Faculty are awarded collaborative UMNursing grants for research into improving post-cardiac surgery outcomes and the effects of gratitude practices and meaningful recognition in inpatient settings.
Photos: Left to right, top row: Ameera Chakravarthy and Kelly Doran; bottom row: Corrinne Kosmowski and Kara Stevens
The University of Maryland School of Nursing’s (UMSON) Ameera Chakravarthy, PhD '22, RN, ACNP-BC, FNP-BC, assistant professor and director of UMSON's Doctor of Nursing Practice Adult-Gerontology Acute Care Nurse Practitioner/Adult-Gerontology Clinical Nurse Specialist specialty, and Kelly Doran, PhD '11, MS '08, RN, FAAN, associate professor and co-director of the Biology and Behavior Across the Lifespan Organized Research Center, have received one-year, $15,000 UMNursing grants, a joint venture between UMSON and the University of Maryland Medical Center (UMMC).
Chakravarthy has partnered with Corrinne Kosmowski, MSN, RN, clinical nurse II at UMMC, for the project "Feasibility Testing for the PROTEC Intervention," while Doran has partnered with Kara Stevens, MS '15, RN, CMSRN, wellness program manager, nursing and patient care services at UMMC, for the project "Testing the Feasibility and Preliminary Efficacy of a GRAtitude and Meaningful Recognition Intervention Program on Patient, Organizational, and Staff Outcomes."
In addition, the UMNursing grant provides $2,500 for each of the researchers, to be allocated based on requests over the course of the 12-month period.
About the Feasibility Testing for the PROTEC Intervention Project
Older adults who undergo heart surgery experience more death, disability, and functional compromise often requiring a nursing home stay after surgery. This increases with age due to an inability to recover activities of daily living (ADL) and function lost before admission or due to new ADL difficulties developed after being admitted to a hospital.
Adequate protein intake is critical to maintaining and increasing muscle mass, especially for hospitalized older adults. Protein is needed to support wound healing, immune function, and maintenance of lean body mass. There is research supporting the influence of muscle mass and protein intake on the functional recovery of older adults. Increased protein intake and resistance or strength training are two strategies that have been shown to be useful in maintaining and or increasing muscle mass.
The purpose of this research is to test a Protein Exercise Post-Cardiac Surgery (PROTEC) program to increase protein intake and physical activity during inpatient hospital stays after cardiac surgery. The PROTEC program is based on the Social Ecological Model and Social Cognitive Theory and includes a four-step approach: (1) successful performance of the activity; (2) verbal encouragement; (3) seeing like individuals perform the activity; and (4) elimination of unpleasant physiological and affective states associated with the activity. We will work with nurses to help them change how they approach care given to patients while hospitalized post-cardiac surgery.
The primary aims of this pilot are to test the feasibility and preliminary efficacy of the PROTEC program. It is hypothesized that patients after cardiac surgery exposed to PROTEC will maintain or improve protein intake, muscle strength, lean body mass, and function (ADL and performance) at discharge and 30 days after discharge and will not experience adverse events (falls) during the hospital stay or falls and/or re-admissions in the first 30 days post-discharge. A total of 30 patients will be included from one hospital. The findings of this study will provide preliminary data to design a larger study to test the PROTEC program.
About the "Testing the Feasibility and Preliminary Efficacy of a GRAtitude and Meaningful Recognition Intervention Program on Patient, Organizational, and Staff Outcomes" Project
Inpatient nurses and health care team members are consistently reporting high rates of stress and feelings of burnout. This is driving uncharacteristically high staff turnover and decreases in retention in the health care setting. Worksite wellness programs that focus on developing a gratitude practice and expression/receipt of meaningful recognition have been shown to reduce emotional exhaustion and burnout. The GRAtitude and Meaningful Recognition (GRAM) Program will implement brief staff interventions to optimize opportunities to express gratitude and provide meaningful recognition in the inpatient clinical setting with nurses and nursing support staff. The primary aim will assess the feasibility of the GRAM Program. The secondary aim will evaluate patient outcomes, including readmission rates, nursing-sensitive indicators, and patient-reported nursing communication scores. The tertiary aim is to evaluate the program impact on staff perception of burnout, turnover, and intent to leave.
The GRAM Program will utilize a quasi-experimental design to engage staff on an inpatient unit in a multi-step wellness program. The program includes three steps delivered over five months: (1) an environmental and policy assessment focused on opportunities to reduce job stress and feelings of burnout; (2) education surrounding gratitude practice and meaningful recognition, which will be linked to nursing values and organizational/unit goals; and (3) goal setting, coaching, peer support, and support for active engagement in gratitude and meaningful recognition practices. All staff members providing direct patient care in the Surgical & Thoracic Intermediate Care Unit will be invited to participate, including nurses and patient care technicians. Outcomes will be measured.
At completion of the intervention, participants will be invited to complete a focus group interview to explore program facilitators and barriers as well as areas for improvement. The work will further explore the impact on well-being programs and interventions on health care team members, in connection with patient/organizational outcomes. This will provide pilot data for our next project aimed at testing the efficacy of the GRAM Program.