Lebanon — The impact that community nurses have on patient care is well-known to the patients themselves and their families.
Now, thanks to a pilot program started last summer, the Upper Valley Community Nursing Project has a way to gather information and track information to evaluate the effectiveness they have in the community.
For one of their capstone projects, four Colby-Sawyer College nursing students looked at the aggregate information gathered through REDCap, a data software system, from August 2017-January 2018 “to better understand the client population,” said Laurie Harding, co-director of the Upper Valley Community Nursing Project, a nonprofit organization that assists community and parish nurses throughout the region.
Community nurses visit residents in their homes to give advice and information, including answering questions about medications and providing support to caregivers. They do not provide hands-on care.
The data gathered will be helpful when the nurse programs in each community apply for grants and ask towns for funding during Town Meeting season. It was collected from five of the towns that are part of the nursing project.
All identifying information, including town names, was removed to ensure the privacy of the nearly 175 patients included.
During a presentation at Alice Peck Day Memorial Hospital last week, the Colby-Sawyer seniors — Emily Crow, Courtney Lampert, Emily Martin and Ashma Shrestha — presented their findings to community nurses and those affiliated with the program.
“What their goal was was to present to the community what it is in fact the nurses … are delivering to their patients,” said Shari Goldberg, a professor in the School of Nursing and Health Professions at Colby-Sawyer College, who works with area organizations to help students find capstone projects. “This pilot project has elucidated how the implementation of this documentation system serves as a tool going forward to capture the scope and breadth of the work of the nurses” serving the community nursing project.
The information gathered ranged from who uses the community nurses (63 percent of patients are female), to the average age (82) and patients’ living situations (the majority live alone, or with one other family member). It also looked at issues that the patients deal with, such as mobility.
“These mobility issues put these patients at a high risk for fall,” Crow said. “Falling is one of the top health problems” of patients served by community nurses.
There were some findings that surprised Harding, such as the high percentage of patients who have prepared advance directives.
The data collected also looked at patient satisfaction, which was exceptional: “100 percent of clients wanted the services provided by the community nurse,” Martin said. Those who stopped using the services did so because they no longer needed them, moved away or died.
This is the third year that Colby-Sawyer nursing students have worked with the community nursing project. The first year, students did a client satisfaction survey and last year did a provider satisfaction survey.
“During their capstone experience, students examine health care at the organizational, community, and public policy levels of care, and develop a growing understanding of the social determinants of health,” Goldberg said in an email. All nursing students also learn through acute-care clinical work at Dartmouth-Hitchcock Medical Center.
This was the first year the students shadowed the community nurses.
“It’s a wonderful experience for students,” Goldberg said.
All four students — who will work at DHMC after they graduate — agreed that it was an eye-opening experience because it enabled them to go into patients’ homes.
Shrestha said the experience helped her grasp the need for a continuity of care.
“I learned that discharge is not the end,” she said.
“I guess I was naive to what discharge really meant,” Lampert said. Doing home visits, she was able to observe the myriad home conditions patients go back to. “This should be an experience all students should have.”
Editor’s note: The public is invited to the Colby-Sawyer College Scholars’ Symposium at Wheeler Hall on Tuesday from 8:30-11:45 a.m., where senior nursing students will present their capstone work. The four students who worked with the Upper Valley Community Nursing Project will present at 8:30 a.m. For more information about the community nursing project visit uvcnp.org/. Liz Sauchelli can be reached at esauchelli@vnews.com or 603-727-3221.