Virtual Nursing: From Planning to Evaluation of Innovative Care Solutions

Description: In this episode, we explore an innovative approach to addressing nursing workforce shortages through virtual nursing programs. Explore how an inpatient virtual nursing program has made a significant impact, improving nurse retention, enhancing patient safety, and reducing length of stay in rural and critical access hospitals. Discuss model expansion that includes a virtual obstetrics nursing program aimed at improving maternal and neonatal outcomes in underserved areas and the impact these programs had on rural health. Join us as we discuss the technology, operational impact, and real-world results of these initiatives, including key metrics and anecdotal success stories.

Objectives

1.Discuss how virtual nursing programs are helping to alleviate nursing workforce shortages and improve patient care in rural hospitals.
2. Explain the integration of virtual obstetrics nursing and its potential to enhance maternal and neonatal outcomes in underserved areas.
3.Identify operational changes, technology, and impact of a virtual nursing program.
4. Describe how AI-driven monitoring and virtual nursing can improve patient safety by reducing falls and enhances nurse retention.

Guest/Bios

Karna Pfeffer, MSN, RN, RHNC

Karna Pfeffer serves as the Director of Clinical Excellence, Education and Quality at Avera St. Mary’s hospital in Pierre, SD. She has over 15 years of hospital nursing experience, specializing in process improvement and quality with a focus in rural healthcare. She received a Bachelor of Science in Nursing from South Dakota State University, and an MSN in Nursing Leadership from Western Governors University.

Kristine Becker, MA

Kristine Becker serves as the director of Virtual Health at Avera Health in Sioux Falls, South Dakota. With nearly 20 years of experience in healthcare, Kristine is an experienced professional specializing in process improvement, healthcare technology and telehealth solutions. With a solid background in rural healthcare, she brings expertise in virtual and digital health initiatives and managing complex technology implementations and systems. Kristine holds a bachelor's and a graduate degree in anthropology from the University of Minnesota.

References

The Center for Health Workforce Studies (CHWS). Health Care Employment Projections: 2010-2020, March 2012. Retrieved from www.healthit.gov/sites/default/fi…_report_2012.pdf 2022 March of Dimes Maternity Care Report. Retrieved from www.marchofdimes.org/sites/default/files/2022- 10/2022_Maternity_Care_Report.pdf

2023 South Dakota Department of Health Maternal Mortality in South Dakota. Retrieved from doh.sd.gov/media/2q4nzral/mate…ty-1-pager_2023.pdf

Lifting the Cloud: Transcranial Magnetic Stimulation and the Treatment of Major Depression

This episode provides an in-depth exploration of Transcranial Magnetic Stimulation (TMS) and its impact on psychiatric disorders. TMS has demonstrated effectiveness in numerous clinical trials and serves as a valuable adjunct to traditional therapy. Designed for clinicians and mental health professionals and those they serve, this podcast offers insights into:
Identifying appropriate patient populations for TMS therapy. Understanding the TMS treatment process from start to finish. Exploring the role of neuromodulation in reshaping brain function for long-term improvement. Reviewing clinical outcome data supporting TMS in the treatment of major depressive disorder. Gain a deeper understanding of how TMS and neuromodulation techniques are advancing the field of functional neuropsychiatry and providing new hope for patients.

Objectives:
Identify appropriate patient populations for Transcranial Magnetic Stimulation (TMS) treatment of psychiatric disorders.
Describe the treatment process of Transcranial Magnetic Stimulation.
Describe possible adverse events associated with Transcranial Magnetic Stimulation.
Explain how neuromodulation techniques impact long-term changes in brain network functioning.
Discuss clinical outcome data for Transcranial Magnetic Stimulation treatment.

Guests:

Dr. Henry Emerle, MD
Dr. Rich Whitaker, PhD

Bios:

Dr. Rich Whitaker began his career in the Quad Cities in 1994 as a doctoral intern at the historic Marriage and Family Counseling Service in Rock Island, Illinois as part of his Ph.D. in Marriage and Family Therapy from Brigham Young University. Since that pivotal year, Dr. Whitaker has pursued a career in community mental health, providing services, supervision, and executive administration at community mental health centers in Grand Island, Nebraska (9 years as COO) and Jasper, Indiana (12 years as CFO). Since January 2017, Rich has served as the CEO of Vera French Community Mental Health Center in Davenport, Iowa. In addition to serving as a Director of Region 7 on the Board of the National Council for Mental Wellbeing, Dr. Whitaker also serves as a Government Relations Committee member for the Iowa Association of Community Providers, as a Board member of Churches United in the Quad Cities, and as a member of the Eastern Iowa MHDS Regional Advisory Committee.

