The NIH Almanac

Mission

The mission of the National Institute of Nursing Research (NINR) is to promote and improve the health of individuals, families, communities, and populations. NINR supports and conducts clinical and basic research and research training on health and illness across the lifespan. The research focus encompasses health promotion and disease prevention, quality of life, health disparities, and end-of-life. NINR seeks to extend nursing science by integrating the biological and behavioral sciences, employing new technologies to research questions, improving research methods, and developing the scientists of the future.

NINR accomplishes its mission through research on preventing, delaying the onset, and slowing the progression of disease and disability. This includes finding effective approaches to achieving and sustaining a healthy lifestyle, easing the symptoms of illness, improving quality of life for patients and caregivers, eliminating health disparities, and addressing issues at the end of life.

NINR supports basic research relevant to its mission, in order to provide a sound scientific basis for changes in clinical practice. In keeping with the importance of nursing practice in various settings, NINR's major emphasis is on clinical research.

NINR programs are conducted primarily through grants to investigators across the country. On the NIH campus, the NINR Intramural Research Program focuses on health promotion and symptom management and also provides research training opportunities.

NINR fosters collaborations with many other disciplines in areas of mutual interest such as long-term care for older people, the special needs of women across the lifespan, genetic testing and counseling, biobehavioral aspects of the prevention and treatment of infectious diseases, and the impact of environmental influences on risk factors for chronic illnesses.

The NINR Strategic Plan: An Overview

Developed with the input of scientists, clinicians, experts in health care and public policy and other stakeholders, and members of the public, the NINR Strategic Plan for 2006-2010 provides a blueprint for continuing to elevate the contributions of nursing research within the health care sciences.

Nursing science offers a rich mix of topic areas for research that can be viewed in the context of diseases and disorders, phases of the lifespan, and population groups. To address current health care needs of the nation, the Strategic Plan lists 4 key, cross-cutting areas of research emphasis:

• promoting health and preventing disease;
• improving quality of life through self-management, symptom management, and caregiving;
• eliminating health disparities; and
• taking the lead in end-of-life research.

The Plan also outlines 4 objectives to advance science:

• integrating biological and behavioral science;
• adopting, adapting, and generating new technologies;
• improving methods for future scientific discoveries; and
• developing scientists for today and tomorrow.

Central to the themes of nursing research and practice are the important roles of the patient, the family, other caregivers, and the community in promoting health and managing disease. The Strategic Plan is available for downloading from our website: http://www.ninr.nih.gov/.

Important Events in NINR History

November 10, 1985—Public Law 99-158, the Health Research Extension Act of 1985, became law, overriding a presidential veto. Among other provisions, the law authorized the National Center for Nursing Research (NCNR) at NIH.

April 18, 1986—The U.S. Department of Health and Human Services (HHS) Secretary announced the establishment of NCNR at NIH.

December 3, 1986—Members of the NCNR Advisory Council were appointed by the HHS Secretary.

February 17, 1987—The first meeting of the NCNR Advisory Council was held.

May 30, 1988—The NCNR Advisory Council was renamed the National Advisory Council for Nursing Research.

June 10, 1993—P.L. 103-43, the NIH Revitalization Act of 1993, became law. Among other provisions, it elevated NCNR to full status as an NIH Institute.

June 14, 1993—The HHS Secretary signed the Federal Register notice establishing the National Institute of Nursing Research (NINR).

1997—The NIH Director designated NINR as the lead NIH institute to coordinate collaborative research on end-of-life palliative care.

Summer 2000—NINR holds its first Summer Genetics Institute.

2003—NINR Director Dr. Patricia A. Grady named co-chair of the Interdisciplinary Research component of the NIH Roadmap for Medical Research.

2004—NINR Director Dr. Grady named co-chair of NIH Public Trust Initiative.

December 2004—NINR co-sponsored the NIH State of the Science conference, Improving End-of-Life Care, bringing together almost 1,000 health care practitioners from around the world.

2006—NINR celebrates its 20th anniversary at NIH. View Image.

NINR Legislative Chronology

November 10, 1985—P.L. 99-158, the Health and Research Extension Act of 1985, became law. Its provisions included the establishment of NCNR to support research and research training related to patient care.

