Student Spotlight: Katherine Dudding

May 7, 2018

Doctoral Candidate; from Sahuarita, AZ. Area of Research focus is Neonate to Nurse Communications with the detection of pain to improve outcomes.

Why did you decide to pursue a nursing degree?

I had great high school science teachers and the opportunity to take Physiology and Anatomy my senior year.  I was completely fascinated with the human body and how it functions to sustain itself.  I also wanted to pursue a career where I would be helping people. This made for a natural progression to a career in nursing.

What drew you to the UA College of Nursing?

You might say that I was in the right place at the right time.  I was working as a nurse educator and I routinely assisted UA clinical faculty to place their students in the Neonatal Intensive Care Unit for clinical experience at Carondelet St. Joseph’s Hospital.  One day, I spoke with Dr. Connie Miller about furthering my education and expressed interest in informatics.  Dr. Miller said that I needed to talk to Dr. Jane Carrington.  Within days, I was in contact with Dr. Carrington.  We had a meeting that was so inspiring.  After learning about Dr. Carrington’s work, I was ready to start classwork that day! Thanks to Drs. Miller and Carrington, I began the application process and started the program in fall 2015.

What features of your program are you especially passionate about?

As a local student, I was able to take on-campus (face-to-face) classes in conjunction with my online classes and obtain a minor in Cognitive Science.The knowledge I acquired with classes in artificial intelligence and machine learning along with the mentorship, from Drs. Mary Peterson and Clayton Morrison, within the Cognitive Science Graduate Interdisciplinary Program (GIDP) were invaluable. Furthermore, classes in informatics along with my minor classes broadened my knowledge base to the innovative application of artificial intelligence and machine learning in nursing to improved patient outcomes.

“As a neonatal nurse for several years, I have witnessed the suffering of neonates due to the current pain standards of care.  I truly believe we can do better to serve this vulnerable population​​​​​." ~ Katherine Dudding

Share your favorite memory from your time at the CON.

My advisor, Jane Carrington, formed a committee of scholars for her advisees, the Carrington’s Cats. My favorite memory has to be with the scavenger hunt that I did with the Carrington’s Cats my second year of RISE. The scavenger hunt took us from the College of Nursing to McKale Center, the Student Union and UAHS Library.I believe we had 19 clues to find specific objects and take a picture of the object with the team and tweet #RNsRISE and #Carringtoncats. This provided an opportunity to meet one another and promote team building while having a blast!

How do you intend to Build Better Futures?

My area of research seeks to increase effective neonate and nurse communication of pain. Here I blend passions with neonates, informatics, and advanced technologies. As a neonatal nurse for several years, I have witnessed the suffering of neonates due to the current pain standards of care.I truly believe we can do better to serve this vulnerable population. Through informatics and advanced technologies in artificial intelligence and machine learning, we can give a voice to neonates to increase effective neonate to nurse communication and ultimately improve outcomes.

For Older Stroke Survivors, a Sustainable Transitional Care Model Addresses the Problem of a Coming Care Shortage

May 3, 2018

If trends continue on their current trajectory, by 2050 there could be a severe shortage of long-term family caregivers available to provide for stroke survivors in the high-risk years of 55-plus. Stroke is the leading cause of preventable disability in the U.S., frequently requiring informal caregiving support. University of Arizona College of Nursing PhD candidate, Lorre Laws, who examines the oncoming crisis in her dissertation, calls the prognosis an approaching perfect storm. “In 2010, we had an average of 7 potential informal caregivers to every person over 80 who needed care,” she says. “In 2030 that’s going to be 4-to-1, and in 2050 it’s going to be 3-to-1. When we look at stroke, the risk is doubling each decade over 55, so we have a huge net risk population. The risk is increasing and the informal caregivers that will be available to support them after stroke is dramatically decreasing.”

