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Helping to Combat Asthma in Rural West Tennessee

By Regina Perry MSN, FNP-BC, Nurse Practitioner, Community Health Dept, Memphis Regional Children’s Health Project

Last month, the Asthma and Allergy Foundation of America (AAFA) released its “2011 Asthma Capitals” in the United States. The city of Memphis was listed in third place and as a resident of the Memphis area and a health care provider at CHF’s Memphis Regional Children’s Health Project, this news is quite worrisome.  Many children living in this city and surrounding areas, particularly those who are poor and living in rural communities, are likely suffering from asthma and don’t have the necessary health care and medications needed to manage their condition.

We’ve known for a while that asthma rates in Memphis were high.  So, in 2009, our team embarked on a mission to bring CHF’s Childhood Asthma Initiative to our program in order to help our kids get properly diagnosed with asthma and learn how to treat this condition. Through the Childhood Asthma Initiative, children with asthma have access to the highest quality care. Clinical visits and medication, asthma severity assessment and allergy skin testing are supplemented by in-depth health education, including access to Children’s Health Fund’s Family Asthma Guide. All of these efforts help children and their families actively manage asthma symptoms. In addition, we provide support for asthma patients and their families, who often experience the anxiety and depression that accompanies chronic illness.

Our progress with this initiative has been fantastic. Many children are learning how to recognize triggers and control their symptoms. Our case manager has assisted numerous families with getting the medications they need to control asthma, regardless of whether or not the family has insurance (as many of you know, asthma control medicines are quite expensive). Through this initiative, we have also helped bridge the gap between primary care providers and patients. Because of transportation barriers, many of our patients can not regularly get to their primary care physician, but because we are available to these patients at their schools, they are able to visit us regularly during the school day. There, we can monitor and manage their symptoms. We also provide ongoing education and medications as needed.

Nurse Practitioner, Regina Perry, with one of the many little patients she sees on mobile medical unit.

It’s wonderful to know that my job helps families combat asthma.  We may be a long way from solving the problem, but every little bit helps children in the Memphis area live a healthier life.

 

Photo Friday - New Center for Child Health and Resiliency

Center for Child Health and Resiliency (CCHR)

► Above is an architect's rendering of the new Center for Child Health and Resiliency (CCHR) a partnership between the Children’s Health Fund (CHF) and The Children’s Hospital at Montefiore.

The new center expands the capacity of the CHF's South Bronx Health Center by 50%.  The CCHR incorporates the science of early childhood development into the medical home model, helping parents build up protective factors against destructive stressors (such as poverty and environmental challenges) and ensuring that they feel equipped to raise healthy, well-adjusted children. 

Learn more about the partnership »

Education and Management – Fighting Asthma in New Jersey

By David Unkle, Program Director, New Jersey Children’s Health Project

david unkleHaving worked in Trenton, Newark, and Camden, New Jersey, three of the most medically underserved cities in the country, I have treated hundreds of children and adults living with asthma. Until last March, when I became the program director of CHF’s New Jersey Children’s Health Project (NJCHP), most of my assessment and treatment for asthma took place in my private practice in Trenton. Kids came to me with problems breathing or with severe allergies and I helped diagnose the problem and worked with their families to develop an asthma action plan. Working on the mobile clinic, I’ve been able to bring what I have learned and practiced in my office into the Newark community, where many children are suffering with asthma and do not have the proper skills and/or medication to control the disease.

One of the major benefits of working on the CHF mobile clinic when treating a patient with asthma is that our team is able to go directly to the patient and understand more about the environment in which he or she lives or attends school. This allows us to determine what in the child’s environment might be triggering asthma and then educate parents, teachers, and children about the triggers, where they are located, and how to avoid them. For example, when in a homeless shelter, we look to see where a child sleeps – as this spot is where the child spends a good portion of his/her day – and look to see if there is anything within this environment, like stuffed animals, cork boards, plants and/or feather pillows, that might be making the child’s asthma worse

When fighting asthma, projects like ours are extremely vital because in addition to treatment, we help bring an awareness of the severity of asthma—something many people, especially those living in poor and underserved communities, do not understand. We are able to help families develop an asthma action plan that includes asthma management and reduction of asthma triggers. When that happens, children are less likely to suffer from an attack, go the ER, and/or miss a day of school—all of which contribute to a better and healthier community.

The numbers don’t lie: over 7 million children under the age of 18 living with asthma. We need to ensure that parents, teachers, legislatures, and children are aware of the severity of this disease and are taught how to properly control their asthma.