1986—A series of continuing resolutions (P.L. 99-500, P.L. 99-599) established NCNR as a separate NIH appropriation.

June 10, 1993—NCNR was redesignated as an NIH institute under a provision in P.L. 103-43, the NIH Revitalization Act of 1993.

Biographical Sketch of NINR Director Patricia A. Grady, Ph.D., R.N.

Dr. Patricia A. Grady was appointed Director, NINR, on April 3, 1995. She earned her undergraduate degree in nursing from Georgetown University in Washington, DC. She pursued her graduate education at the University of Maryland, receiving a master's degree from the School of Nursing and a doctorate in physiology from the School of Medicine.

An internationally recognized researcher, Dr. Grady's scientific focus has primarily been in stroke, with emphasis on arterial stenosis and cerebral ischemia. She was elected to the Institute of Medicine in 1999 and is a member of several scientific organizations, including the Society for Neuroscience, the American Academy of Nursing, and the American Neurological Association. She is also a fellow of the American Heart Association Stroke Council.

In 1988, Dr. Grady joined NIH as an extramural research program administrator in the National Institute of Neurological Disorders and Stroke (NINDS) in the areas of stroke and brain imaging. Two years later, she served on the NIH Task Force for Medical Rehabilitation Research, which established the first long-range research agenda for the field of medical rehabilitation research. In 1992, she assumed the responsibilities of NINDS Assistant Director. From 1993 to 1995, she was Deputy Director and Acting Director of NINDS. Dr. Grady served as a charter member of the NIH Warren Grant Magnuson Clinical Center Board of Governors.

Before coming to NIH, Dr. Grady held several academic positions and served concurrently on the faculties of the University of Maryland School of Nursing and School of Medicine.

Dr. Grady has authored or co-authored numerous articles and papers on hypertension, cerebrovascular permeability, vascular stress, and cerebral edema. She is an editorial board member of the major stroke journals. Dr. Grady lectures and speaks on a wide range of topics, including future directions in nursing research, developments in the neurological sciences, and Federal research opportunities.

Dr. Grady has been recognized with several prestigious honors and awards for her leadership and scientific accomplishments, including the first award of the Centennial Achievement Medal from Georgetown University School of Nursing and Health Sciences, being named the inaugural Rozella M. Schlotfeld distinguished lecturer at the Frances Payne Bolton School of Nursing at Case Western Reserve University, and receiving the honorary degree of Doctor of Public Service from the University of Maryland. Dr. Grady was named the Excellence in Nursing Lecturer by the Council on Cardiovascular Nurses of the American Heart Association. In 2005, Dr. Grady received Doctor of Science, Honoris Causa degrees from the Medical University of South Carolina and Thomas Jefferson University, and Columbia University School of Nursing honored her with its prestigious Second Century Award for Excellence in Health Care.

Dr. Grady is a past recipient of the NIH Merit Award and received the Public Health Service Superior Service Award for her exceptional leadership.

NINR Directors

Name	In Office from	To
Doris H. Merritt (Acting)	April 18, 1986	June 1987
Ada Sue Hinshaw	June 6, 1987	June 30, 1994
Suzanne S. Hurd (Acting)	July 1, 1994	April 2, 1995
Patricia A. Grady	April 3, 1995	Present

Major Programs

Office of Extramural Programs

The Office of Extramural Programs manages the funding activities of NINR that occur outside of NIH, in research institutions across the country and internationally. A major program priority is the integration of biological and behavioral research. Three dimensions—promoting health and preventing disease, managing the symptoms and disability of illness, and improving the environments in which care is delivered—cut across the 7 broad science areas:

• Cardiopulmonary and Critical Care Science
• Chronic Conditions and Infectious Diseases
• End-of-Life and Long-Term Care
• Health Behavior and Minority Health
• HIV/AIDS and Oncology
• Neuroscience
• Reproductive, Child, and Family Health

A full description of the NINR extramural activities is available on our website at: http://www.ninr.nih.gov/ResearchAndFunding/DEA/OEP/.

Research Training and Career Development

NINR supports National Research Service Awards (NRSAs) for pre- and postdoctoral training through individual awards and institutional grants, as well as senior fellowships for experienced investigators. This support ensures that there will be an adequate pool of well-trained nurse scientists to meet future research needs.

