Fighting infectious disease, the very heart of public health and the genesis of contemporary nursing, is about more than handwashing and immunizations. It’s about screening and early detection, identifying risk and protective factors, and educating clinicians, facilities and the public. But it all begins with research, like that underway by nurse researchers at the Johns Hopkins University School of Nursing (JHUSON). Their work is more important now than it has been in nearly the past century. Infectious disease rates, stable since the 1918 influenza pandemic, have been on the rise since the mid-1980s. The battle against these illnesses—from HIV/AIDS to MRSA and from STDs to resurgent tuberculosis (TB), and others—has been escalating, and long before the recent emergence of the H1N1 influenza virus earlier this year.
For JHUSON nurse researchers, the communities around the corner and around the world are their infectious disease laboratories. JHUSON faculty research, for example, is shedding light on curbing sexually transmitted infections and their physical and emotional repercussions on college campuses. It also is exploring best practices to curtail the spread of resurgent diseases like tuberculosis and reducing the impact of treatment resistant infections like MRSA both within and beyond the hospital setting. The community-based inquiry not only is yielding new knowledge but also, when coupled with its translation into clinical education and practice, is helping to save lives today and to be better prepared to save them in an uncertain future.
JHUSON researcher, assistant professor and self-professed “infection control preventionist” Jason Farley, PhD, MPH, ARNP, is working to give nurse colleagues and other health care professionals the research-based tools they need to identify, prevent, and destroy drug-resistant infections in hospitals and in communities from Maryland to South Africa. Growing rates of drug-resistant infections like tuberculosis and methicillin-resistant Staphylococcus aureus (MRSA), coupled with recent H1N1 pandemic concerns, make his work most timely. His MRSA-related research not only has documented its evolution from a hospital problem into a community and public health concern, but also has given health providers.
Farley’s work is as much about transmitting knowledge as it is about curbing infection transmission. In new work supported by the JHU’s Center on Global Health, he is evaluating current tuberculosis infection control practices and strategies in TB hospitals throughout
Most sexually transmitted diseases (STDs) can be readily treated and cured; all can be prevented. Yet, in the
Drawn to the field of STD research because it “affects the human condition as a whole – health, psychology and social environment,” she noted that certain STDs tend to be passed around within specific closed communities, such as a college campus, the nightclub scene or the correctional facility. While it is well know that screening reduces the likelihood of transmitting HIV and bacterial STDs, Mark wondered whether wide-scale, voluntary screening also could help reduce the incidence of the transmission of genital herpes, HSV-2, a viral, often silent STD. that puts people at greater risk for HIV infection. She began her inquiry on a college campus, assessing how to motivate student participation in STD screening and the performance characteristics of the HSV test in college students , reported in the Journal of American College Health and Sexually Transmitted Disease, respectively. Results suggested that to be successful, information about the availability of screening for HSV-2 should be neutral in tone and informative, transmitted broadly by a trusted source such as a student health center. Further, Mark’s finding that a diagnosis of HVS-2 often causes significant emotional and social difficulty (social break-ups, depression, and anxiety) led her to recommend the value of both immediate and follow-up counseling to address both the medical and psychological aspects of infection.
Mark believes nurses are ideally poised to break through the silence that so often surrounds STDs. She notes, “Because we are trained to help people feel comfortable in an uncomfortable medical environment, we can help open the door to STD prevention as well as to screening and treatment. Part of what we do is help people talk about difficult health topics by providing a nonjudgmental environment in which knowledge can be shared. It’s a great model of how nurses work to promote the public health.”