“The elderly or disabled don't often have an advocate. We don't see them on our Instagram, Twitter or Facebook feeds, we're not hearing stories about them in the media, and yet persons over 65 are the biggest demographic we have right now in terms of aging." ~ Lorre Laws

How can we head a health crisis of this magnitude off at the pass? Laws’ answer is contained in her PhD dissertation, “Engagement of Primary Stakeholders to Tailor a Comprehensive Transitional Care Model for Persons Who Have Experienced a Stroke and Their Caregivers,” which examines ways to develop transitional, community-based care for persons affected by stroke. Transitional care – as opposed to discharge planning, which prepares the patient for the first stages of care after the hospital – starts at hospital discharge and runs through community reintegration. Typical transitional care extends through eight weeks of hospital discharge, connecting patients and caregivers with community resources and supports.

“This is not sufficient to meet the needs of a survivor and caregiver, as the consequences of stroke extend far beyond eight weeks,” says Laws. “My long-term research goal is to develop a stroke TC model that extends through the first year after initial onset, since many challenges are identified in that first critical post-stroke year.” The trouble is that the stroke population’s access to transitional care has been understudied because until recently the American Heart Association/American Stroke Association (AHA/ASA) have treated stroke as an acute condition rather than as a chronic condition.

That’s changing thanks to a recent update of AHA/ASA guidelines for stroke rehabilitation.  The new guidelines urge that stroke be treated as a chronic condition, and that it be addressed using community-based models such as those advocated by Laws.  “The consequences of stroke,” she says “can have deleterious effects on a person, so wheeling a patient to the curb and giving them a couple of referrals has resulted in poor outcomes. Often, stroke survivors have depression and functional limitations, which results in considerable caregiver stress and burnout with this population.”

Considering that two thirds of caregivers – more than half of whom are 60 and older – spend more than 40 hours per week in their role, it’s clear that the current system is unsustainable from either a community or a healthcare standpoint. “We have older people who oftentimes have one or more chronic health conditions themselves taking care of older people,” says Laws. “No matter how we look at it, we have a problem in the community.”

“We do really well in the U.S. at discharge planning,” she says, citing a Commonwealth Fund study, which examined developed countries’ statistics on discharge planning and care coordination. “In hospitals, we great at getting people ready to go and aligning them with the short-term services that they need. But in care coordination, which is one aspect of transitional care, we tied for last place.” The good news is that thanks to current research into transitional care from the AHA/ASA and the Commonwealth Fund, the healthcare community as a whole may be on the verge of defining a broader, more encompassing model than discharge planning.

That’s important because the alternative could have catastrophic results. Laws, who comes from a long line of community servants, sees research like hers as giving the older stroke population a voice. “I’ve always advocated for the underdog,” she says. “So when I look at vulnerable populations in general, the elderly come to mind. The elderly or disabled don’t often have an advocate. We don’t see them on our Instagram, Twitter or Facebook feeds, we’re not hearing stories about them in the media, and yet persons over 65 are the biggest demographic we have right now in terms of aging.”

Laws earned her Master of Science in Nursing for Entry to the Profession (MEPN) from the UA College of Nursing in 2012 before entering the PhD program. She is also a faculty member of the UA School of Sociology, uniquely positioning her for a multidisciplinary approach to her research. Thanks to forward-thinking inquiries like hers, the perfect storm of 2050 could be supplanted by a comprehensive transitional care program that begins to fill the care gap sooner rather than later – when it may be too late.

Elder Care with a Human Touch: Comprehensive Health Assessment Project Benefits Patients, NP Faculty and Students

April 30, 2018

For Theresa Allison, DNP, FNP-C, co-coordinator of The University of Arizona College of Nursing’s Comprehensive Health Assessment Project (CHAP), performing in-home assessments for some of Tucson’s most vulnerable is all about the human touch. For her patients, most of whom are 65 and older, a health assessment can be a stressful experience. “Their biggest fear is that we’re going to take away their access, so they’re a little on edge. I take that edge off by telling them, ‘This isn’t about whether you qualify for this benefit or that benefit. It’s about making sure you get the care you need.’ You can literally feel the tension vanish.”

The University of Arizona College of Nursing has a robust history of community involvement, including its Community Cancer Connections program for cancer survivors and their caregivers and its association with the Mobile Health Program for rural and low-income urban areas.  But one of its most enduring partnerships CHAP, which began in 2012 as a consulting agreement with the UA Health Plans (UAHP) for the Centers for Medicare and Medicaid Services (CMS). Currently, the project involves faculty nurse practitioners (NPs) who perform in-home Comprehensive Health Assessments needed by the UAHP for its dual-eligible Medicare/Medicaid members.

