THE PAST, PRESENT & FUTURE OF NURSING SCIENCE: 30 YEARS OF THE - PowerPoint PPT Presentation

THE PAST, PRESENT & FUTURE OF NURSING SCIENCE: 30 YEARS OF THE NATIONAL INSTITUTE OF NURSING RESEARCH (NINR) AcademyHealth Annual Research Meeting, June 28, 2016 Patricia A. Grady, PhD, RN, FAAN Director, National Institute of Nursing Research

TRANSLATING NURSING RESEARCH INTO POLICY AcademyHealth Annual Research Meeting, June 28, 2016 Patricia A. Grady, PhD, RN, FAAN Director, National Institute of Nursing Research

Why Health Policy? “The moral test of government is how that government treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; & those who are in shadows of life, the sick, the needy, & the handicapped.” ~ Hubert H. Humphrey Patricia A. Grady, PhD, RN, FAAN

Translating Nursing Research Into Policy The Interactive Ecosystem of Health Improvement Evidence- Evidence- based based Practice Education Team Science & Patients Stakeholder- Government Families • Engaged Federal Communities • Research State Advocacy Groups • County Community • City Groups Educators Providers/Clinicians Professional Payers Societies Regulators Policy Payers Scientists Regulators Industry Patricia A. Grady, PhD, RN, FAAN

Translating Nursing Research Into Policy Topics • Health Care Challenges • NINR and Nursing Research • Nursing Science and Health Policy • Training and Career Opportunities • Leading Into the Future Patricia A. Grady, PhD, RN, FAAN

Health Care Challenges Health Care Performance Rankings 11 5 3 3 3 4 9 11 5 11 11 11 $8,508 Patricia A. Grady, PhD, RN, FAAN

Health Care Challenges Health Disparities Enhanced Need for Clinicians Racial & Cultural Diversity Value-Based Care Aging Population Technology Patricia A. Grady, PhD, RN, FAAN

NINR and Nursing Research NINR Mission To promote and improve the health of individuals, families, and communities. Inclusive of the Full: Empowering: • Lifespan • Patients & families • Health spectrum • Communities • Healthcare settings • Caregivers • Practitioners Interdisciplinary, Team-based & Community-engaged Science Patricia A. Grady, PhD, RN, FAAN

NINR and Nursing Research Scientific Focus Areas to Implement NINR’s Strategic Plan • Symptom Science • Wellness • Self-Management • End-of-Life & Palliative Care • Technology & Training New Five-Year Strategic Plan To be Released September 2016 Patricia A. Grady, PhD, RN, FAAN

NINR and Nursing Research NINR Extramural Research • Primarily at universities and health science centers • Cross-cutting, interdisciplinary research http://ninr.nih.gov/ResearchAndFunding/DEA / NINR Intramural Research • On the NIH campus in Bethesda, Maryland • Collaborative research in symptom management, TBI, and genomics • Training at all career levels http://ninr.nih.gov/ResearchAndFunding/DIR/ Patricia A. Grady, PhD, RN, FAAN

Symptom Science Evidence-Based Decision & Policy Making: Transitional Care Model High-Value Transitional Care: Translation of Research Into Practice, Naylor, M, et al. Oct. 2013 Patricia A. Grady, PhD, RN, FAAN

Symptom Science Sleep: Critical to Workforce • Wellness & Quality of Care JAMA. 2012 Dec 5; 308(21): 2208-17 R01 NR004281 Patricia A. Grady, PhD, RN, FAAN

Symptom Science Traumatic Brain Injury (TBI) • Sustained by1/3 of military who deploy for combat Aug. 3, 2015 • Increased risk for chronic symptoms • Blood biomarker tau elevated Implications • Ramifications for decades post service • Translatable to TBI in general population? Patricia A. Grady, PhD, RN, FAAN

Wellness Primary & Secondary Prevention Chicago Parent Program Makes a Difference Utilized in 19 States & 3 Major City Head-Start Programs J Ped Health Care 2016 Res Nurs Health 2012, J Prim Prev 2011, Prev Sci 2009, 35(5):475-489 35(5):475-489 32(5-6):283-98 10(1):54-65 Dr. Deborah Gross and colleagues R01NR012444 & R01NR004085 Validated In English & Spanish Patricia A. Grady, PhD, RN, FAAN

