Principal Investigator: Virginia Paganelli, M.S.N.
Institution: Center for Clinical Quality, Wash DC
Grant No: R13 HS10076 (Conference)
Period: 8/1/99-7/31/00
Title: followup Workshop on Community-Based Quality Improvement
Summary: The Investigator plans to convene a followup invitational workshop
of community-based quality improvement by bringing together leaders and
purchasers of health care. The initial workshop, held in January 1997, provided
the beginning structure for sharing successful improvement strategies and
encouraged future collaboration. With the emphasis on improving health care
across populations, this workshop will explore how these collaborative efforts
achieved success and what can be learned from the ten participation states.
Principal Investigator: Ginette A. Pepper
Institution: University of Colorado Health Center
Grant No.: R01 HS11966 (Research Grant)
Period: 9/30/01-9/29/04
Title: Nurses'Working Conditions: Effects on Medication Safety
Summary: The purpose of this study is to describe the relationships
between working conditions that affect nurses and the safety and quality
of care they provide with a focus on medication safety. The emphasis of
this study is organizational variables that can be impacted
administratively, rather than individual nurse characteristics. Specific
aims of this study are to (1) develop a computer-based system for
collection of observational data on the full scope of nurses' functions
in medication administration; (2) develop a measure of safety climate at
the level of the nursing unit; (3) develop and test a predictive model
of medication administration safety that encompasses nurses' working
conditions (e.g., physical environment, safety climate, automation, and
staffing levels), as well as nurse workload and actions (e.g., shift
length, patient assignment, adherence to standards, and actions that
prevent adverse drug effects); (4) evaluate the relationship between
medication safety and other indicators of quality of care; and (5)
disseminate evidence on working conditions associated with medication
safety.
Principal Investigator: Marian M. Pettengill, Ph.D., R.N.
Institution: Midwest Alliance in Nursing
Grant No: R13 HS07873 (Conference)
Period: 9/1/93-8/31/94
Title: Disseminating Clinical Guidelines: Pressure Ulcers
Summary: The Investigator conducted a two-day conference on Pressure Ulcer
Guidelines to clinicians, researchers, and educators; and determining their
post-conference guideline-dissemination efforts. The purpose of this project
was to motivate nurses, physicians, and allied health professionals to implement
AHRQ Pressure Ulcer Prevention Guidelines in the acute, long-term, and
community health agencies in which they work. This project was undertaken to prevent pressure ulcers in persons at risk; so as to decrease financial costs
and human suffering associated with pressure ulcer development.
Principal Investigator: Elayne Phillips, Ph.D.
Institution: University of Virginia
Grant No: R01 HS05513 (Research Project)
Period: 9/1/86-8/31/89
Title: Impact of DRGs on Public Home Health Nursing Services
Summary:
Since the implementation of the Medicare hospital prospective
payment system (PPS) by Diagnosis Related Groups (DRGs), hospitals has
been discharging patients sooner and sicker. In this study, home health
resources requested and delivered were expected to be affected more than
non-Medicare patients. Small but significant increases were observed in all
resource measures except length of episode, which did not change. Requests
were more strongly affected than service delivery. Patterns were not
significantly different for Medicare patients and non-Medicare, but were
somewhat exaggerated in Medicare patients. In comparing Medicare and
non-Medicare samples on resource consumption, the non-Medicare group
consumed more visits and time in the same length of episode than the Medicare
group, and received different types of care. Older non-Medicare patients were
in home health significantly longer, used a greater number of home health aide
visits, and had better outcomes than Medicare patients of the same age.
Availability: NTIS
Final Report Accession Number: PB94144227
Principal Investigator: Barbara Pillar, B.S.N.
Institution: Institution Name Unavailable
Grant No: R03 HS05777 (Dissertation)
Period: 7/1/87-6/30/88
Title: Technology Assessment: Evaluation of EFM
Summary:
The study assessed the impact of electronic fetal monitoring on
laboring mothers, nurses, and obstetricians in one hospital site. Data collection
involved the administration of two questionnaires to postpartal women
regarding their reaction to childbirth and monitoring, two questionnaires to
labor and delivery nurses on their response to health care technology generally
and monitoring specifically, and one questionnaire to obstetricians on their
attitudes toward monitoring. Background information obtained on the mothers
include type of monitoring used, use of labor room versus birthing room and
previous experience with monitoring. Demographic information was obtained
also and a chart audit conducted to ascertain the number of complications
associated with the labor and delivery.
