Sustained Academic-Clinical Partnership Promotes Impactful Nursing Research: Significant Patient Outcomes From Satellite Scholars Program

Purpose: The purpose was to establish and evaluate the impacts of an innovative academic-to-bedside nursing research translation model on patient safety, quality, and care delivery outcomes from 2014 to 2018. Titled Satellite Scholars Program, this unique model, funded by an academic partnership donor, integrated frontline nurses’ academic coursework into the conduct of clinically-relevant research projects at the nurses’ place of employment. Conduct of research included team-building, proposal development, implementation, acquisition of research skills, evaluation and interpretation of findings, and dissemination—funded by the donor partner and under direct supervision of the Director of Nursing Research. Building successful programs of research, in academic or clinical settings, require two important elements, innovation and sustainability, to address healthcare priorities (Grady & Trautman, 2018; Villarruel, 2018). Leeman et al. (2018) have identified national partnerships as an important strategy to accelerate translation of research findings into real-world clinical practice changes. While first steps in engaging clinical nurses in research involve infrastructure, educational strategies, and leadership support, conducting clinically-relevant translational research demands financial support from collaborative partnerships (Berger & Polivka, 2015; Black, Balneaves, Garossino, Puyat, & Qian, 2015; Pintz, Zhou, McLaughlin, Kelly, & Guzzetta, 2018; Scala, Price, & Day, 2016). Within a large urban pediatric medical center (444 licensed beds), the Director of Nursing Research/, in 2014, mentored multiple bedside nurses during their graduate research courses and noted that many nurses’ proposals, assigned as coursework, were clinically-relevant or strategically-important topics to pursue further as research projects. This observation was similar to the mixed-methods findings by Loke, Laurenson, and Lee (2014) who found that nurses were more motivated to participate in the conduct of nursing research when primary focus was placed on being guided through the experience of research, rather than solely receiving educational training. Foundation personnel from the pediatric medical center were approached by the Director of Nursing Research with funding proposal; funding was found from a private university donor to support a new innovative Satellite Scholars program.

Methods: From 2013 to present, the Satellite Scholars Program has: (1) identified nine eligible “Satellite Scholars” who were enrolled in advanced nursing education and have completed course research proposals that could be implemented at the pediatric medical center and (2) funded six fully-powered research projects which included nurse release time and costs to conduct, evaluate, and disseminate projects. Expenditures for studies included: (1) proprietary measurement tools, (2) gift cards for study participants, and (3) supplies such as electronics and surgical equipment. The donor received annual reports on the use of funds/expenditures and information on the funded research studies. The research studies funded were : (1) The Effectiveness of a “Boot Camp” Training-for-Discharge Program for Caregivers of Medically Dependent Children on a Transitional Care Unit: Evaluation of Caregiver Stress and Length of Stay (completed by 4 nurses); (2) Single-Blinded Randomized Control Study on Use of Distraction versus Oral Midazolam to Reduce Pediatric Perioperative Anxiety in Children Four to Twelve Years Old (completed by 12 nurses, 1 child life specialist, and 1 anesthesiologist); (3) Examination of Psychometric Properties of the ACES Questionnaire When Administered to Pediatric Psychiatric Patients and their Caregivers (enrollment ongoing with 6 nurses, 7 psychiatrists, 2 nurse practitioners, and 13 family therapists); (4) Triple-Blinded Randomized Control Study on Use of Carbon Dioxide Versus Room Air for Insufflation during GI Endoscopy/Colonoscopy in Normally Healthy Children 8 to 17 Years (enrollment ongoing with 13 nurses, 2 physicians, and 1 child life specialist); (5) The Impact of Renal Diet Education Alone or Combined with Two-Week Renal Diet Trial on Outpatient and Inpatient Renal Staff Empathy: Comparative Pre- and Post-Interventional Study Design (IRB approval obtained October 2018 with 3 nurses, 1 dietician, and 1 physician ); and (6) Evaluation of Effectiveness of Caregiver Simulation Experiences on Discharge Readiness, Comfort, and Competence in Caring for their Medically-Complex Child (proposal in development with 2 nurses and 1 simulation specialist). The Satellite Scholar metrics, from 2104-2018, included clinical practice/direct patient care outcomes as well as number of professional presentations and peer-reviewed publications.

Results: Study #1 (Boot Camp study) resulted in significantly decreased days of documented discharge training, parental stress and length of stay with impactful financial departmental savings ($53,000 - $69,900/patient); discharge training program was adopted as clinical practice. Five professional presentations and 1 peer-reviewed publication were completed. The two principal nurse researchers (two night nurses) were promoted to Clinical Nurse Leaders and are engaged in multiple quality improvement projects to sustain clinical practice change and prevent readmissions. Study #2 (Distraction versus oral midazolam) demonstrated that age-appropriate interactive electronic tablet distraction significantly reduced preoperative anxiety and post-emergence delirium, were extubated earlier, and were discharged in less time than the oral midazolam group. Anesthesiologists have changed their clinical practice with pediatric ambulatory surgical patients, more tablets have been purchased with request for more child life specialists. Four professional presentations and 1 peer-reviewed publication were completed. Study #3 (Psychometric evaluation of the Adverse Childhood Events questionnaire), with preliminary data, has shown that children are most reliable when responding to questions on adverse childhood events related to physical and sexual abuse; these responses are collected via an electronic tablet where a “talking dinosaur” asks sensitive questions of the child participant. These early findings has increased follow-ups based on child reports of trauma. Preliminary data has been presented at the local Research Forum. Study #4 (carbon dioxide versus room air for GI procedure), with preliminary data, has gone through multiple modifications to address a “surprise finding” on sites of pain. Written annual reports were given to donor related to status of and findings from studies, dissemination efforts, and expenditures.

Conclusion: The funding for the Satellite Scholars Program has increased annually over the past four years based on the sustained commitment from the academic donor. This program has allowed the adoption of nurse-initiated proposals from advanced education coursework into research studies which have changed clinical practice and increased participation of nurses and other interdisciplinary partners in scholarship and professional development.