NPWH Announces Heather L. Maurer as New CEO

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The NPWH Board of Directors is pleased and proud to announce its selection of Heather L. Maurer as the organization’s new CEO. She will assume her leadership role on April 13.

Transdermal or Oral – Which is better for hormone administration?

Many people prefer to simply swallow their medication as it’s quick and easy. But is the oral route the best way to replace hormones?

Etiology of hypoactive sexual desire disorder and implications for treatment: 
Four case scenarios

Faculty: Brooke M. Faught, DNP, WHNP-BC, NCMP, IF, is Clinical Director, Women’s Institute for Sexual Health, Division of Urology Associates; and Adjunct Professor, Vanderbilt University School of Nursing, both in Nashville, Tennessee.

Susan Kellogg-Spadt, PhD, CRNP, IF, FCST, CSC, is Director, Female Sexual Medicine, Center for Pelvic Medicine, Bryn Mawr, Pennsylvania; Professor, OB/GYN, Drexel University College of Medicine and Rutgers/Robert Wood Johnson College of Medicine; Professor, Human Sexuality, Widener University; Faculty, University of Pennsylvania Colleges of Medicine and Nursing and Thomas Jefferson University Department of Couple and Family Therapy; and AASECT certified sexuality counselor/FCST certified sexuality therapist.

Intended audience: This continuing education (CE) activity has been designed to meet the educational needs of nurse practitioners and other healthcare providers who provide primary care for women.

CE approval period: Now through April 30, 2022

Estimated time to complete this activity: 1 hour

CE approval hours: 1.0 contact hour of CE credit, including 0.25 contact hours of pharmacology content

Goal statement: To apply one’s knowledge about the etiology of hypoactive sexual desire disorder (HSDD) in order to select an appropriate therapeutic approach for each woman in whom the disorder is diagnosed.

Needs assessment: About 10% of women—a substantial proportion of a healthcare provider’s (HCP’s) patient population—experience HSDD. The underlying cause of HSDD in a given case may be a simple physiologic one, although in most cases, it is multifactorial. HCPs need to ascertain the likely cause(s) of each woman’s loss of sexual desire and design a treatment plan best suited for her.

Educational objectives: At the conclusion of this educational activity, participants should be able to:

1. Identify patients whose symptoms are suggestive of HSDD.

2. Ascertain physiologic, sociocultural, psychological, and interpersonal factors that might be relevant in each case of suspected HSDD.

3. Diagnose HSDD and consider which nonpharmacologic and/or pharmacologic approaches might be optimal in each case.

Accreditation statement: This activity has been evaluated and approved by the Continuing Education Approval Program of the National Association of Nurse Practitioners in Women’s Health (NPWH), and has been approved for 1.0 contact hour of CE credit, including 0.25 contact hours of pharmacology content.

Faculty disclosures: NPWH policy requires all faculty to disclose any affiliation or relationship with a commercial interest that may cause a potential, real, or apparent conflict of interest with the content of a CE program. NPWH does not imply that the affiliation or relationship will affect the content of the CE program. Disclosures provide participants with information that may be important to their evaluation of an activity. In addition, faculty will identify any unlabeled/unapproved uses of drugs or devices discussed in their presentations. 

Brooke M. Faught, DNP, WHNP-BC, NCMP, IF, discloses that she serves as a consultant, speaker, advisory board member, and/or researcher for AMAG, Therapeutics MD, Lupin, Trophikos, JDS Therapeutics, and Ipsen.

Susan Kellogg-Spadt, PhD, CRNP, IF, FCST, CSC, discloses that she serves as a consultant, speaker, and/or advisory board member for Materna, Duchesnay, Ipsen, Lupin,
MiddlesexMD, AMAG, Therapeutics MD, and Bonafide.

Disclosure of unlabeled/unapproved use: NPWH policy requires authors to disclose to participants when they are presenting information about unlabeled use of a commercial product or device, or an investigational use of a drug or device not yet approved for any use.

Disclaimer: Participating faculty members determine the editorial content of the CE activity; this content does not necessarily represent the views of NPWH. This content has undergone a blinded peer review process for validation of clinical content. Although every effort has been made to ensure that the information presented is accurate, clinicians are responsible for evaluating this information in relation to generally accepted standards in their own communities and integrating the information in this activity with that of established recommendations of other authorities, national guidelines, FDA-approved package inserts, and individual patient characteristics.

Successful completion of the activity: Successful completion of this activity, J-20-02, requires participants to:

1. “Sign In” at the top right-hand corner of the page npwh.org/courses/home/details/1464 if you have an NPWH account. You must be signed in to receive credit for this course. If you do not remember your username or password, please follow the “Forgot Password” link and instructions on the sign-in page. If you do not have an account, please click on “Create an Account.”*

2. Review the educational objectives, disclosures, and disclaimers on the next page and then click the “Continue” button.

3. Study the materials in the learning activity during the approval period (now through April 30, 2022).

4. Complete the post-test and evaluation. You must earn a score of 70% or higher on the post-test to receive CE credit.

5. Print out the CE certificate after you have successfully passed the post-test and completed the evaluation.

*If you are an NPWH member, were once a member, or have taken CE activities with NPWH in the past, you have a username and password in our system. Please do not create a new account. Creation of multiple accounts could result in loss of CE credits as well as other NPWH services. If you do not remember your username or password, please either click on the “Forgot Username” or “Forgot Password” link or call the NPWH office at (202) 543-9693, ext. 1.

Commercial support: This activity is supported by an educational grant from AMAG Pharmaceuticals, Inc.

Before reading the article, click here to take the pretest.

Arousal and orgasmic dysfunction in women

Disorders of female arousal and orgasm induce frustration in healthcare providers for many reasons. Approximately 1 in 20 women in the United States report bothersome sexual problems specifically related to arousal and orgasm, yet there remain no US Food and Drug Administration–approved treatment options available to manage these conditions. This article includes methods for diagnosing female sexual arousal disorder and female orgasmic disorder and reviews off-label and nonpharmacologic treatment options for these conditions.   

A Message from NPWH on COVID-19

Dear NPWH Members,

On behalf of the NPWH Board of Directors and Staff, we want to express our sincerest compassion, appreciation, and support to all of our members during this challenging time. As a professional organization serving nurse practitioners, we are honored to represent our members on the front lines of the COVID-19 pandemic, caring for women and their families, and we earnestly thank you. It is the heroic work of nurse practitioners and healthcare workers around the globe that will see us through this storm together.

Editor-in-chief’s introduction April 2020

beth kelsey editor chiefDear Colleagues,

We are pleased to present our readers with this special issue focused on sexual health. Together, the authors of these articles provide up-to-date, evidence-based information on common female sexual disorders that impact quality of life for our patients and challenge us in our clinical practice. The sexual disorders covered include dyspareunia in both young and postmenopausal women, hypoactive sexual desire disorder with a focus on premenopausal women, and sexual arousal and orgasmic disorders.