Principal Investigator: Pamela K. Pletsch, Ph.D., R.N.
Institution: University of Wisconsin
Grant No: R13 HS08105 (Conference)
Period: 2/1/94-7/31/95
Title: Cultural Values and Health Research: A Methods Conference
Summary:
The purpose of the Cultural Values and Health Research Methods
Conference was to reduce the health disparities among Americans by providing
health intervention researchers with increased knowledge of and skills in cross-cultural research methods. The two and one-half day working invitational
conference was held in Milwaukee, Wisconsin on September 26-28, 1994 and consisted of opening and closing keynote speakers, methods expert speakers,
optional individual consultation time with conference speakers, optional interest
group meetings, and small working groups which were facilitated by conference
planners. Forty-eight researchers, the conference planners, conference
speakers, and six doctoral or post-doctoral students participated. Video tapes
of all presentations were made available to participants who were encouraged
to share the information gleaned with colleagues and students.
Principal Investigator: Grace C. Poertner, R.N.
Institution: Washington University
Grant No: R03 HS06627 (Dissertation)
Period: 8/1/90-12/31/91
Title: Medicaid Policy and Infant Survivability
Summary: Do risks to very low birthweight (VLBW) and infant mortality differ
across Medicaid levels? This study assigned Medicaid averages (expenditure
per Aid to Families with Dependent Children (AFDC) adult, percent of poor
receiving benefits, and medically needy status) to birth and infant death records
by state of maternal residence. Logistic regression is used to analyze VLBW
and mortality. For the 1984 U.S. birth cohort, VLBW accounts for 1.2 percent
of births and 43.6 percent of mortality. Overall, infant mortality ranges from
0.8 to 2.0 percent by state. Findings are: (1) VLBW decreases with adequate
prenatal care, but does not vary by Medicaid; (2) VLBW mortality, lacking
associations with parental risks, improves for African-Americans where state
poverty is less and for Caucasians in states with higher Medicaid spending per
AFDC adult but no medically need coverage; (3) above-VLBW mortality,
given strong associations with parental risks, decreases overall with adequate
prenatal care and for Caucasians in states where greater proportions of the poor
receive Medicaid.
Availability: NTIS Final Report Accession Number: PB94210259
Principal Investigator: Cheryl A. Reilly, M.S.
Institution: University of California
Grant No: R03 HS08950 (Dissertation)
Period: 9/1/95-6/30/98
Title: The Impact of Trending HIV Symptoms on Patient Outcomes
Summary: The primary aim of this study was to determine whether or not the
routine assessment and rending of symptom status contributes to variations in
the treatment and outcomes of patients with HIV disease. A quasi-experimental
design, the untreated control group design with separate pretest and posttest
samples, was used to address the research questions. This study provides a
mechanism for capturing the symptom experience from the perspective of the
patient and examines the effect of his data on both the processes and outcomes
of patient care. The Model for Symptom Management (Larson et al., 1994)
provides the conceptual framework on which this study is based and consists
of three interrelated dimensions: the symptom experience, symptom
management strategies, and symptom outcomes. In this study, the symptom
experience was assessed via the self-report method with a pen-based computer.
Patients who identify symptoms will evaluate the intensity, duration, and
frequency of symptoms and the degree of distress caused by symptoms.
Symptom management strategies documented in the patient record by health
care providers will be abstracted from the medical record. Symptom status at
discharge and patient satisfaction are the primary outcomes of interest. A
secondary aim of this study was to evaluate the pen-based computer as method
of capturing patients' self-reported symptom status and to evaluate the
importance of obtaining and trending symptom data. As symptom management
and the evaluation of symptom management strategies are dependent on the
accurate assessment of symptom status, the need for tools which capture
patients perception of their symptom experience are fundamental to the
symptom management process. The reliable and valid measurement of
symptoms provides valuable data which may be used in the planning and
implementation of interventions aimed at symptom control and for evaluating
the effectiveness of symptom management strategies.
Principal Investigator: Barbara Resnick, Ph.D.
