Penn Nursing UPfront: Spring 2012

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TECHNOLOGY AND THE SCIENCE OF CARING Penn Nursing 2.0 4

Wired for Care 8

Year of Games 14

Women’s Health and the World’s Cities 22

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THE WORLD.

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INTERPROFESSIONAL SYMPOSIUM Partners in Education and Practice: Stronger Teams, Better Health With keynote speaker Jordan J. Cohen, MD President Emeritus of the Association of American Medical Colleges

This inaugural symposium will deliver a fresh perspective on how healthcare professionals can come together to respond justly and equitably to the world’s health needs through patient- and population-centered health systems in locally responsive and globally connected teams.

April 17, 2012 University of Pennsylvania School of Nursing Claire M. Fagin Hall, Ann L. Roy Auditorium 1 - 5pm Reception to follow in the Carol Elizabeth Ware Lobby

The symposium will build on the recommendations of the 2010 report “Health Professionals for a New Century: Transforming Education to Strengthen Health Systems in an Interdependent World,” from The Lancet and the Institute of Medicine, advocating system-wide changes in healthcare delivery.

Please note that seating is limited and registration is required.

To register, go to:

www.nursing.upenn.edu/interprofessionalism For information, contact:

Ann Marie Franco or Caroline Glickman in the Office of the Dean at 215.898.8283 or email franco@nursing.upenn.edu

Scan this QR code with your smartphone to go directly to the symposium website.

Board of Overseers Ms. Rosemarie Greco, Chair Mr. Dean Kehler, Vice Chair The Honorable Marjorie O. Rendell, Past Chair Mrs. Nancy Adelson Mr. Mark Baiada The Honorable Phyllis W. Beck Mrs. Carolyn Bennett Mrs. Carol Lefkowitz Boas Mr. Cornelius Bond (Emeritus) Dr. Lillian S. Brunner (Emerita) Gilbert F. Casellas, Esq. Mrs. Eleanor L. Davis Kim Reisman Dickstein, Esq. Mr. William Floyd, Jr. Mr. Seth M. Ginns Stephen J. Heyman, Esq. Ms. Naomi Higuchi, Ex Officio Mr. Daniel Hilferty Mrs. Ellen R. Kapito

Ms. Gail Kass Dr. Eunice King Mrs. Sallie G. Korman Mrs. Andrea Berry Laporte Dr. Wendy Hurst Levine Dr. Patricia Martín Dr. Barbara Nichols Melanie Nussdorf, Esq. Mrs. Vivian W. Piasecki (Chair Emerita) Mrs. Krista Pinola Mr. Ralph F. Reynolds Mr. Robert D. Roy Mrs. Sandy Samberg Dr. Marie A. Savard Ambassador Martin J. Silverstein Mrs. Patricia B. Silverstein Dr. Susan Drossman Sokoloff Ms. Carol Elizabeth Ware Mr. Michael Wert

University of Pennsylvania School of Nursing Dean Afaf I. Meleis, PhD, DrPS (hon), FAAN, FRCN Director of Marketing and Communications Joy McIntyre Assistant Dean for Development and Alumni Relations Wylie A. Thomas Editor Jennifer Baldino Bonett Online Editor Barbara McAleese Editorial Assistant Victoria Smith Contributors Amy Fuhrmann, Cathy Greenland, Monica Salvia, and Katie Siegmann Photography and Illustration I. George Bilyk, Sarah Bloom, Desirée Carr, Karen Gowen, Melissa Hassey, Dale Parenti, Jack Ramsdale, and SMP Architects Design Dale Parenti Design Printing Pearl Pressman Liberty Advisory Board Christina Costanzo Clark, Academic and Student Affairs; Patricia D’Antonio, Faculty; Carol Ladden, Admissions and Financial Aid; Eileen Lake, Faculty; Eileen Sullivan-Marx, Faculty; Yvonne Paterson, Faculty; Jennifer Pinto-Martin, Faculty; Wylie A. Thomas, Development and Alumni Relations www.nursing.upenn.edu Admissions 215.898.4271 | admissions@nursing.upenn.edu Alumni Relations 215.898.4841 | nursalum@pobox.upenn.edu Marketing and Communications 215.898.5074 | joymc@nursing.upenn.edu UPfront is a bi-annual publication of the University of Pennsylvania School of Nursing.

