Funded Grants Submitted by Nurses: 1980-2005 (continued)

T

Principal Investigator: Marita Titler, R.N.
Institution: University of Iowa
Grant No.: R13 HS14141 (Conference)
Period: 7/7/03-7/6/04
Title: Advancing Quality Care through Translation Research
Summary: The University of Iowa, College of Nursing, and the University of Iowa Hospitals and Clinics Department of Nursing and Services and Patient Care propose to sponsor a two-day invitational conference to address methodological issues and designs of major importance in translation science. This conference will be co-sponsored by Sigma Theta Tau International; Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN); the Veterans Administration; the University of Rhode Island School of Nursing; the Research Dissemination Core of the Gerontological Nursing Interventions Research Center (at the University of Iowa); and the University of Iowa Associate Provost for Health Sciences office. The specific aims are to bring together nurse researchers to: 1. Discuss the state of the science, methodological issues, instrumentation, and research designs of translation science; 2. Analyze strategies for increasing funded research regarding scientific knowledge to promote adoption of evidence-based health care practices; 3. Discuss the impact of translation science on practice and public policy; and 4. Set forth a future research agenda for translation science in nursing.

Principal Investigator: Marita Titler, R.N.
Institution: University of Iowa
Grant No: R01 HS10482 (Research Project)
Period: 9/30/99-9/29/02
Title: Evidence-Based Practice: From Book to Bedside
Summary: This three year study will test, using an experimental design, the effectiveness of an interdisciplinary intervention to promote translation of evidence into practice. Specific aims are: 1) To test the effect on nurse and physician behavior of an intervention designed to promote adoption of an evidence based guideline for acute pain management in the elderly. 2) To test the effect of an intervention designed to promote adoption in practice of evidence based guidelines on decreasing barriers to use of those guidelines in practice. 3) To determine the cost-effectiveness ratios of an intervention designed to promote adoption in practice of an evidence-based guideline for acute pain management in the elderly.

Principal Investigator: Alison Trinkoff, D.S.C., Sc.D., R.N., F.A.A.N.
Institution: University of Maryland Baltimore
Grant No.: R01 HS11990 (Research Project)
Period: 9/30/01-9/29/03
Title: Do Organizational Factors Influence Both Patient and Worker Safety?
Summary: Several recent reports have highlighted growing concerns about the quality of patient care in the U.S. While these concerns are not new, there is a perception that the quality of patient care is decreasing. At the same time, injuries to health care workers remain a serious problem. As it is likely that reductions in staffing and other organizational changes may act as risk factors for adverse outcomes for both patients and workers, patient and worker outcomes will be linked by institution to address this crucial hypothesis. To do this, patient and worker injury rates in both acute and long-term care facilities will be assessed with an ecological framework, measured over time, using the following specific aims: 1) Examine the relationship of adverse patient outcomes (post-surgical complications, post-surgical misadventures) to staffing variables (staffing, skill mix, RN to total) at the institutional level; 2) Examine the relationship of adverse worker outcomes (worker injuries) to staffing variables at the institutional level; 3) Identify changes in the rate of adverse patient outcomes in relation to staffing variables by institution, over time (1998-00); 4) Identify changes in the rate of adverse worker outcomes in relation to staffing variables by institution, over time (1998-00); and 5) Examine the organizational characteristics of hospitals and nursing homes in relation to rates of adverse patient and worker outcomes. Three years of administrative data (1998-2000) will be compiled from three states using acute care hospitals and nursing homes. Acute care adverse patient outcomes will come from the HCUP QI and for nursing homes from the HCFA Minimum Data Set. Organizational descriptors will be obtained from the AHA Annual Survey database (e.g., total FTEs, RN FTE, nonprofit status, and size) and OSCAR (beds, special services, and staffing). Worker injuries will be obtained from state First Report of Injury databases. Longitudinal trends over three years will be examined, using (Generalized Estimating Equations, in addition to cross-sectional analyses. This study will provide empirical data to support the utility of modifications in the organization of health systems, which are designed to improve the quality and safety of patient care while maximizing the health and productivity of workers.

