Category Archives: Executive Nurse Fellows

Sep 25 2014
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RWJF Scholars in the News: Unintended consequences of shorter ER wait times, Ebola response, vaccinations and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

Policies aimed at shortening emergency departments waiting times may have unintended consequences, including unnecessary admission of patients who might be better off being discharged, RWJF Physician Faculty Scholars alumna Renee Hsia, MD, MSc, tells Health Day. Hsia published two research letters in JAMA Internal Medicine on emergency wait times at urban and rural hospitals. RWJF Clinical Scholar alumnus Jeremiah Schuur, MD, MHS, author of an accompanying editorial, seconds Hsia’s concerns. “Medicare started advertising waiting times at ERs about a year ago. And that will be a strong incentive for hospitals to work on and improve their waiting times...[h]owever, some of the hospitals with longer waiting times, like teaching hospitals, care for the most complex patients who often don’t have access to regular care. And these places are, by nature and necessity, going to have longer waiting times,” he warned. The article was republished by U.S. News & World Report and Health.com, among other outlets.

CBS Detroit interviews Howard Markel, MD, PhD, FAAP, recipient of an RWJF Investigator Award in Health Policy Research, for a story on President Obama’s decision to send American troops and medical and logistical support to Africa to stop Ebola from spreading. “It is a humanitarian gesture,” Markel said. “I applaud the president for doing it. Do I wish as a physician and an epidemiologist it was done earlier? Yes, of course.” Markel says he does not expect the virus to spread to the United States. He is also quoted in the New Republic and Politico.

In an op-ed for the New York Times, Jason Karlawish, MD, explores the balance between risk-avoidance and enjoying life as we age. Noting that 3.6 percent of the population is 80 or older, he writes that as Americans age, “life is heavily prescribed not only with the behaviors we should avoid, but the medications we ought to take.” Aging in the 21st century is all about risk reduction, but “[w]e desire not simply to pursue life, but happiness” and “medicine is important, but it’s not the only means to this happiness,” Karlawish writes. National investment in communities and services that improve the quality of our aging may be one answer, he adds. Karlawish is a recipient of an RWJF Investigator Award in Health Policy Research.

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Sep 18 2014
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RWJF Scholars in the News: Antibiotic overuse, sexual assault nurse examiners, diaper banks, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

RWJF Investigator Award in Health Policy Research recipient Anthony So, MD, MPA, co-authors a piece in the News & Observer (Raleigh, North Carolina) about the need to reduce the overuse of antibiotics, in both humans and animals. Overuse accelerates the development of antibiotic-resistant bacteria. The Centers for Disease Control and Prevention estimates that half of human antibiotic use and much animal antibiotic use is unnecessary, the article says. So calls for public policies that create incentives for farmers to decrease use of antibiotics and that limit antibiotic use in animals to disease treatment, rather than growth-promotion or as a substitute for hygiene and infection-control.

In Chicago, most children with asthma or food allergies do not have a health management form on file at school, leaving their schools without information they might need in emergencies, according to a study by RWJF Physician Faculty Scholars alumna Ruchi Gupta, MD, MPH that was covered by Reuters Health. Researchers analyzed 2012-13 school year data on more than 400,000 Chicago schoolchildren, including 18,287 with asthma and 4,250 with a food allergy. Only a quarter of the asthmatic students and half of those with a food allergy had a health management plan on file. The study was also covered by The Chicago Tribune, Fox News, The Baltimore Sun, and Red Orbit, among other outlets.

RWJF Nurse Faculty Scholars alumna Angela Frederick Amar, PhD, RN, FAAN, publishes an op-ed on Talking Points Memo about the report from the White House Task Force to Protect Students from Sexual Assault, Not Alone. Amar notes that effective response to campus sexual assault should include medical care for survivors, and that Sexual Assault Nurse Examiners (SANEs) are trained to tend to the medical and emotional needs of survivors and collect forensic evidence. In other institutions with high rates of sexual violence, such as the military, SANEs are considered an essential part of treatment for victims of sexual violence, Amar writes.