For career development, NINR offers the Mentored Research Scientist Development Award—Nursing (K01) mechanism. This award is available to doctorally prepared students who pursue a mentored research experience with an expert sponsor to gain expertise in an area new to the candidate or to demonstrably enhance the candidate's scientific career.

In addition, the NINR Career Transition Award (K22) provides up to 3 years of support for research training in an NINR or NIH intramural laboratory, followed by 2 years of support for an independent program of research in an extramural institution. It is anticipated that awardees will subsequently obtain a research project grant to support the continuation of their work.

In addition, NINR participates in the NIH Pathway to Independence (PI) Award. This award offers another excellent opportunity for young investigators. It uses the combination K99/R00 funding mechanism, and is designed to facilitate receiving an R01 award earlier in an investigator's research career. Like the K22, the PI Award provides up to 5 years of support consisting of 2 phases: 1-2 years of mentored support for highly promising, postdoctoral research scientists, followed by up to 3 years of independent support contingent on securing an independent research position. Award recipients will be expected to compete successfully for independent R01 support from NIH during the career transition award period.

NINR also funds minority research career awards that offer mentored research experiences. Under this training mechanism, minority investigators have addressed such issues as serious developmental problems in Mexican migrant infants; culturally appropriate community-level youth suicide prevention programs for American Indian rural youth; improvement of awareness of prostate cancer screening among African American men; and ways to identify triggers or markers for increased risk for sudden death in Asian heart failure patients.

For investigators and institutions with relatively new programs of research, NINR supports Nursing Science Centers focused on building research teams for the future. These Centers support the initial enhancement of research capacity at institutions with emerging research programs using the P20 grant mechanism. For investigators and institutions with several years of demonstrated research success, NINR supports Nursing Centers of Excellence. These Centers consist of several medium-sized developmental or foundational research projects organized around shared resources and research infrastructure using the P30 grant mechanism.  In 2007, NINR introduced the Program Project (P01) Grants, for investigators and institutions with proven and long-established research programs. These grants will serve as platforms for conducting innovative, high-impact research on topics of critical importance, supporting shared resources and collaborative effort for several large research projects. The initial P01 Grants will focus on collaborative research into chronic illness by supporting the development of:

• interventions to improve the quality of life, promote health, and prevent disease in persons living with chronic illness,
• interventions to improve the health and quality of life of informal caregivers,
• relevant research methodology and shared resources.

In addition, NINR has developed a CD-ROM program titled "Discover Nursing Research." This program describes nursing research through interviews with current nurse scientists and doctoral students, as a way to improve the understanding of nursing research and recruit nurses into research careers.

Intramural Research Program

NINR continues to build its campus-based Intramural Research Program (IRP) to help the scientific community take full advantage of the resources, infrastructure, and mentoring opportunities available at NIH. The IRP seeks to understand the underlying biological mechanisms of a range of symptoms, their effect on patients, and how patients respond to interventions. It comprises 2 major activities: the Symptoms Management Branch and Research Training. Recent scientific efforts in the Symptoms Management Branch have included evaluating the efficacy of novel interventions for managing symptoms associated with cancer treatment and exploring the molecular and genetic mechanisms that influence an individual’s response to analgesic treatment for acute pain. NINR laboratories leverage the benefits of the highly collaborative research environment of the NIH intramural research community, wherein fruitful scientific partnerships can be readily established. 

Under IRP Research Training activities, training is provided through several mechanisms, including the novel Career Transition Award. This award affords a unique career development opportunity by providing research fellows with both intramural and extramural training toward the goal of achieving status as an independent investigator. The IRP also supports the Graduate Partnerships Program, which supports the pre-doctoral training of future scientists through university partnerships. As part of this program, students from U.S. or international universities conduct part, or all, of their dissertation research activities within the IRP. 

Additionally, the IRP conducts the NINR Summer Genetics Institute (SGI), which provides a foundation in molecular genetics for use in research and clinical practice, and is open to graduate nursing students, faculty, and advanced practice nurses. SGI participants complete 2 months of classroom instruction, laboratory time, and research training in genetic concepts and techniques. They also attend a seminar series to focus on a wide range of ethical, social, legal, and public policy issues. As of 2007, a total of 139 students have graduated, and they have published more than 100 peer-reviewed articles. This program is approved for 12 hours of graduate credit in nursing at the doctoral level.

