Vascular Nursing Society Honors Professor

FAYETTEVILLE, Ark. — New is a relative term. Peripheral arterial disease isn’t new to health care professionals employed in vascular-related specialties — those that deal with the health of the body’s blood vessels — but many in general nursing practice don’t know about the simple test that can detect the disease and prevent pain and suffering as well as progression to life-threatening conditions.

That’s why Glenda Lawson, University of Arkansas clinical associate professor of nursing, has spent years educating the public and nurses, both in the field and as part of the curricula of the UA’s Eleanor Mann School of Nursing, about peripheral arterial disease and the ankle-brachial index. She advocates that the index, a diagnostic tool that requires a nurse to compare blood pressure levels taken at the ankle and the arm, be included in the routine practice of taking a patient’s vital signs.

A reading that is lower at the ankle than one taken at the arm indicates a possible blocked artery, and the patient should be referred immediately for further testing.

Lawson became the first nationally certified vascular nurse in Arkansas in 1997. Over the next 10 years, she published articles about peripheral arterial disease, received a $6,000 grant to conduct research in screening for the disease and presented this research during the 2005 Oxford Round Table Research Conference in England.

Most recently, Lawson was named the winner of the 2007 Jeanne E. Doyle Award, the highest honor given by the Society for Vascular Nursing, an international association dedicated to promoting excellence in the compassionate and comprehensive management of people with vascular disease. The society focuses on providing high quality education, fostering clinical expertise and supporting nursing research.

Lawson will be recognized at the society’s annual convention in Baltimore on June 8.

“The college is extremely proud that Dr. Lawson is being honored for her work concerning peripheral arterial disease,” said Reed Greenwood, dean of the College of Education and Health Professions. “Her efforts to bring attention to this insidious disease will improve the lives of thousands of patients who could otherwise face severe pain and debilitation. Many fledgling nurses will take this knowledge into the medical community with the result that the disease may be seen less and less often.”

The ankle-brachial index is still new to the typical medical-surgical nurse and many nurses who work in physicians’ offices and community health clinics, Lawson said, but by routinely performing this test they could detect the disease much earlier than it is commonly found and head off more serious problems. It requires the same instruments used to take blood pressure readings in the arm plus the addition of a hand-held ultrasonic Doppler that works on the foot where a stethoscope would not be able to achieve an accurate reading.

“I’ve done it for years because I know the significance,” Lawson said. “I travel regularly to senior citizen centers in Northwest Arkansas and to the Jones Center for Families in Springdale to screen older adults and educate them about the disease. I’ve been to the Wal-Mart distribution center in Bentonville to screen truck drivers. After an article I wrote was published in the Journal of Vascular Nursing and an announcement made locally, I heard from former faculty members of the College of Education and Health Professions who wanted me to take their ankle-brachial index.”

Peripheral arterial disease results from narrowing of blood vessels caused by buildup of plaque and is most commonly seen in the legs. Older people commonly dismiss the pain they feel while walking as something associated with arthritis, diabetes or just part of aging. That’s a dangerous assumption that Lawson is hoping her efforts will prevent.

People with untreated peripheral arterial disease face increased risk of stroke or heart attack, and diagnosing it in the early stages can help in preventing these vascular diseases associated with aging that can be fatal. Smoking, diabetes, obesity, family history and a sedentary lifestyle are primary risk factors for peripheral arterial disease.

Public awareness is growing, Lawson said. Now, a handful of nurses in the state have earned the national vascular certification, and the public may occasionally notice peripheral arterial disease screenings offered in community settings and see advertisements on television or in magazines about the disease. Lawson also educates faculty at other nursing schools in the state so that new nurses coming out of those schools can perform the diagnostic test.

“The pain can lead a person to become home-bound, then chair-bound, with the result that their quality of life diminishes greatly,” Lawson said. “I have found people who could have lost a foot or a leg if they had not had the test done. When oxygenated blood can’t reach the lower extremities because of a blockage, the loss of circulation can result in gangrene and eventually amputation.”

Lawson will soon take to the road again to dispense free medical care on a medical mission trip to Guatemala. She’ll have her pocket Doppler with her.