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Dome - Lessons on the Ground

Dome April 2014

Lessons on the Ground

Date: April 1, 2014


Johns Hopkins nurse practitioner Nancyellen Brennan is all smiles as she congratulates nurse manager Geraldine Lewis on becoming one of 20 Caribbean Certified Diabetes Educators in the nation of Trinidad and Tobago.
Johns Hopkins nurse practitioner Nancyellen Brennan is all smiles as she congratulates nurse manager Geraldine Lewis on becoming one of 20 Caribbean Certified Diabetes Educators in the nation of Trinidad and Tobago.

You might say that Nancyellen Brennan has become something of an expert on the national diet in Trinidad and Tobago, the two-island nation in the western Caribbean. For the past seven years, the nurse practitioner from Johns Hopkins Medicine’s Division of Endocrinology, Diabetes and Metabolism has spent hundreds of hours instructing Trinidadian clinicians—and helping them teach their patients—about better diabetes management, including how food choices can help patients avoid complications.

 Some scholars attribute the prevalence of diabetes to the genetic predisposition of the East Indian and African populations, greater caloric intake, and more sedentary behavior.

Brennan has prepared more than two dozen nurses and allied health professionals to take the Caribbean Certified Diabetes Educator (CCDE) exam. Among the group was local nurse manager Geraldine Lewis, who has helped Brennan coordinate all of her educational activities. Now, Trinidad and Tobago boasts 20 CCDEs—more than any other Caribbean nation.

That’s just one of the accomplishments to stem from Johns Hopkins Medicine’s participation in the Trinidad and Tobago Health Sciences Initiative. In 2007, the government invited Johns Hopkins Medicine International to help improve the country’s health care through education and research on diabetes and cardiovascular disease.

Dozens of school of medicine faculty members and Johns Hopkins Hospital nurses and technicians took the 14-hour round-trip flight to Trinidad and Tobago to teach their local counterparts about these diseases, from diagnosis through treatment. If there was a contest for “time on the ground,” however, Brennan would likely win. In 65 trips, she’s spent more than a full year—382 days—in the country.

The nurse practitioner led an initiative to institute comprehensive glucose testing at the site of patient care. She also introduced a “real-time” dashboard to monitor diabetes care. Now Brennan has handed her educational curriculum to the ministry that oversees higher education and vocational training. Lewis and other Johns Hopkins-trained educators will use it in their public health work.

“It was critical to develop strong relationships with respected, connected and passionate people like Geraldine,” Brennan says. “She’s the on-the-ground champion who will keep things moving forward. Relationships like these are perhaps the most important part of working abroad. They’re insurance that the momentum will continue.”

—Cymantha Governs

 

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Training by the Numbers

Over Johns Hopkins Medicine’s seven-year tenure as part of the Trinidad and Tobago Health Sciences Initiative, dozens of faculty and staff delivered in-person training to local health care providers. Here’s just a sampling of what they accomplished:

  • 144,000+ trainee hours on topics related to cardiovascular disease (CVD).
  • 1,000+ physicians received formal refresher courses on CVD and/or diabetes.
  • 3,000+ patients received individual or group education on diabetes.
  • 3,000+ physicians and staff trained in basic and advanced electrocardiogram (ECG) recordings and interpretation.
  • 800+ primary care nurses trained on general CVD care.
  • 600+ allied health professionals (e.g., nurses, dieticians, pharmacists) attended at least one workshop on a diabetes-related topic.
  • 80+ inpatient nurses and staff took intensive skill-focused trainings related to cardiac care.
  • 5 physicians became cardiologists through a specialized 24-month fellowship certified by the school of medicine.
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