The magazine chronicles the research and leadership of Penn Nursing faculty, students, and alumni.

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The Essence of Nursing A message from Dean Afaf I. Meleis

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Technology and the Millennial Nurse Professors incorporate teaching tools for today’s tech-savvy students.

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High Tech, High Touch Penn Nursing advances in smart technology inform research and practice.

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14 Year of Games

Penn Nursing launches Game Solutions for Healthcare.

16 Penn Nursing Science in Action 20 Breaking the ‘Tribal Culture’ in Healthcare

Dr. Richard Horton of The Lancet calls for a “revolution” to address global health inequities.

22 Women’s Health and the World’s Cities

A new book, co-edited by Dean Afaf I. Meleis, illuminates the role of cities in women’s health.

24 How I Care to Change the World – Kaitlin Best, Nu’12, PhD’16 26 Penn Nursing News

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30 Alumni Connections

On the Cover: Retooled simulation space in Fagin Hall will prepare students for advances in nursing and interdisciplinary care. Story on page 4.

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The Essence of Nursing Is technology changing nursing? Absolutely.

Technology is extending the reach of nursing and the depth of what nurses are able to accomplish as scientists, educators, and practitioners. Is technology changing the essence of nursing?

Absolutely not. We remain, at our very core, a profession devoted to improving the human condition and a discipline focused on advancing and translating knowledge about the health and well-being of populations.

Facing page: Dr. Genie Birch, Dr. Afaf Meleis, and Dr. Susan Wachter present Women’s Health and the World’s Cities, examining the correlation of urban planning, policy, and health.

Nursing technology, from the humble bandage to the iconic hospital monitor to today’s wireless devices, always has been about improving health for the individual and for society. As you will read in this issue, nurses are at the forefront of a technological revolution.

Starting on page 8, you will find nurse-led technological innovations in unexpected places, being implemented in unusual ways. You will find our researchers in urban barbershops testing iPads for HIV education; refining telecare to help elderly patients remain independent longer; and using Internet technology to reach cultures that are traditionally reluctant to discuss health concerns.

Technology opens the door wider to opportunities for cultural competence in healthcare and for better access to evidence-based practice.

We realize that to achieve our full potential at Penn Nursing, we must add an entrepreneurial dimension to our thinking. In nursing science and practice, everything we do is in the context of the patient, the family, and the community. With technological innovation, we must find ways to capitalize within this context to answer major questions in healthcare. We can be entrepreneurial without losing the essence of nursing.

We are taking creative steps in this direction, launching Game Solutions for Healthcare, a project based on the University’s Year of Games theme.

As I write, we have 10 teams working to build tools and applications to address specific healthcare problems (page 14). I envision a wildly successful app or game that would further popularize nursing as a career, encourage healthier lifestyle choices, or help society better understand the challenges of particular health problems.

We are taking bold steps to integrate research innovation with practice. In our feature “How I Care to Change the World” (page 24), Kaitlin Best, Nu’12, PhD’16, one of our first Hillman Scholars for Nursing Innovation, is working with two of our accomplished faculty on improving outcomes for critically ill children who require intensive pharmacotherapy.

As a profession, we are harnessing technology to improve science and practice, and we are preparing up-and-coming nurses to do the same, as you’ll read on page 4. At Penn Nursing, our students can peer into the anatomy of the human body as never before using new technologies, and their practice experiences are enriched through simulation and video systems that allow them to reflect on those experiences.

