The College of Nursing's service mission focuses on applying our resources to improve health care for Iowans.

An important part of this endeavor involves extending our academic programs to students who are unable to move to Iowa City in order to advance their nursing education. Some of these students are practicing registered nurses, with families and jobs in communities across the state. Our RN-BSN and graduate programs that are offered online allow them to continue to work, providing nursing care in their communities while pursuing advanced nursing education. The professional development of these practicing nurses is key to expanding the breadth and depth of health care services available to Iowans.

The excellence of health care available to Iowans is directly influenced by the collaborative activities of the College of Nursing with nurses and other health care providers across the state. Through development of partnerships with nurses in facilities and agencies throughout Iowa, the newest research-based information is being implemented into care delivery at the local level. This improves the quality of care Iowans receive and enhances the equality of care available throughout the state.

RN-BSN Program

One of the goals of the Strategic Plan for the College of Nursing is to prepare the next generation of nursing leaders. This includes providing access to baccalaureate education for nurses throughout the state. Our RN-BSN Program is offered to nurses who have graduated from a hospital-based diploma program or from an associate degree in nursing program from a community college. This educational offering has a two-fold impact: 1) the knowledge and skills gained through this education will increase nurses' ability to provide quality care to diverse patient populations with increasingly complex health care needs; and, 2) this education provides the needed preparation for nurses to pursue graduate education. Since the summer of 2005 our program has been delivered through an online format, increasing our annual enrollments from 92 to 156. During this period we received applications from students representing 81% of Iowa's counties.

Ellen Cram [1], PhD, RN, Assistant Dean, Undergraduate and Pre-licensure Programs

Nurse Anesthesia Program

Certified Registered Nurse Anesthetists (CRNAs) are nurses in the health care specialty responsible for putting people to sleep or making part of the body numb. CRNAs take care of you when you are having surgery or giving birth. The University of Iowa's College of Nursing offers the only program in the entire state with the purpose of educating nurse anesthetists to take care of Iowans. CRNAs are a necessity in order for Iowa's hospitals to perform surgery, deliver babies, and operate emergency rooms. Without the ability to provide these services, many of Iowa's hospitals would likely go out of business and force people to travel for all medical care. Nurse anesthetists, often just called anesthetists, are the only anesthesia providers in 91 Iowa hospitals. CRNAs also work in 17 other hospitals that also have physicians doing anesthesia, who are called anesthesiologists. (The map below indicates Iowa communities where our students [SRNAs] provide anesthesia.) Nurse anesthetists, or CRNAs, don't just work in small or rural hospitals. CRNAs also don't just provide anesthesia for minor surgery. There are almost 40 CRNAs at the University of Iowa Hospitals & Clinics doing anesthesia for almost every type of operation. If you have had surgery or delivered a baby in Iowa, a nurse anesthetist likely performed your anesthetic. US News & World Report recently ranked the University of Iowa's nurse anesthesia program at #5 compared to all other public university programs in the US.

Cormac O'Sullivan [2], PhD, CRNA, ARNP, Nurse Anesthesia Program Director

Psychiatric-Mental Health Nurse Practitioner Program

The goal of this program is to increase access to mental health services by increasing the nursing workforce. This program prepares Psychiatric-Mental Health Advanced Practice Nurses to manage the complexity of psychiatric problems, promote mental health and disease prevention, and counsel and refer clients. Psychiatric-Mental Health services are in great need throughout Iowa, particularly in rural areas, so we are increasing student enrollment and financial support in this program, as well as providing psychiatric continuing education courses to primary care Nurse Practitioner providers across the state.

Pat Clinton [3], PhD, RN, CPNP, FAANP, Professor (Clinical) and Assistant Dean for Graduate Programs

Cancer Pain in Elders Grant

Cancer Pain in Elders: Promoting Evidence-Based Practices in Hospices is a six-year grant, funded by the National Cancer Institute, that focuses on promoting adoption of evidence-based practices to improve the quality of pain management for older adults with cancer in hospice. The study addresses barriers to consistent adoption of clinical practice guidelines for managing cancer pain in older adults. Translating Research into Practice (TRIP) is an active process of promoting use of evidence by healthcare providers. This study is evaluating the effect of an interdisciplinary, multifaceted TRIP intervention through selected activities that facilitate use of evidence-based practices for assessing and managing pain in older hospice patients with cancer. The study engages 16 hospices in the Midwest, 13 of which are in Iowa. The Iowa hospices provide services to patients in 53 of Iowa's 99 counties.

Keela Herr [4], PhD, RN, FAAN, AGSF, Chair, Adult & Gerontology Area of Study

Train-The-Trainer: Maternal Depression Screening

Maternal depression affects approximately one in six women. Systematic screening increases the detection of maternal depression and is an important first step in getting women to treatment. The Train the Trainer: Maternal Depression Screening program disseminates maternal depression screening across the state of Iowa. Through the certification of 46 trainers in 29 counties across the state, maternal depression screening has been successfully implemented in many social service programs and hospital settings. Moreover, the certified trainers serve as local educational resources about perinatal depression.