Rich and Miriam are the parents of 3 daughters and one son and the proud grandparents of a growing number of highly intelligent and multi-talented grandchildren. In his spare time, Rich enjoys family time, all types of sports and exercise, singing with the Quad City Singers, and service in the church and community.

Henry Emerle, MD completed his medical school training at the University of Illinois College of Medicine at Urbana-Champaign, IL. He completed Psychiatry Residency training as well as Geriatric Psychiatry Fellowship training at the University of Michigan in Ann Arbor, MI. He is the Medical Director at Vera French Community Mental Health Center. He enjoys spending time with his family exploring the many charming towns in Iowa along the Mississippi River.

References:

Cash RFH, Cocchi L, Lv J, Fitzgerald PB, Zalesky A. Functional Magnetic Resonance Imaging–Guided Personalization of Transcranial Magnetic Stimulation Treatment for Depression. JAMA Psychiatry. 2021;78(3):337–339. doi:10.1001/jamapsychiatry.2020.3794

Jannati, A., Oberman, L.M., Rotenberg, A. et al. Assessing the mechanisms of brain plasticity by transcranial magnetic stimulation. Neuropsychopharmacol. 48, 191–208 (2023). https://doi.org/10.1038/s41386-022-01453-8

Pitcher, D., Parkin, B., & Walsh, V. (2021). Transcranial magnetic stimulation and the understanding of behavior. Annual Review of Psychology, 72, 97-121. https://doi.org/10.1146/annurev-psych-081120-013144

Sequenced Treatment Alternatives to Relieve Depression (STAR*D) Study (n.d.) https://www.nimh.nih.gov/funding/clinical-research/practical/stard

Caring for Boomer Generation: Building Upon History To Plan The Future

As the baby boomer generation ages, America's current long-term service and support system (LTSS) faces mounting pressure. With the volume of seniors requiring care increasing, it's becoming clear that our existing infrastructure has opportunities to build person-centered systems to meet the needs and desires of this growing population. In this episode, we dive into how we can learn from our past to understand the critical need for expanding Home and Community-Based Services (HCBS), allowing more seniors to age in place while ensuring institutional services remain available for those who need them most. Join us as we explore what this shift means for families, healthcare providers, and policymakers and how it could reshape the future of aging in America.

Objectives:

Discuss societal history impacting the evolution of caring for the aging population.
Describe characteristics of populations impacting the care of the aging population.
Explain future considerations in the care of the aging population.

Guests:

Ashley l Ebert, MSN, ARNP, FNP-C

With over a decade of experience as a nurse practitioner, Ashley has spent 8 years mastering acute care across diverse settings and just over 2 years specializing in geriatric care. In both roles, she has led initiatives to enhance quality care, advocated for better access to healthcare, and focused on the unique needs of rural communities. Her passion lies in people leadership and fostering the growth and development of clinicians to ensure long-term success in the field of healthcare.

She is honored to have been selected as her company's Senior Living representative for a national Townhall, sitting alongside senior leaders, bringing collaboration and a focus on improved care transitions to the forefront. Additionally, Ashley was selected as a co-chair for a company-wide NP group, which boasts a vibrant community of nearly 5000 members, where she helps create a space for connection, professional growth, and networking.

Casey Fowler, DNP, ARNP, FNP-C, GS-C, FAANP

Casey Fowler is a family nurse practitioner sub-specialized in geriatrics. He has been working with older adults in institutional and community-based settings for more than fifteen years. The last eight years, he has been leading other nursing professionals caring for this population, and he has been advancing his knowledge in leadership. Casey earned his Doctor of Nursing Practice from Gonzaga University in 2015, studying the use of nonpharmacologic interventions for behavioral and psychological symptoms of dementia using the middle-range nursing theory of Person-Centred Care as described by McCormack and McCance. Casey has gone on to apply these principles to his leadership style, in what he calls person-centered leadership. Casey has been a speaker at many local, regional, and national events on a variety of topics, and this year, he was inducted into the Fellows of the American Association of Nurse Practitioners for his work building the first postgraduate fellowship for nurse practitioners to gain specialty training in geriatrics and complex adults as well as his work developing other leaders in his field. Casey’s current focus is on leveraging our nation’s resources to best care for our aging population in a way that meets the needs of both rural and urban populations.

References:

Administration for Community Living. (2-24, February 27). Retrieved from Administration for Community Living: https://acl.gov/news-and-events/announcements/acls-dcw-strategies-center-launches-multi-pronged-effort-strengthen

Alzheimer's Association. (2011). Generation Alzheimer's: The Defining Disease of the Baby Boomers. Retrieved from Alzheimer's Association

Mindful Pathways: Enhancing Dementia Care Through Person-Centered Practices

Join us for an insightful discussion with Marion Kyner, MSN, APRN, PMHCNS-BC, CDP, and Joanna Fix, PhD, as they share strategies from expert knowledge and lived experiences for healthcare providers, individuals living with dementia, and the greater community to better navigate the journey of living alongside and caring for those experiencing brain changes.