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Sep 11 2014
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RWJF Scholars in the News: Mental health and returning service members, children of incarcerated parents, nurse turnover, more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

When reserve service members return to civilian life, such stresses as marriage and health care problems are more likely to trigger drinking problems than traumatic events that occurred during deployment, according to a study reported by Fox News. When it comes to the “long-term mental health for National Guard members, what matters is what happens after they come home,” said lead author Magdalena Cerdá, PhD, MPH, an RWJF Health & Society Scholars program alumna. “Financial difficulties, re-integrating, difficulties accessing quality health care, all of those seem to matter.” But deployment stress also has an impact. “[T]he more traumatic events they are exposed to during or after combat, the more problems they have in daily life when they come home,” she said. RWJF Investigator Award in Health Policy Research recipient Sandro Galea, MD, MPH, DrPH, co-authored the study. Health Canal also reported on it.

An estimated 17.5 percent of newly licensed RNs leave their first nursing job within the first year, and one in three leave within two years, according to research conducted by RWJF’s RN Work Project. Advance for Nurses quotes co-directors Christine T. Kovner, PhD, RN, FAAN, and Carol Brewer, PhD, RN, FAAN. “One of the biggest problems we face in trying to assess the impact of nurse turnover on our health care system as a whole is that there’s not a single, agreed-upon definition of turnover,” Kovner said. “A high rate of turnover at a hospital, if it's voluntary, could be problematic,” Brewer added, “but if it’s involuntary or if nurses are moving within the hospital to another unit or position, that tells a very different story.” Nurse.com also covered the study.

Having incarcerated parents is associated with significant health problems and behavioral issues, and may be more harmful to children’s health than divorce or the death of a parent, USA Today reports. “These kids are saddled with disadvantages,” said Kristin Turney, PhD, author of the study that reached those conclusions. She is an RWJF Health & Society Scholars program alumna. “They’re not only dealing with parental incarceration, but also mental health issues.” The study found that having a parent in prison was associated with such conditions as attention deficit hyperactivity disorder, learning disabilities, speech or language problems, and developmental delays. Turney’s study was also covered by US News and World Report, Salon, Psych Central, Healthline and Mother Jones, among other outlets. 

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Aug 25 2014
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RWJF Milestones, August 2014

The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni:

James S. Jackson, PhD, a 2009 recipient of an RWJF Investigator Award in Health Policy Research, has been appointed by President Obama to serve on the National Science Foundation’s National Science Board. Jackson is a professor at the University of Michigan School of Public Health, and director of its Institute for Social Research.

Geraldine “Polly” Bednash, PhD, RN, FAAN, will receive the National League for Nursing’s (NLN) highest honor, the President’s Award, at the 2014 NLN Education Summit in mid-September. Bednash is the recently retired chief executive officer of the American Association of Colleges of Nursing (AACN) and director of New Careers in Nursing, a joint initiative of RWJF and AACN focused on increasing diversity in the nursing workforce.

Sally Cohen, PhD, RN, FAAN, has been selected as the 2014-2015 Distinguished Nurse Scholar-in-Residence at the Institute of Medicine of the National Academies. The program provides a yearlong leadership opportunity to participate in shaping health policy. Cohen was also named editor-in-chief of the journal, Policy, Politics & Nursing Practice.  She is director of the Nursing and Health Policy Collaborative at the University of New Mexico.

Lainie Ross, MD, PhD, a 2013 recipient of an RWJF Investigator Award in Health Policy Research, has been named a 2014 Guggenheim Fellow. Ross will use her fellowship year to research the relationship between ethics and genetics for a book, currently titled, From Peapods to Whole Genomes: Incidental Findings and Unintended Consequences in a Post-Mendelian World. The fellowship is awarded by the John Simon Guggenheim Memorial Foundation to recipients with “demonstrated exceptional capacity for productive scholarship or exceptional creative ability in the arts.”

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Aug 21 2014
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New Cohort of RWJF Executive Nurse Fellows

The Robert Wood Johnson Foundation (RWJF) has announced the 20 accomplished nurses from across the United States selected as RWJF Executive Nurse Fellows for 2014.

Executive Nurse Fellows hold senior leadership positions in health services, scientific and academic organizations, public health and community-based organizations or systems, and professional, governmental and policy organizations. They participate in a three-year leadership development program designed to enhance the effectiveness of nurse leaders who are working to improve the nation’s health care system. Fellows receive coaching, education, and other support to enhance their abilities to lead teams and organizations. The program is located at the Center for Creative Leadership.