Institution: University of Maryland
Grant No.: R01 HS13372 (Regular Research Grant)
Period: 9/27/2002-8/31/2007
Title: Testing a Restorative Care Nursing Program
Summary: The primary aims of this study are to implement an investigator developed two tiered restorative care program, the Nursing Assistants Resident Care Activities Intervention (NARCAI). The NARCAI incorporates self-efficacy based interventions for both nursing assistants and residents to improve functional performance, maintain or decrease the number of contractures, maintain or improve muscle strength, decreased falls and fall related injuries, and improve quality of life in long-term care residents. The secondary aims related to residents focus on understanding the mechanism by which residents engage in functional activities, i.e. the mediating effect of self-efficacy and outcome expectations. The secondary aims related to nursing assistants focus on understanding the mechanism by which nursing assistants change behavior to facilitate restorative care activities, and how the NARCAI impacts nursing assistants performance of restorative care activities, employment status and job satisfaction. A total of 520 residents and 560 nursing assistants in 8 long-term care facilities owned and managed by Erickson Life Care Communities will participate in the study. The facilities will be randomly assigned to receive the NARCAI or routine care. A 2(group) by 3(time) repeated measure analysis of covariance will be done to address both the primary and secondary aims. Testing will be done at baseline, 4 and 12 months following implementation of the program. This study will help determine the effectiveness of restorative care programs and provide a realistic model for how to integrate these programs into all long term care facilities. The ultimate goal is to alter the current philosophy of care in long-term care to focus on function, improve clinical outcomes, and inform policymakers on the effectiveness of restorative care programs.
Principal Investigator: Nancy R. Reynolds, R.N.
Institution: Ohio State University
Grant No: R03 HS06971(Dissertation)
Period: 9/1/91-8/31/92
Title: Effects of Case Management on AIDS Informal Caregivers
Summary: A prospective design was used to: (1) explore the role
responsibilities of HIV/AIDS informal caregivers over the course of HIV
illness; and (2) describe the effect of a case management model on HIV/AIDS
informal caregivers' health/well-being and satisfaction with formal services.
Data was gathered in 32 in-depth interviews with 20 subjects who were the
primary caregivers to individuals with HIV/AIDS. A randomized portion of the
sample received case managed services, and its effects were evaluated with
standardized outcome measures of health/well-being and satisfaction with
formal services. HIV informal caregiving was analyzed as a three phase process
that involves beginning the role, sustaining the role, and ending the role. The
basic caregiver role is characterized by physical care giving tasks and
psychosocial demands. The HIV informal caregiver role is particularly intricate
because HIV caregiver role expectations are complicated by the unusual social
meanings surrounding AIDS and gay relationships. It was not established that
case management effected HIV informal caregiver health/well-being and
satisfaction with formal services. Findings indicate that social policy regarding
HIV/AIDS must facilitate flexible and creative caregiver roles.
Availability: NTIS Final
Report Accession Number: PB94203908
Principal Investigator: Kandyce Richards, R.N., B.N.
Institution: University of Miami
Grant No.: R03 HS10788 (Dissertation)
Period: 9/30/00-9/29/01
Title: Development and Testing of An Instrument To Assess Pain
Summary: The primary aim of this project is to further develop an empirically-derived pain assessment instrument that is psychometrically sound and sensitive to the needs and preferences of a diverse cultural and socioeconomic background. The longterm objective is to improve nurses' pain assessment practices on adults from diverse cultural and socioeconomic backgrounds. The pain instrument on which this proposal is based was developed using grounded theory technique, and published in 1967 by Glaser and Strauss. The proposed study will take this instrument and refine it for adults of diverse cultural and socioeconomic backgrounds. The applicant lists several hypotheses to be tested. These include: (1) there are factors that are common to the experience of pain, (2) factors that are common to the experience of pain discriminate between subjects, (3) there is variability between subjects within each factor common to the experience of pain, and (4) there are certain combinations of demographic attributes that put subjects at increased risk of certain factors common to the experience of pain.
Principal Investigator: Barbara Roberge, M.S.N., R.N.
