Vanderbilt School of Nursing Assistant Professor Leanne Boehm, PhD, RN, FCCM, received an R01 grant of more than $3.6 million over five years to examine, with her collaborators, the efficacy of telemedicine services among people recovering from post-intensive care syndrome. This effort, funded by the National Institute on Aging, is the first PICS longitudinal cognitive impairment intervention study.
The Vanderbilt-led study will build on the burgeoning national effort to unite ICU clinicians and primary care providers in providing comprehensive care for patients starting when they are discharged from the ICU and continuing through transitional outpatient care.
“Following ICU discharge, patients have problems lasting months to years that often go unaddressed,” Boehm says. “Primary care providers—and even ICU clinicians taking care of these patients—do not know much about PICS.”
PICS affects up to 80 percent of intensive care unit survivors with a range of cognitive, physical, mental, and socioeconomic impairments—which may result in a poorer quality of life for sufferers and their caregivers. Studies have found that in a broad group of adult ICU survivors in all age groups, 33 percent to 50 percent develop ICU-acquired dementia—a symptom of PICS—which the National Institutes of Health now designates as Alzheimer’s Disease and Related Dementia. The ICU Recovery Center at Vanderbilt and the Critical and Acute Illness Recovery Organization were developed to establish ICU recovery clinics that address PICS.
“Only recently have we started to characterize what PICS assessment and management looks like across ICU recovery clinics,” Boehm says. “We’re seeing so much variation in what clinics are doing. This made us wonder which screening and intervention elements were the most important in ICU recovery clinics.”
To answer these questions, Boehm and her collaborators, including Dr. Carla Sevin, director of the ICU Recovery Center and co-chair of CAIRO’s post-ICU clinic collaborative, and James Jackson, director of behavioral health at the ICU Recovery Center, have developed a telemedicine-based randomized controlled trial to assess how a structured multidisciplinary ICU recovery clinic intervention can help patients and their caregivers live healthier, happier lives. Sevin and Jackson are recognized international leaders in establishing and implementing ICU recovery clinics.
The study’s multidisciplinary intervention will convene a physician and nurse practitioner, a psychologist or psychiatrist, a social worker, and a pharmacist to evaluate patients in the domains affected by PICS—specifically, the cognitive, physical, mental health, and socioeconomic challenges. Caregivers will be assessed for PICS-family and caregiver burden.
The evaluation will result in a care plan tailored to each patient’s needs and shared with their PCP. “Providers will talk with the patient about their assessment, care plan, what they can expect, and the resources to help them in their journey,” Boehm says. “Our team, all familiar with the ICU experience, have a multidisciplinary view of ICU-started problems and serve as a bridge in the transition of care from the ICU to their PCP or specialists. Our primary aim is to see if this intervention can improve cognition, mental health, physical function, social network, and patient activation.”
The choice to make this a study of telemedicine services was considered intentional. “ICU recovery clinics tend to be at major metropolitan academic medical centers, with limited services for patients in rural settings or those with new or worsening disability,” Boehm says. “Telemedicine helps address targeted access and availability gaps in PICS assessment and management.”
The pandemic made the study’s virtual component possible by rapidly adjusting and adopting digital services. A pilot study conducted by Boehm confirmed that patients, providers, and caregiver groups could engage in telemedicine and were willing to accept care through online platforms. The pilot study also informed best practices for efficient and supportive telemedicine ICU recovery clinic assessments; mental health and socioeconomic discussions will be conducted privately, and broader physical health discussions will be with the full group of providers.
Boehm’s other collaborators include Dr. Nathan Brummel, a former clinical fellow in Pulmonary Disease and Critical Care Medicine at Vanderbilt School of Medicine, Marianna LaNoue, professor of nursing, and Joanna Stollings, a medical intensive care unit clinical pharmacy specialist at VUMC.
Vanderbilt University School of Nursing has received a four-year, $2.8 million Health Resources and Services Administration (HRSA) Bureau of Health Workforce grant for a primary care nurse practitioner residency program that will recruit, train, and retain primary care providers with a passion for helping rural and underserved communities. Associate Professor Pam Jones, BSN’81, MSN’92, DNP’13, FAAN, is the grant’s project director, with Associate Professor Christian Ketel, DNP’14, FNAP, serving as primary author and evaluator.
The award builds on a $2.4 million HRSA grant the school received four years ago to develop its Community-Based Nurse Practitioner Fellowship, a postgraduate nurse practitioner/nurse-midwife resident training, hiring, and retention plan for community-based health clinics.
The new grant funds five additional advanced practice nurse fellows—three trained in family or adult gerontology primary care, one trained in psychiatric/mental health, and one trained in nurse-midwifery—to work full-time for one year at a participating community-based health clinic.
