TAG: "Nursing"

UC Davis nursing school welcomes its newest grad students


School honors University of Washington nurse scientist with annual leadership award.

(From left) Heather Young, dean of the Betty Irene Moore School of Nursing at UC Davis, presents nurse scientist Brenda K. Zierler with the 2014 Excellence in Leadership Award.

Nutrition, nursing and public health are just some of the fields represented by the 63 new students entering the four graduate programs at the Betty Irene Moore School of Nursing at UC Davis. The students make up is more than professionally diverse, though, said Dean Heather M. Young, as she formally welcomed the group at the annual Welcoming Ceremony on Tuesday evening (Sept. 23).

“You range in age from 23 to 53. Some of you work for local health systems, some of you work in care centers. Others of you work in public health or provide care in our state prisons.” Young said. “Each of you is here because of what you bring to this school. You came here to be transformed as health care leaders, but at the same time, you also transform each other and all of us at the Betty Irene Moore School of Nursing and UC Davis.”

The incoming fall 2014 classes include eight doctoral students, 20 physician assistant students, 25 master’s degree leadership students and 10 nurse practitioner students — moving the school’s total enrollment to 135.

The Nursing Science and Health-Care Leadership Graduate Group prepares nurse leaders, primary care providers, researchers and faculty in a unique interdisciplinary and interprofessional environment. As with other graduate groups at UC Davis, this program engages faculty from across the campus with expertise in nursing, medicine, health informatics, nutrition, biostatistics, public health and other fields. Currently, the graduate group includes more than 45 faculty.

Brenda K. Zierler, a University of Washington nurse scientist, was honored with the Betty Irene Moore School of Nursing at UC Davis 2014 Excellence in Leadership Award. The award is annual highlight at the Welcoming Ceremony.

Nationally recognized for her work examining education systems for health professionals, Zierler’s research explores the relationships between the delivery of health care and outcomes — at both the patient and system levels.

Young said she was thrilled to name Zierler to the award, not only for her national work in interprofessional education, but for her partnership with UC Davis as well.

“Dr. Zierler has worked with both the School of Nursing and the School of Medicine to help us identify how we can improve our curriculum so that students are exposed to more interprofessional opportunities throughout their education,” Young said.

Her primary appointment is in the School of Nursing at the University of Washington, but Zierler also serves in three adjunct appointments at UW — two in the School of Medicine and one in the School of Public Health. Currently, she is a co-primary investigator on a Josiah-Macy-funded grant with physician Leslie Hall to develop a national train-the-trainer faculty development program for interprofessional education and collaborative practice. She also leads two HRSA training grants — one focusing on technology-enhanced interprofessional education for advanced-practice students and the second focused on interprofessional collaborative practice for advanced heart failure patients at UW’s Regional Heart Center.

“I am interested in improving the quality and safety of health care delivery for all,” Zierler said. “Interprofessional education and collaborative practice are a means to meet these goals. Improving communication, coordination and collaboration of care can improve the quality and safety of care.”

Zierler said the future is bright for students of the Betty Irene Moore School of Nursing.

“This is a true learning organization with excellent faculty leadership that takes a student-centered approach to education and a patient-population-centered approach to providing care,” Zierler said. “This school is the model for the future in nursing.”

The school recently opened applications for fall 2015 master’s-degree leadership and doctoral programs. For more information, visit the school’s website at nursing.ucdavis.edu.

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Higher nurse-to-patient standard enhances staff safety


Study finds drop in occupational injuries to nurses after mandated staffing ratios in California.

J. Paul Leigh, UC Davis

A 2004 California law mandating specific nurse-to-patient staffing standards in acute care hospitals significantly lowered job-related injuries and illnesses for both registered nurses and licensed practical nurses, according to a UC Davis study published online in the International Archives of Occupational and Environmental Health. The study is believed to be the first to evaluate the effect of the law on occupational health.

“We were surprised to discover such a large reduction in injuries as a result of the California law,” said study lead author J. Paul Leigh, a professor of public health sciences and investigator with the Center for Healthcare Policy and Research at UC Davis. “These findings should contribute to the national debate about enacting similar laws in other states.”