We are taking global steps to bring healthcare to vulnerable populations – particularly women and children – around the world. The book Women’s Health and the World’s Cities (page 22), which I was privileged to edit with Dr. Genie Birch of Penn Design and Wharton’s Dr. Susan Wachter, offers novel solutions from around the world to improve conditions for women and girl children in urban environments.

While technology is ubiquitous in today’s world, I would contend that no other profession approaches it as personally as nursing, nor with the same potential to reach so many people and affect the quality of their lives. But then I am biased because I believe nurses and midwives are the heart and soul of healthcare.

The essence of nursing is human intervention.

Add to that the benefits and potential of technology and we have an equation with infinite possibility.

AFAF I. MELEIS, PhD, DrPS (hon), FAAN, FRCN; the Margaret Bond Simon Dean of Nursing; Council General Emerita, International Council on Women’s Health Issues; and International Council of Nurses Global Ambassador for the Girl Child

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www.nursing.upenn.edu

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TECHNOLOGY AND THE MILLENNIAL NURSE With both feet planted firmly in the Information Age, the Millennial nurse uses technology like never before.

In her anatomy and physiology class, Practice Associate Professor Connie Scanga, PhD, pumps her arms up and down, demonstrating the musculature of the arm. Next she is hanging like a rag doll over her left side to demonstrate the work of the obliques. Around the class are muscle and skeletal models. Microscopes are lined up neatly, ready for use. On the lab tables are iPads loaded

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with healthcare apps, the latest addition to teaching and learning in the School of Nursing.

This convergence of teaching tools bridges the personal touch and the tech-savvy for today’s nursing student. Raised on apps and smart chips, the Millennial Penn Nursing student finds technology integrated in the curriculum from the first semester of freshman year.

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“IT’S LIKE MAGIC. I can pull apart the brain and look at all the different sections. I can look at all the sides of the bones and muscles.”

BSN STUDENT SARAH BELL

Students like Sarah Bell, Nu’14, consider the iPad and other technologies companion tools to their education. “It’s like magic,” she says of the iPad. “It has great programs where I can pull apart the brain and look at all the different sections. I can look at all the sides of the bones and muscles.”

November. In the first large study of its kind, Dr. Kutney-Lee found that nurses working with EHR systems reported more improvements to nursing care and better health outcomes for patients than nurses working in hospitals without this technology.

In classes, professors use instructional technology including interactive textbooks, video systems, and avant-garde simulations at every level of a student’s education. (See sidebar on page 7.) And, like a double helix, the instructional technologies entwine with introductions to technologies that students will encounter in practice.

Dr. Kutney-Lee expects the use of EHRs to increase. Beginning in 2011, under the Health Information Technology for Economic and Clinical Health (HITECH) Act, Medicare and Medicaid began to offer federal incentive payments of $2 million or more to healthcare providers and hospitals to use EHR technologies. This heralds a major shift in the role of technology in nursing, one that students must be ready to meet.

“With technology so embedded in today’s healthcare environment, it’s paramount that students be exposed early to what technology offers in support of patient care in order to develop the savvy to maximize its potential,” says Practice Assistant Professor Ann Marie Walsh Brennan, GNu’76, GR’97, PhD, RN, who is Penn Nursing’s coordinator of curricular implementation.

“As one of the few schools in the country with our own electronic health record (EHR) system for educational purposes, we have pushed its use beyond the simulation lab and into the classroom.”

In freshman year, students start to work with an EHR system. An increasingly common technology in nursing practice, the EHR “shows promise in bringing about improved and more efficient nursing care, better care coordination, and safety for patients,” reported Assistant Professor Ann Kutney-Lee, GNu’04, GR’07, PhD, RN, a health outcomes researcher at Penn Nursing, in the Journal of Nursing Administration in

“The use of electronic health records is a revolutionary change that is merging education, technology and healthcare,” says Advanced Senior Lecturer Beth Hogan Quigley, GNu’89, GNu’06, MSN, CRNP who teaches the EHR courses, among the first such courses in the country.