UA College of Nursing
Dr. Audrey Russell-Kibble

For the UAHP members who take part in an assessment each year – two-thirds of whom are 65 and older – that means receiving a personal and compassionate assessment of their health from cutting-edge faculty NPs. This includes NP faculty who are trained in the use of integrative nursing modalities. The comprehensive assessments are evidence-based and examine members’ risks for falls, depression and anxiety, to name a few. The practical benefits for the College include assuring that NP faculty keep their skills sharp and obtain the practice hours needed to retain certification while allowing NP students to gain hands-on experience with comprehensive assessments. Additionally, the NPs are amassing data – including fall risks, cardiovascular/stroke history – that is useful for future research.

“When we started in 2012, it was a small project,” says Audrey Russell-Kibble, DNP, FNP-C, FAANP, the project’s coordinator. “We might have accomplished a few hundred assessments the first year, but since then we regularly meet our goal of 1,000 per year. Currently, the project has nine NP faculty, including two adjunct NP faculty, and a scheduling support person and a student worker who are bilingual in English and Spanish.” The data collected from the visits is entered into an electronic form and coded for researchers.

Data gathered from the assessments is used by CMS and UAHP to determine the need for urgent home health care assistance and to educate plan members on other services that are available, including eye exams, dental services, transportation to care and over the counter medications. But the human side of the equation is a big part of the project, too. A typical assessment in a doctor’s office might take 30 minutes, but the CHAP team schedules a full hour for an in-home visit. The extra time allows for a much more comprehensive visit than usual, but it also allows the NPs to establish a meaningful relationship with the member.

“We have the opportunity for one-on-one, hands-on time with these members...That way, we're letting our local elderly people know, 'You're still important. You still matter.'" ~ Theresa E. Allison

“We have the opportunity for one-on-one, hands-on time with these members,” says Theresa Allison. “It’s essential to establish a rapport, because if you don’t, then when you go through the questionnaire, the answers are, ‘Nope, nope, nope.’ I make sure to let them know we’re not there to determine need or take away benefits. We’re there to make sure the plan is doing everything it can for them. That way, we’re letting our local elderly people know, ‘You’re still important. You still matter.’”

Theresa E Allison
UA College of Nursing
Dr. Theresa Allison

Echoing that sentiment, Russell-Kibble says, “As nurse practitioners, we’re known for teaching our patients. We try to leave each plan member with a little pearl. For example, how to use their inhaler or how to ask their provider for a specific thing. We don’t prescribe medications, we’re not diagnosing, we’re just gathering information and writing and comprehensive assessment with recommendations for their primary care provider (PCP). The comprehensive health assessment is provided to UAHP and the member’s PCP.”

It’s a win-win situation for plan members, faculty and student NPs. Members receive a top-notch comprehensive health assessment, faculty NPs are able to maintain their practice hours and students receive valuable one-on-one training in an in-home setting. Overall, everyone involved received a valuable benefit, whether it’s a learning experience for the member, the faculty NP or student.

UA College of Nursing Receives Prestigious Future of Nursing Scholars Grant

April 27, 2018

TUCSON, Ariz. – The University of Arizona College of Nursing is one of only 31 U.S. schools of nursing selected to receive a prestigious grant from the Robert Wood Johnson Foundation to increase the number of nurses holding PhDs.

The selected schools comprise the fifth cohort of grantees of the Robert Wood Johnson Foundation Future of Nursing Scholars program, which will provide financial support, mentoring and leadership development to nurses who commit to earn their PhDs in three years. The UA College of Nursing selected two nursing students to receive this scholarship. To support their studies, the program provides scholars with a $75,000 scholarship and the leadership, research and other skills they need to take their nursing careers to the highest levels.

The 2018 UA College of Nursing honorees are Emily Moore, MSN, RN, CPNP-PC, and Jamie Besel, MN, RN.

Besel plans to study the role and application of technology as it relates to self-management and quality of life in underserved rural populations. Moore plans to examine surgical outcomes and how morbidity and mortality differ when looking at distance of residence from the primary surgical center in the pediatric population.