More than 200 nurse leaders have participated in the RWJF Executive Nurse Fellows program since it began in 1998. This will be the program’s final cohort.

Read more about the new cohort of RWJF Executive Nurse Fellows.

Aug 14 2014
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RWJF Scholars in the News: Ebola fears, ER closures and mortality, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Bringing two American medical volunteers infected with the Ebola virus back to the United States for treatment triggered some criticism, particularly on social media. But Susan Mitchell Grant, MS, RN, CNAA-BC, who is treating the two patients at Emory Healthcare in Atlanta, writes that the criticism is “unfounded and reflect[s] a lack of knowledge about Ebola and our ability to safely manage and contain it.... We are caring for these patients because it is the right thing to do,” she says in a Washington Post op-ed. “Ebola won’t become a threat to the general public from their presence in our facility.” Grant, an RWJF Executive Nurse Fellows alumna, goes on to explain that “the insight we gain by caring for them will prepare us to better treat emergent diseases that may confront the United States in the future.”

Some hospice providers may not be serving patients in the way the end-of-life care should, according to research covered by the Washington Post. Joan Teno, MD, MS, recipient of an RWJF Investigator Award in Health Policy Research, is lead author of a study that analyzed more than 1 million records of Medicare patients across the country. Her research team found that some hospices, particularly those that are new and for-profit, have discharge rates of 30 percent or higher. That is double the standard discharge rate. Historically, some patients are discharged from hospice because their health unexpectedly improves. But Teno and colleagues say the higher discharge rates suggest two types of improper hospice practices: admitting patients who are not dying; and releasing patients when their care becomes expensive. She suggests that both practices may be driven more by “profit margins than compassionate care.”   

Chronic stress during adolescence can lead to adverse health outcomes later in life, says Keely Muscatell, PhD, an RWJF Health & Society Scholar, in an interview with NPR member station KALW (San Francisco). Based on her study, “How Stress Makes Us Sick,” Muscatell suggests that ongoing psychological stress during childhood triggers physiological inflammation throughout the body and could be a primary link to such conditions as major depression, cardiovascular disease, and rheumatoid arthritis. Muscatell explains that chronic stress can even change patterns of gene expression that lead to poor health later in life.

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Jul 31 2014
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RWJF Scholars in the News: Cesarean sections, hospital readmissions, nurse practitioners, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

RWJF Clinical Scholar Chileshe Nkonde-Price, MD, shared her experiences with the medical system  during the last week of her recent pregnancy in a video featured on Nasdaq.com. Despite have given birth via Cesarean section earlier, Nkonde-Price wished to deliver vaginally with this pregnancy if she could do so safely. C-section has become the nation’s most common major surgery, the piece says. It examines some of the factors behind the sharp increase in the number of women delivering via C-section in the United States.

In a Health Affairs Blog, José Pagán, PhD, analyzes Medicare’s Hospital Readmissions Reduction Program (HRRP), which penalizes hospitals with excessive 30-day readmissions for conditions such as pneumonia and heart failure. While Pagán says that not all readmissions can be avoided, hospitals can improve their performance through effective discharge planning and care coordination. With more incentive programs on the horizon, Pagán suggests that health care organizations “seek and monitor collaborative partnerships and, more importantly, strategically invest in sustaining these partnerships” so they can survive and thrive. He is an RWJF Health & Society Scholars program alumnus and recipient of an RWJF Investigator Award in Health Policy Research.

A study led by RWJF Nurse Faculty Scholar Lusine Poghosyan, PhD, RN, looks at how Nurse Practitioners (NPs) rate their work environments. It finds that those working in Massachusetts fared better that those working in New York on every topic in the survey: support and resources, relations with physicians, relations with administration, visibility and comprehension of their role, and independence of practice. The survey also found that NPs working in community health clinics and physicians’ offices rated their work experiences better than NPs working in hospital-affiliated clinics. Poghosyan told Science Codex the findings suggest “the practice environment for NPs in New York can improve once the state’s NP Modernization Act,” which will expand NPs’ scope of practice, takes effect.

