SSON professor serves on national panel examining nursing home care in U.S.

Original story published by Show Me Mizzou.

April 18, 2022
Contact: Brian Consiglio, 573-882-9144, consigliob@missouri.edu

From staffing shortages to underpaid staff and a lack of personalized care, issues that have plagued nursing homes for decades in the United States were exposed during the COVID-19 pandemic.

In response, the National Academies of Sciences, Engineering and Medicine organized a team of 17 national nursing home experts, including MU’s Marilyn Rantz, a Curators’ professor emerita at the MU Sinclair School of Nursing. The panel, which first met in fall 2020, recently released a national report providing recommendations to the U.S. Congress for improving the quality of care in nursing homes throughout the country.

The report highlighted seven key priorities:

  1. Deliver person-centered, equitable care that promotes autonomy and manages risks.
  2. Ensure a well-prepared and appropriately compensated workforce.
  3. Increase transparency and accountability of finances and operations.
  4. Create a more robust financing system.
  5. Design a more effective system of quality assurance.
  6. Expand and enhance quality measurement and quality improvement.
  7. Adopt health information technology in all nursing homes.

“The COVID-19 pandemic lifted the veil and exposed some of the problems that have existed even before the pandemic,” Rantz said. “As an independent group of experts in this field, our goal is to use evidence-based research solutions to solve complex problems and advise Congress on potential actions that will ultimately improve the quality of care in nursing homes.”

A nurse for more than 52 years and one of MU’s most successful and productive researchers, Rantz has earned more than $100 million in total grants and authored or co-authored more than 200 research studies throughout her career at MU. She has dedicated her career to improving the quality of care in nursing homes.

“One of the most practical things we can implement in nursing homes immediately is incorporating the preferences of the residents themselves into care plans,” Rantz said. “Some simple examples might be ensuring a resident has clean pajamas each night before going to bed, a cup of coffee each morning or a square of chocolate in the afternoon to brighten their mood. It can also be providing socialization opportunities, such as bingo night or music groups, or even time to walk outside every day to get fresh air.”

Rantz said some evidence-based recommendations that nursing homes should implement immediately also include staffing at least one registered nurse in each nursing home 24 hours a day, seven days a week, and hiring both a full-time social worker and an infection prevention and control specialist per nursing home. Another top priority is increasing wages and benefits for staff.

“Other goals going forward include the enhancement and enforcement of minimum staffing standards, increasing the transparency of finances to ensure money is being used appropriately, and ensuring state agencies have adequate resources. In addition, we hope to eventually plan toward the establishment of a federal, long-term care benefit that would expand access and advance equity to all adults who need long-term care, regardless of their ability to pay,” Rantz said. “Nursing homes were particularly affected by the pandemic, and when you look closer within the nursing homes, people of color were disproportionately affected.”

An expert in chronic illness management, leadership and quality improvement, Rantz began her career as a nurse in 1970 before becoming a nursing home administrator in Wisconsin, where she led a staff of more than 400 people, overseeing a 300-bed nursing home.

“What makes an effective leader is someone who is caring, someone who values their staff, listens to them and encourages them as someone who has been in their shoes,” Rantz said. “If a nursing home is dealing with constant staff turnover, there might be something wrong with the way systems are set up, and correcting those issues can help boost morale and overall care delivery.”

To help address the country’s nursing shortage, the MU Sinclair School of Nursing’s new 64,585 square-foot facility, expected to be completed on MU’s campus by fall 2022, will allow the school to increase class sizes and graduate more nurses.

“Creating new knowledge through research and educating young people are what the university is all about,” Rantz said. “I am proud of our nursing students, who often go on to work in underserved communities with high demand for educated nurses.”

During her time at MU, Rantz helped lead the Missouri Quality Improvement Initiative. This program, funded by Centers for Medicare and Medicaid (CMS), implemented advanced practice registered nurses full time into Missouri nursing homes, which helped nursing home staff identify illnesses earlier and reduce avoidable hospitalizations. In 1999, she also developed the Quality Improvement Program for Missouri (QIPMO), a program that provides free clinical consultation of best practices and infection prevention to all Missouri nursing homes and assisted living facilities. Rantz still leads the program today, and the program is a national model for other states to improve quality of care in nursing homes.

“I have been passionate about getting evidence-based practices infused into nursing homes, and hopefully programs like this can serve as a model that other states can adopt,” Rantz said. “As a national panel, our overall objective is to improve the way our country finances, delivers and regulates care in nursing homes.”

AACN/CDC grant will help nurses boost confidence in COVID-19 vaccine

April 11, 2022
Story written by: Brian Consiglio, 573-882-9144, consigliob@missouri.edu

Original story posted on showme.missouri.edu.

As an assistant teaching professor in the MU Sinclair School of Nursing, Stefanie Birk knows there are nursing students unsure of how to talk with people hesitant about getting a COVID-19 vaccine. Being a public health nurse herself, Birk has been in similar situations and is passionate about equipping the next generation of nurses with the knowledge and confidence they need to have conversations that ultimately promote public health.

To help increase knowledge and confidence about the COVID-19 vaccine among nurses and the communities they serve, Birk and an interdisciplinary team of educators and researchers at the University of Missouri have earned a grant from the American Association of Colleges of Nursing (AACN) with funding through the Centers for Disease Control and Prevention (CDC).

“We want to prepare our nursing students as they get ready to graduate and go on to become nurses serving our communities,” said Birk, who teaches public health classes to hundreds of undergraduate and graduate students in the MU Sinclair School of Nursing. “By incorporating these lessons into their current curriculum, they will be better prepared going forward to have effective conversations with people who may be feeling hesitant about the COVID-19 vaccine.”

