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.
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.
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 measures to assessments of neurobehavior. To achieve these aims, nine 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 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.
NICU impact on neurodevelopment
Amy D’Agata, Ph.D, MS, RN
How does the environment of the NICU influence neurodevelopment? More specifically, does stress from the provision of usual care influence brain development? Are some infants inherently more vulnerable to NICU stress than others? These questions were the underpinning of Dr. D’Agata’s dissertation study, which examined stress exposure over 21 days in the NICU, FKBP5 genotype (a gene in the HPA axis) and neurodevelopmental outcomes at discharge from the NICU.
From this small cohort, it was identified that some infants are more vulnerable to stress exposure, thus at greater risk for poorer neurodevelopmental outcomes as a result of their early life experience. Dr. D’Agata has also investigated stress from NICU care. This study is focused on assessing the potential influence of stress and other important environmental factors that may play a role in microbial abundance and diversity on longitudinal neurodevelopment. Dr. D’Agata’s future goal is to translate biobehavioral findings into the NICU practice setting to support improvements in early life protective brain care.
Birth Best Practices
Deb Erickson-Owens, Ph.D, CNM, RN
Dr. Erickson-Owens has an interest in maternal-child health and evidence-based care practices, with a specific focus on birth practices such as the management of the umbilical cord in term and preterm infants. She conducted a pilot randomized controlled trial focused on the management of the umbilical cord at time of cesarean section. Her findings support the importance of placental transfusion at the time of birth.
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 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.
Denise Coppa, Ph.D, APRN-CP, FAANP
Dr. Coppa’s research interests are in the area of alternative health modalities, specifically therapeutic touch. She is a “Qualified Therapeutic Touch Practitioner and Teacher”, certified by the Nurse Healer’s Professional Associates Organization. Dr. Coppa has also conducted therapeutic touch research projects. She has received funding to manage descriptive data sets from the RI Free Clinic.
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 and feasibility, nurse uptake and sustainability, and effectiveness in improving patient and nurse satisfaction along a six-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.
Patricia Burbank, DNSc, RN, FAAN
Dr. Burbank’s research and scholarly work include topics such as exercise promotion among older adults; participation in interdisciplinary research on the effects of interventions using the Transtheoretical Model to change exercise and nutrition behavior in older adults; an evaluation of a fall prevention program with community-dwelling older adults; and a survey of the needs of older gay, lesbian, bisexual and transgender elders in Rhode Island.
Diane Cocozza Martins, Ph.D, RN
Dr. Martins’ research is with vulnerable populations in the community and includes a descriptive phenomenological study of the homeless person’s health care experiences; analysis of food insufficiency and hunger with homeless families; strategies used to survive in the lives of woman facing adversity; and methods to increase nursing students’ knowledge and appreciation with older adults in the community and within the prison population. Dr. Martins has co-authored articles on critical interactionism, risk and vulnerability, elder abuse and nursing education strategies.
Watershed Contamination on Narragansett Tribal Land
Marcella Remer Thompson, Ph.D, MS, CSP, RN, COHN-S, FAAOHN
Dr. Thompson is principal investigator for The Namaus (All Things Fish) Project, community-engaged environmental research in collaboration with the Narragansett tribe from Charlestown, RI. This multi-year, multi-phase project aims to assess the impacts of tribal land and watershed contamination on the Narragansett Tribe, and facilitate evidenced-informed decision making regarding contaminated fish in tribal waters and fish consumption among tribal leaders and members.
This research is funded by the National Institutes of Health, National Institute of Environmental Health Sciences through Brown University’s Superfund Research Program; National Institute of General Medical Sciences through the Advanced Center for Clinical Translational Science; Delta Upsilon at-large chapter of Sigma Theta Tau International Nursing Honor Society; and the University of Rhode Island College of Nursing.