“Nurses are using multiple informatics on a daily basis in caring for patients. As educators, we need to pick up the tempo and apply informatics in the curriculum.”

Here, the Penn Nursing curriculum is decidedly up-tempo, says Ms. Quigley. “We’re trying to reach Millennials in ways that they learn – in bite-sized components. We need to be creative to hold their attention. The standard three-hour lecture is not going to benefit these up-andcoming students.”

For student Sarah Bell, technology like the iPad has redefined the way she studies. “I can bring the lab home with me,” she says. “I have ebooks on my iPad, so essentially I’m carrying my books with me everywhere. It’s saving my back and my time because everything is right there.” And the temptation to check into Facebook or play a round of Angry Birds? The iPad keeps Ms. Bell on task: “On the iPad, you can only have one application open at a time: If I have my book open, I can’t search the Internet.”

MSN students Khulud Abudawood (left) and Rahmah Alalawi use the avant-garde and the traditional in anatomy and physiology. www.nursing.upenn.edu

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Even with the effectiveness of health-related technologies, say Ms. Quigley and her colleagues, it’s crucial to retain the human interaction that defines nursing. Combined with the new Nursing curriculum, which presents academic concepts and clinical work side-byside, technology can assist in conveying knowledge rather than overshadowing it.

Practice Associate Professor Tamara L. Zurakowski, PhD, CRNP, points out the capability of video to “give students a piece of the emotion and salience that are really hard to gain through reading alone.”

In the past decade, she says, nursing schools have harnessed the educational possibilities of the Internet and such interactive programs as DxR Clinician, which provides simulated case studies featuring virtual patients.

Coming Soon: State-of-the-Art Simulation

Renovated and expanded simulation labs at Penn Nursing will prepare students for advances in interdisciplinary care through Sim patients – interactive mannequins that simulate the reactions of live patients – and behavioral, live action, and high fidelity simulations.

Beginning in May, Penn Nursing will upgrade the classroom and simulation space on the first floor of Fagin Hall with the most modern technology in nursing education. The three-month, $4.4 million renovation will more than double the size of simulation space to 7,000 square feet. This project will continue the renovation of academic areas of Fagin Hall, begun in 2004. The retooled simulation center will prepare students for advances in nursing and interdisciplinary care using life-like behavioral, live action, and high fidelity simulations.

The simulation spaces will be designed to reflect real-life care settings, including emergency, home care, and hospital.

Each simulation space will be outfitted with video systems to record students’ simulation experiences, allowing for debriefing and reflection.

Funding for the renovations comes in part from the Helene Fuld Trust, HSBC Bank USA, N.A., and includes a challenge grant of $500,000 to create an educational innovation endowment. The endowment would support the ongoing integration of learning technologies and teaching methods.

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“It is considerably more possible now for students to have exposure to and understanding of a topic before they get to class,” says Dr. Zurakowski. “How will they apply that knowledge? What is the appropriate use of technology in learning a particular fact or concept? New educational technologies put tools in the students’ hands that make them more responsible for their learning experience.

The role of the instructor changes from the ‘sage on the stage’ to the ‘guide at the side.’”

At the same time, human interaction remains front and center in a Penn Nursing education.

Says Dr. Zurakowski: “Communication is an essential part of understanding a person and delivering their healthcare, and one that technology cannot replace.”

Penn Nursing 2.0 Technologies at Penn Nursing complement hands-on learning.

EHR Systems

iPads

Projection Microscope

Video Systems

Penn Nursing was among the first nursing schools to pilot an electronic health record system in the curriculum.

In freshman year, students begin to work with the EHR, an increasingly common technology in patient care settings and one that research shows improves patient care.

Penn Nursing also uses an EHR system at its LIFE (Living Independently For Elders) practice.

With new applications for teaching anatomy and physiology, Penn Nursing installed iPads in the lab.

