UNIVERSITY OF ALABAMA AT BIRMINGHAM, SCHOOL OF NURSING

WHO Collaborating Centre for International Nursing

DIRECTORS

Doreen C. Harper
Adelais Markaki

STAFF

Lisa Theus

RESOURCE FACULTY

Allison Shorten

TERMS OF REFERENCE

Support PAHO/WHO’s efforts to strengthen the quality of nursing education and practice based on Universal Access to Health, Universal Health Coverage, and Primary Health Care.

Collaborate Support PAHO/WHO’s efforts to nhance the use and dissemination of knowledge resources that build capacity and leadership for nurse and midwife educators.

This institution is a member of the
WHOCC MIDWIFERY NETWORK

ANNUAL REPORT 2020

UABSON Faculty and staff with International Visiting Scholars (IVS) and students.
From Left to Right front row: Ong-on Prajankett (IVS), Jackie Moss, Allison Shorten, Ada Markaki, Xiao Chunhong (PhD student), Doreen Harper (Dean), Paulina Banda (IVS), Tejossy John (Global Health Student Intern), Maria Shirey, Rita Jablonski, Silvia Gisiger-Camata, Prasert Kham-ai (PhD student).
From Left to Right back row: Lisa Theus, Marie Bakitas, Richard Taylor, and Yasmine Turkman.

1) Literature review on Academic Nursing Service Partnership initiatives and article publication
We are conducting a systematic literature review to identify and compare existing academic nursing / service partnerships in the PAHO region (Completion: Summer, 2020).

2) Training, coaching, and piloting of the Educational Quality Improvement (EQI) Toolkit
Developed during our previous designation period, the EQI Toolkit will be disseminated and pilot tested in two sites within the PAHO region (Planned for: 2021-2023).

3) Piloting and evaluation of “Quality improvement in nursing and midwifery educational programs: a three-module online course for life-long learning”
Pilot phase is in progress of this new online course with participants, mostly from Latin America and the Caribbean. (Final report: July, 2020).

4) Capacity building of Advanced Practice Nurses (APNs) in managing patients with non-communicable diseases; special focus on diabetes and cancer
A 5-day on-site program for select nurses from the PAHO region will be organized by UAB SON on management of diabetes and cancer by APNs (Planned for: 2021).

5) Enhancing nursing and midwifery capacity in teaching, research, and mentoring
The International Visiting Scholars Program hosted a scholar from Pontifica Universidad Católica de Chile (program development in palliative care) and one from the Thai Royal Army Nursing College (well-being of community-based aging adults).

6) Interprofessional education (IPE) for nurses caring for vulnerable populations
Development of four “Interprofessional Pearls” webinars for nurse and midwifery educators and practitioners in both English and Spanish. Developed and currently translating; “Trauma informed care” and “Human Trafficking”. Other planned webinars: “Domestic violence” (Completion: 2021).

    • Markaki, A., Wingo, N., Watts, P., Steadman, L., Coles, K., Rae, T., Theus, L. & Ortega, J. (2020). Building capacity for nursing and midwifery education through an asynchronous online course. Journal of Nursing Education 59(1):38-41. doi: 10.3928/01484834-20191223-09. PMID: 31945174

    • Markaki, A., Moss, J., Shorten, A., Selleck, C., Loan, L., McLain, R., Harper, D. (2019). Strengthening universal health and primary health care: development of a nursing and midwifery education quality improvement toolkit. Revista Latino-Americana de Enfermagem, 27:e3188 [Epub 2019 Dec 5] doi: 10.1590/1518-8345.3229.3188 PMID: 31826152 [in English, Spanish, Portuguese].

    • Watts, P., White, T., Rae, T., Agu, C., & Markaki, A. (2019). Sustaining global partnerships for simulation integration: Lessons from the field. International Nursing Review [Epub ahead of print] DOI:10.1111/inr.12570 PMID: 31777078
    • Delegation site visit from Thammasat University Faculty of Nursing; Dr. Teeranut Harnirattisai, Dean and Dr. Wichiya Yolpant, PhD Program Manager. Ongoing collaboration between the two schools provides mentorship to PhD students in carrying out their research proposals and completing the final stages of their dissertation.
    • Hosted presentations by International Visiting Scholars: On palliative care: “Walking with the Sickest of All: the Chilean Reality”, by Paulina Banda, Pontificia Universidad Católica de Chile. On community-based elder care: “Trailing Elderly Care: the US and Thai Experience”, by Ong-on Prajankett, The Royal Thai Army Nursing College
    • Nominated as Nurse Leaders and inducted to Nu Chapter-at-Large, Sigma International Honor Society, two International Visiting Scholars; one from Chile and one from Thailand.
    • Submitted a video for WHO Competition entitled “Nurses Making a Difference” to take place in Geneva, May 16-17, 2020. Click here for video: (link)
    • June 16-18, 2020: Co-sponsors of the Advocacy and Policy 2020 Conference “Strengthening the Voices and Capacities of Health Professionals,” Chiang Mai University, Thailand. A delegation of 7 will be attending.
    • Primary Care Scholars Program (GNEPCS): A UABSON initiative to improve the quality of life for 1.6 million Alabamians living in rural areas affected by health professional shortage. With support from the Daniel Foundation of Alabama, the school aims to increase the number of primary care nurse practitioners, building partnerships and increasing access to health care in rural and underserved areas. GNEPCS focuses on educating more advanced practice nurses to work in underserved areas. It creates a pipeline of nurses from rural Alabama counties for recruitment into primary care nurse practitioner programs as Primary Care Scholars. GNEPCS is structured to produce new curricula for teaching students, develop best practice models, and establish an annual summit for health care providers across the state to learn and share approaches for helping the medically underserved.

