Nurse Scholar Training Topics

Agriculture production provides a spectrum of risks for farmers and agricultural workers. Due to the depth of coursework in nursing colleges, and advanced practice programs, there is limited opportunity for practitioners in rural communities to access agriculture specific healthcare training.

The AgriSafe Nurse Scholar program is a distance learning opportunity available to rural nurses. Distance education (a total of 18 hours), provided by experienced health & safety educators, will enable rural nurses to increase their knowledge base in prevention, identification and assessment of diseases related to agricultural work exposures. Classes are in the form of webinars that can be viewed live or OnDemand (your own time).

Increasing the Use of Hearing Protection Among Farmers: Best Practices

Marjorie McCullagh
Marjorie McCullagh

PhD, RN, PHNA-BC, COHN-S, FAAOHN, FAAN

Professor and Occupational Health Nursing Program Director, University of Michigan School of Nursing

Summary

Farm operators, as well as farm youth, experience frequent exposure to high noise and have among the highest prevalence rates of hearing loss among all categories of workers. Additionally, noise exposure impacts multiple organ systems, contributing to cardiovascular disease, hypertension, obesity, and other highly prevalent diseases. This section of the Nurse Scholar program will address methods of assessing worker exposure to hazardous noise and evidence-based nursing approaches to protect workers from the negative effects of noise on hearing and worker well-being.

Objectives

  1. Discuss several risk factors for noise-induced health problems common among farmers.
  2. Describe major features of interventions shown to be effective in influencing farmers' use of hearing protection.
  3. Discuss best practices for clinical application of farm noise mitigation effectiveness research.

Health and Safety Issues of the Aging Farmer

Deborah Reed
Deborah B. Reed

MSPH, PhD, RN, FAAOHN, FAAN

Distinguished Service Professor and Good Samaritan Endowed Chair College of Nursing University of Kentucky

Summary

The average age of a farmer in the U.S. is over 57 years old, indicating a high number of active farmers and ranchers working well past the usual perceived retirement age. This section of the Nurse Scholar program introduces the unique aspects of health and safety for aging farmers and their families using a Total Worker Health/Total Farmer Health lens including how health relates to work, family, and all aspects of the farmer’s life. It will provide a skill set for clinicians to apply to older farmers and provide resources that can improve quality of life.

Objectives

  1. Determine the difference between "normal" and "abnormal" aging processes.
  2. Apply a skill set to determine the health needs of the aging farmer.
  3. Identify resources and make appropriate referrals to assist aging farmers in their activities.
  4. Utilize new knowledge to guide and assist family units in making good health behavior decisions.

Prevention of Heat-Related Illnesses in Agriculture

Charlotte Halverson
Charlotte Halverson

RN, BSN, COHN-S

Nurse Scholar Program Coordinator and Lead Instructor, Clinical Director, AgriSafe Network

Knesha Rose-Davison
Knesha Rose-Davison

MPH

Public Health Program Director, AgriSafe Network

Summary

Exposure to high and moderate heat conditions is a part of the workplace environment in production agriculture. For workers unprepared for intense or long-term exposure or workers with specific health challenges, there is a potential for serious heat related illness. This section of the Nurse Scholar program will address the pathophysiology of heat related illness and critical intervention steps to keep workers well.

Objectives

  1. Explain the pathophysiology of heat related illnesses and identify heat stroke, heat exhaustion, syncope, heat rash, and heat cramps.
  2. Recognize the dangers of a minimum of three pre-existing health conditions that contribute to heat related illnesses.
  3. Identify at least three medications contraindicated while working in extreme heat conditions.
  4. Identify action steps to prevent heat stress and locate evidence based resources recommended to use in patient/client teaching.