Return to Index

V

Principal Investigator: Doris C. Vahey, Ph.D., R.N.
Institution: University of Wisconsin-Madison
Grant No.: R03 HS10581 (Dissertation)
Period: 9/30/99-9/29/00
Title: Quality Health Care Outcomes: Satisfaction and Adherence
Summary: This descriptive correlation study examined the relationships among nurses, job satisfaction, patient satisfaction, and patient adherence to health care provider recommendations after hospitalization.

Principal Investigator: Joyce Verran, Ph.D., R.N., F.A.A.N.
Institution: University of Arizona
Grant No.: R01 HS11973 (Research Project)
Period: 9/27/01-8/81/03
Title: The Impact of Nursing Unit Characteristics on Outcomes
Summary: The purpose of this project is to determine the impact of workplace factors on outcomes of patients discharged from acute care nursing units. Two aims are proposed for the research. The first aim seeks to examine the relationships among Patient Characteristics (unchangeable risk factors); Organizational Characteristics (unchangeable hospital factors; Nursing Unit Characteristics (changeable workgroup factors) and Patient Outcomes (safety factors and generic quality outcomes). The second aim will use an innovative approach of computer modeling to simulate the best mix of nursing unit characteristics in light of constant patient and hospital factors to achieve the highest level of patient outcomes. The research is grounded in the quality health outcomes model as proposed by the American Academy of Nursing Expert Panel on Quality. Ten hospital in the Tucson area have agreed to participate in the research for a total of 35 nursing units with serves as the unit of analysis for the research. Patient and Organizational characteristics will be collected from hospitals for six months to provide two quarters of information for analysis. Unit characteristics will be collected during months 3 and 4 to assure the effect of baseline information on unit data and unit data on patient outcomes. Safety outcomes will be collected from hospital based records. Quality Outcomes (Symptom Distress, Self-Care, Satisfaction) will be collected from 20-25 random patient discharges monthly on each of the 35 nursing unites. Analysis will include multiple regression analysis, correlation and structured equation modeling. Software for computer modeling will be developed during the first year of the project, tested with the data from the first 18 nursing unites and results validated with the data from the second cohort of 17 nursing unites. All data will be group analyzed if validation is supported.

Return to Index

W

Principle Investigator: Laura Wagner, M.S.N., R.N.
Institution: Emory University
Grant No.: R36 HS14663 (Dissertation)
Period: 9/1/04-12/31/04
Title: Use of Incident Reports to Assess Falls in Nursing Homes
Summary: The purpose of this dissertation research was to test the effect of a systematically guided, menu-driven incident reporting system (MDIRS) on the post fall evaluation process in nursing homes (NHs). Falls among frail NH residents are a common and potentially preventable problem that results in adverse economic, medical, and psychological consequences. Approximately one-half of the 1.7 million NH residents fall annually. When a NH resident falls, the licensed nurse documents the incident both in the medical record and incident report. Traditionally, the incident report serves a dual purpose in NHs-risk management and liability, but it is seldom used for quality improvement. Incident reporting systems have been successfully used as a model to reduce errors and improve safety in several disciplines, but their use in improving the quality of care in NHs has not been examined. This study aimed to improve the content and systematic structure of a falls incident report with the overall goal of enhancing the quality of care that nurses provide to NH residents. A secondary goal was to explore the feasibility in entering the MDIRS falls information in a computer software program to facilitate aggregate analysis of data for quality improvement initiatives. The broad, long term objective of this study was to provide a foundation for a program of research aimed at improving the safety among NH residents. The study was a six-month pretest-posttest experimental design to examine the effect of the MDIRS on the post-fall evaluation process in NHs. The candidate had successfully recruited six NHs (3 intervention; 3 control) in the metropolitan Atlanta area to participate in the study. Medical record documentation of residents who fall during the six month study period were examined. By conducting a structured process-of-care audit based on clinical practice guidelines, the candidate tested whether the NH staff utilizing the MDIRS intervention improves how NH staff systematically assess residents in the post-fall evaluation period. The results of this study may lead to improved methods for post-fall assessment in NHs.