Institution: University of Massachusetts
Grant No: R03 HS07953 (Dissertation)
Period: 8/1/93-7/31/95
Title: Improved Targeting of Nursing Home Entrants
Summary: Hospitals are now increasingly admitting large numbers of elderly
patients, a subset of which are at risk of needing admission to long-term care
(LTC). Clinicians are not always able to identify correctly those patients at high
risk of LTC discharge. Delays in discharge planning may result in increased
time spent in the hospital. Since hospitals are not fully reimbursed for these
days, financial losses are associated with them. Targeting patients at risk of
needing LTC discharge has the potential of reducing hospital cost associated
with discharge delays. The purpose of this study was to assess how the risk of
three hospital discharge outcomes differ across subgroups of elders. This study
relies on two administrative data files from a large tertiary care teaching
hospital in the Northeast, which provide information on the daily nursing needs
of patients. The study design includes two empirical models. Three survival
analysis models measure the risk of the three discharge destinations, death,
discharge to LTC and discharge home with services, conditional upon survival
through the current hospital day. These models are compared to a multinomial
logic model estimating the risk of discharge to the same three destinations
compared to discharge home without services. The principal findings are that
indicators of nursing need are strong predictors of all three destination
outcomes under study. They are stronger predictors of the outcomes than are
demographic or diagnostic covariates.
Availability: NTIS Final Report Accession Number:
PB96194089
Principal Investigator: Ann E. Rogers, Ph.D., R.N., F.A.A.N.
Institution: University of Pennsylvania
Grant No.: R01 HS11963 (Research Grant)
Period: 9/30/01-9/29/04
Title: Staff Nurse Fatigue and Patient Safety
Summary: This study will address staff nurse fatigue and patient safety in two ways. The first phase of the study will focus on describing the hours worked by nurses and the effects of these hours on patient safety by 1) describing the work patterns of hospital staff nurses in terms of hours worked, duration of shifts, and amount of overtime worked; 2) determining how much overtime nurses are working, how often they work overtime, when the overtime occurs (time), and if nurses are required to work overtime; and 3) determining if there is an association between errors and the hours worked by hospital nurses. The second phase will involve designing and testing a fatigue countermeasures program for nurses. This countermeasures program will involved strategies used by other industries to minimize the adverse effects of fatigue, sleep loss, and circadian rhythm disruption, and will be evaluated by pre- and post-test measurements of vigilance and sleep/wake patterns.
Principal Investigator: Susan Rogers
Institution: Americans for Better Care of the Dying
Grant No.: R13 HS12090 (Small Conference Grant)
Period: 7/1/02-6/30/03
Title: Meeting People Where They Are: Palliative Care
Summary: In 2000 and 2001, Americans for Better Care of the Dying joined with the D.C. Partnership to Improve End-of-Life Care to conduct dinner conferences focused on improving end-of-life care. The conferences: Incorporating End-of-Life Care into Your Curriculum and Effective Interdisciplinary Teams: An End-of-Life Model, drew over 135 people to meet and discuss much of the current research in end-of-life care training, including the American Medical Association's EPEC (Education for Physicians in End-of-Life Care) curriculum, and the corresponding American Association of Colleges of Nursing's ELNEC (End-of-Life Nursing Education Consortium) curriculum. The planned half-day conference set for September 13, 2002, at Georgetown University, "Making Change Happen in Palliative Care," will broaden the focus to build on national research, as well as on the success of these two previous conferences.
Among those who will attend the September conference will be leaders of hospice, hospital palliative care, and nursing home palliative care programs. In addition, health professionals from emergency rooms, intensive care units, nursing home chronic care units, transplant programs, and various pediatric programs will be invited. All health professional disciplines, including physicians, nurses, social workers, chaplains, therapists, ethicists and other allied health staff will be included as speakers and participants. Approximately 200 participants are expected. Based on information gleaned from the two dinner programs and the poster session, as well as a brief survey conducted with a small group of attendees at the 2001 program, the half-day conference will include two plenary sessions: (1) the 10M report and how that information can be expanded to cover patients with a variety of diagnoses; and (2) the special needs of minority populations, including the difficult questions of access to care.
Principal Investigator: Linda E. Rose, Ph.D., R.N.
Institution: Johns Hopkins University
Grant No.: R03 HS10378 (Small Grant)
Period: 9/30/99-9/29/01
Title: Implementing Family Programs In Psychiatric Settings
Summary: The proposed study will investigate the factors that influence whether families of psychiatric patients receive interventions when their relative is either hospitalized for an acute episode of schizophrenia or bipolar disorder, or is receiving long-term management in a community-based treatment setting. The long-term objectives of the study are to provide direction for implementing a family intervention that is effective in reducing family psychological distress, is feasible in terms of existing resources, and is relevant to a diverse group of families (ethnicity, socio-economic status, geographic location and relationship to the patient). The study will elicit the perspectives of the key "stakeholders" in psychiatric care for families: health care providers, families, patients and mental health advocates. In an effort to identify barriers to family interventions in a variety of settings, 12 focus groups will be conducted. The groups will be used to generate discussion among participants regarding the barriers to offering and/or receiving family centered care, opinions about currently available treatment programs and suggestions for future development of family programs. Findings will be used to recommend content and process of family intervention and suggest methods of implementation.