Lisa Segre [5], PhD, Assistant Professor

Depression Training to Promote Nurses as Advocates for Older Adults

The purpose of the Depression Training project was to maximize the roles of nurses employed in diverse healthcare settings across the state of Iowa in identifying and treating life depression. In partnership with statewide professional and provider organizations, the project developed and disseminated 542 copies of the CD-based training program to nurses and other providers in 98 of the 99 Iowa counties. The 4-part Nurses as Advocates training program focuses on identification of symptoms, application of screening tools, implementation of supportive nursing interventions, referral for evaluation as needed, and monitoring of treatment-related outcomes. The project sought to reduce the needless suffering caused by depression by improving the skills of nurses who often come into contact with depressed older people and have many opportunities to improve quality of care and life by accurately identifying and treating late life depression.

Kathleen Buckwalter [6], PhD, RN, FAAN, Professor
Marianne Smith [7], PhD, RN, Assistant Professor

Dementia Training to Promote Involvement in Meaningful Activity

The goal of the Dementia Training project is to facilitate use of diverse activity-based interventions that are personalized to individual residents in long-term care settings. The 4-part CD-based training program is designed to equip long-term care personnel with skills needed to provide ongoing, meaningful, person appropriate, activity-based care for older persons with dementia. The training program emphasizes the importance of activity-based interventions that are available 24-7 and usable by all staff members, not just activity personnel during scheduled and time-limited programs. A total of 192 CD-training packets have been disseminated to long-term care facilities and services in 70 counties of Iowa, and requests continue. This project seeks to simultaneously improve the engagement and enjoyment of older people with dementia and reduce negative behavioral symptoms by improving the skills and understanding of daily care providers.

Kathleen Buckwalter [6], PhD, RN, FAAN, Professor
Marianne Smith [7], PhD, RN, Assistant Professor

Pediatric Pain Management in Rural Emergency Departments

Although more than 31 million pediatric visits are made to hospital Emergency Departments (EDs) annually in the United States, Eds in rural states like Iowa may work with just a few children each week. The lack of opportunity to work with children may affect how our ED nurses and providers practice pain management. We developed a survey to investigate the current pediatric pain management practices in the EDs of Iowa hospitals, focusing on whether or not professionals use up-to-date practices and, if not, what might assist these professionals to update their practices. The survey was made available to all nurses and providers (physicians, physician assistants, doctors of osteopathic medicine, nurse practitioners) who work in EDs in the state of Iowa. All 118 Iowa hospitals (in 91 counties) participated; 82 are Critical Access Hospitals, 14 are Rural or Rural Referral hospitals, and 22 are Urban hospitals. A total of 1,175 nurse surveys and 265 provider surveys were analyzed. There were significant differences between Critical Access Hospitals and Urban hospitals for use of up-to-date practice, knowledge about children's pain, and perceived barriers to updating practice. Nurses and practitioners would like to have standing orders, protocols, and specific pain relieving products available to them. The research team is currently investigating ways to provide the desired information to our Iowa Emergency Departments.

Charmaine Kleiber [8], PhD, RN, CPNP, FAAN, Associate Professor
Ann Marie McCarthy [9], PhD, RN, PNP, FAAN, Chair, Parent Child and Family

Improving Urinary Continence and Pain Management in LTC: M-TRAIN Intervention

It is estimated that 50% of residents in nursing homes are incontinent of urine and those with untreated pain range from 45-80%. Even though federal guidelines have required evidence based interventions for incontinence management for over 2 years, we still see only minimal compliance with these requirements. In addition, many quality initiatives have focused on improved pain management with little change. The reason for this is unknown, but it is likely lack of knowledge about the problem and ways to incorporate evidence based care into practice. The M-TRAIN project (Multi-level Translation Research Application in Nursing Homes), funded through the National Institute for Nursing Research, is testing innovative strategies to promote the use of best practices for improving urinary continence and pain management in nursing homes in Iowa. In this effort, we are partnering with more than 1200 nursing staff in 50 nursing homes in 20 counties and 35 communities in northeast and north central Iowa. The study will involve more than 500 nursing home residents and 250 family members. This project not only provides an opportunity to improve care and quality of life for residents in many Iowa nursing homes, but also provides opportunities for students to learn about nursing homes, research, and ways to partner with other health care providers to improve care.

Janet Specht [10], PhD, RN, FAAN, Associate Professor
Paula Mobily [11], PhD, RN, Associate Professor

UI Area Health Education Center (AHEC)

Iowa exemplifies the problem of access to health care encountered by rural Americans -- the rural nature of our state, an aging populating, the age of the health care workforce, and a lack of health care providers. Iowa's population trends and infrastructure draw greater attention to the existence of several geographic-based health disparities in the state. Southern Iowa comprises some of the state's poorest counties: the unemployment rate often exceeds the state average, there is a greater proportion of low income farm families, and there is a growing population of elders and ethnic minority immigrants. The purpose of the Iowa Area Health Education Center (AHEC) is to increase access to primary health care for underrepresented and underserved populations through health careers recruitment programs in underserved rural and urban areas, community-based interdisciplinary training of primary care health profession students, and continuing education for health care providers. Three Regional AHEC Centers serve 33 counties in southern Iowa, creating a powerful force for improving the primary health care infrastructure and increasing access to quality health care.

Jill Scott-Cawiezell [12], PhD, RN, Professor and Associate Dean for Academic Affairs