Principal Investigator: Nancy M. Watson, Ph.D., R.N.
Institution: University of Rochester
Grant No: R01 HS08491 (Research Project)
Period: 6/1/96-5/31/01
Title: Urinary Incontinence Guidelines: Application in Nursing Homes
Summary: This project seeks to evaluate the dissemination and implementation of the Agency for Health Care Policy and Research (AHRQ) Guideline for Urinary Incontinence (UI) in nursing home settings. This study evaluates the UI practices of physicians, nurse practitioners, clinical nurse specialists, physician assistants, nursing staff, and nursing aides in 52 nursing homes in a nine-county area of upstate New York. The study also aims to identify barriers to implementation of the guideline and estimate resource implications for its implementation through the use of focus groups of providers and nursing home staff.

Principal Investigator: Nancy M. Watson, Ph.D., R.N.
Institution: University of Rochester
Grant No.: U18 HS11064 Co-op Agreement)
Period: 9/1/00-8/31/03
Title: A Model for Use of the Urinary Incontinence Guideline in US Nursing Homes
Summary: This project will test the effectiveness of a model of care implemented by nurse practitioners in collaboration with nurses and physicians to translate the AHRQ Urinary Incontinence Guideline into practice in 10 New York nursing homes. The study will determine the feasibility of this model in reducing urinary incontinence (UI) in nursing homes, preventing complications associated with UI and improving the quality of life of nursing home residents and families.

Principal Investigator: Betty S. Williams, Dr.P.H., R.N.
Institution: National Black Nurses Association, Inc.
Grant No: R13 HS07862 (Conference)
Period: 2/2/93-1/31/95
Title: The Design of Community-Based Health Research
Summary: The National Black Nurses Association (NBNA) convened African-American nurse researchers and nurse community leaders to participate in a national invitational conference on the Design of Community-Based Health Research through a unique partnership model. It increased the capability of actual community action change agents and health service researchers to develop testable questions and hypothesis from life health problems to be answered through the research process. Research issues including problem statements, testable questions and design/methodological frameworks were developed. Presentations by nurse scientist leaders expanded the knowledge of the participants regarding research funding opportunities and technical assistance available. The research partnership model was concluded to be a very strong strategy to provide vital empirical data about the African-American community necessary to determine the effectiveness of specific interventions for health services and to point to policy implications.
Availability: NTIS Final Report Accession Number: PB95183414

Principal Investigator: Roma Williams, Ph.D., R.N.
Institution: University of Alabama
Grant No: R03 HS0801 (Small Research Project)
Period: 9/30/93-9/30/95
Title: Poor Rural Women and Health Promotion: Instrumentation
Summary: The purpose of this project was to describe the health promotion behaviors and disease prevention behaviors used by poor rural women. Most of the poorest counties in the United States are in the Southern rural regions. These are also the most underserved in terms of health care services. These women are especially vulnerable, bearing and raising children, in single parent households, with few social services. Government insurance programs are based on each states economy. As a result only the poorest poor have access to health services. Rural counties in the southern regions of the United States tend to be predominantly White or Black, but often equally impoverished. It is unlikely that this region will ever have adequate health care resources. Thus, it is imperative that rural dwellers be self-sufficient, yet have available to them a culturally relevant, accessible, and appropriate health care delivery system that fits within the context of their lives.
Availability: NTIS Final Report Accession Number: PB96130091

Principal Investigator: Rebecca Winsett, Ph.D., F.N.P.
Institute: University of Tennessee
Grant No.: R03 HS11472 (Small Grant)
Period: 6/01/01-5/31/03
Title: Impact of Structure on Living Organ Donation
Summary: This research study will evaluate transplant center and individual barriers and facilitators of living donation. Aim 1 will identify transplant center barriers and facilitators of living donation. Aim 2 will identify individual barriers and facilitators of living donation, and Aim 3 will seek to design a model living donor transplant program.