Principal Investigator: Barbara A. Sachs, Ph.D., R.N.
Institution: University of Kentucky Research Foundation
Grant No: R13 HS07950 (Conference)
Period: 9/30/94-9/29/96
Title: Rural Low Birth Weight Children and Families:Visions for the Future
Summary: The long-term goal of this conference for health care providers,
policymakers and parents is to improve health outcomes of low birthweight
(LBW) children and their families residing in a portion of Appalachia, rural
Eastern Kentucky. The conference aims were to: (1) Evaluate current health
care research findings for potential use with this population; (2) Develop
recommendations for changes in health care policy and for new research
directions for LBW children and their families; and Disseminate
recommendations for changes in health care policy and programs and for new
research directions.
Principal Investigator: Anne E. Sales, M.S.N.
Institution: University of Minnesota
Grant No: R03 HS08452 (Dissertation)
Period: 9/1/94-4/30/96
Title: Estimating Wages and Returns to Education Within Nursing
Summary: Registered nurses are the largest single group of health care
professionals in this country. As major changes in the delivery and financing
of health services have occurred over the last 25 years, the forces that shape the
demand for, and supply of, registered nurses in this country have changed have
changed as well. Changes in relative importance of the major sectors (hospitals,
nursing home, ambulatory, and 'other') in the health care industry in the U.S.
have had particular significance in shaping the demand for, and supply of,
registered nurses. This study examined the effect of sector on wages and returns
to education for R.N.s in the U.S. Two competing theories, neoclassical labor
theory, and segmented labor market theory, are compared to explore how well
each describes the R.N. labor market in the U.S. Data for this study come from
the 1992 National Sample Survey of Registered Nurses. A two-step estimation
procedure was used to estimate first, selection into sector, and second, wages
for R.N.s observed in each sector.
Availability: NTIS Final Report Accession Number: PB98152853
Principal Investigator: Marla Salmon, M.S.N.
Institution: Emory University
Grant No.: R13 HS10971 (Conference)
Period: 9/30/01-9/29/02
Title: International Nursing Workforce Conference
Summary: International Nursing Workforce Conference will bring together senior health planners (HP) and human resource (HR) administrators from around the world to join in a dialogue about data and methodologies related to the nursing workforce. Objectives are to examine the methods and approaches to HP and HR development; describe and disseminate existing national and multinational research data and methods for analysis; and develop action plans for individual country nursing and planning leaders to utilize in their own situations. Dissemination plans include a conference Web site with links to each sponsor's Web site and country specific action plans.
Principle Investigator: Linda Sarna, D.N.Sc., FAAN
Institution: University of California Los Angeles
Grant No.: R13 HS15503 (Small Conference)
Period: 9/1/04-8/31/05
Title: Nursing and Tobacco Cessation: Setting a Research Agenda
Summary: The main purposes of the conference are 1) To Promote research, and 2) To disseminate science-based evidence about the efficacy of nurses in delivering tobacco use cessation interventions. The specific aims are to: 1. To identify gaps in nursing research in tobacco cessation and prioritize critical areas for future research; 2. To identify barriers to increasing research in the field, and strategies to overcome these impediments; 3. To identify strategies to enhance the incorporation of existing scientific-based interventions for tobacco use cessation into nursing practice and education; and 4. To produce a synthesis paper describing the state of the science of nursing research in tobacco cessation intervention and including consensus recommendations on how to advance a nursing research agenda. As the largest group of health care professionals, the 2.2 million working nurses have tremendous potential to impact tobacco control through nursing interventions in tobacco cessation. However nurses have not yet realized in full this potential. According to the literature, nurses have underutilized the Treating Tobacco Use and Dependence Clinical Practice Guidelines as a tool in research, practice and teaching. This first-ever national forum will include an overview of the state-of-the-art of nursing research in tobacco use cessation. Break-out groups will identify strategies to support and enhance nursing research in tobacco cessation and how the science-based Public Health Service's Treating tobacco use and dependence. Clinical Practice Guideline and other interventions can be incorporated into these efforts. This conference is aimed at nurse researchers, clinicians, and educators. The final product of this conference will include a synthesis paper for use by nurse researchers, clinicians, and educators at nursing organizations and schools of nursing that provides direction for the development of needed knowledge in the field; and for the implementation of strategies to increase utilization of existing knowledge about tobacco cessation. Dates for the conference: October 5, 2004, in Washington, DC. The date and location are planned to precede the State of the Science which is the biennial national meeting of nurse researchers sponsored by the Council for the Advancement of Nursing Science.
