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

Patricia A. Grady, PhD, RN, FAAN

Director, National Institute of Nursing Research

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

“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

Why Health Policy?

Patricia A. Grady, PhD, RN, FAAN

Translating Nursing Research Into Policy

Evidence- based Practice Evidence- based Education Policy

Team Science & Stakeholder- Engaged Research

The Interactive Ecosystem of Health Improvement

Patients Families Communities Advocacy Groups Community Groups Providers/Clinicians Payers Regulators Scientists Industry Government

• Federal
• State
• County
• City

Educators Professional Societies Payers Regulators

Patricia A. Grady, PhD, RN, FAAN

Topics

• Health Care Challenges
• NINR and Nursing Research
• Nursing Science and Health Policy
• Training and Career Opportunities
• Leading Into the Future

Translating Nursing Research Into Policy

Patricia A. Grady, PhD, RN, FAAN

Health Care Performance Rankings

Health Care Challenges

11 11 11 11 11 3 5 5 9 4 3 3

$8,508

Patricia A. Grady, PhD, RN, FAAN

Health Disparities

Health Care Challenges

Aging Population Racial & Cultural Diversity Technology Need for Clinicians Value-Based Care

Enhanced

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:

• Lifespan
• Health spectrum
• Healthcare settings

Empowering:

• Patients & families
• Communities
• Caregivers
• Practitioners

Interdisciplinary, Team-based & Community-engaged Science

Patricia A. Grady, PhD, RN, FAAN

• Symptom Science
• Wellness
• Self-Management
• End-of-Life & Palliative Care
• Technology & Training

NINR and Nursing Research

Scientific Focus Areas to Implement NINR’s Strategic Plan New Five-Year Strategic Plan To be Released September 2016

Patricia A. Grady, PhD, RN, FAAN

NINR and Nursing Research

NINR Intramural Research

http://ninr.nih.gov/ResearchAndFunding/DEA/

• On the NIH campus in Bethesda, Maryland
• Collaborative research in symptom

management, TBI, and genomics

• Training at all career levels

NINR Extramural Research

• Primarily at universities and health

science centers

• Cross-cutting, interdisciplinary research

http://ninr.nih.gov/ResearchAndFunding/DIR/

Patricia A. Grady, PhD, RN, FAAN

Symptom Science

High-Value Transitional Care: Translation of Research Into Practice,

Naylor, M, et al. Oct. 2013

Evidence-Based Decision & Policy Making: Transitional Care Model

Patricia A. Grady, PhD, RN, FAAN

Symptom Science

• JAMA. 2012 Dec 5;

308(21): 2208-17

R01 NR004281

Sleep: Critical to Workforce Wellness & Quality of Care

Patricia A. Grady, PhD, RN, FAAN

Symptom Science

Traumatic Brain Injury (TBI)

• Sustained by1/3 of military

who deploy for combat

• Increased risk for chronic

symptoms

• Blood biomarker tau elevated

Implications

• Ramifications for decades

post service

• Translatable to TBI in

general population?

• Aug. 3, 2015

Patricia A. Grady, PhD, RN, FAAN

Wellness

• Dr. Deborah Gross and colleagues

R01NR012444 & R01NR004085

Chicago Parent Program Makes a Difference

Prev Sci 2009, 10(1):54-65 J Prim Prev 2011, 32(5-6):283-98

Primary & Secondary Prevention

Res Nurs Health 2012, 35(5):475-489

Utilized in 19 States & 3 Major City Head-Start Programs Validated In English & Spanish

J Ped Health Care 2016 35(5):475-489

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

• Cancer
• Asthma
• Arthritis
• Irritable Bowel Syndrome
• Depression
• COPD
• Obesity
• Diabetes
• Heart Disease

Grady & Gough, 2014 Grady & Daly, 2013

Research Examples

Patricia A. Grady, PhD, RN, FAAN

Self-Management

2015

Whittemore R, Teens.Connect Team

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

Patricia A. Grady, PhD, RN, FAAN

End-of-Life and Palliative Care

Patricia A. Grady, PhD, RN, FAAN

Stopping Statins Benefits Patients with Advanced Illness

• Stopping statins = no

mortality change

• Improved quality of life

when statins stopped

End-of-Life and Palliative Care

Kutner JS, et al. JAMA Intern Med. 2015

Variation in End-of-Life Hospice Use

• Disparities in hospice use
• Hospice patterns use may indicate

inadequate & problematic end-of-life care

From Wang SY, et al. J Palliat Med. 2015 < 28.9% 28.9 - 31.2% 31.2 - 33.8% ≥ 33.8%

Patricia A. Grady, PhD, RN, FAAN

Technology

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)

Evidence-Based Decision & Policy Making:

Patricia A. Grady, PhD, RN, FAAN

Training and Career Development

• 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

SGI, Boot Camps, GPPs Online Training Resources Career Development Awards (K awards) National Research Service Awards (NRSA) NINR Fosters Lifelong Learning

Training and Career Development

Patricia A. Grady, PhD, RN, FAAN

Leading Into The Future

• More PhD-Trained Nurses Needed
• Continue Nursing’s Progress In:
• Diversity growth across profession
• Full-scope practice
• Lifelong learning & educating the public
• Team-based, inter-professional collaboration

& leadership

• Engagement in workforce planning & policy

with better data-collection & -use nationalacademies.org/hmd/

2015

Progress Report

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#

• Dr. Chris

Patricia Hafner- Eaton, PhD, MPH,ND

NIH Health

Science Policy Analyst, Science Writer & Faculty

• Dr. Chris

Patricia Hafner- Eaton, PhD, MPH,ND

NIH Health

Science Policy Analyst, Science Writer & Faculty

www.ninr.nih.gov

www.ninr.nih.gov

Patricia A. Grady, PhD, RN, FAAN

Leading Into The Future

Pamela S. Hinds, PhD, FAAN, RN Professor/Director Children’s National Health System Linda H Aiken, PhD, FAAN, FRCN, RN Professor/Director University of Pennsylvania

Patricia A. Grady, PhD, RN, FAAN

Leading Into The Future

Health Care Workforce and Quality of Care

• Jan. 2016

Feb 26, 2014

Linda H Aiken, PhD, FAAN, FRCN, RN

Patricia A. Grady, PhD, RN, FAAN

Leading Into The Future

Pamela S. Hinds, PhD, FAAN, RN

Patient and family-centered end of life research across:

• Life-limiting serious illnesses
• Cultures
• Settings
• Media
• Interventions to improve quality of life

during the final months/years

Expanding Life Quality for Patients & Nursing Research Opportunities for Professionals

Pamela S. Hinds, PhD, FAAN, RN