ACOG, CDC Recommend Separating Mothers With Confirmed Or Suspected COVID-19 From Newborns For Up To A Week Or More

USA Today (3/26, Rodriguez) reports “pregnant women who become infected with the new coronavirus or are exposed to the illness it causes face more distressing news: possible separation from their newborn for up to a week or more.” The article says that the American College of Obstetricians and Gynecologists and the CDC both recommend that course of action “to stop the potential spread of the virus from mother to child.” According to the new guidelines, “facilities should consider temporarily separating the mother who has confirmed COVID-19 or is a PUI (person under investigation) from her baby until the mother’s transmission-based precautions are discontinued.”

Managing 
postmenopausal 
dyspareunia: 
An update

Many women experiencing postmenopausal dyspareunia do not mention it at routine office visits. In this article, the author guides women’s healthcare providers in starting the conversation to identify the problem, performing an evaluation to confirm the presence of an underlying cause—most likely genitourinary syndrome of menopause (GSM)—and implementing an individually tailored approach to diminish both GSM symptoms and the resulting dyspareunia.

Key words: menopause, postmenopausal dyspareunia, genitourinary syndrome of menopause, vulvovaginal atrophy, sexual intercourse

NPWH Member Spotlight: Kim Choma, DNP, WHNP-BC

We are excited to continue our NPWH Member Spotlight feature, where we highlight different members and their journey to becoming an NP. Our latest Member Spotlight is Kim Choma, DNP, WHNP-BC. Click here to read her story. If you would like to nominate a member or yourself to be highlighted, please email jknox@npwh.org

Nurses, nurse practitioners, and nurse midwives on the front lines of COVID-19: How do we protect the nursing workforce?

Today, we cannot escape the turmoil of living every moment of every day immersed within the chaos of the novel COVID-19 pandemic. Registered nurses (RNs), nurse practitioners (NPs), and nurse-midwives (MWs) are on the front lines of these unprecedented times and are concerned for their patients and the unknown potential adverse effects of COVID-19, the effects on their personal and family’s health and well-being, and the communicability within the neighborhoods in which they live and work.

Study Reveals Correlation Between Endometriosis And IBS Among Adolescents And Women With And Without Endometriosis

Healio (3/21, Jaramillo) reported researchers “revealed a correlation between endometriosis and irritable bowel syndrome [IBS] among adolescents and women with and without endometriosis.” The study found that “more adolescent patients with endometriosis had comorbid IBS (54 of 224 patients) vs. those without endometriosis (7 of 99 patients).” The study also found that “patients with endometriosis had a 5.26-fold higher risk for IBS.”

The findings were published online in Clinical Gastroenterology and Hepatology.

Researchers Say Coronavirus Does Not Appear To Pass From Pregnant Women To Infants

TODAY (3/16, Pawlowski) reports researchers in China “followed four pregnant women” with coronavirus in Wuhan “who gave birth to full-term infants,” and found that “none of the three infants whose parents gave consent for them to be checked for the illness tested positive for the virus.” The findings published in Frontiers in Pediatrics are consistent with previous research that indicated the virus is not transmitted from mothers to their babies. The article says that the American College of Obstetricians and Gynecologistscurrently has “no recommendations about how COVID-19 should be evaluated or managed specifically in pregnant women.” However, on Friday, ACOG issued a practice advisory that “said even though pregnant women don’t seem to be at increased risk for COVID-19, they should still be considered an at-risk population given that other respiratory infections like the flu can pose a danger to them.” Dr. Iffath Hoskins, chairwoman for ACOG in New York, said, “The patients are clearly very concerned – every mother is concerned for her fetus.”

CDC to hold webinar on COVID-19 & maternal care

Editor’s Note 3/11: The following is an an announcement from the Centers of Disease Control and Prevention about an update to its upcoming webinar on care for pregnant women during the COVID-19 outbreak.

Pharmaceutical compounding and its impact on women’s healthcare

As I mentioned in my introductory article, I was a pharmacist who loved compounding before I retired and began writing more seriously. And, as I compounded products for women that were unavailable in Canada, I became increasingly interested in women’s health issues. But, before I describe what I learned while using compounding to solve women’s health problems, I wanted to explain just what compounding is and how patients and practitioners can benefit from this specialized skill of pharmacists.

COVID-19 pregnancy and breastfeeding: What NPs need to know

NPWH is monitoring CDC recommendations regarding coronavirus disease 2019 (COVID-19) prevention and control. We especially encourage nurse practitioners and other healthcare providers who provide care for pregnant and postpartum women to regularly check the CDC website for updates.

The CDC’s Interim guidance is available for: Inpatient obstetric healthcare –https://www.cdc.gov/coronavirus/2019-ncov/hcp/inpatient-obstetric-healthcare-guidance.html

CDC’s Guidance on Breastfeeding – https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-guidance-breastfeeding.html

CDC’s Infection prevention and control in healthcare settings –
https://www.cdc.gov/coronavirus/2019-ncov/infection-control/control-recommendations.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fhcp%2Finfection-control.html

Answers to frequently asked questions about COVID-19 and pregnancy are also available on the CDC website – https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/pregnancy-faq.html

Early data on effects of COVID-19 in pregnant women

The World Health Organization said early studies suggest pregnant women may not be at a higher risk than the general population of severe symptoms from COVID-19, which is caused by the novel coronavirus. An analysis of data for 147 women found 8% had severe disease and 1% were in critical condition, with no evidence of transmission from mother to child. Full Story: The New York Times (tiered subscription model).

NPWH Member Spotlight: Sarah Freeman, FNP

NPWH highlights member, Sarah Freeman, FNP. Sarah is a previous Chair of the NPWH Board of Directors.

First genetic test for Fragile X Syndrome

The U.S. Food and Drug Administration (FDA) recently approved marketing for the very first genetic test to help diagnose Fragile X Syndrome (FXS).

NPWH Member Spotlight: Heather Quaile, DNP, WHNP-BC, SANE

In this spotlight, we get to know Heather Quaile, DNP, WHNP-BC, SANE. Heather is on the Program Committee for our 22nd Annual Premier Women’s Healthcare Conference and currently in training to be a sexuality counselor.

Women’s Healthcare welcomes NYU Meyers PNP Program Director, Dr. Donna Hallas

Connectedness: Women and their Daughters Heart Health

Since 1963, February has been celebrated as American Heart Month. In 2004, the American Heart Association expanded this initiative with their Go Red for Women campaign to raise awareness of the importance of heart health for women. Heart disease is the leading cause of death for women in the United States with a statistical report of approximately 1 in every 5 female deaths in 2017 attributed to heart disease.

