AACN Impact Research Grant


Feasibility of Journal Writing in the PICU to Reduce Parental Stress and Stress Symptoms
Rhonda Board, PhD, RN, CCRN, Associate Professor at Northeastern University School of Nursing, and principal research investigator. Having a child hospitalized in a pediatric intensive care unit (PICU) can be a very traumatic experience for parents. This project will test the feasibility and acceptability of expressive writing in the PICU as an intervention to decrease parental stress and stress symptoms. Journal writing requires minimal financial investment for hospitals to implement and can provide parents an account of the hospitalization to reflect on following discharge.
Rhonda Board, PhD, RN, CCRN
Associate Professor Northeastern University School of Nursing, Boston, Massachusetts


Moral Distress Consultations

Most moral distress interventions focus on distinct groups of healthcare providers or specific ethically challenging situations, but the Moral Distress Consult Service of the University of Virginia (UVA) Health System is one of the few programs that are multidisciplinary and institution-wide in scope. A team from the UVA School of Nursing and Center for Biomedical Ethics and Humanities, led by Elizabeth Epstein, RN, PhD, and co-primary investigator, Mary Faith Marshall, PhD, BSN, FCCM, will formally evaluate the consult service and its effects on moral distress and elements of a healthy work environment.

Elizabeth Epstein, RN, PhD
Associate Professor University of Virginia, Charlottesville, Virginia


Arrhythmia Monitoring and Alarm Fatigue

Arrhythmia alarms alert nurses to changes in a patient’s heart rhythm, but the sheer number of alarms contributes to alarm fatigue, a known patient safety issue. Michele Pelter, assistant professor and director of the ECG Monitoring Research Lab at the University of California at San Francisco, will lead a research team to analyze a large dataset of annotated arrhythmia alarms to learn whether these arrhythmias have clinical significance or are associated with serious outcomes. Results will provide guidance to manufacturers to better define their alarms requiring action and to hospitals as they create policies and procedures to address alarm management requirements mandated by The Joint Commission.

Michele M. Pelter, RN, PhD
Assistant Professor Department of Physiological Nursing and Director of the ECG Monitoring Research Lab, University of California, San Francisco School of Nursing, San Francisco, California


Postoperative Respiratory Failure

Postoperative respiratory failure is the most common and severe postoperative pulmonary complication, and this matched case-control analysis seeks to identify the impact of nursing care on potentially modifiable risk factors. Lead researcher is Jacqueline Stocking, a critical care nurse pursuing her doctoral degree at the Betty Irene Moore School of Nursing at the University of California at Davis.

Jacqueline C. Stocking, PhD (c) , MBA, MSN, NEA-BC
Quality and Safety Nurse Analyst Department of Internal Medicine, University of California at Davis Health System and PhD candidate at the Betty Irene Moore School of Nursing at UC Davis


Unavoidable Hospital-Acquired Pressure Ulcers
Joyce Pittman, PhD, RN, ANP-BC, FNPBC, CWOCN, is both clinician and researcher providing system-wide wound/ostomy/continence expertise at Indiana University Health-Methodist, a 750-bed Level I Trauma Center, and Indiana University School of Nursing, Indianapolis. This study will examine patients with unavoidable pressure ulcers in the critical care setting, Pressure ulcer rates in critical care units are among the highest and are often attributed to patient acuity. Pittman’s practice and research focuses on improving the quality of life and the quality of care for individuals with wound, ostomy and continence conditions.
Joyce Pittman, PhD, RN, ANP-BC, FNPBC, CWOCN
Nurse Practitioner Team Lead WOC Team, Indiana University Health, Indianapolis, Indiana


Safety of Chlorhexidine Gluconate (CHG) Baths in Patients Less Than 2 Months of Age
Scientific evidence overwhelmingly supports reducing healthcare-associated infections using CHG baths for skin antisepsis; but not for patients less than 2 months of age. Cheryl Toole, RN, MS, CCRN, NEA-BC, director of the Neonatal Intensive Care Unit at Boston Children’s Hospital, and co-primary investigator, Celeste Chandonnet RN, BSN, CCRN, infection prevention nurse, are studying the safety of biweekly CHG baths in a sample of Newborn Intensive Care Unit (NICU) and pediatric Cardiac Intensive Care Unit (CICU) patients to inform neonatal healthcare providers about the safety profile of CHG baths, leading the way to prevent healthcare-associated infections in this vulnerable patient population.
Cheryl Toole, RN, MS, CCRN, NEA-BC
Director Neonatal Intensive Care Unit, Boston Children's Hospital, Boston, Massachusetts


CO-ADVOCATE: A Program to Prevent Ethical Conflict and Moral Distress in the ICU

The research team from the University of California Los Angeles, Mayo Clinic and the Massachusetts General Hospital will test effectiveness of a proactive education program and screening protocol to support ethics deliberation and interdisciplinary communication about the care of complex critically ill patients and their families. Researchers will measure the impact of promptly identifying and collaboratively addressing ethically difficult situations.