    • Nurse Family Partnership (NFP) program: ln 2018, UABSON launched the Nurse Family Partnership (NFP) program to serve low income, high risk, first-time mothers in Jefferson county, Alabama. Nurses visit families in their homes from pregnancy through the baby’s second birthday, and provide timely physical and psychosocial assessments, education, health coaching, advocacy, and support. The program is in its third year and continues to show remarkably improved birth outcomes for mothers and babies, as well as breastfeeding and employments rates as compared with the county and state. For example, the NFP program enrollees in Jefferson County, Alabama preterm birth rate is 9.4% as compared to a 12% county and state rate. Eighty-four percent of NFP mothers in Jefferson County breastfeed compared to a 78% county rate and a 67.5% state rate. Employment is better as well, 74% of local NFP mothers are employed or enrolled in school at 12 months after birth as compared to 65% in Jefferson County and a 61% state rate (mothers employed with children under 6).

    • RNPC Scholars: Building a Resilient Primary Care Registered Nurse Workforce for Chronic Disease Prevention and Control in Alabama: This 4-year, grant-funded project focuses on training and sustaining baccalaureate-prepared RNs in medically underserved areas of the state. This project aims to improve health outcomes in rural areas and educate undergraduate nursing students and practicing RNs in team-focused primary care. Thus far, 20 undergraduate nursing students have enrolled and completed the program. The program created a nurse-led primary care hub with community partners in five Alabama counties (Jefferson, Etowah, Bibb, Shelby and Macon) each designated as a Medically Underserved Area (MUA). Part of the project focuses on providing professional development opportunities for RNs in primary care. To meet this aim, the RNs in Primary Care webcast is available on demand from the UAB Nursing Network. The first annual Primary Care Summit will take place March 26-27, in Birmingham.

ANNUAL REPORT 2019

Nurse educators at UWI-Mona in Jamaica work practice during a UAB faculty-led “Train-the-Trainer in Simulation” course.

1) Development of the Educational Quality Improvement (EQI) Toolkit for nursing and midwifery schools in Latin American and Caribbean (LAC) countries. The toolkit supports undergraduate nursing and midwifery educators in implementing a QI plan that can be tailored to specific needs. It addresses Universal Health and Primary Health Care educational outcomes within the framework of transformative education and competency-based interprofessional collaborative practice. The toolkit is freely available through the school’s website at: https://www.uab.edu/nursing/home/images/OCGP/PAHO-WHO/QI-Toolkit-Joint-Publication.pdf

2) New online course, “Quality Improvement in Nursing and Midwifery Educational Programs – a three-module online course for lifelong learning” for educators in LAC countries. This course, available in English and Spanish, consists of three open-access online modules designed to build workforce capacity. Participants learn key principles of teaching and learning, as well as instructional and evaluation strategies for students and courses. Once pilot testing and evaluation are completed, web link for free access will be widely disseminated.

3) Integrating clinical simulation into nursing and midwifery programs in Jamaica

As part of an on-going partnership with the University of the West Indies-Mona WHOCC, mutual faculty exchanges took place. In Summer 2019, two UABSON faculty, Drs. Penny Watts and Tracie White, visited UWI-Mona campus for a train-the-trainer 4-day clinical simulation and on-site consultation. On-going support has been provided through virtual follow-up meetings. In January 2019, UABSON hosted an International Visiting Scholar from the UWI School of Health Professions and Nursing. Ms. Chinwendu Agu, a midwife lecturer and PhD student, was trained in High Fidelity Simulation midwifery scenarios and explored potential research collaboration on the topic of substance use among pregnant women.  