New study reveals insight into prevalence of mental health conditions in young mothers

A study recently published in the Journal of Adolescent Health examined the prevalence of mental illness in young mothers (younger than 21). The researchers surveyed 450 women living in Ontario, Canada.

NPWH Member Spotlight: Linda Dominguez, CNP

In this spotlight, we get to know Linda Dominguez, CNP. Linda has been a nurse for more than 50 years and is former Chair of the NPWH Board of Directors.

NPWH Member Spotlight: Cookie Bible, WHNP-BC

In this spotlight, we get to know Cookie Bible, WHNP-BC. Cookie has been a member of NPWH since its first year and is a former Board member. She currently serves on the Policy Committee. She is also former President of the Board of Nursing for the State of Nevada. She is pictured here with her rescue dog, Zephyr.

Study shows reduced risk of cardiovascular disease during times of bereavement with daily aspirin intake

A study published in the American Heart Journal explored the effects of aspirin and low dose metoprolol intake during early bereavement periods.

NPWH Member Spotlight: Laurie Hudec, WHNP-BC

In this spotlight, we get to know Laurie Hudec, WHNP-BC.

Study highlights potential effectiveness of yoga for chronic back pain in nurses

A recent study published in the Holistic Nursing Practice journal highlights the positive effects of yoga, tai chi, and other “movement-based mind-body interventions” for nurses and nurse practitioners who suffer from chronic back pain.

Study examines rate of cancer overdiagnosis in Australia

A recent study published in the Medical Journal of Australia examined the “proportion of cancer diagnoses in Australia that might reasonably be attributed to overdiagnosis.”

Study shows a specific nutrient could help non-alcoholic fatty liver disease

A recent study published in the Hepatology journal of the American Association for the Study of Liver Diseases investigates if indole, a microbiota metabolite may help alleviate inflammation and diet-induced non-alcoholic fatty liver disease (NAFLD)

Study reveals link between asthma and atrial fibrillation risk

A new study published in Circulation: Arrhythmia and Electrophysiology examined if there is a link between “persistent” asthma and an increased risk of atrial fibrillation (AF).

WHO announces official name for coronavirus

The World Health Organization (WHO) has recently announced the official name of the coronavirus: COVID-19.

WHO reports that coronavirus transmission outside of China may increase

The World Health Organization (WHO) recently announced that the rate of coronavirus transmission outside of China may soon be increasing.

New York City to launch program for postpartum depression

A new program for helping families affected by postpartum depression is set to hit New York City in 2024. The program is The New Family Home Visits initiative, and will first begin in Brooklyn before expanding throughout the rest of the city.

FDA launches mobile app on antiretrovirals

On Jan. 29, the FDA launched an interactive database that will offer a wealth of critical information about antiretrovirals eligible for purchase under the President’s Emergency Plan for AIDS Relief (PEPFAR) program.

ECRI Institute launches digital resource for coronavirus

The ECRI Institute recently launched its Coronavirus Outbreak Preparedness Center for healthcare providers and hospitals to learn how to protect themselves and their patients.

Women’s Healthcare welcomes women’s health writer, Jeannie Collins Beaudin

My name is Jeannie Collins Beaudin, and I’m a retired Canadian pharmacist and former owner of a specialty compounding pharmacy. Compounding, by the way, is essentially making medicines from scratch. While all pharmacists do some compounding, I went further with a dedicated lab space and two full-time compounding technicians. The best part of my job was helping my patients. Nothing made my day better than having a client come back and tell me my advice or my specialized compounded medicine had solved their problem!

Top heart health apps for nurse practitioners

To acknowledge American Heart Month, Women’s Healthcare would like to highlight some of the best heart health apps, including some providers can use in their practices:

Study examines link between gut health and Parkinson’s

A new study examines the connection between gut health and Parkinson’s Disease (PD). The study explores the idea of gut-brain health, which has become a more relevant idea and has been studied at length for the past two decades.

The World Health Organization aims to reduce mortality of cervical cancer

In a recent study, the World Health Organization (WHO) describes a study which aims to eliminate cervical cancer “as a public health problem.”

Marijuana Use during Pregnancy and Lactation

The National Association of Nurse Practitioners in Women’s Health (NPWH) advocates for a nonjudgmental and evidence-based approach to screening and counseling women concerning marijuana use during pregnancy and lactation. NPWH supports strategies to educate the public about safety concerns and to reduce marijuana use during pregnancy and lactation. Legislation, policies, and clinical processes should ensure that women who use marijuana have access to nonjudgmental, nonpunitive, patient-centered healthcare throughout pregnancy, birth, and postpartum period. NPWH supports ongoing research on the effects of marijuana use on fetal and neonatal outcomes, long-term effects on neurodevelopment, and safety of use during breastfeeding.

Abnormal uterine bleeding in reproductive-aged women utilizing the PALM-COEIN system

In this article, the author discusses how the PALM-COEIN classification system helps clinicians group various causes of abnormal uterine bleeding into structural and nonstructural etiologies, allowing assessment and management to be more specifically employed by nurse practitioners to offer women the most effective treatments.

Caring for women on adjuvant therapy for breast cancer: Role of the NP in the primary care setting

Faculty: Rachel Gorham, MSN, WHNP-BC, AGN-BC,  holds board certification as a women’s health nurse practitioner and in advanced genetics nursing. She is a member of the NPWH Board of Directors.

Intended audience: This continuing education (CE) activity has been designed to meet the educational needs of nurse practitioners and other healthcare providers who provide primary care for women.

CE approval period: Now through February 28, 2022

Estimated time to complete this activity: 1 hour

CE approval hours: 1 contact hour of CE credit, including 1 contact hour of pharmacology content

Goal statement: Primary care providers will increase their knowledge about the indications for, mechanism of action, side effects, and potential risks associated with breast cancer adjuvant therapies so they can be aware of specific problems and concerns that may arise with patients on these medications and manage care appropriately.

Needs assessment: Breast cancer therapies are ever evolving. Survival rates continue to improve following initial treatment. Because the number of breast cancer survivors is growing, healthcare providers need to understand potential post-treatment effects that these patients may experience, particularly with regard to the adverse effects of prescribed adjuvant therapy. Although nurse practitioners in women’s health and/or primary care—other than those who specialize in oncology—do not prescribe or manage this adjuvant therapy, they need to understand the rationale for it and the effects of it on their patients.

Educational objectives: At the conclusion of this educational activity, participants should be able to:

1.  Describe indications and mechanisms of action for breast cancer adjuvant therapies.

2. Discuss potential risks associated with the use of breast cancer adjuvant therapies.

3. Describe strategies to reduce potential risks associated with the use of breast cancer adjuvant therapies.

Accreditation statement: This activity has been evaluated and approved by the Continuing Education Approval Program of the National Association of Nurse Practitioners in Women’s Health (NPWH) and has been approved for 1 contact hour of CE credit, including 1 contact hour of pharmacology content.

