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Release: Dec. 15, 2000

UI College of Nursing wins coveted geriatric nursing excellence center grant

IOWA CITY, Iowa -- A five-year, $1.33 million grant from the John A. Hartford Foundation will permit the University of Iowa College of Nursing to establish a center for geriatric nursing excellence, the college announced Friday. The Iowa Hartford Center for Geriatric Nursing Excellence will implement initiatives in research, education, nursing practice and health policy to improve the quality of nursing care for older people.

Creation of the center will mean more funding and more collaborative relationships for gerontological nursing researchers, new educational programs in the College of Nursing, including a Ph.D. track for graduates of the college's bachelor's program, more outreach and more continuing education offerings to practicing nurses and nursing home administrators, and stepped-up efforts to inform health policy makers about gerontology nursing issues and standards.

"We're extremely proud to be chosen for this prestigious award," said Meridean Maas, Ph.D., professor of nursing at the UI and principal investigator for the new center. "The Hartford Foundation is a leading force nationally in improving health care for elders. For them to select our proposal demonstrates their confidence that we'll succeed in carrying out the center's mission."

That mission is to enhance research and teaching in geriatric nursing and speed up the adoption of improved treatments in actual nursing practice, Maas said. "This will allow us to build on our efforts to conduct research and teach the best, evidence-based practices to Iowa nurses who care for the people of this state and elsewhere." A large percentage of the UI's nursing graduates stay in Iowa to practice, Maas said, and many choose to work with older individuals in nursing homes and other settings.

Robert P. Kelch, M.D., dean of medicine at the UI, said the new center will be a vital addition to the health sciences campus. "I'm very gratified by the award establishing the Iowa Hartford Center for Geriatric Nursing Excellence," Kelch said. "Not only does it attest to the superb work being done by nursing scientists and educators at Iowa, it also provides a focus for interdisciplinary collaboration to improve geriatric care in Iowa and the nation."

Kathleen C. Buckwalter, Ph.D., professor of nursing and a co-principal investigator for the Hartford Center, said the UI college was one of just 12 nursing schools the New York-based Hartford Foundation invited to submit proposals, and called the selection process "extraordinarily competitive." Iowa and four other schools -- the University of California-San Francisco College of Nursing, the University of Pennsylvania College of Nursing, the Oregon Health Sciences University College of Nursing and the University of Arkansas College of Nursing -- ultimately were chosen to receive funding and designation as Hartford centers for geriatric nursing excellence.

"In a very real sense this designation recognizes the excellence Iowa has achieved in gerontological nursing," Buckwalter said, noting that U.S. News & World Report magazine this year ranked the college's gerontology nurse practitioner program fourth in the country based on a national survey.

The college has developed substantial resources in gerontological nursing research, including the National Institutes of Health-funded Gerontological Nursing Interventions Research Center (GNIRC). Directed by Toni Tripp-Reimer, Ph.D., professor and associate dean for research in the college and a co-principal investigator for the new Hartford Center, the GNIRC supports a wide array of initiatives to strengthen gerontological nursing research and move effective practices into everyday care settings.

Improved practices developed through the GNIRC relate to such areas as pain assessment and management, fall prevention, pressure ulcer prevention and treatment, training family care givers of individuals with Alzheimer's disease and reducing urinary incontinence. Many of these evidence-based practices have been disseminated through a government-sponsored clearinghouse, textbooks and working directly with practicing nurses.

College of Nursing faculty also are starting businesses that incorporate research-based practices into their operations, and the college has developed collaborative relationships with the UI Center on Aging, the Iowa Geriatric Education Center, the UI Hospitals and Clinics, the UI College of Public Health and the Veterans Affairs Medical Center in Iowa City.

"One reason we were successful in receiving the Hartford Center designation is the range and high level of activities we already have going on here," Maas said. "All of that will contribute to the Hartford Center's success."

The Hartford Center will have "practical and clear benefits for the people of Iowa," according to Tripp-Reimer. "Iowa has the largest number of long-term care beds per capita in the United States," Tripp-Reimer said. "It only makes sense to improve the quality of care in nursing homes,

even as we work to support the best possible care for elders living at home and in other institutional and noninstitutional settings."

About 15 percent of Iowans are 65 or older, Buckwalter said, and Iowa leads the nation in the proportion of its population -- 2 percent -- that is 85 or older. Most older adults have chronic health problems, she added, with half of those who are 65 or older reporting at least one disability that affects their ability to perform normal activities of daily living. Medicare, the federal health insurance program for older Americans, currently pays about 18 percent of all U.S. health expenditures, and that figure is expected to reach almost 26 percent by 2030.

"Addressing the health care concerns of elders isn't just the right thing to do based on compassion, it's an economic necessity," Buckwalter said.

The John A. Hartford Foundation, established in 1929, promotes programs addressing health and aging issues and distributes about $20 million a year in grants. In 1997, New York University established the John A. Hartford Foundation Institute for Geriatric Nursing with funding from the foundation. The organization also has spearheaded efforts to improve patient care through its Best Practices initiatives.