Objectives:

Identify strategies and resources to enhance compassionate and effective support for delivering person-centered care for individuals with dementia.

Advocate for person-centered care for individuals living with dementia, highlighting its benefits and systemic changes that prioritize the well-being, dignity, and individuality in healthcare and community settings.

Guests:

Joanna Fix, PhD

Marion Kyner, MSN, APRN, PMHCNS-BC, CDP
https://www.facebook.com/MarionKynerLLC

Bios:

Dr. Joanna Fix is a former college professor and psychologist. She was diagnosed with Alzheimer's in October 2016 at the age of 48. Since then, she has volunteered over 10,000 hours for numerous organizations, most notably the Alzheimer's Association, Teepa Snow Positive Approach to Care, and National Council of Dementia Minds, to share her lived experience expertise in order to educate, advocate, and support family, caregivers, professionals working in the dementia community as well as those newly diagnosed. She lives in Colorado Springs with her husband and two dogs.

Marion Kyner is an Advanced Practice Registered Nurse and a Psychiatric Clinical Nurse Specialist with over 40 years of experience in nursing. She teaches dementia skills to nursing students in Virginia; at Longwood University and the University of Virginia.

She began working with seniors and persons living with dementia in 2007 when she went to work in a nursing home. She initially worked as a nurse manager in skilled rehab and then developed a psychiatric services program where she was the mental health provider and dementia specialist for over 10 years. She also helped develop and manage a dementia care day program called the Meaningful Life Program for patients with advanced stages of dementia. In addition to teaching, she is also in private practice as a dementia care consultant.

Marion lives in Cumberland, Virginia, where she is a community volunteer with the Alzheimer's Association and facilitates a caregiver support group. Marion is passionate about changing the culture of dementia care and HOW nurses provide care for patients with dementia.

References:

Alzheimer’s Association: https://www.alz.org/

Dementia Friendly America: https://dfamerica.org/

Integrating Brain Health into Health IMprovement Planning: The Healthy Brain Initiative Road Map and MAPP 2.0:

https://www.alz.org/professionals/public-health/models-frameworks/hbi-road-map

Teepa Snow’s Approach™

https://teepasnow.com/#:~:text=Teepa's%20Snow%20Approach%E2%84%A2%20methods%2C%20a%20series%20of,Relationship.%20Experience%20Less%20Resistance.%20Experience%20Less%20Stress.

Presenters discuss a personal experience and drugs for dementia or dementia-related behaviors. This discussion should not be misconstrued as promotion. Listing of drug generic/trade names that were discussed: (Trade name/Generic name), (Aricept or Aricept ODT/Donepezil), (Ativan/Lorazepam), (Exelon/Rivastigmine), (Namenda/Memantine), (Razadyne/Galantamine), (Rexulti/Brexplprozole).

https://docs.google.com/document/d/17aPXoX7jWMQqbtEgCpQmhv_5lGJQc3m6dvkLQHL5IUU/edit?usp=sharing

Welcome to "Thriving with Dignity: Embracing a Person-Centered Approach to Disability."

Objectives: Listeners will understand the importance of a person-centered approach to disability, gaining insights from real-life stories, expert opinions, and innovative strategies that promote dignity, respect, and individualization in supporting people with disabilities.

Guests:

Alana Hougland, BSN ‘18, RN
Kevin Sullivan, Disability Rights Activist, Accessibility Consultant

Alana Hougland, BSN ‘18, RN: "My name is Alana Hougland. I am a graduate of the St. Ambrose University BSN nursing program. I had a few years of hospital and clinic experience before my son Mason was born.
I am now my son's full-time home health nurse. He was born several months early and had a brain hemorrhage at birth, resulting in hydrocephalus, cerebral palsy, and other medical conditions. Mason is now 3.5 years old and requires full-time nursing care to provide feeding tube support, meds, and mobility assistance. He's had six brain surgeries, spine surgery, and others. I was fortunate to be hired for Mason's home health case, so I can be one of several nurses providing care for him.

I feel that I have a unique experience from having a healthcare background and now being on the receiving end of the medical system in a complex way. I believe that because of my experience, I am better able to advocate for my child, as well as make sure the system around him is functioning as it should be. As most of us know, we have a long way to go as a collective society for optimizing healthcare for people with disabilities. My goal is to continue to advocate for the best care, safety, and accessibility for those with disabilities and their support systems."

