Role of APRNs in Promoting Population Health Within the Context of International Medical Mission Trips

Monday, 18 November 2019

Elizabeth Ann Hoover, DNP
College of Health and Public Administration, Franklin University, Columbus, OH, USA

Advance Practice Registered Nurses (APRNs) can make meaningful contributions toward improving population health outcomes by working collaboratively within an interprofessional team on short-term international medical missions (STM). Historically international STMs lack consideration of how the trip might affect current efforts to provide health care within the country, how the efforts will be sustained, self-empowerment of the people served, and coordination of care between various members of the health care team (Hensley,2016) (Lough, Tiessen and Lasker, 2018). APRNs are well qualified to assist interprofessional teams to review current evidence related to STMs and translate into best practices for improving global population health.

This presentation provides an example of STM team approach in rural area of Honduras. This STM is a partnership between church volunteers and the organization of Heart to Honduras (www.hth.org ). The team has adapted a transformational approach based on the concept of helping without hurting (Corbett, 2014). The approach utilized an interprofessional team to gather information for a community assessment. We found a need to improve communication on current initiatives and link leaders between communities.

Using constructs of the World Health Organization Conceptual Model on Social Determinants of Health the team planned visits to include meeting with leaders within schools, government, churches, and the community. Mission team activities have been aligned to support the Heart to Honduras community development program. These activities support patient- centered approaches and the use of self-empowerment. Annual STM trips help to add to the understanding of current resources. Activities include relationship building through both face to face visits and email correspondence to support the growth of the community. This assists in identifying talents and facilitating processes for sustainable change that benefits the health of the population (H3C). Some of the specific activities this team has undertaken include:

  1. Facilitated community leaders to address financial issues related to maintenance of water

filtration system and water conservation activities.

  1. Identified group of women leading a campaign to promote good hygiene practices with

pilas( sinks) and toilet areas and encouraged expansion of into neighboring

village.

  1. Identified volunteer first aid stations in community and are exploring possible replication in other areas.
  2. Incorporated teaching healthy behaviors nutrition, exercise, hygiene, self -care and

the importance of immunizations into Compassion International classes in the village.

  1. Included a nurse from the village to participate in our medical team clinic to reinforce good practices for water hygiene and trash disposal.
  2. Participated in home visits to help reach out to families needing resources for care

of a handicapped child.

  1. Led training for a group of lay people in remote village wanting to give first aid

including techniques for suturing for farmers.

  1. Provided participants in medical clinic information about nearby resources

for follow up on acute and chronic illness, prenatal care, and immunizations.

9.Visited a local school and encouraged community leaders to explore ways to provide

additional classroom space and teachers to meet needs of the community.

  1. Met with local government representative and advocated for the need for

improved sanitation and electricity in the local community and nearby villages..

  1. Took into consideration of a barrier to water purification in a second village that was

unable to use disinfecting bleach due to organic farming of coffee but did not have

water filtration system.

APRNs can consider adopting similar approaches for their own mission trips through collaborative partnerships. There is a lack of research on the effectiveness of STM (Sykes, 2014). Future APRN research could examine different approaches and establish best practice guidelines for volunteer medical mission trips with goals to improve population health outcomes.