California is the only state in the country with mandated minimum nurse-to-patient staffing ratios. They are established based on type of service (such as pediatrics, surgery, or labor and delivery) and allow for flexibility in cases of health care emergencies. (The ratios are available on the California Department of Public Health website.)

According to Leigh, some hospitals have argued against extending the law to other states because of the increased costs of additional nursing staff. There is also no consensus that the law has improved patient outcomes, which was its primary intent. Some studies show improvement, while others do not.

“Our study links the ratios to something just as important — the lower workers’ compensation costs, improved job satisfaction and increased safety that comes with linking essential nursing staff levels to patient volumes,” Leigh said.

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Study shows evidence that sleep apnea hurts brain


UCLA researchers find that people suffering from sleep apnea have weaker brain blood flow.

This brain scan shows that the brain blood flow in a subject with obstructive sleep apnea (left) is markedly lower compared to a subject without the sleep disorder.

Employing a measure rarely used in sleep apnea studies, researchers at the UCLA School of Nursing have uncovered evidence of what may be damaging the brain in people with the sleep disorder — weaker brain blood flow.

In the study, published Aug. 28 in the peer-reviewed journal PLOS ONE, researchers measured blood flow in the brain using a non-invasive MRI procedure: the global blood volume and oxygen dependent (BOLD) signal. This method is usually used to observe brain activity.  Because previous research showed that poor regulation of blood in the brain might be a problem for people with sleep apnea, the researchers used the whole-brain BOLD signal to look at blood flow in individuals with and without obstructive sleep apnea (OSA).

“We know there is injury to the brain from sleep apnea, and we also know that the heart has problems pumping blood to the body, and potentially also to the brain,” said Paul Macey, associate dean for Information Technology and Innovations at the UCLA School of Nursing and lead researcher for the study. “By using this method, we were able to show changes in the amount of oxygenated blood across the whole brain, which could be one cause of the damage we see in people with sleep apnea.”

Obstructive sleep apnea is a serious disorder that occurs when a person’s breathing is repeatedly interrupted during sleep, hundreds of times a night. Each time breathing stops, the oxygen level in the blood drops, which damages many cells in the body. If left untreated, it can lead to high blood pressure, stroke, heart failure, diabetes, depression and other serious health problems. Approximately 10 percent of adults struggle with obstructive sleep apnea, which is accompanied by symptoms of brain dysfunction, including extreme daytime sleepiness, depression and anxiety, and memory problems.

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Three UC schools receive grants to prepare doctoral nurses


Part of initiative supporting IOM goal to double number of doctorally prepared nurses.

Three University of California nursing schools are among only 14 nationwide to receive the first grants from a new Robert Wood Johnson Foundation (RWJF) program to increase the number nurses with Doctor of Philosophy degrees.

The recipients of the Future of Nursing  Scholars grants include the nursing schools at UC Davis, UCLA and UC San Francisco. Each UC school will select one student to receive financial support, mentoring and leadership development over the three years of their Ph.D. programs. Some schools will select more than one student, supporting a total of 17 students initially. The Future of Nursing Scholars program expects to support up to 100 doctoral nursing candidates over its first two years.

The Future of Nursing Scholars program is supported by several funders. In addition to RWJF, United Health Foundation, Independence Blue Cross Foundation, Cedars-Sinai Medical Center and the Rhode Island Foundation all provide financial support.

“We are honored to be included as one of the first nursing schools to receive the Future of Nursing Scholars grants, especially as a new school that this year graduated our first Doctors of Philosophy,” said Heather M. Young, associate vice chancellor for nursing and dean of the Betty Irene Moore School of Nursing at UC Davis. “Being a part of the Future for Nursing: Campaign for Action has brought home to me the importance of increasing the number of doctorally prepared nurses in the nation. This effort goes a long way toward promoting that goal. It’s a wonderful way to create community among doctoral scholars who will be our future leaders.”

In its landmark nursing report, the Institute of Medicine recommended that the country double the number of nurses with doctorates; doing so will support more nurse leaders, promote nurse-led science and discovery, and put more educators in place to prepare the next generation of nurses.

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Sen. Boxer highlights efforts to prevent medical errors


She visits UCSF Medical Center.