In its landmark nursing report, the Institute of Medicine recommended that our nation double the number of nurses with doctorates. Although  enrollment in doctorate of nursing practice programs has increased exponentially, PhD enrollment has seen less growth. The Future of Nursing Scholars program was designed to increase PhD-prepared nurses. Doing so will ensure that more nurses are conducting vital research and also will help address the nurse faculty shortage.

The Future of Nursing Scholars program is a multi-funder initiative. In addition to RWJF, Johnson & Johnson, Cincinnati Children’s Hospital Medical Center, Sharp HealthCare and Memorial Sloan Kettering Cancer Center are supporting the Future of Nursing Scholars grants to schools of nursing this year.

“The UA College of Nursing and the Robert Wood Johnson Foundation are strongly committed to the success of our two current and two new RWJF nursing scholars,” said Lois Loesher, PhD, RN, FAAN, director, UA College of Nursing PhD Program. “These scholars must complete our rigorous PhD program in three years to accelerate their entry into the workforce, with the goal of hastening transformational change in nursing and health care. We thank the RWJF for providing numerous resources and consistent support for these new nursing leaders and their faculty mentors.”

“When this program concludes, we will have graduated more than 200 PhD-prepared nurses. RWJF is thrilled to see the program succeed so well, and we are very thankful for the other funders who have joined us in support of this work,” said Susan Hassmiller, PhD, RN, FAAN, co-director of the program and RWJF’s senior adviser for nursing. 

University of Arizona PhD Student Welcomed into the Distinguished University Fellows Program

April 24, 2018

Incoming University of Arizona College of Nursing PhD student Elizabeth Johnson, BSN, MS, is the latest CON student to receive a prestigious University Fellows award. Offered to the UA’s top incoming graduate students through a collaborative selection process, the University Fellows Award is a multiyear fellowship that provides in the first year a $32,000 fellowship, base graduation tuition in the fall and spring semesters, and healthcare coverage through the University of Arizona Student Health Insurance Plan; in the second year, Fellows are awarded funds for attending conferences or professional development activities. In addition to the financial benefits, University Fellows receive specialized leadership, professional development, mentoring, and interdisciplinary training.

Elizabeth Johnson, BSN, MS
Elizabeth Johnson
Elizabeth Johnson, BSN, MS

“To be named a University Fellow is to be associated with an interdisciplinary group of leaders and innovators, a fantastic touch point to have as a developing nurse scientist,” said Johnson. “The honor resonates in the ability to convert ideas and collaborations to enhanced nursing practice and community outreach.”

Before coming to the UA College of Nursing, Johnson received her BS in Nursing from Purdue University and her MS in Clinical Research Management from Arizona State University. She has held positions as a research nurse in pediatric endocrinology/metabolic disorders at Baylor College of Medicine and as a Clinical Trial Manager in adult oncology with the US Oncology Network. Throughout her nursing career working with research participants, their families and participating sites, Elizabeth participated in numerous task forces and appointments to support optimal trial conduct and elevate research integrity. Given this experience, her research interests include research participant protections within Electronic Health Records (EHRs) with a focus in prevention of participant withdrawals and injury. A newcomer to Tucson, Elizabeth eagerly awaits desert nature walks with her husband and son. 

“To be named a University Fellow is to be associated with an interdisciplinary group of leaders and innovators, a fantastic touch point to have as a developing nurse scientist." ~ Elizabeth Johnson

“We are delighted to welcome Elizabeth as our new University Fellow representing the College of Nursing,” said Lois Loescher, Director UA CON PhD Program. “The College of Nursing has a 100 percent success rate in nominating exceptional, newly-admitted PhD students who are as University Fellows. The University Fellows Program provides an amazing opportunity for new doctoral student to work with leaders in the CON and on main campus. The fellowship will provide additional training and experience for Elizabeth to become a well-informed, collaborative, and innovative leader on campus and beyond.”