Principal Investigator: Lawrence J Schneiderman, M.D.
Institution: University of California San Diego
Grant No.: R01 HS10251 (Research Grant)
Period: 09/01/00-08/31/03
Title: Impact of Ethics Consultation in the Intensive Care Unit
Summary: This scientific study is about effects of ethics consultations in intensive care unit settings. Research efforts propose a multi-center randomized control trial that will examine the impact of ethics consultation for patients identified as having "value-based treatment conflicts." This project is co-funded by AHRQ and the National Institute of Nursing Research.
Principal Investigator: Peggy Schuber, M.S.N.
Institution: University of Texas Health Science Center
Grant No: R03 HS10583 (Dissertation)
Period: 9/30/99-11/30/00
Title: Cancer Patient's Attitudes Toward Cancer Trials
Summary: This project will develop and test a valid and reliable instrument to
measure the prevalence of positive and negative attitudes of former cancer
patients toward cancer trials in general and cancer prevention trials in
particular. It will focus specifically on former cancer patients who, because of
their increased risk for future cancer, are likely to be eligible for cancer
prevention trials. It will also measure group differences in attitudes by cancer
site and ethnicity.
Principal Investigator: Jill R. Scott, Ph.D., R.N.
Institution: University of Colorado Health Center
Grant No.: R01 HS12028 (Research Grant)
Period: 9/30/01-9/29/03
Title: Nursing Home Working Conditions and Quality of Care
Summary: The purpose of this exploratory study is to describe selected working conditions in the nursing home and to determine what relationship these selected conditions have to nursing home performance. The specific aims of this study are: 1) determine the frequency and variability of selected working conditions (culture and environment, staff interaction, and staffing) among a sample of Colorado nursing homes; 2) determine the frequency and variability of targeted organizational performance measures (MDS Quality Indicators, state survey citations and complaints filed with the state, and perceived effectiveness); 3) examine the relationship between selected working conditions and targeted organizational performance measures and; 4) elicit an in-depth description of organizational culture (rituals, heroes, celebrations) from key informants and explore their relationship to quality care. Data related to nursing home working conditions will be gathered via surveys of all nursing home staff, interviews of key informants, and using the Observable Indicators of Quality Scale. Performance measures will be collected using staff surveys of perceived effectiveness, quality indicators from the Minimum Data Set (MDS) Resident Assessment, state survey citations and complaints filed with the state. Thirty-six nursing homes will be selected for the study using a stratification process based on 3 MDS quality indicators.
Principal Investigator: Jinah K. Shin, D.N.S.C.
Institution: Columbia University School of Medicine
Grant No.: F32 HS00149 (Fellowship)
Period: 09/01/00-08/31/02
Title: Utilization of Mental Health Services by API Americans
Summary: The purpose of this study is to examine whether ethnic differences in use of inpatient mental health services exist, and investigate factors affecting utilization by API American compared with other ethnic groups. Design: Multivariate analysis of admissions to inpatient psychiatric services in New York State from 1995 and to 1998. Data: The data for this study will come from SPARCS data sets on inpatient discharges. Analysis: Univariate descriptive analyses and chi-square tests will be used to examine the possible ethnic differences in utilization of inpatient services. Logistic and multiple regression analyses will be also used to determine the important predictors of the inpatient service utilization.
Principal Investigator: Maija Selby-Harrington, Dr.P.H., R.N.
Institution: University of North Carolina
Grant No: R01 HS06507 (Research Project)
Period: 4/1/90-3/31/95
Title: Nursing Interventions to Improve EPSDT Utilization
Summary: The major purpose of the Project was to conduct a randomized
controlled trial to test the effectiveness and cost-effectiveness of three outreach
interventions to promote use of the Early and Periodic Screening, Diagnosis
and Treatment (EPSDT) program. EPSDT provides well-child screening for
children on Medicaid. In rural North Carolina, the authors selected a random
sample of 2,053 families with children due for an EPSDT screening and
stratified them according to whether they had a home phone. Within strata, the
authors randomly assigned families to receive EPSDT information by the usual
(control) method of informing at Medicaid intake only; or enhanced informing
by a home visit, a mailed pamphlet and letter, or (for families with phones) a
phone call. All interventions produced more screenings than the control
method, but increases were significant only for families with phones. Among
families with phones, a home visit was the most effective intervention but a
phone call was the most cost-effective. However, absolute rates of effectiveness
were low, and incremental costs per effect were high. The study showed the
need to develop new interventions, particularly for families without phones.