Photo Friday - Celebrating Healthy Kids in Detroit

►Last month, our Children’s Health Project of Detroit took part in a day of health and exercise during the “Kids Matter Here Summit II.”  This event celebrated the 50th anniversary of The Skillman Foundation, an organization started by Rose Skillman in 1960 in response to her commitment to the welfare of vulnerable children.  Guests enjoyed healthy food, carnival games, rides music, information on excellent schools and preparing for college.

Our Detroit team talked healthy eating, gave tours of our mobile medical clinic, and even played jump rope with kids. It was a great and healthy day had by all!

Faces from the Field: Becoming a Nurse and Paying it Forward

Posted by Kimberly Williams, RN, Children's Health Fund’s Phoenix Children’s Health Project

Hello, it’s Nurse Kim again. In my last blog, I promised to write about my passion for nursing and I never make a promise that I can’t keep. I’ll try to keep this story short for the purpose of this blog, but I could write an entire book about my journey as a nurse. The funny thing about my story is that I never knew that I wanted to be a nurse. The only thing I knew back in 1990 was that if I became a nurse, I would always have a job and would be able to support my children. That’s it. That’s the real reason that I became a nurse. I never even considered all the intrinsic rewards, like making people feel better, or being a part of a team that saves lives.

There hasn’t always been a nursing shortage like there was before the economy took a nose dive. In 1994, Phoenix Children’s Hospital was the only hospital hiring new graduate nurses. I was offered a job working on the general pediatrics unit on the day of my graduation. I had no idea that I was meant to be a pediatric nurse, but I was… to the bone! I’ve spent the last 17 years practicing pediatric nursing and have loved every minute of it. Even the hard days have been rewarding.

"My goal is to end homelessness and the nursing shortage at the same time."

In my last post, I mentioned that I have been responsible for providing nursing care at the largest family shelter in Arizona that houses approximately 200 adults and their children. I also mentioned that my passion for nursing has skyrocketed and I wanted to tell you why. Because I am responsible for all the health screenings, I have the opportunity to meet every family and spend some time getting to know them. During a typical screening, I usually discover the many reasons that have contributed to their becoming homeless. On occasion, I will meet someone who expresses their desire to enter the healthcare field and I simply ask them, “What’s holding you back?” Sometimes I get a multitude of reasons and some legitimate, but sometimes I meet someone who realizes that now is the time to become the person that they have always wanted to be. I meet people who realize that education is the answer to their problem and that nursing can provide them the paycheck that they’ve been seeking to help them take care of their family. Sound familiar?

In September, 2009, I started a club to help those who had started college or who were planning to start college pursuing a career in healthcare. We call ourselves the HealthCare Career Club. The club, which meets once a month for meetings and more often for events and fundraisers, is there to support and guide anyone who is experiencing challenges while pursuing their degree. The club has been able to provide each member with a computer, CPR certifications, help with vaccines, fingerprinting and any supplies that haven’t been covered by grants or scholarships. We have 20 members including a President, a Vice President, a Secretary, a Historian, a Photographer and a Special Committees Chairperson. We have honor students, scholarship winners and working interns. We have members from age 17 to 50 years of age. We have a mother-daughter team and a mother-son team. We have members pursuing nursing, sports medicine and respiratory therapy. We have members who are medical assistants and phlebotomists who are working while going to college. We have 3 members who recently completed their Nursing Assistant training as part of the nursing curriculum. Soon they will start working and collecting a paycheck while they continue on their nursing journey. Each member is dedicated and determined to end their homelessness and begin a new life. It has been very rewarding to watch each member grow, little by little into a professional that knows what it’s like to suffer and will have compassion beyond comparison. No one could ask for a better caregiver who practices with true empathy. You can’t learn that from a book or class.

Healthcare Career Clup started by Nurse Kim of CHF

The HealthCare Career Club believes in the individual, the family and community and that is what guides our activities. The club is small now but continues to grow. My goal is to end homelessness and the nursing shortage at the same time. It could happen. You can keep up with our progress at www.healthcarecareerclub.com.

 

Photo Friday - Happy Nurses Day!

►Today, May 6th is National Nurse's Day and it kicks off National Nurses Week.   The theme for Nurses Week this year is "Nurses: Trusted to Care." 

Children's Health Fund recognizes the contributions and commitments all nurses make, and are thankful for the wonderful nurses working at Children's Health Fund programs across the country.  Nurses play an integral role in our fixed site clinics, our mobile medical clinics and school based programs, providing quality health care to America's underserved children.  Thank you for all you do!