Community Practice Becomes a Journey of the Heart with Elder Patients

April 18, 2018

Shu Fen Wung’s patients love her and she loves them right back. A nurse scientist with a decades-long research interest in cardiovascular disease, she has a serious compassionate streak for the elder patients she sees in the community during her clinical work. “I tend to like people who are older,” she says with a smile. “I value their wisdom.” And her patients, whether they live in an adult care facility, assisted living or their own home, treasure the personal, compassionate care that she provides. A certified acute care nurse practitioner since 2003, Dr. Wung has been conducting community visits for 14 years.

Many of her first patients – several of whom are in their 90s and 100s – are still with her. “My oldest one right now is 107 and I had several others who lived to 106,” she says. 

“I enjoy caring for patients in the community because I get to see their home and interact with their caregiver,” says Dr. Wung, who is a strong proponent of holistic compassionate care. “People don’t come with one single problem when they have heart failure. Sometimes they have arrhythmia, sometimes they have diabetes. They have a variety of health issues, and I love to be able to manage all the multiple chronic illness at the same time, because if I’m able to get their diabetes under control, that helps their cardiovascular system. It’s all interconnected.”

Dr. Wung’s community practice is as multi-faceted as her patients, many of whom are low-income or on Arizona Health Care Cost Containment System (AHCCCS) care. Her in-home work encompasses managing ventilators for patients with chronic respiratory failure, feeding tubes for nutrition needs for patients with traumatic brain injuries, and IV infusions for patients who are dehydrated. She also works with medical equipment companies to secure wheelchairs, walkers and shower chairs, coordinated services with pharmacy, hospice and other home health care nurses, and consolidates and manages multiple medications. 

“I enjoy caring for patients in the community because I get to see their home and interact with their caregiver." ~ Dr. Shu Fen Wung

What she loves most about her job, though, is building long-term relationships with her patients. “The most rewarding part is being able to help them make decisions and to solve their problems, whether it is related to their health conditions, social issues, nutrition, safety or basic needs,” she says. “I treat them as my family.” She also enjoys raising the College of Nursing’s profile in the community, pointing out that patients give her complete trust because of her association with the UA. She’s proud of taking care of patients not only because of the warm human connection she makes with them, but because her community practice feeds into how she teaches her students at the College. “They’re the people who will carry out the work that I foster for future patients,” she says.

Shu Fen Wung, PhD, MS, RN, ACNP-BC, FAAN, is as Associate Professor at The University of Arizona College of Nursing.

College of Nursing Faculty and Staff Honored at UA Visionary Leadership Awards Ceremony

April 13, 2018

Please join us in congratulating two members of the UA College of Nursing faculty and staff who were selected by the UA Commission on the Status of Women (CSW) as the recipients of 2018 Maria Teresa Velez Outstanding Mentor Awards.

The Outstanding Mentor Awards were renamed in 2017 in honor of Maria Teresa Velez, associate dean of the Graduate College, who died in 2016. She worked to extend access to higher education for students who historically have been underserved. The Outstanding Mentoring Awards recognize individuals who have demonstrated an outstanding commitment to mentoring within the UA and are awarded to a faculty member, appointed professional staff member and classified staff member. The UA College of Nursing won in both faculty and appointed professional categories.

Judith S Gordon
Dr. Judith Gordon

Maria Teresa Velez Outstanding Mentor Award – Faculty

Dr. Judith Gordon, Professor of Nursing, is being recognized for her mentorship as a faculty member as well as her involvement in Women in Academic Medicine, a group that aims to bring inclusivity and equity to women faculty in academic medicine at the UA.

A year after joining the group in 2011, Gordon became a member of its steering committee; in 2014, she became chair of that committee. During her time as chair, Gordon coordinated events and led an effort to revise the group's mission statement to foster mentorship, networking, career development and institutional advancement for female faculty, according to Archita Desai, one of Gordon's nominators and interim director of the UA's Thomas D. Boyer Liver Institute.

“I am truly honored to have been selected for this award,” says Dr. Gordon. “Maria Teresa Velez was an outstanding mentor and role model, and I aspire to follow the example she set. I am very grateful to the outstanding women faculty who nominated me for this award; it’s their recognition that means the most to me.”