Within the context of the Project and minority supplement, numerous
substudies also were conducted.
Availability: NTIS Final Report Accession Number:
PB95222121
Principal Investigator: Lee Sennott-Miller, Ph.D., R.N.
Institution: University of Arizona
Grant No: R01 HS0774 (Research Project)
Period: 9/1/94-8/31/98
Title: A Peer Practice Model for Vulnerable Rural Elderly
Summary: The purposes of this investigation were to: 1) Test the effectiveness
of a peer counseling model in improving self-care knowledge and behavior
among Hispanic and Anglo elderly in a rural community; 2) Determine what
level of contact is necessary to observe changes in knowledge and behavior in
areas such as nutrition, stress reduction and exercise, and in the management
of chronic illness; 3) Determine whether Anglo and Hispanic elderly respond
the same way to contact by peer counselors; and 4) Describe differences in
patterns of information sharing between Anglo and Hispanic peer counselors.
Principal Investigator: Carla J. Serlin, Ph.D.
Institution: American Nurses' Association
Grant No: R13 HS08671 (Conference)
Period: 4/1/95-3/31/98
Title: Ethnic/Racial Minority Health Policy Research Institute
Summary: Health policy research is a key element in decreasing the disparity
in health outcomes between ethnic minorities and the general population and
incorporating innovative practice into the established health care system.
Because nurses have direct patient contact in a variety of settings, they have the
expertise to determine the immediate and potential consequences of health
policies. Nurse researchers have both the clinical experience and the research
ability to make the link from clinical practice to the overall health needs of this
country. What is missing, however, is a clear understanding among nurse
researchers of what constitutes health policy, how clinical practice reflects
current policy, and what research questions must be formulated to assess
current programs and offer effective alternatives. A health policy conference
provided the necessary policy education so that empirical research could be
translated into work relevant to policy decisionmakers.
Availability: NTIS Final Report Accession Number: PB99110421
Principal Investigator: Rita Snyder-Halpern, Ph.D., R.N.
Institution: University of Arizona
Grant No.: R01 HS13131 (Research Project)
Period: 9/1/03-8/31/06
Title: Impact of Community Hospital CPOE System on ADE Outcome
Summary: Computerized provider order entry (CPOE) systems are a type of information system that can significantly improve medication safety and decrease ADEs. Limited research attention, however, has focused on factors that contribute to successful CPOE system implementation and the impact that these systems have on ADE incidence, especially in non-teaching community hospitals. A three-year study is proposed to coincide with the implementation of a commercial CPOE system in three non-teaching community hospitals in an integrated health care delivery system in Southern California. The specific aims of the longitudinal study are to 1) test a theoretical model positing relationships between CPOE system implementation variables (i.e., information technology/systems (IT/S) innovation readiness, perceived usefulness, and satisfaction), and ADE incidence; 2) test the effect of a commercial CPOE system on ADE incidence; and 3) explore the impact of hospital contextual factors on CPOE system implementation variables and ADE incidence.
Principle Investigator: Lynn Soban, M.P.H., R.N.
Institution: University of California Los Angeles
Grant No.: R36 HS14518 (Dissertation)
Period: 6/1/04-12/31/04
Title: Organizational Predictors of Colon Cancer Screening
Summary: Several reports including the Institute of Medicine's Crossing the Quality Chasm have called attention to systems or organizational level factors as critical to the improvement of health care quality in the United States. In addition, understanding the context or environment in which an organization exists is also important to crafting policy-relevant research. The predominance of managed care organizations over the last two decades is an example of an environmental influence that has changed the organization and delivery of health care in the United States. The purpose of the proposed research was to examine how the environmental context of an organization influences organizational structures and processes and ultimately affects the care delivered at the site. The clinical focus of this study was colorectal cancer (CRC) screening. To date, most of the research on the delivery of CRC screening has focused on individual patient-level factors, leaving the influence of organizational factors poorly understood. This cross sectional study used data from several different sources including: Interstudy, the Area Resource File, and the Veteran's Health Administration (VHA). Ordinary least squares and multi-level logistic regression models were used to explore: (1) the relationship between managed care penetration and adoption of managed care practices in the VHA that may affect CRC screening rates; (2) the relationship between managed care penetration and receipt of colorectal cancer screening within the VHA system; and (3) the effect of managed care penetration on the probability of receiving CRC screening inside the VHA system among those who received CRC screening. Understanding the relationship of organizational influences and variations in the delivery of CRC screening will provide a better understanding of the barriers to the use of this service. Such information may serve as the basis for the design of interventions to improve CRC screening.