The fellows benefit from specialized training in behavioral health and psychopharmacology, maternal health, cultural competency, and mitigating issues caused by social determinants of health. They also learn from clinical immersion experiences, mentoring, collaboration with other providers, and providing evidence-based treatments for rural or medically underserved clinics.
Nationally, many new providers based in clinics serving rural or underserved populations become overwhelmed and leave their positions within the first few years. The CBNP Fellows effort is poised to tackle that issue and help new practitioners build confidence and resilience and increase job satisfaction so they continue to practice in communities where they are most needed.
“This program provides, in partnership with our community agencies, a gradual and structured onboarding and an educational program that gives the new provider additional knowledge and ongoing support from the grant team,” Jones explains.
The fellowship will increase access to primary care nurse practitioners for general physical health issues. Behavioral health assistance will be offered as part of holistic primary care and support for people with psychiatric conditions that often aggravate other health conditions. Certified nurse-midwives will promote maternal health through patient education and increased access to providers.
“Chronic diseases, including cardiovascular disease, diabetes, arthritis, and depression, contribute significantly to healthcare costs and affect six out of ten adults, with multiple chronic conditions being common,” Ketel says. “Risk factors such as tobacco use, poor nutrition, sedentary lifestyle, and alcohol consumption exacerbate the situation.”
This program is a part of the Vanderbilt School of Nursing’s programs and educational opportunities that focus on community needs and health equity, helping people overcome disparities to live healthy lives.
“VUSN has a long history of developing and managing nurse-managed practices with APRNs and programs that meet the needs of underserved populations,” says Jones, who has seen the good these types of programs can do and how much they are needed. “In my former role as a chief nursing officer, I saw the profound impact of the lack of appropriate primary care in our underserved communities.”
Ketel continued, “Underserved populations often face significant healthcare disparities, including limited access to quality care and higher rates of chronic diseases. By supporting this program, Vanderbilt School of Nursing demonstrates its commitment to addressing healthcare disparities, working towards health equity, and producing culturally sensitive healthcare providers.”
The program seeks new nurse practitioners and nurse-midwives within 18 months of graduation. After a screening process through the Vanderbilt School of Nursing, applicants may be chosen to interview with a partner community-based health clinic, where those hired will become full-time employees for one year under the supervision of a mentor. They will also have access to continuing education opportunities, monthly conferences, and support/coaching from the School of Nursing faculty.
As an innovative program created to collaborate with community partners and support healthcare needs, the Community-Based Nurse Practitioner Fellowship is one way the School of Nursing supports Vanderbilt’s Dare to Grow philosophy, and it supports the passion Vanderbilt nursing faculty and staff have for helping others.
Vanderbilt University School of Nursing Associate Dean for Equity, Diversity, and Inclusion Rolanda Johnson, PhD’98, received the Vanderbilt University Joseph A. Johnson Jr. Distinguished Leadership Professor Award at the university’s Spring Faculty Assembly.
The award recognizes a faculty member who has proactively nurtured an academic environment where everyone feels valued and where diversity is celebrated. It is named for Joseph A. Johnson Jr., the first African American to earn a Vanderbilt bachelor’s degree and the first to earn a doctoral degree.
In recognizing Rolanda Johnson with the award, Vanderbilt University Chancellor Daniel Diermeier says, “Rolanda’s experiences in nursing — as a clinician, educator, researcher, and administrator — inspired her to make a difference in the lives of those who experience health disparities and inequities and are often overlooked. Her passion is educating nurses to better meet the healthcare needs of all populations and delivering high-quality, culturally sensitive care to all patients. Among her efforts at the School of Nursing was advocating for holistic admissions, contributing to more diverse enrollment.”
Johnson has positively impacted equity, diversity, and inclusion on regional, national, and international levels. She serves as membership chair for the Tuskegee University National Nursing Alumni Association, was the inaugural chair of the American Association of Colleges of Nursing’s DEI Leadership Network (DEILN), mentors for the AACN Diversity Leadership Institute, and a member of the American Nurses Association National Commission to Address Racism in Nursing Education Work Group. She co-founded Nashville’s chapter of the National Black Nurses Association. Johnson also served on the U.S. Pharmacopeia Health Equity Advisory Group.
At Vanderbilt School of Nursing, Johnson helps faculty create inclusive curricula and classrooms, offers guidance to student affinity groups, and is exceptionally skilled at recruitment, retention, and inclusion. Her research and scholarship focus on increasing EDI in nursing education and assisting vulnerable populations.
“Most recently, Dr. Johnson co-developed and co-directed the inaugural Vanderbilt Academy for Diverse Emerging Nurse Leaders, a one-week immersive for nurses who have been in leadership roles for less than five years,” says Pamela R. Jeffries, PhD, FAAN, ANEF, FSSH, dean of Vanderbilt School of Nursing. “This was an amazing week for 18 fellows from academia and healthcare systems all over the country. Many described the program as ’life-changing.’ The academy is well poised to be sustainable and in the long-term, will help to mitigate the diversity disparities evident in nursing leadership.”