The instructor can manage the iPads remotely from a central computer, seamlessly conveying information and addressing students’ questions.

This interactive teaching tool enables instructors to project images directly from the microscope onto a blackboard-sized screen.

This allows students to see precisely what the instructor is describing – be it a molecular structure or a dissection sample – creating a more unified and effective learning experience.

Unprecedented technologies like video recording of individual student simulation experiences are key components of the Penn Nursing curriculum. These recorded demonstrations allow for reflection and debriefing, so students can see how they handled particular patient scenarios and discuss with faculty how they can improve care and technique.

HIGH TECH, HIGH TOUCH ‘Smart’ Technology Meets Patient Needs

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HEALTHCARE INNOVATION in entrepreneurial ways is a relatively

new concept for nursing, yet it is incredibly important.”

DR. YVONNE PATERSON

As an oncology nurse in South Korea, Eun-Ok Im, PhD, MPH, RN, CNS, FAAN, was accustomed to giving minimal doses of pain medication, which was the protocol to ward off addiction. Oncology patients were used to being stoic and minimizing their pain, according to cultural custom.

But one patient compelled Dr. Im, now a professor at Penn Nursing, to question approaches she thought she understood. In the very late stages of his cancer, a South Korean man on her unit sent his wife on an errand. Alone in his room, he jumped from the hospital’s 12th story, taking his own life.

At first Dr. Im felt helpless and perplexed, thinking she would never learn the true answer to the question that haunted her: “What made him kill himself?” In Korea, explains Dr. Im, “men don’t express as much emotion or admit to pain.

There is a proverb: ‘Men can cry three times in their lives, once when they are born, once when their parents die, and once when their country collapses.’”

Today, Dr. Im has more clarity. She believes the patient chose to take his own life rather than voice his pain and fear, and she has the research to support her theory.

Dr. Im has dedicated her career to research on cultural customs around pain and health. She is a pioneer in the novel approach of using Internet surveys and online discussion formats to ascertain age-old practices and beliefs that prevent people from seeking healthcare or speaking up about health questions that could save their lives.

Wired for Care As Dr. Im’s work demonstrates, technology is wired to nursing like never before. Through technology-supported research and research to develop technological devices, Penn Nursing faculty are establishing innovative new ways to address patient needs, bringing together the high tech nature of modern healthcare with the traditional and the high touch methods of the compassionate caregiver.

Among the first to harness digital technology to address ethnic and gender disparities, Dr. Im, now the Marjorie O. Rendell Endowed Professor in Healthy Nursing Transitions, is adding to her internationally recognized body of data with Internet-based studies in breast cancer, menopause, and physical activity among middleaged women.

Dr. Im capitalizes on the anonymity and relative privacy of the Internet to glean data on how Asians culturally approach cancer pain, menopause, and other mid-life women’s health issues. “Cancer is a stigmatized disorder among older Asians,” explains Dr. Im. “It is kept quiet and considered shameful. And women in Chinese, Japanese, and Korean cultures don’t like to talk about menopause and other health issues that affect them.”

This reticence makes it challenging for healthcare providers to approach treatment in culturally specific ways. By using anonymous Internet surveys that participants can take in the privacy of their own homes, Dr. Im has found a way around this barrier. In a study on menopausal symptoms, a participant wrote a message saying that this was her first time talking about her symptoms, which she never discussed even with her family members. Similarly, in a study on cancer pain, some participants wrote that they would not talk with others about their cancer pain in person, but they could talk about their pain and cancer experience online because people cannot identify them.

Facing page: Penn Nursing researcher Dr. Eun-Ok Im uses Internet technology to study cancer, pain, and women’s health in Asian populations.

“With Internet technology, my research team and I can get rich data on participants’ hidden experiences related to their health and illness issues, which would not be possible in face-toface interactions,” says Dr. Im. “Subsequently, the findings from my studies could provide directions for culturally competent approaches and treatment in these populations.”