4) The following peer-reviewed presentations and posters related to WHOCC work were given:

    • Markaki, A., Shorten, A., Moss, J., Selleck, C., & Harper, D. (2018, July). A framework for global health action: making SDGs our school of nursing’s business. Paper presented at the 12th Biennial Conference of the Global Network of WHO Collaborating Centers for Nursing and Midwifery, Cairns, Australia.
    • Markaki A, Shorten A, Dawson M, Enah C, Gakumo A, Johnson K, Ladores S, McLain R, Sample N, Speck P, Theus L, Turkman Y, Moss J, Selleck C. (2018, November). Global health in action: raising faculty awareness and engagement. Poster presented at the Sigma Nu Chapter 60th Celebration, Birmingham, AL.
    • Markaki, A., Harper, D. (2018, November). Embracing universal health and primary health care: a paradigm shift for nursing and midwifery education? Paper presented at the XVI Pan American Colloquium of Nursing Research, Havana, Cuba.
    • Markaki, A., Moss, J., Shorten, A., Selleck, C., Loan, L., McLain, R., Miltner R, Patrician P, Theus L, Ferrer L, dos Santos Nogueira de Goes F, Valenzuela Mujica MT, Zarate Grajales R, de Bortoli Cassiani SH, and Harper, D. (2019). Strengthening universal health and primary health care: development of a nursing and midwifery education quality improvement toolkit. Revista Latino-Americana de Enfermagem, 27:e3188.  DOI: 10.1590/1518-8345.3229.318

    • Markaki, A., Wingo, N., Watts, P., Steadman, L., Coles, K., Rae, T., Theus, L. & Ortega, J. (2019). Building capacity for nursing and midwifery education through an asynchronous online course. Journal of Nursing Education [in press].

    • Site visit by PAHO/WHO Regional Officer, Dr. Silvia Cassiani, who met with UABSON administration, faculty, and the Global Partnerships Advisory Board. The visit included presentation of WHOCC deliverables completed as part of the 2015-2019 Terms of Reference, and a tour of the new SON facilities.
    • Sigma Nu Chapter 60th Anniversary Celebration and 17th Annual Alumni Event.  A Global Leadership in Nursing panel, moderated by WHOCC Deputy Director, Dr. Ada Markaki included presentations by: Wipada Kunaviktikul, Professor and Dean, Faculty of Nursing of Chiang Mai University in Thailand; Larry Slater, Clinical Associate Professor at the Rory Meyers College of Nursing at New York University; Patrician Thompson, CEO and past president of Sigma; and Constance Smith Hendricks, Dean, Tuskegee University.
    • Global Partnerships Advisory Board meeting – The annual meeting took place in November, 2018 concurrent with the PAHO RO’s visit. The Advisory Board is comprised of UAB and external stakeholders with expertise or special interest in global work and outreach.
    • Primary Care Scholars Program (GNEPCS): A UABSON initiative to improve the quality of life for 1.6 million Alabamians living in rural areas affected by health professional shortage. With support from the Daniel Foundation of Alabama, the school aims to increase the number of primary care nurse practitioners, building partnerships and increasing access to health care in rural and underserved areas. GNEPCS focuses on educating more advanced practice nurses to work in underserved areas. It creates a pipeline of nurses from rural Alabama counties for recruitment into primary care nurse practitioner programs as Primary Care Scholars. GNEPCS is structured to produce new curricula for teaching students, develop best practice models, and establish an annual summit for health care providers across the state to learn and share approaches for helping the medically underserved. 

    • Nurse Family Partnership (NFP) program: ln 2018, UABSON launched the NFP program to serve low income, high risk, first-time mothers in Jefferson county, Alabama. Nurses visit families in their homes from pregnancy through the baby’s second birthday, and provide timely physical and psychosocial assessments, education, health coaching, advocacy, and support. During the program’s first year, birth outcomes for mothers and babies were remarkably improved, while impacting select social determinants of health for families participating in the program.

    • Building a Resilient Primary Care Registered Nurse Workforce for Chronic Disease Prevention and Control in Alabama: This 4-year, grant-funded project focuses on training and sustaining baccalaureate-prepared RNs in medically underserved areas of the state. This project aims to improve health outcomes in rural areas and educate undergraduate nursing students and practicing RNs in team-focused primary care. Over the grant period, it will create a nurse-led primary care hub with six community partners, expanding existing and creating new academic-practice partnerships in various counties across the state. The sites will serve as clinical training locations for BSN students focusing on primary care nursing with an emphasis on chronic disease prevention and control in diabetes, high blood pressure, mental health and substance abuse. Part of the project will also focus on building a resilient workforce by providing the primary care RN workforce with skills to cope with the challenges of caregiving and the unique needs of vulnerable populations.

UAB School of Nursing Global Partnerships Advisory Board (November 13, 2018)

Front row: Janet Turan, Doreen Harper, Dr. Silvia Cassiani, PAHO Regional Officer, and Lisa Theus. 

Second row: Jacqueline Moss, Maria Shirey, Lynda Wilson.

Third row: Allison Shorten, Comfort Enah, Juanzetta Flowers.

Fourth row: Rubin Pillay, Ada Markaki, Jeannie Horton Michael Saag.

Top row: Cindy Selleck, Dr. Wipada Kunaviktikul, Dean of the Chiang Mai University Faculty of Nursing, Majd Zayzafoon.