Principal Investigator: Candice C. Wong
Institution: University of California San Francisco
Grant No.: R01 HS10276 (Regular Research Grant)
Period: 9/30/00-9/29/2003
Title: Quality of Hypertension Care for Asian Refugees
Summary: The specific aims of this project are to: 1) define quality of care (QOC) for hypertension from the Hmong perspective; 2) develop a hypertension quality-of-care instrument for use with Hmong patients; and 3) pilot-test the hypertension quality-of-care instrument.

Principal Investigator: Sabrina T. Wong, R.N., M.S., Ph.C.
Institution: University of California
Grant No: R03 HS10004 (Dissertation)
Period: 9/30/98-12/31/99
Title: Factors Influencing Children's Health Care Utilization
Summary: Few studies on children's health care utilization have specifically examined a primarily low-income, minority community population, reinforcing the need to examine parents' and family's contribution to children's health. The primary aim of this study is to test, in a low-income minority, nurse-managed primary care clinic site, a theoretical model that has been designed specifically for pediatric health care utilization. Some of the variables, such as the family environment and parenting behavior, hypothesized to affect children's health status and their use of health care, are targets of advanced practice nursing interventions. A prospective cohort design is being used to address the research questions in this study.

Return to Index

Y

Principal Investigator: Hannelore Yoos, Ph.D., R.N., C.P.N.P.
Institution: University of Rochester
Grant No: R03 HS10689 (Small Research Project)
Period: 3/1/00-2/28/01
Title: Barriers to Anti-Inflammatory Use in Childhood Asthma
Summary: This project will develop a simple clinically useful questionnaire to aid clinicians in determining what are the specific barriers to use of anti-inflammatory therapy in the treatment of asthma. The specific aims of the project are: 1) to identify the domains of parental beliefs and attitudes related to anti-inflammatory use in their children with asthma; 2) to develop a questionnaire that reflects potential beliefs and attitudes affecting anti-inflammatory use that is reliable, valid, and appropriate for use in clinical research as well as in a busy clinical setting; and 3) to evaluate the psychometric properties of the instrument.

Return to Index

Z

Principal Investigator: Brenda Zierler, Ph.D., R.N.
Institution: University of Washington
Grant No: R03 HS09348 (Small Research Project)
Period: 9/30/96-8/28/98
Title: Integrated Care Pathway for Venous Thromboembolism
Summary: The goal of this study was to change the organizational design of health care delivery for patients with venous thromboembolism (VTE) to determine if a multidisciplinary team using an evidenced-based integrated care pathway (ICP) could provide high quality, cost effective care throughout the continuum of inpatient and outpatient management. The existing approach to the care of patients with VTE is fragmented, nonuniform, and carried out independently by a variety of different provider disciplines and patient services without any continuity in care. The impetus for this study was the impending shift in location of care from inpatient to outpatient with the introduction and use of low molecular weight heparin (LMWH) for the treatment of DVT. The rationale for developing an ICP model of care for patients with VTE was to decrease variation in current practice and to establish a standard of care for the treatment of VTE at the UWMC. In order to ensure quality treatment protocols for VTE, it was essential to first develop the standards for inpatient treatment.
Availability: NTIS Final Report Accession Number: PB98152838

Principal Investigator: Dan Zhang, Ph.D., R.N.
Institution: University of Pennsylvania
Grant No: F32 HS00073 (NRSA Award)
Period: 9/1/93-8/31/94
Title: Cost of Capital and Profitability of Pharmaceutical Research and Development
Summary: The first part of this research project applied the Capital Asset Pricing Model (CAPM) in estimating the cost of capital; Fama and Macbeth's method were adopted to obtain empirically determined risk free rate and market risk premium. The second part used the Arbitrage Pricing Theory (APT) as an alternative to the CAPM, incorporating both factor analysis and predetermined macroeconomic factors for estimation. The Investigator expected that the API model would generate higher estimation of cost of capital than that of CAPM. Predictions for the returns of hold-out samples were be tested for the above models to assess and compare the strength of different models.

Return to Index