CATALOG DESCRIPTION:

This clinical course focuses on the implementation of the roles of the advanced practice nurse in tertiary care pediatrics.  Applications of nursing, biological and behavioral science are emphasized in the clinical assessment and management of acutely ill children and their families. The student gains the necessary clinical management skills to provide specialized care to acutely ill children and to assist their adaptation and the adaptation of their families.

COMMUNITY PROJECT TITLE:

Decreasing Diabetes Risk Factors in the Community through a Partnership between Nurse Practitioner and High School Students: Dance for Health

PRE-REQUISITE(S):

N684 or N685, N720, N721

CO-REQUISITE(S):

N722 or N717, N637

PROJECT OVERVIEW:

The purpose of this assignment is to further develop student’s leadership, teaching, and research skills.  All students will work in the community setting at Sayre High School with Dr. Terri Lipman and Mary Schucker.  This academically based community service (ABCS) experience will engage students in real-world problem solving related to APN teaching and research opportunities. While all students will participate, a core group of students who volunteer will be responsible for assuming oversight of the project.

PROJECT OBJECTIVES:

ABCS (academically based community service) clinical experience at Sayre High School

Upon completion of this project, the student will demonstrate the ability:

• To plan, implement, and evaluate a formal clinical teaching plan focusing on a key indicator of child health in partnership with students and key individuals in a community setting
• To have a community immersion experience in which the community members are true partners in the educational, practice and research process.
• To develop culturally relevant interventions, in collaboration with the community, to address a child health issue.
• To gather, organize and interpret data regarding this key indicator of child health.
• To disseminate data regarding this key indicator of child health.

Goals:

• At the completion of this project Sayre students enrolled in the health education class will attain knowledge of normal growth and growth disorders and diabetes risk factors.  They will also acquire important skills for medical intake.
• These students will then implement these skills in the after school program.
• Sayre students and children whose growth is evaluated will be in possession of ACCURATE growth assessment and growth charts which will also provide accurate data for calculation of BMI and diabetes risk factors.
• Children at the Sayre Recreation Center with growth disorders and risk factors for diabetes will be identified and referred to their primary care providers to consider further evaluation.
• The Sayre Dance Team will provide a weekly dance program for the children at the recreation center
• Sayre students, mentored by  NP students, will obtain baseline and post dancing heart rates on the children.
• Children at the recreation center will have their activity monitored via pedometers placed during the dance activity and for one hour on days they do not dance.
• Data related to BMI, fitness and activity level of the children at the recreation center will be analyzed.
• Abstracts of the data will be prepared by the NP and Sayre students and submitted to a national conference for presentation.

Student, Faculty, and RA roles:

• Two student leaders will develop and present 4 teaching sessions in the Sayre Health Education Class. All other students should assist in preparation of sessions- if needed- and must attend one teaching session to support didactic and practice sessions. All teaching plans and homework assignments must be discussed with and approved by the classroom teacher.
• Faculty:  Patrice Johnson (Penn/ Sayre liaison) and Jill Bazelon (executive director of the Sayre Health Center) will be our faculty contacts at Sayre.  Terri Lipman will provide leadership for this project at the School of Nursing assisted by Mary Schucker.
• Research assistant:  TBA will assist students with data management and analysis

Classes

• Consist of 10^th and 11^th grade students.  Sessions will include handouts, a visual display and one homework assignment.
• Didactic Teaching sessions (suggested content) -Importance of growth assessment, principles of growth, causes of short stature, obesity epidemic, type 2 diabetes, need for referral, how to perform assessments, interventions to decrease obesity.  Practice session– Sayre students assess growth and diabetes risk factors of one another
• Clinical Teaching sessions– (suggested content) – How to calculate age, how to plot height and weight, calculate BMI. Practice session– Practice session- Sayre students plot growth measurements
• Sayre students will have observational experiences at the Instructional Technology Center and the Bio-behavioral  Research Laboratory in the School of Nursing and the Diabetes Technology Center at the Children’s Hospital of Philadelphia.

After School Project Tuesdays:

Week 1

Introduction

Review goals

Link between fall and spring

Review ht, wt

Teach heart rate and pedometers

Weigh/ measure Sayre students

Put on growth charts

Demonstrate charting data

Week 2

Discussion of previous week

Growth charts rec cneter children’s data

Chart HR pedometer data

Film-NP students Interview Sayre students re

Activity in the community

Week 3

Discussion of previous week

Review preparing a poster

Chart HR pedometer data

Film- Sayre student interview NP students re: Nursing as a career, Working with children

Week 4

Discussion of previous week

Chart HR pedometer data

Begin designing a poster

Film- Sayre student interview one another re: Penn/ Sayre project

Topics below are part of Sayre Heath Center curriculum and can be included in discussions

Sports, exercise and fitness

Nutrition, healthy cooking

Obesity and cardiac diseases, cholesterol

Physiology and vital signs

Patient interviews and patient history.

Communication skills including listening, presentation and organizational skills.

After School Project- Thursdays

NP and Sayre Health Center Students working with children at Sayre Recreation Center

Week 1

Introduction and describe project

Assign teams- record subject data

Obtain baseline ht/ wt/HR

Attach pedometers

Dance program by Sayre dance students

Resting HR

Document pedometer data

Week 2

Obtain baseline HR/ attach pedometers

Dance program by Sayre dance students

Resting HR

Document pedometer data

March 25

Obtain baseline HR/ attach pedometers

Dance program by Sayre dance students

Resting HR

Document pedometer data

March 31

Obtain  wt/HR/ attach pedometers

Dance program by Sayre dance students

Resting HR

Document pedometer data

Tally teams

Give prizes

(film and photography throughout)

After project-  wrap up for parents- dance performance

Grading criteria

Group grade

1. Teaching plan (20%)
   1. Description of client group
   2. Format for dissemination
   3. Objectives
   4. Content-overview
   5. Length of the session
   6. Plan for process and outcome evaluation includes
2. What data that will be gathered
3. How it will be managed
4. Analyzed
5. Interpreted
6. Implementation of project (60%)
   1. Attentiveness to negotiating with setting leaders and project personnel
   2. Competency to join with and engage learner(s)
   3. Fidelity to objectives of project
7. Evaluation of the project (20%)
8. Process (e.g. learner satisfaction)
9. Outcomes: Key child health outcomes: collection; organization; interpretation

References:

• Assessment of growth and diabetes risk factors in the community:   A partnership between nurse practitioner and high school students Funded by the Netter Center for Community Partnerships (T. Lipman [PI] and J. Deatrick [Co-Investigator])
• Key health indicator-Growth (See: Lipman, T.H. et al.  (2004). A multicenter randomized controlled trial of an intervention to improve the accuracy of linear growth assessment.  Archives of Disease in Children, 89, 342-246 on blackboard)

Lipman TH, Schucker MM, Ratcliffe SJ, Holmberg T, Baier S, Deatrick JA.(2011). Diabetes risk factors in children: A partnership between nurse practitioner and high school students. American Journal of Maternal Child Nursing,  36(1), 56-62.