Faculty disclosures: NPWH policy requires all faculty to disclose any affiliation or relationship with a commercial interest that may cause a potential, real, or apparent conflict of interest with the content of a CE program. NPWH does not imply that the affiliation or relationship will affect the content of the CE program. Disclosure provides participants with information that may be important to their evaluation of an activity. 

Rachel Gorham, MSN, WHNP-BC, AGN-BC, has no actual or potential conflicts of interest in relation to the content of this article.

Disclosure of unlabeled use: NPWH policy requires authors to disclose to participants when they are presenting information about unlabeled use of a commercial product or device or an investigational use of a drug or device not yet approved for any use.

Disclaimer: Participating faculty members determine the editorial content of the CE activity; this content does not necessarily represent the views of NPWH. This content has undergone a blinded peer review process for validation of clinical content. Although every effort has been made to ensure that the information is accurate, clinicians are responsible for evaluating this information in relation to generally accepted standards in their own communities and integrating the information in this activity with that of established recommendations of other authorities, national guidelines, FDA-approved package inserts, and individual patient characteristics.

Successful completion of the activity: Successful completion of this activity, J-20-01, requires participants to:

1.  “Sign In” at the top right-hand corner of the page npwh.org/courses/home/details/1356 if you have any NPWH account. You must be signed in to receive credit for this course. If you do not remember your username or password, please follow the “Forgot Password” link and instructions on the sign-in page. If you do not have an account, please click on “Create an Account.”*

2. Read the learning objectives, disclosures, and disclaimers on the next page and then click the “Continue” button.

3.  Study the materials in the learning activity during the approval period (now through February 28, 2022).

4.  Complete the post-test and evaluation. You must earn a score of 70% or better on the post-test to receive CE credit.

5. Print out the CE certificate if successfully completed.

*If you are an NPWH member, were once a member, or have taken CE activities with NPWH in the past, you have a username and password in our system. Please do not create a new account. Creation of multiple accounts could result in a loss of CE credits as well as other NPWH services. If you do not remember your username or password, please either click on the “Forgot Username” or “Forgot Password” link above or call the NPWH office at (202) 543-9693, ext. 1.

Commercial support: No commercial support was supplied for this activity.

Before reading the article, click here to take the pretest.

New report puts coronavirus infection count over 75K in Wuhan

A new report indicates that there could be over 75,000 reports of coronavirus infections in Wuhan, China, and almost 10,000 cases across the entire nation of China.

February 2020: Editor-in-chief’s message

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beth kelsey editor chiefDear Colleagues,

I hope the start of 2020 has been a good one for everyone. This year promises to be bigger and better than ever for Women’s Healthcare: A Clinical Journal for NPs. We are planning six issues, including four regular issues and two special topics issues. As well, we now bring articles to readers in digital format on the journal website ahead of publication in the journal. We look forward to providing you with a broad selection of outstanding articles in 2020.

Factors associated with HPV vaccination before first sexual intercourse among female college students

The first aim of this study was to identify characteristic differences between college women who completed the 3-dose human papillomavirus (HPV) vaccine series prior to first sexual intercourse and those who did not. The second aim was to identify the knowledge and social influences associated with successful HPV vaccine completion prior to the first intercourse. Results of this study, which have useful implications for healthcare providers caring for adolescents and college-age women, are presented.

New NPWH chair message

Auspicious beginnings and courageous conversations

As the new NPWH Board of Directors Chair (2020–2022), I am eager to start a new role, new year, and new decade with auspicious beginnings. The World Health Organization (WHO) has designated 2020 the International Year of the Nurse and the Midwife in honor of the 200th birthday of Florence Nightingale. Nurses and midwives are the essential and often only healthcare providers in communities around the world, constituting more than 50% of the health workforce in many countries.

H.E.R. Hub is now live!

It is my pleasure to announce the launch of the National Association of Nurse Practitioners in Women’s Health (NPWH) new and innovative online website for women: H.E.R. [Health. Education. Resources.] Hub at www.myherhub.com. H.E.R. Hub captures the unique perspective and expert advice of women’s health nurse practitioners (WHNPs) and offers it to women in a convenient, one-stop, digital portal. By focusing on both preventive well-woman care and the treatment of women’s health conditions, H.E.R. Hub is a valuable new online resource for patients and clinicians alike.

Increase in confirmed coronavirus cases in US

Over the weekend, there was an increase in the amount of confirmed coronavirus cases to hit the United States; currently, there are five confirmed cases.

Study fails to show benefit of adding vitamin C to treatment of septic shock

A study recently published in the Journal of the American Medial Association aimed to examine if a treatment combination of vitamin C, hydrocortisone, and thiamine would lead to a “rapid resolution of septic shock” compared to using only hydrocortisone.

First FDA-approved treatment for preventing Ebola virus

In late December 2019, the U.S. Food and Drug Administration (FDA) announced the approval of Merck’s Ervebo, the first FDA-approved vaccine to prevent Ebola virus disease.

New findings from the American Cancer Society on reduced cancer mortality rates

Based on new findings from a 2020 American Cancer Society report, mortality rates from cancer have declined by 29% between 1991 to 2017 in the US. Additionally, between 2016 to 2017, there was a 2.2% drop, which is the largest drop within a single year that was ever recorded.

First coronavirus patient identified in U.S.

On the heels of today’s earlier post regarding the increase mortality rates in Wuhan, China from the coronavirus, The New York Times (NYT) just released an article detailing news that the first U.S. patient with coronavirus has been identified.

Deaths from coronavirus rise

In the past 24 hours, news coverage of the coronavirus in Wuhan, China has become more and more rampant. I first heard of the outbreak from my husband last night before bed, and was surprised how I missed the news before our conversation, especially after seeing the onslaught of news from a quick Google search this morning.

Linguistics in healthcare: Why it matters

MK Hedrick is a former colleague of mine who works in healthcare market research. When we worked together, we were tasked with trying to understand the ins and outs of different online disease communities for our clients.

First targeted therapy for rare mutation of gastrointestinal stromal tumors

The U.S. Food and Drug Administration (FDA) recently announced the approval of Blueprint Medicines Corporation’s avapritinib (Ayvakit) for the treatment of adult patients with metastatic gastrointestinal stromal tumor (GIST) with the “platelet-derived growth factor receptor alpha (PDGFRA) exon 18 mutation.”

The Parkinson’s Foundation launched first-ever Nurse Fellowship program

The Parkinson’s Foundation recently announced the launch of its new Parkinson’s Nurse Fellowship program in the U.S.