An online Research Training Workshop targets doctorally prepared nurses and provides them with knowledge and skill development for submitting competitive grant applications for research funding.

Leadership in End-of-Life Research

In recent years, many factors have converged to increase public and professional interest in issues surrounding the end of life.

The 1997 report from the Institute of Medicine, Approaching Death: Improving Care at the End of Life, found widespread dissatisfaction with end-of-life care and many gaps in our scientific knowledge of this phase of life. In response, NINR sponsored a workshop on the symptoms of terminal illness. Later that year, the NIH Director designated NINR as the lead Institute within NIH for end-of-life research. NINR studies on the management of pain and other symptoms, family decision-making, caregiving, advance planning, and maintaining the health and function of the elderly and the critically ill provided an important base of knowledge on which to build. NINR has sponsored several community events to get input on concerns related to end-of-life issues.

In December 2004, NINR co-sponsored the NIH State of the Science conference, Improving End-of-Life Care, bringing together almost 1,000 health care practitioners from around the world. This conference served to evaluate the current state of the science in end-of-life care and to determine future directions for research. It also highlighted the interactions among patients, caregivers, and the health system, and their effects on outcomes. The consensus statement from this conference is available at: http://consensus.nih.gov/2004/2004EndOfLifeCareSOS024main.htm.

NINR also helps to lead the HHS End of Life Scientific Interest Group (EOL SIG). The purpose of this Interest Group is:

1. To provide a means for HHS agencies interested in end-of-life research to coordinate planning activities,
2. To provide a means for communicating these HHS activities to the broader community interested in end-of-life research.

The link to the EOL SIG website is available from the NIH website at: http://www.nih.gov/sigs/.

NINR and trans-NIH Initiatives

NINR plays an active role in several trans-NIH initiatives, including:

• The NIH Roadmap for Medical Research
• The NIH Public Trust Initiative
• The NIH Pain Consortium
• The NIH Neuroscience Blueprint

The NIH Roadmap is based on the idea that bringing new disciplines together holds the best promise of opening up new and currently unimagined scientific avenues of inquiry. Under the Roadmap theme of Research Teams for the Future, NINR Director Dr. Grady co-chairs the Interdisciplinary Research Working Group. The goal of this initiative is to lower institutional barriers that impede research progress and to challenge individual disciplines to work together to provide new ways of solving complex problems in the biomedical sciences. Nursing science's experience and expertise in collaborative research will be a benefit to all of NIH as this initiative continues to move forward. NINR also participates in the Clinical Research Training initiatives, toward the goal of training a highly skilled workforce of investigators who have strong backgrounds in multidisciplinary clinical research.

Dr. Grady serves as the co-chair of the NIH Public Trust Initiative. The goal of the initiative is to improve the public's health by promoting trust in biomedical and behavioral research. In national polls, the public consistently ranks nurses among the most trusted professionals, so this is a good fit for NINR. One national survey by Research!America found that almost 60% of respondents think that taxpayers pay for most of the medical research done in this country. However, less than 5% could name NIH as the primary agency of taxpayer-funded medical research, and over 80% did not know which agency manages these funds. This indicates that many people are not aware of the function of NIH or its 27 individual Institutes and Centers. NIH cannot control public perceptions about research, but it can improve its communication and interaction with the public by translating research knowledge into practice and disseminating findings through the Internet and other vehicles, as a way for the public to learn and care about the work of NINR and NIH.

NINR is a key member of the NIH Pain Consortium, which Dr. Grady co-chairs. The consortium promotes collaboration among the many NIH Institutes and Centers that conduct or fund pain research. NINR is also a member of the NIH Neuroscience Blueprint, which is designed to develop resources (i.e., people, tools, methods, knowledge bases) for the advancement of research in neuroscience. NINR involvement in these areas opens further avenues of research to NINR-supported investigators.

For more information about nursing research and NINR, please visit the new NINR website at: http://www.ninr.nih.gov/.