U.S. Sen. Barbara Boxer (second from right) tours UCSF Medical Center on July 2 to learn how it is working to reduce preventable deaths. Susan Barbour (left), R.N., talks about pressure ulcer prevention. (Photo by Cindy Chew)

Every year, between 210,000 and 440,000 Americans die as a result of preventable errors in hospitals, according to a special report released at UC San Francisco by Democratic Sen. Barbara Boxer.

She presented the updated report detailing the most common and harmful errors at our nation’s hospitals and highlighted what UCSF Medical Center is doing to prevent them.

“We have the opportunity to save not just one life, but to save hundreds of thousands of lives,” Senator Boxer said during her visit to UCSF Medical Center on July 2. “Many people will be shocked to hear this, but medical errors are one of the leading causes of death in America today. These deaths are all the more heartbreaking for families because they are preventable.”

Boxer said she is grateful to UCSF for the steps it has taken to save patients’ lives.

“If we all work together – doctors, nurses, hospital administrators, patients, patient advocates, medical technology pioneers, public health experts and federal officials – we can prevent so much heartbreak for families and stop these tragedies before they occur,” said Boxer at a press conference following a tour of UCSF Medical Center.

Preventable errors in hospitals, such as hospital-acquired infections, adverse drug reactions, patient falls and bedsores, total $19.5 billion annually and that the economic costs of medical errors, including lost productivity, could be as much as $1 trillion a year, according to Boxer’s report.

“We’re one of the nation’s top hospitals,” said Mark R. Laret, CEO of UCSF Medical Center and UCSF Benioff Children’s Hospitals. “But that is meaningful only as it relates to every single patient who walks through our doors, and how we administer their care, follow up and safety. We’re proud of the great strides we’ve made as a leader in patient safety and to partner with Senator Boxer to help all hospitals become places where safe care is offered to every patient, every day.”

While touring UCSF Medical Center, Senator Boxer was shown the interdisciplinary approach UCSF takes to address major hospital issues such as sepsis, ulcer prevention, medication errors and hand hygiene.

As part of its interdisciplinary approach, UCSF creates teams comprised of nurses, pharmacists, doctors and medical center leaders, in addition to staff in medical records and environmental services. Those teams focus on understanding the underlying causes that may have allowed an error to occur and on collaborative problem solving. An open discussion ends with a clear action plan, which might involve implementing a new system, purchasing a piece of equipment, or training doctors and nurses in communication strategies.

UCSF processes and results for sepsis prevention

Sepsis is a potentially fatal, full-body inflammation caused by infection, and one of the main sources of sepsis is hospitals themselves.

“At UCSF we now treat sepsis as a true emergency with a focus on immediate interventions proven to help patients,” said Joshua Adler, M.D., chief medical officer at UCSF Medical Center and UCSF Benioff Children’s Hospital San Francisco. “This approach has involved innovations in our electronic health record systems, use of rapid response personnel, novel nursing protocols, and continuous evaluation of our performance.”

UCSF’s electronic sepsis surveillance system continuously searches for warning signs, alerts clinicians to the potential presence of sepsis, and provides a means to activate “Code Sepsis”. The Code Sepsis team – a rapid response team, critical care nurse practitioner, and pharmacist – has helped UCSF to treat sepsis as an emergent situation requiring immediate attention and action. “With this approach we have reduced the mortality rate for sepsis by nearly 25 percent since 2012,” Adler said.

Processes and results for ulcer prevention

Ulcers resulting from being bedridden, and thus immobile for a lengthy time, are an ongoing challenge for hospitals. In addition, to training all patient care providers in pressure ulcer prevention, UCSF conducts quarterly pressure-ulcer prevalence study days. On these days, every patient in the hospital is examined for evidence of a pressure ulcer. The total number of pressure ulcers counted is divided by the total number of patients examined to obtain a percentage of patients with pressure ulcers.

UCSF has reduced the rate of hospital acquired pressure ulcers among adult and pediatric patients by 79 percent, from 4.98 percent in fiscal year 2008 to 1.03 percent in fiscal year 2014.

Preventing inpatient medication errors

In 2011, UCSF launched what is believed to be the nation’s most comprehensive automated hospital robotic pharmacy that is designed to prepare and track medications, with the goal of improving patient safety. The pharmacy operation is now linked to the electronic health record system, creating an end-to-end electronic system in which a nurse at the bedside scans the barcode on the patient’s wristband, scans the medication and then scans the bar code on his/her own ID badge. Only after confirming all the information matches is the medication administered. UCSF administers over 10,000 doses of medication daily.