FDA issues warning letter for medication-assisted treatment for opioid use disorder

The U.S. Food and Drug Administration (FDA) recently issued a warning letter to Alkermes, Inc. due to misbranding on the drug Vivitrol, which is used to prevent opioid dependence relapse. The letter was issued because promotional materials didn’t including warnings about risks associated with the treatment, specifically a lack of language about the “vulnerability to opioid overdose.”

Potential consideration for physicians regarding cannabis edibles

In early January 2020, the Canadian Medical Association Journal published a commentary from Drs. Jasleen Grewal and Lawrence Loh regarding potential concerns around the use of cannabis edibles.

New study reveals no statistical significance between use of talcum powder and ovarian cancer

A new study recently published in the Journal of the American Medical Association reveals that there is no statistical significance between a women’s use of talcum powder and developing ovarian cancer.

New guidelines for the management of school-based asthma

The Community Preventative Services Task Force (CPSTF) recently released new recommendations around the management of school-based asthma. These management strategies aim to reduce the amount of hospitalizations and emergency room visits from children and adolescents suffering from the condition.

New treatment for migraine

The U.S. Food and Drug Administration (FDA) recently approved Allergan’s ubrogepant (Ubrelvy) for treatment of acute migraine with or without visual disruptions (aura).

Potential new targeted therapy for Duchenne muscular dystrophy

The U.S. Food and Drug Administration (FDA) recently granted accelerated approval for Sarepta Therapeutics’ golodirsen (Vyondys 53), an injection for patients with Duchenne muscular dystrophy (DMD) with a mutation in the dystrophin gene “that is amenable to exon 53 skipping.”

Nursing profession ranked most honest and ethical profession for 18 times in a row

The results of the Annual Gallup poll were released on January 6, 2020 which, for the 18th consecutive year, revealed that nurses were ranked as the #1 most honest and ethical profession.

Acupressure improves QOL in nurses with chronic back pain

A study published in Applied Nursing Science details how acupressure may help nurses who experience chronic back pain.

Closing the gap: Establishing a women’s preventive health visit

Women typically visit an ob/gyn practice, family practice, or internal medicine practice for routine, annual well-woman visits (WWVs). The focus of this visit may vary within these different settings.1 This can result in missing important components in the history, physical examination, and screening tests that constitute a comprehensive preventive health assessment along with appropriate health promotion education and counseling.

New data reveal that women now make up the majority of medical students in the US

New data from the Association of American Medical Colleges (AAMC) reveal that for the first time, women now make up the majority of first-year medical students in the United States.

Top apps for nurses in 2019

As smart phones become more and more integral in our lives, the Women’s Healthcare team would like to share some of the top apps for nurses in 2019! These apps all have features that may enhance your practice and day-to-day lives.

How nurse practitioners can affect women’s health in rural America

Approximately 46 million individuals—about 15% of the population of the United States—reside in rural areas of the country.1 A slightly larger proportion, 22.8%, of US women aged 18 years or older call rural America home.2 For all rural residents, top priorities set forth by Healthy People 2020 include increasing access to primary care services, emergency department (ED) services, and insurance coverage.3 Rural women, when compared with their urban counterparts, experience more disparities in terms of primary care and reproductive healthcare.1 Although the need for specialists in women’s healthcare is particularly evident in rural areas, few such healthcare providers (HCPs) cover these areas.3 Nurse practitioners (NPs), including women’s health nurse practitioners (WHNPs), can help reduce health disparities, improve access to care, and promote favorable health outcomes for female rural residents.

Accelerated approval for new sickle cell disease treatment

The U.S. Food and Drug Administration (FDA) recently granted accelerated approval to Global Blood Therapeutics’ voxelotor (Oxbryta), a treatment for adults and pediatric patients (12 years and older) with sickle cell disease (SCD).

Exciting changes to the Women’s Healthcare Website

The Women’s Healthcare team is excited to announce several changes to our site, all of which are intended to enhance your experience.

Alcohol Free Holidays for Baby and Me

It’s the holiday season and for many people alcohol is a part of celebrating at family, friend, and co-worker get togethers. But what if a woman is pregnant or may be pregnant? Here are some tips to help her plan for an alcohol-free holiday season – Alcohol Free Holidays for Baby and Me.

You can find more information on fetal alcohol spectrum disorders (FASD) and preventing alcohol-exposed pregnancies at
www.cdc.gov/FASDtraining and the NPWH webinar series Optimizing Preconception Health: Preventing Unexpected Teratogen Exposure in Reproductive Age Women.

NPWH news & updates – December 2019

Message from the CEO

You know what they say — go out with a bang! This year’s conference in Savannah certainly hit all the high points and was a great success.

Hypoactive sexual desire disorder: How do you identify it and treat it?

Approximately 1 in 10 women has distressing low sex drive, otherwise known as hypoactive sexual desire disorder (HSDD). How do healthcare providers determine whether a given patient has HSDD? And how should they treat it? The authors address these challenges in this article.

NPWH 2018 Conference Podium Presentation Abstracts

Editor’s Note: 2019 conference presentations coming soon! 

This issue of Women’s Healthcare: A Clinical Journal for NPs features the podium presentation abstracts that were introduced at the 21st annual NPWH conference in San Antonio in October 2018. Abstracts of the first- and second-place poster award winners and the first- and second-place student poster award winners appeared in the September 2019 issue of the journal.

My heartiest congratulations to all! Each year the NPWH conference is enriched by these podium presentations. Please take time to review the abstracts that provide state-of-the-science information about women’s health, and please consider submitting your work for 2020.

–Lorraine Byrnes, PhD, FNP-BC, PMHNP-BC, CNM (ret.), FAANP
2018 NPWH Research Committee Chair

Editor-in-Chief’s Message | December 2019

Dear Colleagues,

beth kelsey editor chiefAs we wrap up the year, I can say proudly that 2019 has been a great one for the journal and for NPWH. Our five issues of the journal this year have provided readers with interesting, relevant, evidence-based information on a wide variety of topics: gestational diabetes, prenatal care models, decreased sexual desire, contraception, insomnia, intimate partner violence, sexually transmitted infections, secondary postpartum hemorrhage, male sexual and reproductive health, urinary tract infections, vaginal infections, and more.

Low-risk pregnancies may result in fewer interventions with midwives

A new study from Obstetrics & Gynecology indicates that women with low-risk pregnancies, who delivered in a hospital setting with a midwife, may need fewer interventions and cesarean sections (C-sections) than women who saw obstetricians. However, these results may reveal more questions than answers.

2018 NPWH Women’s Health Nurse Practitioner Workforce Demographics and Compensation Survey: Highlights Report

The National Association of Nurse Practitioners in Women’s Health (NPWH), in collaboration with the National Certification Corporation (NCC), completed its Women’s Health Nurse Practitioner (WHNP) Workforce Demographics and Compensation Survey in fall 2018. Major objectives of the survey were (1) to obtain detailed demographic information to understand who today’s WHNPs are, where they work, what they do, and which populations they serve, (2) to identify trends in employment compensation specific to WHNPs, (3) to ascertain associations among WHNP education, experience, practice characteristics, and compensation, (4) to identify associations among experience, practice characteristics, and employment/role satisfaction, and (5) to explore trends and attitudes regarding the preceptor role.

