to distribute to local hospitals and clinics. One hospital received endotracheal intubation equipment while its pediatric ward received beanie babies and toys.  Other supplies and medications were donated to Dr. Elmor Mejia, who is the only doctor with a hyperbaric chamber for treating injured Miskito lobster divers.

Before leaving Honduras, the group met with US Attorney David Arizmendi, vice consul of the US Embassy, who expressed appreciation for the group’s service.

View photos from their trip here.

Meg Zomorodi selected for Nurse Faculty Leadership Academy

Dr. Meg Zomorodi

SON clinical associate professor Meg Zomorodi, RN, CNL, PhD, was chosen to participate in the 2012-13 Nurse Faculty Leadership Academy. By pairing new nurse educators with mentors and NFLA expert faculty members, this 20-month intensive program seeks to develop leadership skills in new nurse faculty. Dr. Zomorodi will work with Dr. Judith Halstead, PhD, RN, ANEF, FAAN, from the Indiana University School of Nursing to enhance her leadership capabilities and SON’s Clinical Nurse Leader curriculum.

Dr. Zomorodi chose Dr. Halstead as her mentor because of her expertise in online education. The two will work together to develop ideas for an innovative, engaging online CNL program and revise two core CNL courses. They will receive additional guidance from Dr. Carol Winters of East Carolina University.

“I was so surprised by the first meeting and the wealth of knowledge that was in the room,” Dr. Zomorodi said. “It was in the first 5 minutes of meeting my mentor that I knew I had made the right decision.”

The Honor Society of Nursing, Sigma Theta Tau International’s Leadership Institute developed the NFLA with a grant from the Elsevier Foundation. The academy promotes faculty retention and high performing, supportive work environments through a challenging learning experience that gives new nurse educators the leadership skills necessary for their transition into the faculty role. The Academy chose 16 fellows from all over the nation to participate in its 2012-13 program.

By participating in the program, Dr. Zomorodi will gain unbiased perspectives from schools that face similar challenges, giving her valuable insight into leadership and course curriculum development. Dr. Zomorodi believes that her participation in the program will benefit not only her but the School as a whole.

“It is an opportunity for us to be seen on the national level and I know I will be provided with many ideas that I will share with the faculty,” she said. “It’s also an opportunity for us to build up the CNL program which will benefit our students, faculty, and the surrounding hospitals who are interested in the role.”

SON Pediatric Clinical Students Featured

Clinical Assistant Professor Megan P. Williams was excited to see her pediatric clinical students pictured in an article from the N.C. Children’s Hospital. From left to right are Adria Gillespie,  Aaron Parsons, Victoria Neff & of course the star of the show Christian! Read the whole story here:

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Grant Supports Study of Ethical Issues in Dialysis Facilities

Mi-Kyung Song, PhD, RN

Associate Professor has received a grant ($50K) from the  which is administered by The Greenwall Foundation. The grant will support Dr. Song’s research project that  examines management of ethical issues in free-standing dialysis facilities. This prestigious award recognizes the significance and potential impact of individual research projects and researchers in bioethics areas. In the 62 years of the Foundation’s history, only two nurse researchers have been awarded grants.

Beth Black Receives NIH Funding to Study End of Life Care

Beth Black, PhD, RN

Assistant Professor has received funding from the National Institute of Nursing Research at NIH for her grant entitled “End-of-Life Care After Severe Fetal Diagnosis.” The grant is for $407,000 over 2 years to study the implementation of a perinatal palliative care program at the UNC Center for Maternal and Infant Health, and responses to a life-threatening fetal diagnosis by women, their partners and health care providers. Dr. , Cary C. Boshamer Professor, is a co-investigator and is a research adviser to the study.  

“We need to learn how to support these families in the best way possible. The way to learn is to talk to them, to find out what they need, identify their grief trajectory, and find out how they do after the loss,” Dr. Black says. In the long term, Dr. Black wants her work to provide a good theoretical foundation for the development of interventions for these families. She also wants to align perinatal issues with the end of life care issues conceptually. “I’m really committed to the care of these families. I want to find out from them and from their providers how we can best care for them in this heartbreaking situation.”
Look for more on Dr. Black’s work in the next issue of .

Study examines NC cancer patient emergency department visits


Deborah Mayer, PhD, RN, AOCN, FAAN

When cancer patients experience medical problems, they may visit emergency departments, but how often and for what reasons, there is little data.

A first-ever study of emergency room use by oncology patients in North Carolina was published in the May 23, 2011 online issue of the Journal of Clinical Oncology. Authors hope the study can give them information so that they can target clinical problems to improve delivery of quality cancer care, thus avoiding emergency room visits.

Deborah Mayer, PhD, RN, AOCN, FAAN, associate professor of nursing in the UNC School of Nursing, study lead author, said, “While some cancer patients develop acute problems that do require a visit to the emergency department, some visits might be avoided with better symptom management.” Mayer is a member of UNC Lineberger Comprehensive Cancer Center.

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2011 SON Global Health Awards

Congratulations to the School of Nursing students and faculty who received global health awards this year. These awards are primarily from the School’s global health funds, which are generated from the Visiting Scholars program. This year $22,000 was awarded.

Applications were reviewed by three teams from the Global Nursing Advisory Council (GNAC) joined by faculty who received awards in previous years. Award amounts are primarily based on airfare to the destination. We were still unable to fund all who applied. Through the GNAC we have focused our areas of support so that students and faculty are helping expand our capacity in global health but also are involved in sustainable work, either through service that can be built on from year to year, or in developing scholarship opportunities. We are particularly pleased to award two Cronenwett Global Awards designated for undergraduate students (see Global Study Award Helps Students Gain World Experiences).

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Merle Mishel to be Inducted into Nurse Researcher Hall of Fame

Dr. Merle Mishel

Kenan Professor of Nursing Dr. Merle Mishel will be inducted into the 2011 Sigma Theta Tau International (STTI) Nurse Researcher Hall of Fame. The Hall of Fame recognizes scholars and leaders whose funded program of research has had a long-term impact on the profession and patient/family outcomes. The nomination recognized Dr. Mishel’s more than 20 years of federally funded research and her development of the theory of uncertainty in illness. Dr. Mishel says she is pleased that this award recognizes the importance of nursing research and is honored to have an international organization recognize her work as meaningful.

The scales she developed to help investigators measure uncertainty in illness are used in 30 countries and have been translated into many languages. Dr. Mishel will be inducted into the International Nurse Researcher Hall of Fame at STTI’s 22nd International Nursing Research Congress in Cancun, Mexico, in July.

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Nursing in the Genomic Era Conference

The Nursing in the Genomic Era Conference was held at the School of Nursing on Friday April 8. During the conference students taking the Family-Centered Genomic Health Care class displayed poster presentations on various genetic conditions.

See a sample of the creative posters from the student in the slide show here.

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