“The barcoding system is a way to minimize the potential for an error at every step of the medication delivery process,” said Laret.

Hand hygiene training and surveillance

Hand hygiene is considered one of the most effective approaches for reducing hospital-related infections. In July 2010, UCSF implemented a hand hygiene education and surveillance program. Since then the rate of hand hygiene has improved from 75 percent to about 92 percent each month. The data are collected and monitored by cameras in some hospital areas, and a daily report is distributed. Some floors even feature real-time monitoring that displays hand hygiene compliance rates.

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Many young smokers aren’t aware of hookah dangers


Survey finds many young adults believe that smoking hookah is not harmful to their health.

In a UCLA survey, 60 percent of respondents said hookah smoking is a trendy way of socializing. (Photo by Fredler Brave)

Despite warnings from the Centers for Disease Control and Prevention that hookah smoking can be just as dangerous as cigarettes, many young adults believe that using the water pipes is not harmful to their health, according to a UCLA School of Nursing study.

Researchers visited three Southern California hookah lounges and asked patrons between the ages of 18 and 30, “Do you believe smoking hookah is harmful to your health?” Fifty-seven percent said they thought that it was not. When asked why they thought hookahs were not harmful, 47 percent of the participants said they believed that the smoke gets filtered through water, and 35 percent said they thought that fruit used to flavor the tobacco detoxify tobacco’s harmful chemicals. Still others, 16 percent, said they assumed hookahs are not harmful because the tobacco is not addictive and does not contain nicotine.

Unfortunately, none of those beliefs is true.

“With hookah smoking on the rise, particularly among young adults, our goal was to identify factors influencing perceptions, attitudes and preferences toward hookah smoking,” said Mary Rezk-Hanna, a UCLA nursing doctoral student and lead researcher for the study, which was published in the July–August issue of the journal Nursing Research.

Other recent studies have shown that even as cigarette use continues to decline, hookah smoking is increasing, especially among college students. It is the only form of tobacco use that is not regulated in the United States, and its exemption from clean indoor air legislation, such as the California Clean Air Act, is contributing to its rapidly growing popularity. In California alone, there are more than 2,000 shops that sell hookah tobacco and related products, in addition to 175 hookah lounges and cafes, and a disproportionate number of them are in Los Angeles, near universities and colleges.

When asked why hookah smoking is more attractive than cigarette smoking, 60 percent of the participants in the UCLA study said it is a trendy way of socializing. And although 43 percent of hookah smokers said they believe the practice is indeed harmful, “socializing with friends appeared to outweigh health concerns,” Rezk-Hanna said.

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UCSF nursing professor honored by American Heart Association


Barbara Drew named a 2014 Distinguished Scientist.

Barbara Drew, UC San Francisco

The American Heart Association has just selected Barbara Drew, R.N., Ph.D., to be a 2014 Distinguished Scientist. Drew, professor of physiological nursing and founder of the ECG Monitoring Research Lab in the UCSF School of Nursing, will receive the award at the Annual Scientific Sessions of the AHA in Chicago in November.

Of the six scientists selected this year, Drew is the only nurse and the only woman. In fact, this is the first time in the history of AHA that a nurse scientist has been selected as a Distinguished Scientist. The award is recognition of the extensive contributions Drew has made in the care of patients with cardiac arrhythmias.

Drew has taught clinical electrocardiography to medical students, residents, and graduate nursing students for 32 years. She also founded the ECG Monitoring Research Lab in the School of Nursing and mentored numerous graduate students pursuing studies in the field of electrocardiology.

The primary goal of Drew’s research is to improve cardiac monitoring techniques and clinical practices in hospital and pre-hospital settings for more accurate diagnosis of cardiac arrhythmias, myocardial ischemia, and drug-induced long QT syndrome. Drew’s research has shaped the development of commercial cardiac monitors, including the introduction of multilead ECG monitoring, ST-segment and QT interval monitoring, and strategies to reduce clinical alarm fatigue.

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First class of UC Davis doctoral nurses graduates


Betty Irene Moore School of Nursing celebrates 62 graduates.

