Chronic Disease: A Self-Management Educational Experience for APRN Students

Thursday, 15 July 2010: 4:25 PM

Pamela Willson, RN, PhD, FNP, BC
College of Nursing, Prairie View A & M University, Houston, TX
Jane A. Anderson, PhD
Neurology Care Line, Michael E. DeBakey VA Medical Center, Houston, TX

Purpose: Advanced Practice Registered Nurses (APRN) students are expected to become competent in the management of patients with stroke and multiple complex health conditions, utilize national guidelines for secondary prevention of disease, and to counsel patients on self-management preventive health behaviors. The purpose of this project was to carry concepts throughout two courses and provide an education-practice link to improve student competencies.
Methods: In an APRN faculty practice, the Self-management TO Prevent (STOP) Stroke Clinic focused on the provision of secondary prevention interventions for persons who experience stroke or transient ischemic attack. The STOP Stroke clinic provided a learning experience where secondary prevention was implemented in an integrative process that combined 1) clinical management, 2) patient education, and 3) patient self-management. Nurse practitioner students supervised by faculty served as patient care providers.  Clinical management of patient stroke risk factors was guided by protocols. The Stanford Chronic Disease Self-Management Course served as the framework for stroke self-management and allowed NP students to follow clients weekly for 8 weeks. Additionally, a computerized template-based tool facilitated the care delivery process by providing automating guideline adherent documentation. Two courses were linked in sequence of course content—Management of Complex Health Problems (2 hours of didactic: 20 hours of practicum) and Chronic Disease Self-Management Counseling (3 course credit elective). Knowledge and skills for advanced competencies were taught in these two didactic courses during the same semester.
Results: Knowledge of stroke self-management added to the students skill sets, demonstrating theoretically based (self-efficacy, health prevention) patient education methods and materials. By linking two courses—a core course (management of complex health problems) and an elective (chronic disease self-management) nurse practitioner faculty were able to provide a learning experience that demonstrated translation of evidenced based medicine.