Principal Investigator: Karen Sousa, Ph.D., R.N.
Institution: Arizona State University
Grant No.: R13 HS12061 (Conference)
Period: 9/30/01-9/29/02
Title: Optimizing Outcome Research for Nursing Practice
Summary: The primary purpose this conference is to disseminate new outcomes research findings to those in leadership positions who have the potential to incorporate them into practice. The relationship of nursing staffing to quality will be a focus for discussions given that workforce planning is a strategic activity for nursing leadership. Participants will be nurse executives, advanced practice nurses, quality assurance managers, case managers, unit managers staff nurses, teachers, researchers, and health policymakers. Outcomes will be in the form of further discussions to produce collaboration and/or research grants evaluating different practice models and health systems effect of patient outcomes.
Principal Investigator: Richard L. Sowell, M.S.N., R.N.
Institution: University of South Carolina
Grant No: R03 HS06315 (Dissertation)
Period: 9/1/89-8/31/90
Title: The Effect of Case Management on Cost of Care for PWAS
Summary: The study compared lifetime costs of a case management approach
to a less organized, ad hoc approach to care. The subjects were men, ages 20
through 49, who died of acquired immunodeficiency syndrome (AIDS) in
Georgia, between 1986 and 1989. Retrospective inpatient medical and financial
data from five Georgia hospitals were analyzed. A case management system
was used for half the patients. Charge figures across hospitals were
standardized and adjusted for annual inflation rates. The two groups were
equivalent in terms of race, and history of intravenous drug, alcohol, and other
drug use. Results show that for the 121 patients in the study, the total adjusted
hospital charges for the case managed group were significantly lower. Also,
case managed patients lived significantly longer. Thirty-one percent of the case
managed group was diagnosed during the first hospitalization, compared to 56
percent of the total sample.
Availability: NTIS Final Report Accession Number: PB94214327
Principal Investigator: Kathleen Stevens, F.A.A.N.
Institution: University of Texas Health Sciences Center San Antonio
Grant No.: R13 HS14114 (Small Conference Grant)
Period: 6/5/03-6/4/04
Title: Best Practice Improving Quality
Summary: Not available.
Principal Investigator: Kathleen Stevens, F.A.A.N.
Institution: University of Texas Health Sciences Center San Antonio
Grant No.: R13 HS14734 (Small Conference)
Period: 4/15/04-4/14/05
Title: Fostering Quality Climates
Summary: Not available.
Principal Investigator: Patricia W. Stone, Ph.D., M.P.H., M.S., B.S.N.,
A.S.N.
Institution: Columbia University
Grant No.: R01 HS13114 (Research Grant)
Period: 9/30/01-9/29/04
Title: Outcomes of ICU Working Conditions
Summary: The main objective of this study is to investigate the effect
of varied working conditions (workforce staffing and organizational
climate) in ICUs on elderly patient safety outcomes (nosocomial
infections [NIs], length of stay, mortality, and disposition at
discharge), and healthcare worker safety (musculoskeletal injuries,
blood/body fluid exposure, sick days, and disability days).
Principal Investigator: Mary Suave, D.N.Sc., R.N.
Institution: University of California
Grant No: R03 HS10701 (Small Research Project)
Period: 2/1/00-1/30/01
Title: Cognitive Retraining in Sudden Cardiac Arrest Survivors
Summary: The purposes of this pilot study are twofold: 1) to determine to what
extent two targeted cognitive retraining interventions can realistically be used
to improve memory function in patients with chronic anoxic brain damage
secondary to sudden cardiac arrest; and 2) to assess whether improvements in
memory, if any, are accompanied by survivor and spouse/caregiver reports of
improved everyday functional status.