Integrating Environmental Health into Nurse Practitioner Training—Childhood Pesticide Exposure Risk Assessment, Prevention, and Management

Abstract

The use of pesticides in agriculture, public places, and private homes and gardens is ubiquitous throughout the United States. Children are particularly vulnerable to pesticide exposure because of immature biological and developmental processes. Thus, it is important that primary health care providers identify clients at risk for pesticide exposure and poisoning and know how to respond effectively if clients experience exposure. However, many primary health care providers are not adequately trained or prepared to manage the health-related effects of pesticide exposure. Recent efforts, supported by the U.S. Environmental Protection Agency, have addressed this shortcoming in nursing and medical education. A primary initiative is to find ways to integrate basic environmental health content, specifically regarding pesticide exposure, into nursing and medical curricula. As one strategy to achieve this, a pilot case study was developed by revising and enhancing an existing pediatric case study used in a required course for nurse practitioner students. The aim was to raise students’ awareness of risk assessment, prevention, and appropriate care strategies for pesticide exposure. Evaluation of students’ experience with the pilot case study suggested it was a meaningful and valued addition to their training, as well as an efficient way to introduce environmental health content into primary health care provider curricula.

A nursing socio‐environmental approach for acute pesticide poisoning: A qualitative focus group study

“…Similarly to other studies (Beitz & de Castro, 2010;Frost-Lucas & Jackson-Allen, 2009), a number of them expressed difficulty assessing and managing pesticide exposure due to a lack of knowledge, experience and training, notwithstanding that almost all participants found the experience of a near-real simulation-based scenario to be enriching and prompted self-awareness. Introducing educational, trainee programmes, up-to-date policies, as well as evidence-based care models like the socio-environmental approach, may thus be effective in addressing local professional challenges in primary care settings such as professional isolation, ongoing patient follow-up or a lack of resources to provide safe, high-quality and culturally competent care from a global perspective (Senarathna et al, 2008).…”

The concept of exposure in environmental health for nursing

“…, Rogers & Cox , Larsson & Butterfield ); and the places where exposures occur as in ‘occupational’ or ‘residential’ exposures (Gilmore , King & Harber ). The use or presence of a hazard in the same environment as a target was identified as a ‘source’, ‘risk’ or ‘potential for exposure’ (Beitz & de Castro , Gilden , Chaudrue ).…”

“…With respect to preconditions (antecedents), exposure was used to refer to the presence of hazards in the environment as in 'hazardous exposures' (Shaffer 1995, Grady et al 1997, Rogers & Cox 1998, Larsson & Butterfield 2002; and the places where exposures occur as in 'occupational' or 'residential' exposures (Gilmore 1990, King & Harber 1998. The use or presence of a hazard in the same environment as a target was identified as a 'source', 'risk' or 'potential for exposure' (Beitz & de Castro 2010, Gilden 2010, Chaudrue 2013.…”

Prevalence and predictors of naturopathic practitioners’ self-reported practice behaviours: results of an international survey

“…However, there is a growing understanding that environmental health and medicine needs to be integrated into patient care at all levels. 39 , 40 , 41 Naturopathic principles 3 and the leading international naturopathic organisations 42 emphasise the importance of the environment on health and healing, and this is reflected in the large proportion of respondents discussing this topic with their patients. It is also worth noting that discussions about environmental health were less likely to be reported by naturopathic practitioners in our study that practiced in jurisdictions with statutory registration or occupational licensing.…”