This week is National Nurse Practitioner’s Week!

This week is a special week for Women’s Healthcare and we’re excited to highlight the importance of all nurse practitioners (NPs) during National Nurse Practitioner’s Week.

Longer estrogen exposure improves cognitive function

According to findings from a new study, longer duration of endogenous estrogen exposure (EEE)may positively affect cognitive status in late life.

Do alternative therapies help with menopause?

A recent study examined the use of complementary and alternative medicine (CAM) to help women as they transition into menopause. These CAM therapies included nutrition-based options, physical treatments, psychological therapies, herbal medicines, and folk medicines.

Addressing women’s healthcare needs in the U.S. military

Greetings to all our readers from the Policy Chair and Treasurer-Elect of the NPWH Board of Directors. Before you read my first Policy & practice points column, in which I aim to provide insight into policies affecting women who serve in the military from the perspective of a woman serving in the military, I want to introduce myself. I am a women’s health nurse practitioner (WHNP) and a Lieutenant Colonel in the United States Air Force (USAF). I have 13 years’ experience serving in the military as a WHNP. I have served in multiple locations, including highly operational positions where I have supported military women worldwide. I now serve in the largest research organization in the USAF, where I am developing solutions to better incorporate women into the armed services.

NPWH 2018 Conference Poster Abstracts

This issue of Women’s Healthcare: A Clinical Journal for NPs features poster abstracts presented at the 21st annual NPWH conference in San Antonio in October 2018. These abstracts include those of the first- and second-place poster award winners and the first- and second-place student poster award winners. Abstracts of the podium presenters will appear in the December 2019 issue of the journal. My heartiest congratulations to all! Each year the NPWH conference is enriched by these poster sessions. Please take time to review the abstracts that provide state-of-the-science information about women’s health, and please consider submitting your work for 2020!

How the opioid epidemic affects women

Opioid use disorder (OUD) has become such a prominent topic in today’s society that it’s hard to go one day without hearing news about new death statistics or pending litigation issues, but one aspect of this ever-growing tragedy that may be overlooked is how OUD affects women specifically.

Suggestions to help parents reduce child’s anxiety

The Journal of the American Academy of Child & Adolescent Psychiatry released a study in March 2019 that showcases steps parents can take, in addition to standard therapy, to help lower or prevent anxiety in their children.

Use of music during hysterosalpingography: An NP-led intervention

The expanding role of the nurse practitioner (NP) into subspecialty settings such as reproductive endocrinology and infertility (REI) necessitates acquiring new technical skills that are particular to the subspecialty in question. NPs who enter the field of REI care for many women who need to undergo hysterosalpingography (HSG), a procedure in which radiopaque dye is instilled into the uterus and fallopian tubes to evaluate tubal patency. Because 30%-40% of female infertility is attributable to a tubal factor,1 this procedure is commonly performed. A major downside of the procedure is that it can engender a considerable amount of anxiety and pain,1-5 a concern to NPs providing patient-centered care.

Brain Health is Womenʼs Health

The National Association of Nurse Practitioners in Women’s Health (NPWH) supports collaborative action to establish brain health as a crucial aspect of women’s healthcare. A comprehensive approach includes promoting brain health, detecting cognitive impairment (CI) to facilitate accurate diagnosis and early intervention, and identifying and addressing the needs of individuals who are caregivers for loved ones with CI.

NPWH believes a need exists for extensive research to better understand modifiable factors that influence brain health, improve one’s ability to make an early diagnosis of CI, establish effective therapies to prevent and treat CI, and support families and caregivers of individuals with CI. NPWH endorses federal and state policies that devote resources to finance the needed research and that ensur e access to needed diagnostic, care, and treatment resources for individuals with CI, caregivers, families, and healthcare providers.

Background

Cognitive function refers to memory, speech, language, judgment, reasoning, and planning and thinking abilities.1 Brain health is a term commonly used to describe healthy cognitive function.2,3 Changes in these functions may indicate CI. These changes may range in their level of severity, may be progressive, and may have treatable causes.

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition’s (DSM-5’s) diagnostic categories of minor and major neurocognitive disorders (NCDs) reflect the range in CI severity. Minor NCD is a condition in which the individual has mild but measurable changes in cognitive function that are noticeable to the person affected and to family members and friends but do not affect the individual’s ability to carry out activities of daily living (ADLs).1 Minor NCD may be progressive. Approximately 15%-20% of persons aged 65 years or older have minor NCD.4 Major NCD is impairment characterized by decline in at least two cognitive domains (e.g., memory, attention, language, visuospatial function, executive function) severe enough to affect a person’s ability to perform ADLs; the individual also may exhibit behavioral and psychological symptoms.1 Dementia is a commonly used term for major NCD.

Alzheimer’s disease (AD), a progressive degenerative brain disease, is the most common cause of dementia.1 Most statistics on dementia reflect data related to AD. As of 2018, about 5.7 million adults in the United States have AD, with 5.5 million of them being aged 65 years or older. As the size and proportion of this older U.S. population grows, it is projected that 7.1 million persons aged 65 or older will have dementia, primarily AD, by 2025.1 The annual number of new cases of AD and other dementias will likely double by 2050 unless research discovers the key to prevention.1

These statistics do not reflect pre-clinical AD. Current thinking is that Alzheimer’s-related brain changes may begin 20 or more years before symptoms occur.1 No proven strategies are available to prevent AD. However, recognized risk factors for cognitive decline and AD, some modifiable, do exist.5,6 Increasing evidence suggests that lifestyle interventions may have a long-term impact on preserving brain health. The Alzheimer’s Association published a report in 2015 summarizing existing evidence related to risk factors and risk reduction (Box 1).5

All nurse practitioners (NPs) who care for midlife and older adults play a critical role in early recognition of CI. Early signs and symptoms include problems with memory or language, noted deficits in personal or instrumental ADLs, and concerns reported by the individual or a family member or caregiver.7-9 Assessment to detect CI is a required component of the annual wellness visit established in 2011 for Medicare recipients under the Patient Protection and Affordable Care Act.7

The Alzheimer’s Association has published guidance on detection of CI during the annual wellness visit. This guidance includes an algorithm for health risk assessment, patient observation, unstructured questioning, and structured assessment.7 Use of a structured cognitive assessment instrument can improve detection of CI in primary care settings by identifying individuals who may need further evaluation. Validated brief cognitive assessment tools that can be administered in 5 minutes or less in the primary care setting are available. Individuals whose assessment findings indicate possible CI should be evaluated further or referred to a specialist.7 Several initiatives have provided lists of these assessment tools, as well as recommendations and strategies NPs can use to address brain health and CI (Box 2).10-12

Early detection of CI and diagnosis of dementia are integral to individual and family counseling, advance care planning, and consideration of supportive therapies.13-15 The years from diagnosis to end-of-life may be fraught with poor health and disability, resulting in loss of independence and, over time, a substantially lowered quality of life. When interprofessional team members work together with the individual, family members, and caregivers, the changes that occur throughout the course of the disease process can be anticipated and the best care provided.