“There are still students who are looking for that one person to believe in their ability to succeed." ~ Amanda Gluski

Amanda L Gluski
Amanda Gluski

Maria Teresa Velez Outstanding Mentor Award – Appointed Professional

Amanda Gluski, Director of Student Engagement, leads initiatives to support College of Nursing students as they apply, matriculate and advance through the program, according to Dr. Sheila Gephart, Associate Professor of Nursing and Gluski's nominator.

She's known for being very responsive and thorough, and pursuing issues on behalf of students until they're resolved. Gluski is also known for helping faculty follow best education practices. Her work along these lines, Gephart wrote, "promotes an atmosphere of high-quality mentoring across the College of Nursing. Amanda's passion for the University and our students draws them into the Wildcat spirit and makes them feel like they belong here," Gephart added.

“This award means that there is still work to do.,” says Amanda. “There are still students who are looking for that one person to believe in their ability to succeed – colleagues looking for validation or challenges to grow – faculty committed to providing an exceptional student experience – and precious few resources to accomplish these goals.  Receiving this award motivates me to redouble my own efforts to build the capacity for rewarding mentoring relationships in both the College of Nursing, and the University of Arizona communities.”

Some elements of this story were provided by University Communications.

Alumna Spotlight: Tranise Hamilton Goodlow

March 12, 2018

This fall you earned the Mary Opal Wolanin Award for your DNP project. Can you tell us about that?

My project was about hypertension guidelines. The Eighth Joint National Committee (JNC 8) is the governing body that determines how this country treats hypertension. In their latest guidelines, they stated that in the African American population, first line medications should be thiazide diuretics or calcium channel blockers, but I was not seeing that in my nursing experience. I saw African Americans being treated with (angiotensin converting enzymes) ACEs and (angiotensin II receptor blockers) ARBs and not thiazide diuretics or calcium channel blockers, so when I realized that was wrong I decided to implement my study to see if prescribers were writing prescriptions correctly. I looked at MDs, DOs, NPs and PAs; the general consensus is they are either prescribing ACEs and ARBs or they are prescribing beta blockers, which are much further in the guidelines for treating hypertension. Long story short, the African American population is not being managed correctly. That’s concerning, because over half of African Americans have hypertension. So if they are not being treated correctly, then they have higher mortality and co-morbidity risks for strokes, heart attacks, kidney disease and things of that nature.

Is your project ongoing?

I have concluded it, but Dr. Sheila Gephart has encouraged me to continue my research once I actually get a nurse practitioner job. Eventually, yes, I do want to do another study with a larger sample size. My sample size was 231 patients and I would like to do a more robust investigation.

Why did you pursue a career in nursing?

My answer has three parts. When I was a senior in high school, my great-grandmother passed. We were at the hospice and I saw how caring the nurses were with her. It really touched me to see how they interacted with my family. That sparked my interest. Around the same time, Hurricane Katrina hit New Orleans, which is where I am from. I was really inspired by the good that health care professionals, specifically nurses, were doing to help people who did not have their insulin or needed dialysis. Also, I come from a line of teachers, so I love being able to explain complex information in layman’s to someone who is non-medical. Teaching is my favorite part of nursing.

What are your hopes for your nursing career now that you have your DNP?

It is actually kind of funny. I said I would never do research, but now thanks to Dr. Gephart and Dr. Brian Buchner, I am very interested in research. I would like to help address the health disparities that are happening in the African American population. With my research, I can make a difference in someone’s life by helping to control their hypertension. Research is important to me, but I also do want to teach. I am trying to touch everyone: The new nurses, the established ones, the patients and everybody in between.

What drew you to the UA program?

My dad always told me, ‘If you’re going to do something, do it to the best of your ability and get to the top.’ A lot of my peers that were going to get their masters, but I thought, ‘Why get a masters when I can get a doctorate?’ The UA’s DNP program was a big draw. Another thing I really liked about the university is the opportunity for mentorship. When I was considering applying in 2013, I came across Dr. Buchner and saw that he had worked as a nurse in Dallas. Although I am from New Orleans, I live in Dallas, so I felt like we were connected in a weird way, so I went ahead and reached out to him. He responded immediately. He was super-supportive from the beginning, when I was not even in the program. So I thought, if the faculty is this caring and I am not even there yet, that’s the school I want to be a part of.