Respiratory Health of Agricultural Producers in Clinical Practice

Sarah Hunt
Sarah Hunt

DNP, MSN, APRN, FNP-BC

Regis University and Sanford Center for Digestive Health

Summary

Agricultural producers are exposed to a variety of respiratory hazards in their day-to-day work environment. Because it is not always possible to eliminate these exposures, acute and chronic illnesses can and do occur. This section of the Nurse Scholar program will address the major exposure hazards, identify symptoms and preventive measures, and discuss the value of obtaining an occupational health history.

Objectives

  1. Review rural healthcare challenges for providers.
  2. Identify the importance of an occupational health history and a respiratory specific health assessment tool.
  3. Discuss the respiratory hazards and symptoms associated with agricultural activities.
  4. Implement the respiratory health assessment tool.

Identification of Skin Diseases Common to the Agricultural Industry

Kelley J. Donham
Kelley J. Donham

MS, DVM, DACVPM

Consultant in Agricultural Medicine and the Rural Health Clinic of Eastern Iowa

Summary

In addition to the high prevalence rate of skin cancer among agricultural workers, there are multiple dermatological exposures and infections resulting from close and persistent contact with animals, vegetation, and chemicals. This section of the Nurse Scholar program will address the stages of skin cancer and identifying markers, common dermatological infections and diseases and the respective signs and symptoms, and preventative measures and treatment modalities.

Objectives

  1. Identify at least three signs of potential skin cancer.
  2. Recognize at least two symptoms of dermatological responses to chemical exposures.
  3. Recognize a minimum of four dermatological symptoms of exposure to animals and vegetation common in agricultural areas.
  4. Locate a minimum of four evidence based resources for use in clinical practice and patient education.
  5. Integrate knowledge gained into identification, patient education, and treatment modalities for skin diseases common to the agricultural industry.

Musculoskeletal Disorders and Ergonomics: Case Study

Nate Fethke
Nate Fethke

PhD, CPE

Associate Professor Occupational &Environmental Health, University of Iowa

Summary

Agriculture as an occupation has one of the highest rates of chronic and acute musculoskeletal pain and injury – especially back pain. This section of the Nurse Scholar program is intended to help nurses practicing in rural/agricultural communities identify ergonomic issues leading to musculoskeletal injuries in farm and ranch patients as well as discover resources to aid in injury treatment and prevention.

Objectives

  1. Identify a minimum of three work site hazards and potential resulting musculoskeletal injuries.
  2. Recognize the role of the clinician in preventing disabling and lost time incidents.
  3. Discuss the value of an occupational health history and a minimum of two action steps to reduce risk.
  4. Locate at least three evidence based reference and patient/client education resources for use in rural practice.
  5. Integrate at least two assessment strategies into health history information and patient education protocol.

The Opioid Crisis: Evolution, Impact on Workers, Mitigation Strategies

Rupali Das
Rupali Das

MD, MPH, FACOEM

Senior Vice President, California Medical Director, Zenith Insurance Company, and Associate Clinical Professor, Division of Occupational and Environmental Medicine, University of California San Francisco

Summary

Prescription drug overdoses are the leading cause of unintentional death in the United States. Opioid overuse, which accounts for a large fraction of unintentional drug deaths, is a serious public health problem in rural communities. This section of the Nurse Scholar program will explore the origins of the opioid epidemic, review the medical and social impacts of opioid prescriptions on workers and businesses, and discuss interventions to mitigate opioid overuse while providing appropriate treatment for injuries and pain.

Objectives

  1. Describe what the opioid crisis means.
  2. Understand the recent history leading to the current opioid crisis.
  3. List three health consequences of opioid use and ways to reduce the likelihood of opioid dependence.
  4. Recognize the difference between physical dependence and addiction.

Integration of Behavioral Health for Rural Practice

Christine L. Chasek
Christine L. Chasek

LIMHP, LADC, LPC

Associate Professor, Department of Counseling and School Psychology, Director of BHECN at UNK University of Nebraska at Kearney

Summary

Rural mental health care is a challenge on several fronts – fewer qualified and licensed providers, distance from care, workplace demands, and the stigma that remains. This section of the Nurse Scholar program will highlight behavioral issues seen in rural communities, especially areas that have reduced access to mental health care providers who cover large geographical regions. Clinicians will have access to resources and receive contact information for rural mental health care specialists across the country.