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Jul 25 2014
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Working to Improve Nursing Education and Promote Academic Progression

Juliann Sebastian, PhD, RN, FAAN, is dean of the University of Nebraska Medical Center College of Nursing and president-elect of the American Association of Colleges of Nursing. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (1998-2001).

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Human Capital Blog: Congratulations on your recent election as president-elect, and future president, of the American Association of Colleges of Nursing (AACN)! What is your vision for the 2014-2016 term?

Juliann Sebastian: I am honored to have been selected by the members of AACN to serve in this role for an organization that is pivotal to the future of baccalaureate and higher degree nursing education. I support the president and the board in advancing our shared vision of excellence in nursing education, research, and practice.

I look forward to working with the entire board to address issues of concern to AACN’s member schools. Because AACN’s membership encompasses large/small, public/private institutions, we have the special advantage of incorporating diverse voices into shaping the organization’s vision. I am enthusiastic about deepening my opportunity to support the vision AACN has identified for itself and the profession.

  •  AACN’s own vision is: “By 2020, as a driving force for quality health care, AACN will leverage member schools in meeting the demand for innovation and leadership in nursing education, research and practice.”
  • AACN’s vision statement for the profession is: “By 2020, highly educated and diverse nursing professionals will lead the delivery of quality health care and the generation of new knowledge to improve health and the delivery of care services.”

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Jul 24 2014
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Sharing Nursing’s Knowledge: The July 2014 Issue

Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. Following are some of the stories in the July issue.

Nurses Lead Innovations in Geriatrics and Gerontology
As the nation becomes older and more diverse, and more people are living with chronic health problems, nurses are developing innovations in geriatric care. They are finding new ways to improve the quality of care for older adults; increase access to highly skilled health care providers with training in geriatrics; narrow disparities that disproportionately affect older minorities; avoid preventable hospital readmissions; and more. Nurse-led innovations are underway across the nation to improve care for older Americans.

Improving Care for the Growing Number of Americans with Dementia
By 2050, 16 million Americans—more than triple the current number—will have Alzheimer’s disease. RWJF Nurse Faculty Scholars are working now to get ahead of the problem. “We’re all well aware of our aging population and how we’re going to see more individuals with Alzheimer’s disease or some other form of dementia,” says alumna Elizabeth Galik, PhD, CRNP, who is researching ways to improve functional and physical activity among older adults with dementia.

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Jul 10 2014
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RWJF Scholars in the News: Healthcare.gov, depression and mortality, stress among nurses, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Young adult users of Healthcare.gov, the health insurance marketplace established under the Affordable Care Act, recommend that the site offer better explanations of terminology, more clarity about the benefits various plans offer, and checkboxes and other features that make it easier to compare plans. Those are among the findings of a study conducted by RWJF Clinical Scholar Charlene Wong, MD, along with alumni David Asch, MD, MBA, and Raina Merchant, MD, that looked at the experiences of young adults who used the website. The scholars write about their findings in the Philadelphia Inquirer. Wong told the Leonard Davis Institute of Health Economics blog that these users “may not know what insurance terms mean but they have a lot of expertise and insights about maximizing the usability of the digital platforms that have always been such an integral part of their lives.”

Major depression (also known as “clinical depression”) is associated with an elevated risk of death from cardiovascular disease, according to research covered by Kansas City InfoZine. The study, co-authored by Patrick Krueger, PhD, an RWJF Health & Society Scholars program alumnus, also found that the relationship between depression and early non-suicide mortality is independent of such factors as smoking, exercise, body mass, education, income, and employment status. The authors say the findings indicate that the relationship between depression and mortality is not due solely to the interplay between depression and health-compromising risk factors.

Expanding scope of practice for advanced practice nurses and implementing better management practices could alleviate some stress factors for nurses and improve patient care, Matthew McHugh, PhD, JD, MPH, FAAN, tells Healthline News. For example, in some medical facilities, nurses are empowered to decide if a patient’s urinary catheter should be removed without consulting a doctor, thus preventing delays in care. “Lots of things that don’t require policy change” can have an important impact on patient outcomes and nurses’ job satisfaction, said McHugh, an RWJF Nurse Faculty Scholars alumnus.

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