Senior Associate Dean for Academics Mavis Schorn, PhD, FACNM, FNAP, FAAN, nominated Johnson for the leadership award. “She has advanced equity, diversity, and inclusivity by developing a strategic plan focusing on both recruitment of diverse individuals while also creating a welcoming environment where everyone feels like they belong,” Schorn wrote. “She led the efforts to create a diversity statement for the school and later led efforts to update it to include antiracism language. She has worked with all the admission committees to ensure the admission process is holistic.”
Johnson will carry the Joseph A. Johnson, Jr. Distinguished Leadership Professor title for one year.
“This award was a wonderful surprise,” she says. “I am humbled to receive this honor. While I am the honoree, the VUSN family deserves accolades for ‘WE’ have accomplished much and will continue to be leaders in diversity, equity, and inclusion in nursing and healthcare.”
Nurses from underrepresented groups in nursing who are interested in leadership are invited to apply for the Academy for Diverse Aspiring Nurse Leaders to be held at Vanderbilt University School of Nursing July 17-19, 2023. The academy is for those with more than three years of nursing experience and not yet in healthcare or academia leadership roles.
The unique leadership development program is led by experienced leaders from diverse backgrounds committed to equipping nurses for future leadership roles. I
The Academy for Diverse Aspiring Nurse Leaders was created by the Vanderbilt School of Nursing and Vanderbilt University Medical Center to serve the needs of nurses from underrepresented groups in nursing leadership and/or those committed to expanding and supporting diversity in nursing leadership.
“If you’re a registered nurse, advanced practice nurse, nurse educator, case manager, or nurse informaticist, this program will help you develop a career plan and toolkit for future leadership roles,” says Mamie Williams, PhD, senior director for nurse diversity and inclusion at VUMC and academy co-director.
The Academy for Diverse Aspiring Nurse Leaders is a companion event to Vanderbilt’s highly successful Academy for Diverse Emerging Nurse Leaders for nurses who have been in academia or healthcare leadership for less than three years.
“Participants called that program ‘life-changing,’ ‘transformative,’ ‘profound,’ and ‘the most meaningful and impactful thing I have participated in,” says Rolanda Johnson, PhD, VUSN associate dean of equity, diversity and inclusion and academy co-director. “They felt strongly that learning how to be a successful diverse leader at an earlier stage in their careers would have been valuable and suggested the creation of a similar program for nurses who aspire to leadership.”
Spots are limited, so applicants are encouraged to apply by May 31.
Vanderbilt University School of Nursing created a new leadership development program for nurses new in health care leadership and academic positions who are from groups historically underrepresented in nursing and/or those who support them. The Academy for Diverse Emerging Nurse Leaders will be held in Nashville from November 14-18. Applications for the inaugural class of fellows are now being accepted.
“The need for nursing faculty and nurse leaders from groups historically underrepresented in nursing is well established, but research shows a need for career development resources that address the specific needs and challenges of diverse nurse leaders,” says Pamela Jeffries, PhD., FAAN, ANEF, FSSH, dean of Vanderbilt School of Nursing. “We believe that the knowledge, mentorship, strategy, and skills that new leaders will attain via the Academy for Diverse Emerging Nurse Leaders will empower them to continue to advance and lead.”
VUSN Associate Dean for Diversity, Equity and Inclusion Rolanda Johnson and Vanderbilt University Medical Center Senior Director for Nurse Diversity and Inclusion Mamie Williams will co-direct the academy, designed for nurses who have been in academic or health care leadership roles for less than three years.
“What makes this fellows program different from other professional development opportunities is that it incorporates and builds on the lived experiences of diverse faculty and health care leaders who have navigated a similar leadership path,” says Johnson. “It explores the challenges of being a leader from an underrepresented group as well as the challenges of supporting and expanding diversity in nursing leadership.”
Academy for Diverse Emerging Nurse Leaders
Academy for Diverse Emerging Nurse Leaders
The academy is taught by experienced faculty and health care leaders from diverse backgrounds and is specifically designed to serve the needs of new and emerging nurse leaders and faculty. In addition to the initial five-day, in-person meeting, fellows will also participate in virtual sessions, receive mentorship from an executive coach and institutional mentor and develop a leadership project.
Williams said that the idea for the academy resonated with her as she thought about her own nurse leadership journey of more than 25 years. “This leadership academy, based on specialized education, discussions, and interactions with peers and diverse nurse leaders, affords the emerging leader an opportunity to thoughtfully design their leadership journey,” she says.
She and Johnson said the academy was developed to help new nursing faculty and new nurse leaders build skills, gain knowledge, and build a network of colleagues and mentors to help them advance their careers and mentor other emerging nurse leaders.