Wellness Recognized Best Evidence: Wellness Be Proud! Be Responsible! Be Protective! NR03123 (Jemmott); NR005041 & NR007077 (Koniak-Griffin); NR04855 (Villarruel) Patricia A. Grady, PhD, RN, FAAN

Self-Management Self-Management: A Comprehensive Approach to Management of Chronic Conditions Research Examples • Cancer • Asthma • Arthritis • Irritable Bowel Syndrome • Depression • COPD • Obesity Grady & • Diabetes Daly, 2013 • Heart Disease Grady & Gough, 2014 Patricia A. Grady, PhD, RN, FAAN

Self-Management Self-Management: A Comprehensive Approach Helping Teens With Type 1 Diabetes TeenCope & Teen.Connect Diabetes Care 2013 Grey M, Whittemore R, Jeon S, Murphy K, Faulkner MS, Delamater A & the TeenCope Study Group 2015 Whittemore R, Teens.Connect Team Patricia A. Grady, PhD, RN, FAAN

End-of-Life and Palliative Care Patricia A. Grady, PhD, RN, FAAN

End-of-Life and Palliative Care Variation in End-of-Life Hospice Use • Disparities in hospice use • Hospice patterns use may indicate Stopping Statins Benefits inadequate & problematic end-of-life Patients with Advanced Illness care • Stopping statins = no mortality change • Improved quality of life when statins stopped < 28.9% 28.9 - 31.2% 31.2 - 33.8% Kutner JS, et al. JAMA Intern Med. 2015 ≥ 33.8% From Wang SY, et al. J Palliat Med. 2015 Patricia A. Grady, PhD, RN, FAAN

Technology Evidence-Based Decision & Policy Making: Discharge Decision Support System (D2S2) • Evidence-based technology • Integrates with EHR systems • Helps identify high-risk patients upon admission • Reduces 30 & 60 day readmissions http://healthblog.ncpa.org (Bowles, et al. Jan 2015, NR 013609 RightCare Solutions) Patricia A. Grady, PhD, RN, FAAN

Training and Career Development NINR Fosters Lifelong Learning SGI, Boot Camps, GPPs Online Training Resources Career Development Awards (K awards) National Research Service Awards (NRSA ) • Individual NRSA (F31, F32, F33) • Institutional NRSA (T32) Centers • Research Supplements to Promote Diversity ninr.nih.gov/training youtube.com/user/NINRnews grants.nih.gov/grants/guide/pa-files/PA-15-322.html ninr.nih.gov/Training/OnlineDevelopingNurseScientists Patricia A. Grady, PhD, RN, FAAN

Training and Career Development

Leading Into The Future Progress Report • More PhD-Trained Nurses Needed • Continue Nursing’s Progress In: o Diversity growth across profession o Full-scope practice o Lifelong learning & educating the public o Team-based, inter-professional collaboration & leadership 2015 o Engagement in workforce planning & policy with better data-collection & -use nationalacademies.org/hmd/ Patricia A. Grady, PhD, RN, FAAN

Leading Into The Future NIH Framework for Building National, Large-scale Research Cohort for Precision Medicine nih.gov/precision-medicine-initiative-cohort-program ninr.nih.gov/researchandfunding/precisionmedicine# Patricia A. Grady, PhD, RN, FAAN

www.ninr.nih.gov Dr. Chris Dr. Chris Patricia Patricia Hafner- Hafner- Eaton, Eaton, PhD, MPH,ND PhD, MPH,ND NIH Health NIH Health Science Science Policy Policy Analyst, Analyst, Science Science Writer & Writer & Faculty Faculty www.ninr.nih.gov

Leading Into The Future Linda H Aiken, PhD, FAAN, FRCN, RN Pamela S. Hinds, PhD, FAAN, RN Professor/Director Professor/Director University of Pennsylvania Children’s National Health System Patricia A. Grady, PhD, RN, FAAN

Leading Into The Future Health Care Workforce and Quality of Care Feb 26, 2014 Jan. 2016 Linda H Aiken, PhD, FAAN, FRCN, RN Patricia A. Grady, PhD, RN, FAAN

Leading Into The Future Pamela S. Hinds, PhD, FAAN, RN Expanding Life Quality for Patients & Nursing Research Opportunities for Professionals Patient and family-centered end of life research across: • Life-limiting serious illnesses • Cultures • Settings • Media • Interventions to improve quality of life Pamela S. Hinds, PhD, FAAN, RN during the final months/years Patricia A. Grady, PhD, RN, FAAN