What features of the program were particularly valuable to you?

Number one, the faculty are very caring. Every professor that I had was genuinely interested in me, gave me great feedback, cared about me as a person. That mattered to me, especially with it being a distance program. Somebody in particular that I would not have graduated without her is Christina Norman, Clinical Placement Coordinator. She worked so hard to find me placement, because in Texas I could not get placement until the last semester. She helped place me in Arizona for one semester and Albuquerque for another semester, so I would not even be here without her.

Can you share a favorite memory or story from your time at the College?

I would have to say the first RISE. It was August 2014 when I came to campus, and I was nervous. Dr. Ted Rigney was fantastic. One thing he did that I loved was break down what Doctor of Nursing Practice is: He was the one that made me respect and understand that Doctorate is a level of education, not a job. He said, ‘Pharmacists have doctorate degrees, physical therapists have doctorate degrees. A doctorate means you are an expert and teacher in your field and that is it.’ He gave us the history and the philosophy behind it. He really inspired me to stand up for my degree when people say, ‘Well, you are not a physician.’ That’s true, but I still have a doctorate just as a physician has a doctorate.

How do you intend to build better futures?

By being open. My current job is as a nurse educator, so I deal with new graduate nurses all the time who are super green. They are nervous and they do not know what to do, but I tell them, ‘Keep things very simple.’ They laugh, but it is true. I tell them all the time, ‘As long as no one dies, we can fix it.’ They put so much pressure on themselves, but let’s be very basic and simple in the beginning. Did anybody die or did anybody get hurt? If this answer is no to both of those questions, then we can fix whatever you did. I feel confidence with simplicity. And I like to do that with patients too. I say ‘I do not expect you to be perfect. I understand you like cake. I like cake, too, but maybe have two slices of cake instead of five. I am not asking you to be perfect, I am just asking you to be better.’ That was my approach with my patients, trying to compromise with people and meet them in the middle with what is realistic for them. I am not trying to get patients, nurses or myself to be perfect, I am just trying to do better. If I can do better every day, I will get what I need and everyone else will, too.

From the Bench to the Bedside

March 5, 2018

A UA College of Nursing Professor’s Start-Up Will Improve the Electronic Health Record for Nurses

If you think commerce and academia don’t mix, University of Arizona College of Nursing Associate Professor Dr. Jane Carrington is here to show otherwise. A foremost nursing informatics expert, she will soon be one of the first nursing faculty members to bring a product to the commercial market.

On the heels of a $745,417 RO1 grant from National Institute of Health (NIH) and the National Institute of Biomedical Imaging and Bioengineering (NIBIB) for her Electronic Health Record (EHR) algorithm to alert nurses to important clinical events, she was invited to participate in the 2017 Coulter College Commercializing Innovation (C3i) program. C3i helps inventors in the academic world usher their discoveries on to commercialization by uniting inventors with business advisors, consultants and marketers. In a moment straight out of Shark Tank, after she presented her pitch two venture capitalists offered her $3 million in seed money in exchange for 10% of her invention.

“It wasn’t just because of the product,” she says of her offbeat approach. “It was because I pitched it in a different way. I said, ‘You know what? All of us are patients in this health care system. And we have two simple goals every time we’re in the hospital: one, Get out as soon as possible and two, survive. Our current EHRs don’t promote enough guarantees that these goals will be met. But with the addition of our product, we will now have a way to up the ante.”

Tell us about your product.

We named it CECAMS – Clinical Event Communication Management System. It’s for early detection of change in status of six events – fever, pain, bleeding, urine output, breathing and consciousness – so as to prevent complications or unexpected death. Basically, it’s an algorithm and clinician interface that tracks the status of patients and based on a data pattern, triggers an alert to the clinician about the potential for or actual occurrence of a clinical event. The company we’re forming so far is named Quantum Communication Tools. Right now, we plan to name a CEO and using a business innovation approach, submit a Small Business Technology Transfer (STTR) grant proposal in order to have more resources to advance the product.

What’s unique about your approach?

