1. Dominican Republic

4. Proyecto ADAMES Adelante, Asegurando Madres e Infantes Sanos (Onward! Assuring Healthy Mothers and Babies) Ongoing education and leadership conferences to improve quality of maternity care Participatory process in capacity-building NIH support for community based participatory research with nurses and community leaders

5. View of city

6. Dominican Health Care System: Public Primary: Unidades de Atencion Primaria (UNAP) Secondary: Municipal hospitals Tertiary: Regional hospitals The system doesn’t always function as it is supposed to. Often, patients bypass the first two referral centers and go straight to the regional hospitals, because of problems such as inadequate staffing and lack of resources at the UNAPS and Municipal hospitals.

7. Dominican Health Care System: Private Includes private hospitals, clinics, outpatient offices, and birth centers Seems to be mostly accessed by wealthier populations May have better technology and more resources than public health centers, but not always Not regulated by any governing quality control review board Nurses are paid less than in public sector

8. Nursing in the DR roles and responsibilities Types of nurses Baccalaureate nurses Auxillary Nurses Roles In the hospital In the community Responsibilities Staffing entire units Responsible for all aspects of patient care

9. Risks Risks for DR nurses Infection control Worker injury protection Staffing Challenges Finding a job Public vs. Private

10. Nursing Students at UASD Meetings with nursing students Group discussion at the hospital Campus tour and presentation

11. CURNE Campus Tour

12. CURNE Classroom Observation Visit to the “old” campus Observed History of Nursing lecture Presentations on Community Health by senior nursing students

13. Interactions with nursing students in the community Monday morning - community health clinical with nursing students Walking through and assessing the community Looking for key informant “community leader” “Windshield survey” on foot

14. Monday afternoon - attempted home visits with nursing students One successful home visit turned into breastfeeding support group Wednesday afternoon - public elementary school health screenings with nursing students In-classroom screenings for lice, malnutrition, abnormal growth and development Interactions with nursing students in the community

15. A Taste of Dominican Culture Home stays Dancing Music Food Politics Beach Spanish Lessons Overall Impression

16. Ideas for Future Partnership Continue conversations NOW - Collaboration between Emory SON and faculty and nursing students in the DR to identify: Areas they would like help in Joint projects or activities they might be interested in Ideas they may have for collaboration.

17. Collaborative undergraduate research theses Assessment of factors contributing to high cesarean rate Hand hygiene education and evaluation Hospital/nurse safety survey Joint community health interventions and projects Community health rotation/exchange Infection control improvements PartnershipPossibilities Data surveillance at the bedside (per nursing unit) and at community levels Help establish Student/ professional organizations

18. Thank You! ¿Preguntas?