When it comes to community stewardship, nurses are naturals.

And why wouldn’t they be? Nursing is a profession where helping others is part of the job description and one that attracts folks who are already passionate about doing just that. Community service, in fact, is such an important part of the profession that it is typically woven directly into nursing education.

Ellen Hennessy-Harstad, DNP, RN, FNP-BC, clinical professor of nursing at Indiana University Northwest, recently earned her Doctor of Nursing Practice (DNP) degree. As part of her studies, she developed a community outreach project with the aim of taking clinical research directly to the front lines of care.

She hopes that what began as a pilot project at two local schools, involving a staff of school nurses and 15 adolescents, and with a mission to help those students better control their asthma, will set a precedent for future outreach practices in the profession of nursing.

Hennessy-Harstad’s special interest in asthma began early in her career, when she worked as a pediatric nurse.

“(At that time), we didn’t know exactly what was triggering asthma,” she explained. “Was it emotional? Was it physiological? There were a lot of misconceptions about asthma. As I went through my career, working with children with respiratory conditions became my primary focus.”

National guidelines about managing asthma were developed in 1997 and are updated about every five years by the National Heart, Lung and Blood Institute. Unfortunately, Hennessy-Harstad said, the guidelines have been slow to hit the mainstream.

“As (the national guidelines) became more available to people, I began to realize that health providers were not putting them into practice. Why do we have this great set of national guidelines that are not trickling down to the practice level?” she said.

Hennessy-Harstad decided to use those guidelines as the foundation for her DNP project. She set out to bring the research and evidence-based best practices into clearer focus at the community healthcare level.

She sat down with a group of school nurses to identify the roadblocks they were seeing among their adolescent students. She reasoned that, if school nurses could be called in to help empower students to learn how to control their asthma, it would result in fewer asthma episodes and fewer ER visits and hospitalizations.

The school nurses met with the students twice during school hours to monitor the students’ asthma and to provide asthma education according to the national asthma guidelines.

The nurses gave the students tools to use, including an Asthma Control Test and a fact sheet about controlling factors that worsen asthma. They also referred the students and families to their primary healthcare providers to compose an asthma action plan. The nurses made sure the students knew the names and purposes of their medications and how to use them. They also helped the students to identify their asthma triggers.

“We gave them (the students) information to take home and really empowered the adolescents to discuss with their family the things they could change at home to help them control their asthma,” Hennessy-Harstad said.

The schools Hennessy-Harstad worked with cannot be identified because of confidentiality conditions set forth by the school boards and university governing boards. However, Hennessy-Harstad said that nurses at both schools stated that they found significant value in the project and have continued to implement it across their entire school populations of students with asthma.

Moving forward

Linda Delunas, PhD, RN, CNE, Director of the School of Nursing and Associate Dean of the College of Health and Human Services, praised the project and its implications for the future of nursing education and care at the community level.

“This was an important project because it showed how collaboration between the School of Nursing and our community partners can really impact the health of the community,” she said. “Asthma rates in Northwest Indiana are high and while we know a lot about evidence-based standards of care for asthma, those standards are not always used. Professor Hennessy-Harstad was able to demonstrate that by implementing those evidence-based standards according to national guidelines, it can make a difference in asthma control.”

Hennessy-Harstad welcomed the prospect of working with other school nurses and administrators who want to implement similar programs at their schools.

“The more we can do to support and empower the school nurse to function at the level of their education and experience,” she said, “the more healthcare providers we have in the community.”

Hennessy-Harstad said she plans to involve her IU Northwest nursing students in her future projects at the community level.

“It’s fundamental,” the professor said. “Nurses are healthcare providers and educators and we coordinate care across settings. For the students to be actively involved in seeing how those roles come together when you do a community project is an essential part of their (students’) learning.”

Hennessy-Harstad holds an undergraduate degree in philosophy from Loyola University and an undergraduate nursing degree from St. Xavier University in Chicago. She earned her master’s degree in nursing with a parent-child focus from Valparaiso University and did her post-master’s work as a family nurse practitioner. Her Doctor of Nursing Practice degree is also from Valparaiso University.

In addition to her duties at IU Northwest, Hennessy-Harstad works in a pediatrics and family practice office in Munster and Merrillville.

School nurses and administrators who are interested in implementing a similar asthma project at their schools may contact Hennessy-Harstad at (219) 980-6883 or ebhennes@iun.edu.