A day in the lives of APNs in the U.S.
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Adult↗
Biomedical subjects
Martha K Swartz
Publications and source records attributed to Martha K Swartz.
Barriers to effective pediatric asthma care.
Although progress has been made in understanding the pathophysiology of asthma and identifying key features of quality asthma care, the prevalence of childhood asthma remains high. Barriers to effective asthma care that currently exist include the persistence of environmental risk factors, disparities in care that stem from poverty and cultural differences, and inconsistencies in the quality of asthma care provided by clinicians. Pediatric nurse practitioners at Yale New Haven Children's Hospital have actively implemented the recommended guidelines for asthma care and addressed causes for some of the disparities in asthma health care. Two major initiatives are described: the Asthma Care Coordination Project at Yale New Haven Hospital Pediatric Primary Care Center, and the establishment of an Asthma Outreach Program. Recommended resources and Web sites for the practitioner are also provided.
Anti-Asthmatic Agents↗
Establishing a practice-based research network of advanced practice registered nurses in southern New England.
BACKGROUND: Biomedical research focuses on highly controlled clinical trials in academic health centers, where the emphasis is on disease treatment and rehabilitation. The results, therefore, are not readily applicable to patient populations that primary care clinicians encounter in their community practices, where the focus is on health promotion and disease prevention. Although the number of practice-based research networks (PBRNs) is growing in primary care, these networks are governed by the physicians who created them and address research questions reflective of physicians' practices and perspectives. Other primary care clinicians, such as advanced practice registered nurses (APRNs), who routinely provide care for underserved and minority populations lack a forum for studying their practice problems and processes. A PBRN of APRNs in primary care provides a means for this research. SUMMARY: The Advanced Practice Registered Nurses' Research Network in southern New England is the first PBRN established for APRNs. This article describes the development of the network.
Evidence-Based Medicine↗
Supporting adolescent mothers and their children through a high school-based child care center and parent support program.
INTRODUCTION: A pilot study was conducted of adolescent parents and their children at a high school-based child care center to examine the influence of the program on parental competence, parent-child interaction, and child development. METHOD: A convenience sample of 18 urban adolescent mothers with children was interviewed at the end of one academic year. Mothers completed the Maternal Self Report Inventory (MSRI; short form) and the Parenting Daily Hassles Scale (PDHS). Parent-child teaching interactions were rated with the Nursing Child Assessment Teaching Scale (NCATS), and the Michigan Early Developmental Profile (MEDP) was used to evaluate child developmental outcomes. RESULTS: Mothers reported positive scores on the MSRI and PDHS. NCATS observations indicated ratings significantly higher when compared (assuming unequal variances) with a group matched for age range and length of time in school of adolescent mothers from the Nursing Child Assessment Satellite Training (NCAST) national database. The MEDP indicated that 77% of the children assessed were within normal limits for all domains (fine motor, cognition, language, gross motor, and self care). DISCUSSION: The results of this pilot study indicate that adolescent mothers and their young children in the sample benefited from the educational and support services offered at a school-based child care and parent support program. Further study is indicated to test the strength and duration of the effects.
Adolescent↗
Parenting preterm infants: a meta-synthesis.
PURPOSE: To synthesize the findings of qualitative studies on parenting preterm infants and present a framework that will enable clinical nurses to provide better care. STUDY DESIGN AND METHODS: A meta-ethnographic approach was used to synthesize the findings of 10 qualitative research studies that focused on parenting the preterm infant upon hospital discharge and on into the toddler years. RESULTS: Five themes of parenting preterm infants emerged: adapting to risk, protecting fragility, preserving the family, compensating for the past, and cautiously affirming the future. CLINICAL IMPLICATIONS: Nurses provide expert care, anticipatory guidance, and education for NICU babies and families, but should also foster the inclusion of all family members in the NICU setting, provide opportunities for parental peer support, establish effective systems of continuity of care, and advocate for parents of preterms in policy-making arenas.
Adaptation, Psychological↗
Gastroesophageal reflux in infants: a primary care perspective.
This clinical paper discusses the role of the pediatric nurse in the evaluation and management of gastroesophageal reflux (GER) in infants. During an infant's first year of life, GER is a common occurrence and concern of families. The infant with uncomplicated GER may be managed conservatively with feeding schedule modifications, thickened feeds, changes in positioning, or a trial of formula change. Gastroesophageal reflux disease (GERD) is a pathological process in infants manifested by poor weight gain, signs of esophagitis, persistent respiratory symptoms or complications, and changes in neurobehavior. Management of the infant with GERD, in addition to non-pharmacological interventions, involves further diagnostic evaluation and pharmacologic therapy, depending upon the child's history and clinical presentation. While most cases of GER are self-limiting, complications include esophagitis, bronchospasm, apnea, aspiration pneumonia and other otolaryngologic disorders. The pediatric health care provider should offer an ongoing, comprehensive clinical approach to the family based on considerations of growth and development, and the quality of interactions between the caregivers and child.
Gastroesophageal Reflux↗