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research

Faculty at the URI College of Nursing have taken on leading roles in some key areas of research in the field. Below are just a few examples.

Women in Correctional Facilities

Ginette G. Ferszt, Ph.D., RN, PMHCNS-BC, Associate Professor

Health Care of Pregnant Women in Correctional Facilities
Dr. Ferszt’s research is focused on improving health care of pregnant women in correctional facilities. She recently completed a national survey examining health care practices of pregnant women in women’s state prisons funded by The Nursing Foundation of Rhode Island. The findings will be used to inform and encourage Warden’s, Health Care Correctional Professional Staff, and policymakers to address health care inequities of this underserved population.

The Experience of Nurse Researchers Conducting Research in Women’s Correctional Facilities
Although women are the fastest growing segment of the burgeoning prison population in the United States, little research has been done with this population that addresses the significant health disparities between women in prison and women in the free world. By examining the experience of nurse researchers across the country who have and/or are conducting research with incarcerated women, Dr. Ferszt hopes to identify strategies to promote the nursing research in this field.

Nursing Best Practices

Developing a Protocol for Nurse-to-Nurse Shift Handoffs

Marlene Dufault, Ph.D., RN, Professor

With ineffective communication being the most frequently reported cause of sentinel events in hospitals, this study’s purpose is to test an evidence-based, patient-centered protocol for nurses’ end-of-shift “handoff” communications. Our study incorporates directions established by the Agency for Healthcare Research & Quality, The Joint Commission, and the National Quality Forum to create policy for meaningful and sustainable clinician change to reduce missing or incorrect communication of patient information, and omissions of relevant care. Guided by Roger’s “adoption of innovations” theory, Dufault’s “translating-research-into-practice” model (Collaborative Research Utilization Model) is being used in this multi-site RCT to evaluate outcomes of cost & feasibility, nurse uptake & sustainability(N=324), and effectiveness in improving patient (N=360) and nurse satisfaction (N=216) along a 6-point implementation trajectory, from pretest to 3 years post-implementation. Study sites include a 129-bed community Magnet-designated hospital, a medium sized Magnet teaching hospital, and a large tertiary medical center. A Best Practice Audit Instrument, Nurse Satisfaction Survey (National Database for Nursing Quality Indicators), Press-Ganey Survey, and Satisfaction with SBARP Survey with analysis using change score transformations, Fisher’s exact test, and repeated-measures ANOVA (p < .05) will determine study outcomes to be completed in August, 2011

Premature Infants and Birth

Mary Sullivan, Ph.D., RN, Professor, Interim Dean

Discovering the Long-Term Outcomes of Premature Birth

A unique sample of 213 infants grouped by prematurity and perinatal morbidity with a full term control group are followed in an eighth study at age 23. It is one of the longest studies of preterm infants in the United States. Its purpose is to learn about development outcomes of preterm and full term infants from birth to young adulthood. Specifically, the study examines the influences of prematurity, medical, social, and other factors on achievements and deficits during young adulthood. Biomarkers of blood chemistry, pulmonary function testing, cardiopulmonary response to exercise and metabolic functioning, and HPA (hypothalamic-pituitary adrenal axis) function by salivary cortisol are also examined to better understand the impact prematurity has on health and early disease. Data are collected during home and laboratory visits using standardized questionnaires, interviews and objective performance based assessments. Biomarkers are integrated and include blood chemistry, pulmonary function testing, cardiopulmonary response to exercise and metabolic functioning, and HPA function by salivary cortisol. See the article about Dr. Sullivan’s research in URI’s 2009-2010Research & Innovation publication.

Magnetic Resonance Imaging of Moderate and Late Preterm Infants: A Pilot Study
The specific aims of this pilot study are: 1) to determine the feasibility of using magnetic resonance imaging (MRI-mcDESPOT technique) to investigate brain development following premature birth, quantifying brain volume (both regional and global), myelin volume and myelin maturation among MPT, LPT, and full term infants; and 2) to relate these structural meaures to assessments of neurobehaviour. To achieve these aims, nine (9) infants will be recruited into one of three groups: MPT, LPT, and full term (FT; 390- 420 wga), with three infants per group.

Effects of Open-Bay vs. Single Room NICU on Infant Outcomes at Discharge
Efforts to improve preterm infant outcomes include environmental stimulation (sound and light), psychosocial factors, developmental care, family centered care and staff behavior and attitudes. Women and Infants Hospital has built a new NICU with 70 individual single rooms. The “single family room” model of care is one of the environments thought to enhance medical and developmental outcomes. The single room concept is attractive because factors that adversely affect the infant can be better controlled, patient care can be individualized and parent satisfaction can be improved. This study aims to compare the medical and neurodevelopmental course from birth through discharge from the NICU between infants in the current open bay nursery with infants in the new single room nursery. This provides an exciting one-time opportunity to conduct a naturalistic study and compare infant outcome in the current open bay nursery with the outcome of infants in the coming single room nursery. Medical outcomes include length of stay, gestational age at discharge, weight, weight gain, illness severity and resource utilization, gestational age at enteral feeding, sepsis and necrotizing enterocolitis. Neurobehavioral outcomes include better NICU Network Neurobehavioral Scale (NNNS) profiles, better sleep state organization and sleep physiology, better infant mother feeding interaction scores and lower pain scores. We also hypothesize that the positive effects of the new NICU will be explained in part by other mediating factors that can be expected to co-occur with the transition to the new NICU. These factors include changes in family centered care, developmental care, parenting and family factors, staff behavior and attitudes and changes in medical practice. These factors will be measured repeatedly before and after the move to the new NICU and used as mediators in the statistical analysis. Findings from this study will likely influence the future quality of NICU design and model of care throughout the Nation.

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