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The Barber and the Researcher Armed with iPads and street smarts, Loretta Sweet Jemmott, GNu’82, GR’87, PhD, RN, FAAN, brings technology and nursing research to an unlikely venue: Urban barbershops. In her “Shape Up! Barbers Building Better Brothers” initiative, Dr. Jemmott, who directs the Center for Health Equity Research at Penn Nursing, aims to bypass the stigma attached to HIV/STDs in the urban African-American community. Using a novel iPad application she and her research team designed, they are training barbers – trusted confidantes in the community – to discuss HIV prevention strategies with their clients.

Waiting for their cuts and shaves, clients at the 17th District Barbershop in South Philadelphia are given an iPad to watch a custom-developed video about making wise choices that can prevent HIV. Once their clients are settled into the barber’s chair with iPads in hand, the barbers, trained by Dr. Jemmott and her research team, converse with their clients about the app. The goal is for the clients to leave the barbershop not only with a great cut, but with a greater understanding of how to prevent becoming infected with HIV/STDs. “We needed to connect with a high-risk, hard-toreach population in a way that would be engaging, interactive, creative, and positive,” says Dr. Jemmott, the van Ameringen Professor in Psychiatric Mental Health Nursing. “The iPad app, which the community and the barbers

“Shape Up! Barbers Building Better Brothers” brings a novel HIV and STD prevention effort into urban neighborhoods using iPads and computers to share and collect research information.

inspired us to develop, gave us a way to reach this hip-hop, techno-savvy group with the potential to change their lives.”

With 50 participating barbershops throughout Philadelphia and an expected 1,180 participants between the ages of 18 and 24, this study is the first and largest of its kind.

Damond Young, known to his clients as “Skeet the Barber,” says the barbershop is “a place where men come to meet.” Barbers and clients “develop a personal relationship,” with the barber as “the holder of everyone’s secrets.” Amid the hum of razors and the snip of clippers, that connection and level of trust make the barbershop a natural setting for discussing something as intimate as HIV prevention, says Mr. Young. “I let them open up to me and go into dialogue,” he says. “The barbershop is like the therapist’s headquarters.”

Dr. Jemmott has a multi-tiered approach to discerning the success of the prevention effort.

First, participants stop into a Penn healthcare van outside the barbershop where Dr. Jemmott and her team collect urine samples to determine participants’ STD status. In addition, participants respond to a computerized questionnaire before they begin their session. Next, they go into the barbershop and begin their session with their barbers. Participants return at three, six, and 12 months for follow-up assessments to determine what they learned in the barber’s chair and whether they changed their HIV/STD risk-related behaviors. If they test positive for an STD at any time, they receive treatment. Now at the baseline stage, Dr. Jemmott will use this protocol to determine if the effort may have prevented new STD infections.

“Once we determine the success of this strategy,” says Dr. Jemmott, “it has the potential for barbers nationwide to use it to prevent HIV and STDs and to literally save the lives of young brothers in their communities.”

View Dr. Jemmott’s video (2:31)

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“We needed to connect with a high-risk, hard-to-reach population in a way that would be

ENGAGING, INTERACTIVE, CREATIVE, and POSITIVE.” DR. LORETTA SWEET JEMMOTT www.nursing.upenn.edu

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Big Breakthrough for Tiny Patients Nurses have a rich history of innovation, both by design and necessity. Some of the inventions attributed to nurses include the simulated patient model, foot supports, an early surgical gown with multiple pockets for sterile supplies, an early trauma transport stretcher, and a method of preventing paralysis from polio.

“Nurses have long been the consummate inventors because we are the ones who have always had to get things done as efficiently and effectively as possible,” says nursing historian Patricia D’Antonio, GRN’92, PhD, RN, FAAN, the KillebrewCentis Endowed Term Chair in Undergraduate Education and chair of Family and Community Health. “But it is not just about making things – it is also about making things work.”