The content will be incorporated into Birk’s current ‘nursing in communities’ course for the spring 2022 semester as well as future semesters. The updated course content will cover topics including vaccine development, safety and efficacy, vaccine hesitancy, differentiating between factual, evidence-based information and misinformation related to COVID-19 vaccines, motivational interviewing, health communication and social media marketing.

“We want our students to not only have knowledge about the COVID-19 vaccine, but also to feel empowered and confident to engage with members of local communities who might feel hesitant about it, and to target key rural and underserved populations in Missouri where vaccine hesitancy may be more common and the vaccination rates might be lower,” Birk said.

Birk also will work with faculty and students from the Missouri School of Journalism to identify effective communication strategies, including print advertisements, billboard advertisements, radio advertisements and social media marketing strategies. The project will end in June, when the students, some of whom may be graduating in May, will earn a certificate signaling they have completed the curriculum. Resources from the curriculum will be shared with nursing programs at Lincoln University and Central Methodist University.

“When having these conversations, part of our health promotion strategy is to acknowledge people’s feelings, listen to what their reservations are, and then use encouragement and motivational approaches,” Birk said. “Whether it is in a clinical setting or with family and friends, we want to offer support and promote public health outcomes.”

Birk is collaborating with Mary Fete, Valerie Bader, Deidre Wipke-Tevis and Malaika Gallimore of the MU Sinclair School of Nursing, and Jon Stemmle and Kathleen Rose of the Missouri School of Journalism.

#BuildingVaxConfidence

 

Early detection warnings can reduce medical emergencies

April 5, 2022
Written by: Brian Consiglio, 573-882-9144, consigliob@missouri.edu

Original story posted on showme.missouri.edu.

For critical care nurses, identifying declines in patient condition as soon as possible can help improve the quality of care delivered and reduce medical emergencies.

Now, Eydie Tipton, a doctoral student at the MU Sinclair School of Nursing and nurse researcher at Blessing Hospital in Illinois, is part of a team that implemented an early warning detection system – one who employs real-time alerts monitored by an experienced, critical care registered nurse that is trained to recognize changes indicating a worsening of condition. The team found this evidence-based practice can reduce medical emergencies and mortality rates before patients’ health declines.

The pilot project started at Blessing Hospital, where Tipton, Yvonne Goellner, Tammie Verzino and Laura Weigand work. The project included both an early warning detection system that details around-the-clock changes in patients’ vital signs and cardiac rhythm, as well as the creation of a new, full-time nursing position, known as a high-acuity response team nurse. This nurse utilized constantly updated data to monitor subtle changes in a patient’s condition and collaborated with the primary care nurses to make informed care decisions before a patient’s condition rapidly deteriorated.

“We never want to wait until it is a crisis situation, so if the high-acuity response team nurse notices subtle changes in a patient’s condition, including drops in blood pressure or rises in heartbeat, they can quickly talk with the primary care nurse and make informed decisions quickly and efficiently,” Tipton said. “This allows for early interventions to be implemented when patients are clinically deteriorating, which ultimately improves the quality of care.”

Tipton explained nurses may often be responsible for more than one patient at a time, so adding the new nurse position both promotes professional collaboration and decreases the chances of declining patient condition to go unnoticed. She hopes more hospitals around the country can incorporate a similar model to improve the quality of care.

“When the right people are equipped with the right technology, we can help reduce mortality rates and improve patients’ quality of life,” Tipton said.

“Improving care quality through nurse-to-nurse consults and early warning system technology” was recently published in Nursing Management. Yvonne Goellner, Tammie Verzino and Laura Weigand were co-authors on the study.

For critical care nurses, identifying declines in patient condition as soon as possible can help improve the quality of care delivered and reduce medical emergencies.

Now, Eydie Tipton, a doctoral student at the MU Sinclair School of Nursing and nurse researcher at Blessing Hospital in Illinois, is part of a team that implemented an early warning detection system – one who employs real-time alerts monitored by an experienced, critical care registered nurse that is trained to recognize changes indicating a worsening of condition. The team found this evidence-based practice can reduce medical emergencies and mortality rates before patients’ health declines.

The pilot project started at Blessing Hospital, where Tipton, Yvonne Goellner, Tammie Verzino and Laura Weigand work. The project included both an early warning detection system that details around-the-clock changes in patients’ vital signs and cardiac rhythm, as well as the creation of a new, full-time nursing position, known as a high-acuity response team nurse. This nurse utilized constantly updated data to monitor subtle changes in a patient’s condition and collaborated with the primary care nurses to make informed care decisions before a patient’s condition rapidly deteriorated.

“We never want to wait until it is a crisis situation, so if the high-acuity response team nurse notices subtle changes in a patient’s condition, including drops in blood pressure or rises in heartbeat, they can quickly talk with the primary care nurse and make informed decisions quickly and efficiently,” Tipton said. “This allows for early interventions to be implemented when patients are clinically deteriorating, which ultimately improves the quality of care.”

Tipton explained nurses may often be responsible for more than one patient at a time, so adding the new nurse position both promotes professional collaboration and decreases the chances of declining patient condition to go unnoticed. She hopes more hospitals around the country can incorporate a similar model to improve the quality of care.

“When the right people are equipped with the right technology, we can help reduce mortality rates and improve patients’ quality of life,” Tipton said.

“Improving care quality through nurse-to-nurse consults and early warning system technology” was recently published in Nursing Management. Yvonne Goellner, Tammie Verzino and Laura Weigand were co-authors on the study.