Objectives

  1. Identify a minimum of three common stressors prevalent among agricultural producers.
  2. Describe at least four signs and symptoms of depression and anxiety.
  3. Describe a minimum of four population based and individual based behavioral health interventions.
  4. Locate three current evidenced based resources in the field of agricultural behavioral health.

Allergic and Non-Allergic Respiratory Disease in Farmers

Jill Poole
Jill Poole

MD

Professor of Medicine Section Chief and Medical Director of Allergy Nebraska Medical Center University of Nebraska Medical Center Pulmonary, Critical Care, Sleep & Allergy Division Department of Medicine

Summary

Healthcare providers in agricultural communities attend to workers presenting with exposures to commonplace allergic and non-allergic respiratory diseases. This section of the Nurse Scholar program will cover a general overview of allergic and non-allergic respiratory diseases including asthma, chronic obstructive pulmonary disease, hypersensitivity pneumonia, and organic dust toxic syndrome.

Objectives

  1. Recognize and determine allergic respiratory disease and discuss relevance with on farming community.
  2. Discuss the diagnostic evaluation of occupational induced asthma.
  3. Recognize the common causes of non-allergic respiratory disease among farmers including chronic obstructive pulmonary disease, organic dust toxic syndrome, and hypersensitivity pneumonitis.
  4. Discuss treatment options for respiratory disease in farmers.

Respiratory Protective Equipment Selection for Agricultural Producers

Charlotte Halverson
Charlotte Halverson

RN, BSN, COHN-S

Nurse Scholar Program Coordinator and Lead Instructor, Clinical Director, AgriSafe Network

Summary

Respiratory exposures are an inherent part of the majority of agricultural operations. Selecting the right protective gear for specific exposures can be a challenge for workers and managers. This section of the Nurse Scholar program will provide nurses practicing in rural communities with training and resources to assist clients in the selection, use, and fit of personal protective equipment appropriate for agricultural respiratory exposures.

Objectives

  1. List a minimum of four major agricultural workplace hazards.
  2. Describe at least two major respiratory illnesses caused by agricultural workplace exposures.
  3. Identify and describe a minimum of three types of respiratory protection used in the agricultural workplace.
  4. Integrate four evidence based resources used in personal protective equipment education for clinicians and patient/client information.

Zoonoses: Infectious Diseases We Share with Animals in the Farm Environment

Kelley J. Donham
Kelley J. Donham

MS, DVM, DACVPM

Consultant in Agricultural Medicine and the Rural Health Clinic of Eastern Iowa

Summary

There are over 250 infectious diseases we share with animals. About two dozen of them are significant occupational hazards for agricultural workers and their families. This section of the Nurse Scholar program will address signs, symptoms, treatment, and prevention. It will be delivered in a story telling context by case example.

Objectives

  1. Identify evidenced-based references and resources that provide information on zoonotic infections.
  2. Recognize which zoonotic infections present a risk in a dairy operation.
  3. Recognize which zoonotic infections present a risk in a swine operation.
  4. Identify recommendations for prevention of zoonotic infections in a livestock production operation.

Prevention Strategies to Protect Women Working in Agriculture

Knesha Rose-Davison
Knesha Rose-Davison

MPH

Public Health Program Director, AgriSafe Network

Linda Emanuel
Linda Emanuel

RN

Community Health Nurse, AgriSafe Network

Summary

Nearly 300,000 women serve as principal operators on farms and ranches across the U.S. and countless more women live and work in an agricultural environment. This section of the Nurse Scholar program will review some of the women’s issues related to life in agriculture, the impact on their health and safety., and the intersect with rural healthcare providers.

