Nursing Update 2007 - 2008 - Yale-New Haven Hospital

School-based nurses
keep teens in the care loop
Adolescents aren’t likely to go to the doctor
on their own, and even parents who have
insurance may be too busy to get them there.
As a result, advanced practice nurses at seven
YNHH school-based health centers (SBHC) in
the greater New Haven area provide on-site
services, including primary health assessments
as well as diagnosis and treatment of major and
minor illnesses.
In 2007, the YNHH SBHCs treated nearly 9,000
students in elementary, middle and high schools
in Branford, Hamden and New Haven. Nurses
may treat or advise students on diabetes, obesity,
pregnancy and sexually transmitted diseases.
Lynn Peckham, advanced practice registered
nurse in New Haven’s Sheridan Middle School,
said the most prevalent problem she sees among
students is asthma. She explains that schoolbased
nurses make an impact in helping students
manage asthma so they can stay in school and
out of the hospital. In addition, YNHH social
workers work on-site at the SBHCs and help
students with anger management, anxiety,
depression and phobias.
In addition to providing an important link
between students and additional community
services, school-based nurses establish YNHH as
a medical home for those who don’t have one.
They also provide health education that gives
students a firm understanding of the importance
of taking responsibility for their own
health.
Nurses help detect cancer
early in the community
If success means convincing women to take
responsibility for their health, the Connecticut
Breast and Cervical Cancer Early Detection
Program for medically underserved women is
making its mark. Working out of the YNHH
Department of Community Health, the staff has
always had to make multiple calls to get some
patients in for screenings, but lately more women
have been seeking out the program and making
appointments themselves.
Christine Galla, R.N., case manager, gives credit to
media marketing efforts and vigorous outreach.
YNHH, one of 18 sites in the state to offer cancer
screening through this program, sends outreach
workers to churches, hair salons and housing
projects to educate women. The program provides
Pap smears to women 19 to 64 years of age
who have no insurance coverage or prohibitive
deductibles, and mammograms to medically
underserved women who are 40 and older.
The program especially hopes to reach older
women, who are likely to avoid mammograms;
and African-American and Hispanic women,
who have the highest mortality rate among all
racial and ethnic groups.
In the grant’s fiscal year that ended in June 2007,
the Early Detection Program made outreach visits
to 902 women at 20 locations in the greater New
Haven area, and provided services to 251 women.
Last July, YNHH launched a digital mammography
van, the first in Connecticut, to provide mammograms
to women where they live and work.
Stroke team takes the
offensive against brain attacks
Since YNHH revamped its stroke program,
nurses have played a key role in helping the
hospital earn the distinction as a Joint Commission
Primary Stroke Center, providing acute
and recovery care for the more than 600 stroke
patients the hospital admits each year.
Karin Nyström, A.P.R.N., clinical coordinator,
said the stroke program and neuroscience units
at YNHH offer rich opportunities for nurses interested
in research or clinical nursing. They can
participate on multidisciplinary teams specially
trained to evaluate and treat stroke and other
cerebrovascular diseases. Nurses also collaborate
with the YNHH Emergency Department to
enhance the effective use of the clot-dissolving
agent tPA.
YNHH was the first hospital in southern Connecticut
and the fourth in New England to
become nationally certified as a Primary Stroke
Center by The Joint Commission.
In addition, YNHH nurses are actively involved
with the program’s Stamp Out Stroke (S.O.S.)
team, which educates people in the community
to recognize symptoms of stroke and get to the
hospital by calling 9-1-1 within the three-hour
window when treatment is most successful.
While the program has yet to measure the clinical
outcomes of these efforts, Nystrom believes
outreach, close teamwork and cutting-edge
treatments are making a powerful impact in the
diagnosis and treatment of stroke.
Every woman in New Haven should make appointments for
annual mammograms and cervical screenings. Unfortunately,
needy women have incredibly difficult lives – they have to get
past economic and transportation barriers, not to mention the
fear barrier. At YNHH, we are reaching these women and letting
them know we can help. Their health is important to us.”
— Christine Galla, R.N., Case Manager, Connecticut Breast and Cervical Cancer
Early Detection Program
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