UIC College of Nursing

Marquis D. Foreman, PhD, RN, FAAN, Funded Projects

Outcomes of Delirium in the Elderly

Funding Source: National Institute of Nursing Research

Dates: 2/1/02 – 1/31/07

Co-Investigators: Mary Ann Anderson, Minu Patel

Abstract: Delirium is a common disorder affecting as many as 80% of older hospitalized patients. Despite the fact that at least 30% of delirious patients continue to manifest symptoms at the time of discharge from the hospital, little investigation of delirium has occurred outside of acute care settings. The health outcomes directly attributable to delirium, the utilization of health care resources, the effects of continued care on delirium, and the actual course of delirium remain largely unknown. A prospective, longitudinal, cohort design with 10 years of follow-up is proposed; the work described here covers the first five years of study, and reflects the first 3 years of follow-up. The specific aims are to: (1) evaluate the long-term effects of delirium on selected health outcomes, specifically, functional and cognitive status, mortality, and utilization of health care resources; (2) document the effect of continued care (e.g., institutionalization, rehabilitation, and home care) on the severity, duration, and reoccurrence of delirium; and (3) describe the natural course of delirium beyond an episode of hospitalization. Elderly subjects hospitalized for greater than 48 hours will be followed during their hospitalization. All delirious subjects and an equivalent number of randomly selected non-delirious subjects will be followed at I week, and 1, 2, 3, 6, 9, 12, 18, 24, 30, and 36 months after discharge. Major variables include cognition (Mini-Mental State Exam, Digit Span, modified Blessed Dementia Rating Scale), delirium (Confusion Assessment Method, NEECHAM Confusion Scale, Delirium Rating Scale), physical functional status (Activities of Daily Living, Instrumental Activities of Daily Living), resource utilization (Resource Utilization Inventory, continuing care, Readmission Inventory), and covariates (Charlson Index of Co- morbidity, Geriatric Depression Scale-Short Form). Data will be analyzed using descriptive statistics, repeated measures ANOVA and NFANOVA, and survival analysis. Results of this study will establish a better understanding of the natural history of delirium, its long-term consequences, and the effects of continued care on delirium by which to design efficacious and cost-effective interventions to prevent or treat delirium.

Nurse Faculty Loan Program (NFLP)

Funding Source: Health Resources and Services Administration

Dates: 7/1/03 – 6/30/06

Co-Primary Investigators: Carole Kenner, Joan Shaver

Abstract: The University of Illinois College of Nursing (UIC CON) is a top-ten ranked graduate school in the country and the largest and lead college in Illinois . The CON and several masters 'majors are ranked in the top IO (US News and World Report, 2003), including nurse midwifery (3d) and advanced community health nursing (5'h). Moreover, the UIC CON holds a ranking of 3d among nursing programs in research funding by the National Institutes of Health (2001 and 2002). Our graduate program is headquartered in Chicago with thriving regional programs in 4 other cities in Illinois . We are the major source of nursing leadership for education, research and advanced practice in the state and contribute substantially beyond and most particularly globally through our Office of Global Health Leadership and the first U.S. WHO Collaborating Center for Nursing and Midwifery. Our educational programs entail quality academic and research training in a

stimulating and nurturing interdisciplinary learning environment and prepare nursing leaders for a complex and dynamic global workplace.

Our faculty number close to 100, with appointments in regular professorial, clinical professorial, research professorial (N~ 60) and clinical instructor positions (N~40, several part-time). All faculty members in professorial positions hold a doctorate. Therefore, the UIC CON has been and continues to be well positioned to provide superior quality education for faculty desperately needed in nursing due to a growing shortage. It is important that faculty members be educated in Colleges and Schools that generate nursing and healthcare knowledge as well as disseminate it. Superb investigative experiences with research-intensive faculty optimize the chances for having teachers who can promote the best discovery thinking in others. With respect to other resources, we have our own 11-story building with a core and individual laboratories for biological, biobehavioral and behavioral research plus core laboratories for research support of faculty and students. We acquired state of the technology videoconferencing and web-based learning to provide broader access to our learning opportunities and courses and currently offer a web-based certificate in teaching/learning Leadership to upgrade faculty skills in teaching/learning and curriculum.

There is a growing and relentless shortage of nurse faculty in the nation and in our target region that parallels the shortage of practicing RNs. In a 2000 national survey, 41.7 percent of responding schools cited insufficient faculty numbers as a reason for not accepting all qualified applicants and a faculty vacancy rate of 7.4% was cited (AACN, 2003). Among 71 Illinois schools surveyed recently, 22 have openings for nurse faculty. Since the mean age of faculty in Illinois is 50.1 years; 67.2% are over 45 years of age; and 42.9% of nurse faculty plan on retiring within the next IO years (Baldwin & Metcalfe, 200 1), the need for doctorate prepared faculty is and will continue to be critical. Therefore, this Nurse Faculty Preparation Loan Program as an incentive for individuals to consider preparation to be faculty members is most timely and relevant.

UIC PhD in Nursing Science Program

Funding Source: US Department of Education

Dates: 8/14/06 – 8/13/07

Abstract: This project will enable UIC to increase current enrollment of doctoral students especially those from traditionally underrepresented backgrounds, but more importantly to enable a larger number of these students to enroll in study full-time, thereby accelerating the time to completion of degree requirements—by which we can address the national need addressed by the GAANN program. Moreover, increasing the numbers of full-time students will allow them to better immerse themselves in this educational experience and take advantage of the rich resources, opportunities, and talented faculty currently existing at UIC CON.

Given the large number of outstanding doctoral students who we are currently unable to accommodate through fellowship awards, this fellowship program, combined with a UIC focus on research and teaching competencies in nursing science, will enhance the visibility and quality of our nursing science program, and thereby improve our ability to recruit and retain highly qualified students, especially those from traditionally underrepresented backgrounds.

The proposed GAANN award would enable UIC CON to:

Attract more highly talented applicants to PhD in nursing science programs;
Enroll and retain a higher percentage of the most talented students;
Recruit and retain more students from traditionally underrepresented backgrounds;
Accelerate degree completion; and
Enrich and challenge the entire population of doctoral students in nursing science by ensuring the presence of some of the most talented students in the field.