Objectives

  1. List a minimum of four factors related to women's health and safety in agriculture.
  2. Discuss a minimum of three potential solutions that would address the unique safety and health challenges to women engaged in agriculture.
  3. Locate a minimum of three recommended clinical and community health resources that address women's agricultural health and safety program development and education needs.

Safeguarding Children Who Live and Work on Farms: A Clinician's Guide

Barbara C. Lee
Barbara C. Lee

RN, MSN, PhD

Director and Senior Research Scientist, National Farm Medicine Center, Marshfield Clinic Health Systems, and Director, National Children's Center for Rural and Agricultural Health and Safety

Summary

Agriculture remains one of our nation's most dangerous occupations and one of the few work sites where children's presence is permitted. In addition to demographic data on injury victims, agents of injuries, and impacts/sequelae, this section of the Nurse Scholar program will explore factors that put certain children at increased risk of future injuries. Strategies for preventing childhood agricultural injuries, including resources for farm owners and parents will be described. Rural clinicians' roles in counseling farm families and their opportunities for rural community advocacy will be addressed.

Objectives

  1. List the five most common hazards leading to serious injuries and fatalities of children on farms.
  2. Describe at least four risk factors for injury exposures to children on farms.
  3. Respond to parent/farm owners' requests for take-home resources with safety strategies.
  4. Underst and rural clinicians' options for advocating for safer conditions for childrenon farms.

Health and Well-Being of Immigrant and Migrant Farmworkers

Athena Ramos
Athena Ramos

PhD, MBA, MS, CPM

Assistant Professor, Center for Reducing Health Disparities, College of Public Health, University of Nebraska Medical Center

Summary

Migrant and immigrant farmworkers, particularly Latino workers, comprise a large share of the agricultural workforce. As the demographic composition of many rural communities changes, it will be imperative for health professionals to understand the unique health and cultural challenges associated with serving their changing patient population. This section of the Nurse Scholar program will define who are migrant and immigrant farmworkers, discuss physical, behavioral, and social health characteristics of these workers, discuss available resources, and assist participants in working with diverse patient populations.

Objectives

  1. Describe the population of migrant and immigrant farmworkers in the U.S.
  2. Understand the physical, behavioral, and social health challenges found among migrant and immigrant farmworkers.
  3. Locate evidence-based resources to serve migrant and immigrant farmworkers.

Head to Toe Personal Protective Equipment

Charlotte Halverson
Charlotte Halverson

RN, BSN, COHN-S

Nurse Scholar Program Coordinator and Lead Instructor, Clinical Director, AgriSafe Network

Summary

In addition to respiratory protective equipment, hearing, vision, torso, head and skin protection is critical to agricultural health and safety. This section of the Nurse Scholar program will provide examples of recommended and evidence based personal protective gear with discussion on appropriate use, wear, and maintenance.

Objectives

  1. Identify and describe multiple types of personal protective equipment appropriate for agricultural workers.
  2. Identify work scenarios where personal protective equipment is important.
  3. Review evidence based resource material for use in clinical and community education settings.

Chemical/Pesticide Exposures and Health Effects in Agricultural Communities

Diana R. Simmes
Diana R. Simmes

MPH

Pesticide Medical Education Director University of California Davis Continuing & Professional Education + Courtesy Assistant Professor of Practice Oregon State University

Summary

Pesticide exposures in agriculture can have a far-reaching impact, not only on workers, but also their families. This section of the Nurse Scholar program will focus on the major agricultural pesticides that have been associated with toxic health effects in agricultural families. Exposure pathways will be described along with measures to reduce exposure, using examples from research programs. Major health effects according to chemical type will be discussed and prevention will be stressed and implications for nursing interventions will be emphasized.

Objectives

  1. Identify a minimum of three types of pesticides used in agriculture in the U.S.
  2. Discuss exposure pathways and interventions to prevent exposure in susceptible populations.
  3. Integrate the use of biomarkers to identify exposure and health effects in agricultural research.
  4. Discuss the clinicians' role in pesticide safety education with emphasis on the protection of vulnerable populations.