Last month, Susan Gaunt visited a seniors apartment complex to talk to residents about strokes. As the neuroscience clinical nurse specialist at Gwinnett Health System's stroke unit, part of her mission is to raise community awareness about strokes. She makes presentations and conducts screenings at churches, civic organizations and corporations to help people determine their risk factors.
"Not enough people know the causes, symptoms or what to do when it happens. Community education for stroke has lagged behind other diseases," said Gaunt, RN, MS, CCRN, CNRN.
Someone suffers a stroke every 45 seconds, yet only a small percentage of patients make it to the hospital within the threehour window for them to benefit from TPA, the only FDAapproved drug that saves lives and decreases disabilities in stroke patients.
When Gaunt saw only about eight people show up for the apartment presentation, she was disappointed. "But then later, I heard that one of the participants recognized the symptoms of a TIA (transient ischemic attack) and had the sense to call 911 and get to the hospital. That talk bore fruit," she said.
"Prevention education is a quiet thing," she added. "It doesn't grab you like other lifesaving measures, but when you consider that a woman was saved from disability and high hospital costs - how do you put a monetary value on that? If you only get a higher-quality outcome in one case, it's worth going out."
Spiraling costs, an aging population and epidemic growth in some diseases and conditions (like diabetes and obesity) have more health care systems taking their expertise and resources to the community.
"We're in the business of caring
for people, and that doesn't
mean just when they're sick,"
said Tara Robinette, CHES,
MeD., coordinator of health
education and wellness at Gwinnett
Health System.
Classes, screenings, support groups and wellness programs are growing, as hospitals, community organizations, insurance companies and corporations look at the bigger picture ofkeeping a nation healthy.
"The trend is toward keeping people well and out of the hospital," Robinette said. "We're seeing better patient outcomes; cost savings for patients, the health care system and employers; and a better quality of life that is good for the community as a whole. An ounce of prevention is definitely worth a pound of cure."
Education and rehabilitation
So what does prevention look like?
For Danita Turner, RRT, manager of the respiratory care department at Gwinnett Health System, it means educating cardiac and pulmonary patients in the hospital and getting them enrolled in 12 weeks of rehabilitation at the hospital's gym, where they learn how to exercise and manage their diseases. With the aim of preventing second heart attacks and worsening conditions, the Gwinnett Health System plans to double the size of its rehab gym in its next expansion.
"We've seen a growth in our clientele since Medicaid changed its reimbursement practices for rehabilitation and smoking cessation classes," Turner said.
With a $25,000 smoking cessation grant from the Department of Public Health, her staff starts educating patients in the hospital and follows up frequently for a year.
"The amount of information out there is overwhelming to most people, but our program is working because we offer a personal touch," Turner said. "We tell people that most smokers try seven times before they actually quit. Instead of wagging our finger at them or letting them beat themselves up, we act as coaches and mentors to encourage them to keep at it.
"If we can keep even one person from dying a horrible death from emphysema or lung cancer, it's worth it."
As manager of wellness services, Stacey Zehnder, CHES, plans community and corporate health-risk assessments, prostate and colo-rectal screenings, and lunch-and-learn talks on subjects from obesity to new drug therapies.
"There are a lot of mixed messages out in the media," Zehnder said. "As health educators, it's our mission to share accurate information and resources. People need a trusted source."
"As clinicians, we have so much opportunity to educate the public because we see what happens in the hospital. We know the latest in stroke and heart disease treatment. People want to know that, and they're so appreciative," Gaunt said.
People are taking a more active role in their own health care, by getting flu shots and screenings, for example, said Zehnder. Gwinnett Health System is sponsoring support groups for more diseases.
"Educator-led support groups are another way of educating people about chronic diseases and making good choices," Zehnder said.
Knowing that people learn in different ways, health educators use a variety of verbal, written and video means to convey their messages.
"I see the health educator's role as planting seeds. They may not use them immediately, but you keep giving people information to add to their knowledge bank, and you encourage them," Robinette said.
Some of the most tangible rewards
come after screenings, when patients call
to say they didn't know their blood pressure
or blood sugar levels were elevated
and seek help, Zehnder said. "They just
want to say thanks."
Sometimes that person is a worker from the hospital, who took advantage of an employee wellness program screening or talk.
"We can't assume that workers always
know their own risks," Robinette said.
"We have to find ways to remind them
they need to take care of themselves so
they can take care of their patients."
Promoting wellness in DeKalb
For 20 years, DeKalb Medical Center
has supported wellness among its staff
and the community through the Wellness
Center, a gym on the hospital campus
that offers discount memberships to staff. The program's yearlong fitness contest
gives incentives for teams of employees to
work out and helps boost morale.
The Wellness Center offers classes, including weight loss, nutrition, water aerobics, yoga, meditation and healing touch massage to its 2,000 associates and community members.
"The center dramatically affects the overall health of the community, as well as improving employee health and patient care," said Gail Winfrey Winston, RN, MSN, director of health promotion and the Wellness Center. "Fit people have fewer sick days, and those who exercise find it easier to give up other risky habits, like drinking, smoking or over-eating. Our hospital associates are our ambassadors in the community, and it speaks volumes when you have a healthy work force."
Many Wellness Center community members come from the hospital's clinical units that treat heart disease, stroke, diabetes, osteoporosis, arthritis or cancer.
"The former patients can transition easily from doing rehab to becoming a member," Winston said. A full schedule of informational meetings and fun activities is offered to seniors through the Senior Spectrum Plus program.
One of the most popular center activities is the physician-supported Talk About Health series, presented in the community on subjects that include sleep disorders and pregnancy. The Stroke Train the Trainer program is an outreach to train people in organizations to prevent and recognize stroke.
"It's a grass-roots effort to blanket the area with information and decrease the amount of strokes," Winston said.
Winston was an ER nurse for 10 years before coming to work at the Wellness Center. She's been the director since 2003.
"Education has always been a huge part of nursing, and this is education at its best," she said. "It's so much fun to see people improve. Working in the ER was about saving lives, but so is this. We're also about improving the quality of life."