The impact of this disease on quality of life extends to the more than 16 million adults in the U.S. who provide unpaid care for loved ones with dementia.1 Approximately two-thirds of these informal caregivers—that is, 10.7 million of them—are women, and more than one-third of these women are the daughters of the individuals with dementia.1 The average age of caregivers is 49 years, although about one-third of them are aged 65 years or older.1,16 One-fourth of caregivers belong to a sandwich generation—that is, they are caring not only for an aging parent but also for children younger than age 18.1

Caregiving tasks include helping with instrumental ADLs (e.g., shopping, providing transportation, managing finances) and personal ADLs (e.g., bathing, dressing, feeding). In addition, caregivers may coordinate healthcare and support services. As dementia progresses, caregivers often must manage behavioral symptoms of the disease (e.g., aggressive behavior, wandering).1 Such tasks can take an emotional and physical toll on caregivers, as well as affect their financial status if they must modify or terminate paid employment and pay for healthcare services for themselves and their care recipient.1,16 In many cases, their own needs go unrecognized and unattended.15

A call to action has arisen to transform policies and practices affecting the role of informal caregivers as a major source of care for a growing population of older adults with dementia. A strategic national-level action plan will be required to address the needs of these caregivers. Policies to create evidence-based training for informal caregivers specific to the care of individuals with dementia, provide support such as expanded family leave and job protection for working caregivers, and fund evidence-based caregiver services are critical. Policies must recognize the needs and values of a diverse population of caregivers and the individuals under their care.15,17,18 Box 3 lists resources devoted to caring for caregivers themselves.

Implications for women’s healthcare and NP practice

Nurse practitioners who provide healthcare to women of all ages have the opportunity to address brain health during annual well-woman visits and/or during other visits if concern about patients’ cognitive function arises. In addition, NPs are likely to see, on a regular basis, a large portion of the roughly 10.7 million informal caregivers who are female. NPs are in an excellent position to identify women who are in the caregiver role and address their physical and mental health needs, including their brain health needs.

Recommendations

Nurse practitioners who provide healthcare for mid-life and older women, as well as women of any age who may be caregivers for loved ones with dementia, should:

  • raise the topic of brain health as part of women’s health during routine healthcare visits;
  • address risk factors for cognitive decline that may be reduced with lifestyle changes (e.g., improved nutrition, regular physical activity, cognitive training, smoking cessation);
  • include a question about memory or cognition on health risk questionnaires;
  • observe for signs and symptoms of CI;
  • use an evidence-based protocol for screening and diagnostic evaluation of patients’ brain health and referral for further evaluation if indicated;
  • include a question about any caregiving responsibilities in health assessment;
  • offer additional screening for caregivers to assess preparedness for caregiving and caregiver strain;19,20
  • develop health system partnerships to connect individuals with dementia and their caregivers with community agencies to identify needs and access help;
  • collaborate with affected individuals, caregivers, and an interprofessional team to facilitate decision making and planning (e.g., living arrangements, advance care planning, end-of-life care) that addresses changing needs over time and across care settings; and advocate for policies at local, state, and national levels that address the needs and values of individual with dementia and their caregivers.

NPWH will provide leadership to ensure that:

  • continuing education programs and other evidence-based resources are available for NPs to learn and update knowledge regarding brain health, dementia, and caregiver needs;
  • ongoing collaborative engagement occurs with a variety of stakeholders to address brain health and caregiving issues as important components of an older women’s health agenda;
  • research moves forward in all aspects of brain health to prevent dementia, treat existing CI, help those with CI maintain function and quality of life, and support caregivers; and
  • policies strongly support individuals and families in coping with the physical, emotional, and financial burden of dementia.

 

References

  1. Alzheimer’s Association. 2018 Alzheimer’s Disease Facts and Figures. alz.org/alzheimers-dementia/facts-figures
  2. Alzheimer’s Association. Brain Health. 2018. alz.org/help-support/brain_health
  3. National Institute on Aging. What is Brain Health? 2018. brainhealth.nia.nih.gov/
  4. Roberts R, Knopman DS. Classification and epidemiology of MCI. Clin Geriatr Med. 2013;29(4):753-772.
  5. Baumgart M, Snyder HM, Carrillo MC, et al. Summary of the evidence on modifiable risk factors for cognitive decline and dementia: a population-based perspective. Alzheimers Dement. 2015;11(6):718-726.
  6. Moga D, Roberts M, Jicha G. Dementia for the primary care provider. Prim Care Clin Office Pract. 2017;44(3):439-456.
  7. Cordell CB, Borson S, Boustani M, et al. Alzheimer’s Association recommendations for operationalizing the detection of cognitive impairment during the Medicare Annual Wellness Visit in a primary care setting. Alzheimers Dement. 2013;9(2):141-150.
  8. Falk N, Cole A, Meredith TJ. Evaluation of suspected dementia. Am Fam Physician. 2018;97(6):398-405.
  9. Scott J, Mayo A. Instruments for detection and screening of cognitive impairment for older adults in primary care settings: a review. Geriatr Nurs. 2018;39(3):323-329.
  10. Alzheimer’s Association. Cognitive Assessment Toolkit. 2013. alz.org/professionals/healthcare-professionals/cognitive-assessment

 

Message from the CEO

0

As the New Year continues to un- fold, I am excited about all that lies ahead. First, we welcome four new board members:

  • Heidi Fantasia, PhD, RN, WHNP-BC, Assistant Professor at the University of Massachusetts in Lowell
  • Rachel Gorham, MSN, WHNP-BC, AGN-BC, women’s health nurse practitioner at Physicians Medical Center in the State of Washington
  • Shawana Moore, DNP, MSN, CRNP, WHNP, Assistant Professor/WHNP and Program Director at Thomas Jefferson University College of Nursing in Philadelphia, Pennsylvania
  • Sandi Tenfelde, PhD, RN, APN, WHNP-BC, Associate Professor and Director of the Women’s Health Nurse Practitioner program at Loyola University Chicago, Marcella Niehoff School of Nursing, in Illinois.

 

Gay Johnson, CEO

We look forward to working with these WHNPs as part of our team.