It’s a hot thing on the market right now. Everybody sees the value of EHR data and not everybody has access to that data. But not all of these ventures are solid because they’re quick start-ups looking for the fast dime. Our project is more science based, following the rules of computer science for algorithm and machine learning. We’re moving more slowly but that gives us more accuracy and relevancy for clinicians. We’re using innovative data visualization strategies to develop a prototype EHR that we can test and eventually put on the market.

What sets my work apart is that I look at the EHR as a communication system rather than as a documentation system. I use the principles of information theory. I adhere to what is known about human factors for the user technology interface and I put all that together for messaging, receiving the message and then determining where the data goes after the message has been received. Current EHRs are great for data entry but not as great for retrieving the data, which often makes them useless for continuing care. We’re working on understanding how nurses use the EHRs so we can re-design to be useful as a communication system. The idea is to turn vast amounts of data into actionable knowledge.

How did you become involved inTell us about the C3i program?

We got an email from the SBIR program officer for NIH saying we were eligible to participate in the C3i program through the Coulter Foundation. The C3i is one branch of that foundation composed of people who are committed to helping people like me learn how to commercialize their inventions. Once I formed a business team, I had to stay on top of weekly assignments and web presentations, and take part in coaching exercises with venture capitalists. These people are masters at helping you take your scientific idea and lay it out in a way that will want someone to invest in it. They also assigned us a journalist who specializes in helping people tell their story in a way that’s succinct. And then our final was presenting our pitch in Bethesda in front of NIH representatives.

Tell us about you provisional patent?

What it means is we have put a flag on the moon, if you will. People are monitoring the patent list to ensure nothing threatens our patent before we’re done. It’s provisional, meaning we’ve got a flag out there and we’re protecting our corner.

What will Phase Two of the EHR Prototype interface involve?

The first step was defining each clinical event and then developing an event classification system – developing the rules, so to speak. We’ve ended up with a classification system that’s enormous but is an absolutely powerful document. One of the phases of the algorithm development is to make it scientific, so in Phase Two we’re going to send it out to staff nurses for review.

What are your hopes for the future?

The success of my business and my research are two facets. However, another facet is extending the application of EHR communications technology to other healthcare problems.  For example, I plan to shift my thinking from technology underpinning hospital individual patient acute care to creating technology solutions that will advance care systems safety and excellence. Informatics is a ubiquitous key to needed innovations.

Student Spotlight: Erin Leigh Galligan

Feb. 28, 2018

Senior in the DNP Nurse Anesthetist specialty program, from the Bay Area

Why did you decide to pursue a nursing degree?

I originally pursued an accelerated BSN degree, knowing I wanted to become an advanced practice nurse, but I wasn’t sure of the specialty.  After seeing a CRNA do the job, I immediately knew that I wanted to become a CRNA.  

What drew you to the UA College of Nursing?

I was already living in Tucson, gaining ICU experience to eventually go to CRNA school. When the UA created its CRNA program, it was very serendipitous. 

What is it about nurse anesthesia that you find particularly appealing?

Every day, people trust anesthesia providers with their lives and the lives of the people they love.  This is a huge onus of responsibility, and I try very hard to honor that trust put in me. The practice of anesthesia is real-time medicine with results that are immediately appreciable.  Also, I find anesthesia to be this area of confluence between evidence-based practice, physiology, pharmacology, pathology, vigilance, collaboration, cost-consciousness and efficiency where consideration of every variable must take place when developing an anesthetic plan.

What features of your program are you especially passionate about?

I appreciate that this degree is terminal, which will allow me to one day teach future CRNAs at the collegiate level. Also, the CRNA program starts with a cadaver lab, which is a feature not many CRNA programs offer. We also get to rotate through different clinical sites, affording us the opportunity to experience rural medicine, academic medicine, private practice and independent CRNAs. 

Please share your favorite memory from your time at the CON.

This summer, I was able to spend about a month in Luang Prabang, Laos, working in the OR at the only pediatric hospital in the country.  This was a life-changing, challenging and incredible experience from which I feel I am still decompressing.  Luang Prabang is where the idea for my DNP project in third world pain education came to life. 

How do you intend to Build Better Futures?

Having a terminal degree to teach, and being able to do mission trips caring for disenfranchised populations are both in my future as a CRNA.