Kevin Sullivan: "My name is Kevin Sullivan, but feel free to call me Kev. I’m just an average guy, or at least I try to be as much as possible. I'm the youngest of three children and also the only member of both my immediate and extended families to be born with a permanent physical disability.

I was born in a suburb outside Chicago with a condition known as Arthrogryposis Multiplex Congenita, or AMC for short. My condition causes abnormal fibrosis of my muscle tissue, which results in general weakness and limited range of motion in both my arms and legs. While my condition is both permanent and irreversible, AMC is neither a degenerative nor genetic condition. My life expectancy also will not be affected.

I was born in the early 1990s, less than a year after the Americans with Disabilities Act was signed into law. My right to participate in everyday life alongside my able-bodied peers was codified into law at just the right time. As a part of the first generation of Americans living with disabilities having these rights guaranteed from birth, I've experienced both the successes and the shortcomings of this legislation.

I currently work a full-time job for a technology company in the logistics industry and am able to live semi-independently with the assistance of family members and hired caregivers."

Assessing Family Caregiver Needs: Policy and Practice Considerations: https://www.caregiving.org/wp-content/uploads/2020/05/AARP-caregiver-fact-sheet.pdf

Caregiving for Family and Friends - A Public Health Issue:
https://www.cdc.gov/aging/caregiving/pdf/caregiver-brief-508.pdf

Services for Children with Disabilities:
https://childcare.gov/consumer-education/services-for-children-with-disabilities

Welcome to "Empowering the Ethics of Person-Centered Care through Practice." In this two-part podcast, we explore the fundamental principles and practical applications of person-centered care within the realm of healthcare ethics. Objectives: Listeners will gain a comprehensive understanding of the ethical principles and practical methodologies underpinning person-centered care within healthcare contexts. They will learn actionable strategies to implement person-centered practices, aiming to enhance patient experiences, uphold dignity, and promote positive outcomes in healthcare delivery.Guests: Jessa Roisen, PhD, SAU Philosophy and MPH ProfessorDoug Johnson, System Patient Experience Officer, Northshore Edward-Elmhurst Hospital Planetree Gold CertifiedDr. Roisen has more than 18 years in higher education regularly teaching Ethics, Applied Ethics, and Conflict Analysis for the Philosophy Department at St. Ambrose University. She chairs the Bioethics and Humanities Initiative and is a certified mediator and Health Care Ethics Consultant with over 10 years of experience. Dr. Roisen also trains community mediators and mediates regularly for the Davenport Civil Rights Commission and the Rock Island County Circuit Court.Doug Johnson is the Patient Experience Officer at North Shore Edward Elmhurst Health, a Planetree Gold Certified campus. He has worked across disciplines, including healthcare, the marketing industry, retail, and within professional baseball with the Chicago Cubs! References: Berwick DM. The Moral Determinants of Health. JAMA. Published online June 12, 2020. doi:10.1001/jama.2020.11129Ekman, I. (2022). Practicing the ethics of person-centred care balancing ethical conviction and moral obligations. Nursing Philosophy, 23, e12382. doi.org/10.1111/nup.12382Entwistle, V. A., & Watt, I. S. (2013). Treating Patients as Persons: A Capabilities Approach to Support Delivery of Person-Centered Care. The American Journal of Bioethics, 13(8), 29–39. doi.org/10.1080/15265161.2013.802060Harris, E. (2020, May) Person-Centered Care: Why it means everything & how to provide it? www.crisisprevention.com/Blog/Person-…orram-Manesh, A., Gray, L., Goniewicz, K., Cocco, A., Ranse, J., Phattharapornjaroen, P., Achour, N., Sørensen, J., Peyravi, M., Hertelendy, A.J., Kupietz, K., Bergholtz, J., &Carlström, E., (2024). Care in emergencies and disasters: Can it be person-centered?, Patient Education and Counseling, doi.org/10.1016/j.pec.2023.108046.Marmot M. The Health Gap: The Challenge of an Unequal World. Bloomsbury; 2015.Planetree International www.planetree.org/Santana MJ, Manalili K, Jolley RJ, Zelinsky S, Quan H, Lu M. (2018) How to practice person-centred care: A conceptual framework. Health Expect. 21(2):429-440. doi:10.1111/hex.12640Sprouts. (2019, November 29). Kohlberg’s 6 stages of moral development [Video]. www.youtube.com/watch?v=bounwXLkme4Tomaselli G., Buttigieg S.C., Rosano A., Cassar M., Grima G. (2020) Person-Centered Care From a Relational Ethics Perspective for the Delivery of High Quality and Safe Healthcare: A Scoping Review. Front Public Health. 8:44 doi: 10.3389/fpubh.2020.00044.

This podcast is CEU Accredited.