Some of you had a sneak peek at our H.E.R. Hub (Health, Education, Resources for Her) while attending the NPWH conference in San Antonio this past October. If you haven’t seen it, check out this link on our website. This portal, which we plan to launch soon, will offer helpful information for you to share with your patients.

2019 marks the sixth year that NPWH is offering the Women’s Sexual Health Course for NPs. This year, the course will be held in Orlando, Florida, from May 30 through June 2. We look forward to welcoming new NPs to the course and are always delighted to see NPs who have attended in the past. This is the only program specifically designed for NPs regarding female sexual dysfunction (FSD). The knowledge and skill-building provided

by this course will help prepare NPs to initiate sensitive discussions with their patients and increase their ability to evaluate, diagnose, and manage FSD. The faculty members for the course are highly trained and sought after for their expertise in the field of sexual medicine. The course schedule appears on the following pages. We look forward to seeing you in Orlando!

– Gay Johnson Chief Executive Officer, NPWH

 

Please download the PDF 1Q March 2019_WH-p19-23
for more information on this course.

The history of secnidazole

In September 2017, the FDA approved secnidazole for the treatment of bacterial vaginosis. Although new to the United States, secnidazole is a well-established anti-infective agent utilized worldwide for the treatment of various bacterial and parasitic infections. Published studies on secnidazole date back to the late 1960s, yet many U.S. healthcare providers remain unaware of the existence of this medication. This column details the history of secnidazole.

The iGeneration: New consumers of healthcare

The iGeneration (iGen) comprises individuals who are adolescents and young adults right now. This generation is the first to have been familiar with the Internet since childhood and to use technology readily, even automatically. How the use of technology, including social media, is affecting their formative years and beyond is uncharted territory. The author reviews characteristics of iGens, reports what is known about their attitudes regarding healthcare, discusses the increased rate of certain mental illnesses among iGen members, and provides suggestions for healthcare providers in terms of how to better care for this population.

NPWH news & updates


Gay Johnson, CEO

Message from the CEO

For almost 23 years, I have had the joy of working for the National Association of Nurse Practitioners in Women’s Health (NPWH). For the past 8 years, I have had the privilege of representing all of you as your Chief Executive Officer (CEO). And now, it is time for me to shift my focus and energy to my family members, who require more time than I have to give. For that reason, I will be retiring as of January 3, 2020.

This decision to retire has not been an easy one for me because serving as CEO of NPWH is not just a job, but a passion. I have truly enjoyed supporting all of you, and I am immensely proud of all that we have been able to accomplish together to advance the profession of women’s health nurse practitioners and other advanced practice nurses who care for women. I have seen NPWH grow and change over the years, and I feel honored to have played a part in seeing this association emerge as a leader in women’s health. We are now sought after as an organizational leader in women’s health by industry and other advocacy groups, and we are highly respected among our fellow healthcare associations. Our opinion matters.

For me, it’s not just about NPWH, the association. It’s also about knowing and working with so many esteemed NPs during my time at NPWH. To this day, I am still in awe of the tireless and compassionate work you do each day to care for women. I extend my heartfelt thanks to each and every one of you for your friendship and support over the years.

– Gay Johnson Chief Executive Officer, NPWH

Editor-in-Chief’s Message | September 2019

beth kelsey editor chief

Dear Colleagues,

In July 2019, the NPWH Board of Directors approved a position statement entitled Eliminating Preventable Maternal Deaths. Readers can find the position statement in this issue of the journal. Within this position statement, NPWH makes a commitment to provide members with continuing education (CE) programs and evidence-based resources regarding causes, contributing factors, and strategies to eliminate preventable pregnancy-related deaths.

This year’s 22nd Annual NPWH Premier Women’s Healthcare Conference provides numerous sessions in various formats that inform NPs about how we can lead in the elimination of preventable pregnancy-related deaths. The preconference day includes a 4-hour panel format presentation, Maternal Mortality: Beyond the Hospital Walls, that focuses on quality improvement (QI) efforts and how to implement relevant Alliance for Innovation on Maternal Health safety bundles in clinical settings. A breakout session, The Heart of the Matter: What Every Obstetrical Provider Must Know About Pregnancy-Related Hypertensive Disorders and Peripartum Cardiomyopathy in 2020, provides important information on these two leading causes of preventable pregnancy-related death. To address growing evidence that mental health disorders and substance abuse are major contributors to maternal mortality—most apparent in the first year postpartum—the conference includes a breakout session, Maternal Mental Health: A Comprehensive Pathway, and a 4-hour American Society of Addiction Medicine (ASAM) Treatment of Opioid Use Disorders Course. The ASAM course, combined with 4 hours of online content, meets the required education to obtain a waiver to prescribe medication-assisted treatment for opioid use disorder. I strongly recommend attending at least one of these sessions.

The journal itself is an excellent avenue for CE and for sharing of evidence-based resources. To that purpose, I am putting out a special call for submission of journal manuscripts on topics related to:
• risk factors that can be identified prior to a pregnancy and mitigated by care individualized to each woman’s needs (See Box 3 of the position statement);
• leading causes of maternal mortality during the pregnancy-through-postpartum continuum (See Box 1 of the position statement);
• strategies for action to address contributing factors for
• pregnancy-related deaths at community, health facility, patient/family, and/or provider levels (See the Table in the position statement);
• racial/ethnic disparities in maternal mortality; and
• addressing implicit bias at provider, health facility, and health system levels.

If you wish to respond to this call for manuscripts, you can access our Guidelines for Authors hereA. If you wish to discuss a potential manuscript topic, please contact me at bkelsey@npwomenshealthcare.com.

Nurse practitioners who provide healthcare for women before, during, and in between pregnancies must heed the call to lead or be part of the collaborative effort needed to make a difference. As you read the position statement, I hope you take to heart and implement at least some of the recommendations. I hope that you get involved in planning and implementing evidence-based maternal mortality prevention strategies not just at provider and patient levels but also at community and health facility levels. You can lead and/or participate in research and QI projects addressing preventable maternal mortality. You can educate your state and federal legislators so they understand and embrace the imperatives to reduce racial and ethnic disparities in pregnancy-related mortality and to ensure access to quality care for all reproductive-aged women.

In a country as rich in resources as the United States, the maternal mortality rate should not be higher than that in other countries with similar resources. But it is. If three in five pregnancy-related deaths in the U.S. are preventable, then they should be prevented.1 Please join with NPWH in our commitment to make a difference.

 

 

 

Reference

1. Petersen EE, Davis NL, Goodman D, et al. Vital signs: pregnancy-related deaths, United States, 2011-2015, and strategies for prevention, 13 States, 2013-2017. MMWR. 2019;68(18):423-429. cdc.gov/mmwr/volumes/68/wr/mm6818e1.htm

Web resource

A. npwomenshealthcare.com/wp-content/uploads/2019/04/WH-Guidelines-for-Authors-04-8-19.pdf