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Related Concept Videos

Rheumatic Heart Disease IV: Nursing Management01:20

Rheumatic Heart Disease IV: Nursing Management

441
AssessmentA comprehensive assessment is essential in managing a patient with rheumatic heart disease (RHD). Begin with obtaining a detailed medical history, including recent streptococcal infections, a history of rheumatic fever, or previously diagnosed rheumatic heart disease. Assess the patient for symptoms such as fever, chest pain, widespread joint pain (arthralgia), tachycardia, pericardial friction rub, muffled heart sounds, heart murmurs, peripheral edema, subcutaneous nodules, and...
441
Rheumatic Heart Disease III: Medical Management01:21

Rheumatic Heart Disease III: Medical Management

484
Rheumatic heart disease (RHD) management can be divided into two main strategies: prevention and long-term management.Primary PreventionPrimary prevention focuses on timely diagnosis and management of group A streptococcal pharyngitis to prevent acute rheumatic fever. The most widely used antibiotic for treating this condition is intramuscular benzathine penicillin G.Acute Rheumatic Fever TreatmentThe primary treatment goal for a patient diagnosed with acute rheumatic fever is to suppress the...
484
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

545
Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
545
Rheumatic Heart Disease I: Introduction01:23

Rheumatic Heart Disease I: Introduction

821
Rheumatic heart disease or RHD is a chronic condition that results from rheumatic fever, causing permanent damage to the heart valves.Etiology and Risk FactorsIt primarily arises from rheumatic fever, an inflammatory disease that can develop after untreated or inadequately treated group A streptococcal (GAS) pharyngitis. Streptococcus spreads through direct contact with oral or respiratory secretions. While the bacteria are the causative agents, factors like malnutrition, overcrowding, poor...
821
Peripheral Artery Disease IV: Nursing Management01:26

Peripheral Artery Disease IV: Nursing Management

586
 The nursing management of a patient with peripheral artery disease (PAD) begins with a thorough assessment of the patient’s health history and clinical manifestations.AssessmentHealth History: Evaluate the patient’s history of hypertension, hyperlipidemia, family history of cardiovascular issues, and lifestyle factors such as dietary patterns, smoking, and physical activity.Physical Examination:Assess the affected extremity for decreased or absent peripheral pulses,...
586
Pericarditis IV: Nursing Management01:25

Pericarditis IV: Nursing Management

537
Pericarditis, an inflammation of the pericardium, necessitates diligent nursing management to ensure effective patient care and recovery. The initial step in managing pericarditis is a comprehensive patient medical assessment.The patient reports chest pain aggravated by breathing, coughing, and swallowing, which worsens when lying supine. The pain often improves when sitting up and leaning forward. Additional symptoms may include fever, malaise, and, in severe cases, signs of heart failure.
537

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Related Experiment Video

Updated: Mar 24, 2026

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A Rheumatoid Arthritis Training Program for Primary Care Providers on the Navajo Nation.

Jennifer Mandal1, Tabitha Carroway1, Gwendolyn Grant2

  • 1University of California, San Francisco.

Arthritis Care & Research
|March 23, 2026
PubMed
Summary

A rheumatoid arthritis (RA) training program using Project ECHO improved primary care providers' knowledge and confidence in managing RA patients on the Navajo Nation. This telementorship model is a scalable solution for underserved areas.

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Area of Science:

  • Rheumatology
  • Medical Education
  • Health Disparities

Background:

  • The Navajo Nation experiences a high burden of rheumatoid arthritis (RA) alongside a significant shortage of rheumatology specialists.
  • Primary care providers (PCPs) are essential for managing RA in underserved populations but often lack specialized training.

Purpose of the Study:

  • To evaluate the effectiveness of a rheumatoid arthritis (RA) Extension for Community Healthcare Outcomes (ECHO) telementorship program.
  • To assess the impact of the RA ECHO curriculum on PCPs' knowledge, confidence, and clinical behaviors in managing RA.

Main Methods:

  • A 12-week RA ECHO curriculum was delivered via weekly Zoom sessions, incorporating didactics and case discussions.
  • Content was tailored using a needs assessment and input from Navajo cultural interpreters.
  • PCPs completed pre- and post-program surveys, including knowledge tests and confidence ratings, with a 1-year follow-up to assess sustained changes and clinical behaviors.

Main Results:

  • Knowledge scores significantly improved from 46% to 71% post-program and were sustained at one year (69%).
  • Confidence levels increased from "Neutral" (2.9) to "Somewhat comfortable" (3.9) and remained stable at follow-up.
  • Participants reported enhanced clinical practices, including more thorough joint examinations and appropriate pre-treatment protocols for RA patients.

Conclusions:

  • The RA ECHO curriculum effectively enhanced PCPs' RA knowledge, confidence, and clinical practice on the Navajo Nation.
  • This culturally adapted telementorship model is a feasible, acceptable, and scalable strategy to expand rheumatology care access.
  • The program demonstrates a successful approach to workforce development in areas facing specialist shortages.