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Release: Nov. 7, 2001

UI health service researchers receive $1.3 million grant

IOWA CITY, Iowa -- Health service researchers at the University of Iowa have received a four-year, $1.3 million grant to evaluate a methodological approach for conducting nursing outcomes effectiveness research. Specifically, the investigators will describe the effectiveness and cost of nursing care for three patient populations composed of older adults and will develop a research guideline for use by other researchers.

Investigators note that the study promises better understanding of the effectiveness of health care provided to hospitalized elders with hip fracture or heart failure, as well as the effectiveness of nursing treatments in helping prevent falls among older adults. These three health care problems are leading causes of morbidity and mortality among the elderly. The researchers plan to quantify the contribution of nursing care by comparing outcomes of patients who receive specific nursing interventions with the outcomes of those who do not receive them for the same diagnosis.

The study's principal investigator is Marita G. Titler, Ph.D., director of Research, Quality, and Outcomes Management in the UI Hospitals and Clinics Department of Nursing Services and Patient Care. Joanne Dochterman, Ph.D., UI Foundation Distinguished Professor of Nursing and director of the Center for Nursing Classification, is co-principal investigator. The National Institute of Nursing Research is providing funding for the study.

Titler, Dochterman, and the investigative team will analyze three years of data from electronic data repositories at UI Hospitals and Clinics, focusing specifically on the medical diagnoses of heart failure and hip fracture and on records of patients who receive the nursing treatment of fall prevention. The investigators will identify the most frequently used nursing diagnoses and interventions, pharmacological agents and medical treatments associated with each. This information will then be used to describe statistical relationships among patient characteristics, clinical conditions, treatments, nursing unit characteristics and health outcomes.

Finally, the researchers will compare the costs of health care for patients who receive specific nursing treatments with those who do not receive these treatments. Incorporating nursing diagnoses, nursing interventions and outcomes into health care effectiveness research is critical to understand the contribution of nursing care to patient outcomes.

"With increasing competition in the health care industry, understanding the relationship between nursing treatments and patient outcomes becomes more important," Titler said.

"Unfortunately," Dochterman noted, "nursing interventions are not included in standard coding or reimbursement systems, such as Medicare's Diagnosis Related Groups, so nursing care has not been factored into most previous studies of outcomes effectiveness."

What makes the current study possible is the advent of standardized languages to describe nursing treatments and the patient outcomes associated with them.

Other members of the investigative team include:

-- Paul Abramowitz, Pharm.D., UI professor of pharmacy and director of the UI Hospitals and Clinics Department of Pharmaceutical Care;
-- John Brooks, Ph.D., UI assistant professor of pharmacy;
-- Ginette Budreau, associate director of Nursing Finance and Informatics in the UI Hospitals and Clinics Department of Nursing Services and Patient Care;
-- Gloria Bulechek, Ph.D., UI professor of nursing;
-- Lee Carmen, director of Health Care Information Systems at the UI Hospitals and Clinics;
-- Connie Delaney, Ph.D., UI associate professor of nursing;
-- Linda Everett, Ph.D., associate director of the UI Hospitals and Clinics and the Hospital's director of Nursing Services and Patient Care/Chief Nursing Officer at the UI Hospitals and Clinics;
-- R. Edward Howell, director and CEO of the UI Hospitals and Clinics;
-- Christopher Klitgaard, project manager in Hospital Administration at the UI Hospitals and Clinics;
-- Vicki Kraus, Ph.D., advanced practice nurse in the UI Hospitals and Clinics Department of Nursing Services and Patient Care;
-- Sue Moorhead, Ph.D., UI associate professor of nursing;
-- Debra Pettit, Ph.D., advanced practice nurse in Research, Quality and Outcomes Management in the UI Hospitals and Clinics Department of Nursing Services and Patient Care.

University of Iowa Health Care describes the partnership between the UI College of Medicine and the UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide. Visit UI Health Care online at www.uihealthcare.com.