Carol Pavlish, RN, PhD, FAAN
Associate Professor University of California, Los Angeles


Testing Feeding Tube Placement in Infants

Dr. Metheny will work with Kathleen L. Meert, MD, professor of pediatrics at Wayne State University, Detroit, to evaluate the pH method’s effectiveness in determining feeding tube placement (gastric versus pulmonary) in a population of critically ill children less than 1 year of age. Data collection will take place at the Children’s Hospital of Michigan.

A total of 200 gastric aspirates will be obtained near the time a radiograph is performed; pH comparisons will be made according to the use (or non-use) of gastric acid inhibitors and the use (or non-use) of recent gastric feedings. In addition, pH testing will be performed on 50 tracheal aspirates obtained during routine suctioning. Another purpose of the study is to determine the effectiveness of a rapid pepsin assay in distinguishing between tracheal secretions and high-pH gastric secretions.

Norma A. Metheny, RN, PhD, FAAN
Professor Saint Louis University, St. Louis, Missouri


National Survey to Identify ACNP Models of Care
Nurse practitioners are an increasingly important component of the nation’s acute care workforce, yet there is limited information on the specific care models across the diverse practice settings. Therefore, the specific aims of the study are to 1) describe the types of acute care NP care models currently in use in hospital and emergency department settings; 2) assess the impact of key system-level and regional-level factors on acute care NP care models; and 3) determine the relationship of state regulation of advanced practice registered nurse practice and the implementation of differing acute care NP care models.
Ruth Kleinpell, RN, PhD, FAAN, FCCM
Director-Center for clinical Research and Scholarship Rush University Medical Center, Chicago, Illinois


Two-group Trial of a Terminal Ventilator Withdrawal Algorithm: Pilot Testing

Campbell’s research team will investigate the process of ventilator withdrawal for patients at the end of life. Their study will look at standardizing a nurse-led approach to patient comfort during the ventilator withdrawal process, reducing patient suffering and family distress.

The researchers will compare outcomes for patients who receive the new standardized approach with patients who receive usual care; the data will guide a future randomized trial.

Margaret Campbell, RN, PhD
Associate Professor-Research Wayne State University, Detroit, Michigan


Predicting Immobility-related and Medical Device-related Pressure Ulcer Risk in Pediatric Patients

Curley and her research team with colleagues from five pediatric hospitals will further assess the predictive validity of the Braden Q Scale for the development of immobility-related pressure ulcers.

In addition, they will test a new element, referred to as the Braden Q+D, to describe pediatric patients’ risk for medical device-related pressure ulcers.

Martha A. Q. Curley, RN, PhD, FAAN
Kapito Professor in Nursing Science University of Pennsylvania


Intra-abdominal Pressure Monitoring of Extremely and Very Low Birth Weight Preterm Infants (< 1500 Grams) During Enteral Gastric Tube Feedings

Carter and her research team will monitor intra-abdominal pressure in very low birth weight preterm infants with the aim of identifying early symptoms of feeding intolerance. The findings could help healthcare providers better adjust feeding volumes, resulting in more rapid postnatal growth, thereby reducing the length of hospital stay and hospital costs.

Brigit Carter, RN, PhD, MSN, CCRN
Assistant Clinical Professor Duke University School of Nursing, Durham, N.C.


Consortium Congenital Cardiac Care Measurement of Nursing Practice (C4MNP) — Description of the Current State of Cardiovascular Nursing Measurement in Free-Standing Children’s Hospitals in the United States

Connor and her research team will conduct a 12-month pilot study to explore how children’s hospitals across the United States measure the quality of care provided by pediatric cardiovascular nurses. The resulting baseline data will help identify key performance indicators specific to pediatric nursing and articulate their value in the delivery of nursing care — a crucial element to ongoing efforts to improve quality and reduce costs.

Jean Anne Connor, RN, DNSc, CPNP
Director of Nursing Research Children’s Hospital Boston

Sigma Theta Tau Critical Care Grant


Transitioning the Hospitalized Preterm Infant: A Randomized Control Trial
Sherri McMullen, PhD, CNS, NNP-BC, focuses her clinical practice and scholarly research on preterm neonates and their caregivers. McMullen is investigating safe infant sleep practices to decrease the persisting sudden infant death syndrome rates across the nation. Her work seeks to standardize evidence-based practices for timing of transitioning preterm infants to supine sleep position that has potential to impact standards, policy and care procedures for this vulnerable population nationally and globally.
Sherri McMullen, PhD, CNS, NNP-BC
Assistant Professor Upstate Medical University, Syracuse, New York


Learning Transfer from Simulation to Bedside in Nurses Using Technology to Interpret Patient Ventilator Asynchrony

Mellott’s long-term aim is to determine how nurses can use ventilator technology and graphics to recognize patient ventilator asynchrony occurrence for integration into patient care decision making and management. This study will determine whether those nurses who participate in lecture and simulation teaching interventions demonstrate better transfer of learning to interpret patient ventilator asynchrony using ventilator technology at the bedside as compared with a control group that participates in a lecture-only teaching intervention.