The Class of 2014 Doctor of Philosophy Class shows their appreciation for the school's namesake, Betty Irene Moore.

For the first time, eight Doctor of Philosophy students collected degrees through the Betty Irene Moore School of Nursing at UC Davis this graduation season, along with 24 Master of Science students and six nurse practitioner and 24 physician assistant certificate graduates.

“In a month, or year, or perhaps in a decade, the facts that you learned will have changed. Many will be, frankly, wrong. But your ability to approach questions systematically, to thoughtfully define your objectives, to gather accurate information, to work with colleagues, to apply what you know, will remain with you forever,” said Jill Joseph, associate dean for research who provided the keynote speech at the school’s annul graduation celebration on June 12. “And already, those of us who have walked with you during your time here can see the impact.”

Following the School of Nursing event, the graduates received their degrees at the formal Office of Graduate Studies commencement later that day, which included presentation of more than 1,100 graduate degrees.

According to both Joseph and Dean Heather M. Young, the continued growth and impact of the 5-year-old Betty Irene Moore School of Nursing can be measured by the accomplishments of its students and graduates.

“There are many measures of what we are accomplishing and certainly we should each take great pride in the students who graduate today,” Joseph said. “Equally remarkable, we are also forging, however imperfectly, a culture characterized by respect and collaboration and mutual support, as well as a lot of very hard work.”

Young emphasized this impact is the direct result of the vision of the school’s namesake, Betty Irene Moore.

“Together, we will make certain the next generation of nurses, physician assistants and other health-care professionals are equipped to make a difference in ways that are important to the individuals, families, and communities we serve,” Young said.  “As you will see today, our students are assuring Mrs. Moore’s dream takes shape in very important ways.”

Five students were recognized by nursing faculty with awards of excellence highlighting the school’s five core attributes:

  • Excellence in Leadership Development: Lauren Burke
  • Excellence in Interprofessional Education: Robin MacPherson-Dias
  • Excellence in Transformative Research: Katherine Kim
  • Excellence in Cultural Inclusiveness: Bertha Odhiambo
  • Excellence in Innovative Technology: Deborah Greenwood

The graduation marks the school’s third graduation since the Betty Irene Moore School of Nursing was established in 2009 and opened its doors in 2010. The school now boasts 48 alumni.

The Nursing Science and Health-Care Leadership Graduate Degree Programs, which includes master’s degrees in leadership, nurse practitioner and physician assistant studies as well as a doctoral program, are led by an interprofessional team of faculty from across UC Davis. Learn more at http://nursing.ucdavis.edu.

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Telehealth improves forensic exams for sexual abuse


‘With this technology, we can help children who might otherwise not receive this level of care.’

Sheridan Miyamoto, UC Davis

Researchers at UC Davis and other facilities have shown that telehealth consultations for clinicians at rural hospitals improve their ability to provide forensic examinations for sexual abuse. Published in the journal Child Abuse & Neglect, the study showed that clinicians with access to expert UC Davis nurses provided more thorough and nuanced exams, improving their ability to gather evidence and to make an accurate diagnosis.

“Providing telehealth support really improves the quality of these forensic exams,” said first author Sheridan Miyamoto, a forensic nurse practitioner and research nurse at the Betty Irene Moore School of Nursing at UC Davis. Miyamoto is also a 2014 doctoral graduate of the Betty Irene Moore School of Nursing. “With this technology, we can help children who might otherwise not receive this level of care.”

Provided by advanced practice nurse practitioners and sexual assault nurse examiners with more than 10 years of experience evaluating abuse, telehealth consults offer tremendous benefits for rural communities. In addition to improving quality, they ease the burden on families, who no longer need to travel many hours for expert care, and clinicians, who have access to trained mentors when conducting these delicate exams. As a result, these consults provide a safety net for clinicians, patients and parents, ensuring these procedures are both thorough and accurate.

“It’s important that we get this right,” said Miyamoto. “Due to a lack of experience and regular exposure, many examiners are prone to assess normal variations as injuries from trauma. On the other hand, we also want to protect the child. Strong evidence may result in a plea bargain, eliminating the added stress for children of having to testify in court. Telehealth offers support and built-in peer review for nurses, physicians and other clinicians practicing in relative isolation.”