World Asthma Day

Today is World Asthma Day—an annual event organized by the Global Initiative for Asthma to improve asthma awareness and care around the world.  Over the next few weeks, we’re excited to share blog posts that will explain more about the work our providers are doing across the country to help underserved kids and families learn how to control asthma.

by Dr. John Carlson, pediatrician and asthma/immunology specialist, New Orleans Children’s Health Project and Plaquemines Parish

I see many patients who are living with asthma and allergies while working on the mobile clinics in the 9th ward of New Orleans and in southern Plaquemines Parish. When I see a patient with asthma, I work with the family to select the right controller medications so that they have no limitations in the activities they can take part in. If they have difficulty running, sleeping or going to school because of their asthma, I know that we can find a better medication. I also look to see if they have problems with food allergies, eczema, snoring and nasal allergies because controlling these other problems are an important part of controlling asthma.

For Plaquemines Parish resident, Marie*, helping to keep her son Sam’s* asthma under control was difficult.   Although Marie was employed, she was not able to afford health insurance for her children.  Subsequently, Sam’s asthma was not properly managed, causing frightening outbreaks that made breathing extremely difficult.  A few months ago, Marie discovered our clinic outside of the school where she works and learned that her child could receive care, regardless of her ability to pay.  After bringing Sam to the clinic, I was able to get Sam on an “Asthma Action Plan,” give him proper medication, and help Sam and Marie understand what was triggering Sam’s asthma outbreaks.  As it turned out, we also discovered Sam had severe allergies after providing him allergy testing and treatment. 

Allergies and asthma run in families, so I often see kids in groups, and help parents find the resources to control their own asthma. This is helpful especially when it is time to do allergy testing. I perform skin testing using drops of oil that contain various common substances that children are allergic to. Children are often apprehensive about skin tests, but are more comfortable when they see older members of the family go first. After applying the allergy extracts (using a plastic device that "pricks" the oil into the skin) we wait 15 minutes to see which extracts cause a reaction. Depending on what the child is allergic to, we can sometimes help them to avoid or at least predict when they will have more problems. Simply knowing that the patient does have allergies at all helps predict how effective some of the medications will be.

Once asthma is effectively controlled, the children are able to do everything that normal children are supposed to do without limitations from their asthma.  It’s great to be a part of this solution and help kids, like Sam, learn about triggers, get the proper medication, and take control of their asthma.

*patients’ names changed to protect privacy

Photo Friday: Lead Heads Show Benefits CHF

Will you be in NYC this weekend? Do you enjoy the music of the Grateful Dead?

If yes, come check out the Lead Heads, America's only teen Grateful Dead tribute band, at The Bitter End this Sunday, May 1. For the third year in a row, the Lead Heads are contributing all proceeds from ticket sales to CHF!

Visit the event site to buy your tickets today: www.leadheads.net/tickets.html

News From Our Programs Across Country

By Arturo Brito, MD, MPH, Chief Medical Officer & Executive Vice President, Children’s Health Fund

With 24 CHF programs in 16 states, it’s not surprising that there is a lot going on within our National Network. We thought our readers would love to hear some of the exciting things happening within our programs around the country. Enjoy!

The construction of the brand new Pediatric Center of Excellence at the Chiricahua Community Health Center, home of the Southern Arizona Children’s Health Project, has been completed and they expect to begin seeing children in early June. This new site will allow them to see more children and provide additional services, such as subspecialty care, helping to meet the complex needs of the many children with special health care needs living within their service area.

The New Jersey Children’s Health Project is currently coordinating an expansion into Camden, NJ, a city with a large homeless population and high crime rate.

The mental health team at the Mississippi Gulf Coast Children’s Health Project received a grant from BP last year and they have been using those funds for the development and implementation of a Peer Listening Program. They anticipate this program will be very useful for helping children cope with stress they experience around hurricane season and other natural disasters as well as the oil spill.

CHF’s Center for Community Health Technology (CCHT) recently trained the Baton Rouge Children’s Health Project to use eClinical Works, the electronic medical record that CHF uses and has developed content for. By all accounts, BRCHP staff is happy with their new EHR system and feel like it will improve their practice flow and allow for more research and publication opportunities. A special thank you to Sue Spalding (Medical Director, Dallas CHP) for joining CCHT as part of the training team.

Photo Friday - The Happiest Paint Job In Colorado

►"That's the happiest van I ever saw," a flagman told the driver of Children's Health Fund (CHF)'s affiliate program in Montrose, Colorado.  Joining CHF's fleet of vibrant blue "doctor's office's on wheels," the van funded from a grant from American Idol "Idol Gives Back", is part of our local Child Health Transportation Initiative, a partnership with Telluride Foundation.

Lack of access to reliable transportation is one of the most pervasive barriers to health care for children in the United States, resulting in missed opportunities for routine well-child care, increased incidence of untreated chronic illnesses, increased use of emergency rooms for non-emergency care, and an increase in preventable hospitalizations.  The local program in Colorado offers patients living in three counties a ride to follow-up and special medical and dental apppointments if they do not have their own transportation to get them there.

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