Karen Mellott, RN, PhD
Assistant Professor University of Texas Health Science Center, Houston, Texas


VALIDATE-Variable Analysis for Infection Discovery and Treatment: Exploratory Study

VALIDATE (Variable AnaLysis for Infection Discovery and Treatment): An Exploratory Study, is a critical care nurse-led project to determine the feasibility of using a compact monitoring device (Biopatch™) to capture physiologic data on patients admitted to the hospital with a primary diagnosis of infection. The data collected will be then sent to a lab for analysis to determine usability as a predictor of morbidity and mortality in sepsis. If proven feasible, use of these monitors would highly impact nurses’ ability to assess, care for and assist the team in determining the appropriate disposition of such patients.

Susan Finn, RN, MN, CNL, CCRN, CNRN
Quality Clinician Billings Clinic, Billings, Montana


Noise Assessment and the Effect of Two Noise Reduction Protocols

Alarm reduction strategies for critical care units have been promulgated but noise reduction and nurse stress on progressive care units have not been examined. A prospective, quasi-experimental, repeated measures design will be used to determine the effect of protocols to reduce noise pollution and nurse stress in a progressive care unit central nurses’ station of a 30-bed progressive care unit. A similar configured and sized non-monitored medical-surgical unit will serve as the control unit for the outcome variables.

Susan Fetzer, RN, PhD, CNL
Professor University of New Hampshire


ABCDE Bundle Efficacy and Factors Influencing Adherence Pilot Study

Boehm’s study aims to explore the culture around interdisciplinary protocol use in the ICU and the influence of organizational factors. The primary goal is to study organizational structure and process variables that may contribute to ABCDE interdisciplinary bundle adherence. In addition, the study will evaluate the effectiveness of the ABCDE bundle in improving cognitive and physical outcomes for ICU survivors. The study will identify system and clinician issues that could subsequently be targeted to improve adherence to interdisciplinary protocols.

Leanne Boehm, RN, MSN, ACNS-BD
Research Nurse Specialist Vanderbilt University Medical Center, Nashville, Tennessee


Effect of Nursing Interventions on Reducing Cardiac Monitor Alarm Burden in the Neurosurgical ICU

Mammone’s study is focused on assessing the effectiveness of nursing interventions to reduce alarm fatigue related to physiologic monitors in the neuroscience ICU.

She will examine sources of alarms and implement interventions to minimize the clinical risks associated with excessive alarms and alarm fatigue among clinicians.

Tina Mammone, RN, MSN
Director of Clinical Operations, Department of Nursing University of California, San Francisco Medical Center, San Francisco, California


Generating a Theoretical Model of the Psychological Processes of Surrogate Decision Making at Adult End of Life in the ICU, Using Cognitive Task Analysis

Dionne-Odom’s long-term aim is to design and test novel, nursing-led decision support interventions for surrogate decision makers undergoing the often burdensome role of making choices for others who are dying in the ICU.

The study will address the creation of healing and humane environments and improve processes and systems that foster the optimal contribution of critical care nurses.

James "Nick" Dionne-Odom, RN, MSN
Staff Nurse Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire


Relationship Between the Organization of Hospital Nursing and In hospital Cardiac Arrest Outcomes

Rochman and her team will examine the relationship between nursing delivery system strategies and in-hospital cardiac arrest patient outcomes; the study will merge two unique large national databases and provide significant insight into the connection between nursing care and resuscitation outcomes.

Monica Rochman, RN, PhD
Post-doctoral Fellow University of Pennsylvania, Philadelphia, Pennsylvania


Physiologic Responses to a Passive Exercise Intervention in Mechanically-Ventilated Critically Ill Adults

Stewart-Amidei and her team will assess the cardiopulmonary, neurodynamic, inflammatory and pain responses to an early standardized passive exercise intervention (ESPEI) in mechanically ventilated critically ill patients.

Christina Stewart-Amidei, MSN, RN, CNRN, CCRN, FAAN
University of Central Florida College of Nursing, Orlando, Florida


Feasibility and Safety of Implementing a MICU Short-Term Intubation Nursing Swallow Screen

Pearson and her research team will assess the feasibility and safety outcomes of an evidence-based, nurse-driven, short-term intubation swallow screen protocol for critical care patients intubated < 48 hours. Secondary aims will assess length of stay and patient care costs.

Camilla Pearson, RN
Medstar Washington Hospital Center, Washington, D.C.


Quality of Life of Parental Caregivers of Children (1 – 36 months) With a Tracheostomy

Joseph and her research team will conduct a cross-sectional descriptive study to gather data on stress, coping and quality of life in parents of children with a tracheostomy age 1 month to 36 months.

Rachel Joseph, RN, MSN, CCRN
Christiana Care Health Systems, Newark, Delaware


Cranial Cup Use for the Correction of Positional Head Shape Deformity in Premature Infants: A Pilot Study

DeGrazia and her research team will conduct a pilot study to determine if the cranial cup is successful in correcting positional head-shape deformity in a sample of prematurely born infants.

Michele DeGrazia, RN, PhD
NNP-BC Children’s Hospital Boston