The telehealth network uses secure teleconferencing equipment to link UC Davis nurses with rural clinicians. The systems provide video and audio, as well as images from colposcopes (magnifying devices used to examine genitalia) and other equipment. This advanced technology essentially puts expert nurses in the room with examining clinicians.

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UCLA nursing school names acting dean


Linda Sarna will serve one-year term.

Linda Sarna, UCLA

Professor Linda Sarna, who holds the Lulu Wolf Hassenplug Chair in the UCLA School of Nursing, has been appointed acting dean of the School of Nursing as of July 1, 2014. She will serve a one-year term while Dean Courtney Lyder is on leave.

Sarna served as chair of the UCLA Academic Senate during the 2012–13 academic year, and she chairs the committee that implemented UCLA’s tobacco-free policy.

At UCLA and beyond, Sarna is recognized for her scholarship promoting the role of nursing in tobacco control and for her research on the symptoms and quality of life of people with lung cancer. As the principal investigator for the Tobacco Free Nurses Initiative and through her active involvement in tobacco-control policy efforts nationally and internationally, she has emphasized the need to change expectations for nursing education and clinical practice.

Sarna is the author of more than 200 peer-reviewed articles, books, chapters and other publications. Her numerous honors and awards include election as a fellow to the American Academy of Nursing and recognition as a distinguished research professor by the Oncology Nursing Society.  She has served on commissions and task forces for the National Cancer Institute, the American Society of Clinical Oncology, the Institute of Medicine and the University of California, among others. Sarna received her bachelor’s and master’s degrees in nursing from UCLA, and her doctorate from UC San Francisco.

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UC Davis nursing leader tapped for White House advisory group


Heather Young is only nurse leader on Systems Engineering for Healthcare Working Group.

Heather Young, UC Davis

Betty Irene Moore School of Nursing at UC Davis founding Dean Heather M. Young serves as the only nurse leader on the 14-member Systems Engineering for Healthcare Working Group of the President’s Council of Advisors on Science and Technology (PCAST). The group, which includes hospital CEOs, health care leaders, physicians and other experts, is developing a report for President Obama that focuses on how to improve quality and lower costs of health care from the management and design perspectives.

“Because interprofessional collaboration is essential to improving health systems,” Young said, “I was honored to be a part of this group and add a nursing leadership perspective. We know that it takes input from all members of the health care team to effect change. To me, this opportunity to participate in a national work group affirmed that our UC Davis programs and research are on the cutting edge of this important area of system improvement.”

PCAST is an advisory group of the nation’s leading scientists and engineers who directly advise the president and the Executive Office of the President. The council convenes a number of work groups to study various issues and report back to the president.

The Systems Engineering for Healthcare project builds on the council’s previous assessment of information technology for health care. The council sought recommendations for improving health care that utilizes systems engineering. The group recently presented its recommendations which include:

  • Accelerating alignment of payment systems with desired outcome
  • Increasing access to relevant health data and analytics
  • Providing technical assistance in systems engineering approaches
  • Involving communities in improving health care delivery
  • Sharing lessons learned from successful improvement efforts
  • Training health professionals in new skills and approaches

The council will use the work group’s study to develop a final report to the president.

You can view a webcast of the group’s report here.

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Cancer care specialist named oncology nurse of year


UC Irvine’s Deborah Boyle is honored.

UC Irvine Health nurse Deborah Boyle, R.N., has received the 2014 Advanced Oncology Certified Nurse of the Year award for her work with cancer patients and commitment to advancing oncology nursing.

The award is bestowed by the Oncology Nursing Certification Corp., a subsidiary of the Oncology Nursing Society, and recognizes nurses who are leaders in patient care, education and research into best nursing practices.

An oncology clinical nurse specialist and palliative care nurse lead in the Chao Family Comprehensive Cancer Center, Boyle’s responsibilities include ensuring adherence to national quality of cancer care standards, leading the nursing component of UC Irvine Medical Center’s palliative care team, patient education and acting as a liaison between inpatient and outpatient cancer care.

“Being recognized by one’s peers is the highest of all accolades,” said Boyle. “I am humbled to receive this honor and do so in acknowledgment of the tremendous contributions made within cancer care by all oncology advanced practice nurses.”

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