The nurse behind the innovation is equally important, explains Julie A. Fairman, GNu’80, GRN’92, PhD, RN, FAAN, the Nightingale Professor of Nursing who directs the Barbara Bates Center for the Study of the History of Nursing. “Technology is much more than machines or equipment or the application of knowledge. It includes the nurse making the tool or equipment work for the patient within a particular time and place; that's the key and perhaps even more important than creating something new.”

Barbara Medoff-Cooper, PhD, CRNP, FAAN, internationally

known for her work with infants with congenital heart defects, is following this historic trend.

From 2003 to 2008, Dr. Medoff-Cooper, the Ruth M. Colket Professor of Pediatric Nursing, conducted the first comprehensive evaluation of feeding difficulties in infants with complex congenital heart defects. She developed a feeding device that could help these babies avoid another life-threatening problem.

Failure to thrive (FTT) is a debilitating postsurgical condition affecting half of all infants with serious heart defects, even after their lesions are surgically corrected. “Due to increased successes in the surgical treatment of congenital heart disease,” says Dr. Medoff-Cooper, “FTT is a significant issue for clinicians, as well as an ongoing source of stress for families.”

Dr. Medoff-Cooper’s research has successfully documented a relationship between feeding behavior and development. Her work has demonstrated that feeding behaviors can predict 12

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developmental outcomes in high-risk infants because of the complicated interplay of movements and physiologic responses needed to feed. The premise of her work is that feeding effectiveness corresponds to how well infants will achieve other developmental milestones.

“Feeding actually speaks loudly to us about the brain,” says Dr. Medoff-Cooper. “If a child is feeding well, it gives us one fewer major issue to worry about.”

For newborns, feeding is a complex task – one that involves careful coordination of sucking, swallowing, and breathing in a tightly choreographed interplay of movement. The task is especially challenging for ill or preterm infants.

With Penn bioengineers, Dr. Medoff-Cooper invented a device that analyzes an infant’s ability to feed effectively. Data derived during feedings can be correlated with growth or developmental problems in the first year of life.

Dr. Medoff-Cooper’s pending patent on this technology is the first of its kind at Penn Nursing.

This device will allow healthcare professionals to assess infants at risk for dysfunctional feeding and poor weight gain.

“Thinking about healthcare innovation in entrepreneurial ways like patents and for-profit partnerships is a relatively new concept for nursing, yet it is incredibly important,” says Yvonne Paterson, PhD, professor and associate dean for research. “If you want an idea to be picked up and used to benefit a patient population widely, you’re going to need the for-profit sector to help you.”

Dr. Paterson, who holds upwards of 15 patents in cancer immunology and has some 30 more in process, shares with Nursing faculty candid advice that helped her early on: “No innovation is going to cure cancer unless it becomes a product, and it won’t become a product unless a company is interested in investing in it. Only then can it become publicly available.”

Nurses need to be aware of this reality, says Dr. Paterson. “If they hit on something – an idea, an approach, an algorithm, a device – there are only benefits to considering commercial approaches to it. There is a lot of ingenuity in the School, which holds entrepreneurial promise.”

Tech at Home Kathryn H. Bowles, GR’96, PhD, RN, FAAN, has tested the use of telehomecare among elderly patients receiving nursing care in their homes. A telehomecare unit typically includes a blood pressure cuff, pulse oximeter to measure oxygen levels, weight scale, glucometer, and sometimes a video phone, all of which feed into a small portable device that transmits health information from the patient at home to a clinician station.

In an earlier study, Dr. Bowles, the Ralston House Endowed Term Chair in Gerontological Nursing, found that on average, patients with telehomecare have a greater reduction in symptoms and a lower probability of hospitalizations and emergency department visits than did patients in a control group.

“Telehomecare not only has the potential to lower re-admission,” says Dr. Bowles, “it encourages patients to be more actively engaged in their own care. Even after the home health nurse leaves, people understand what’s going on with their bodies. Our hope is that it helps older adults stay safely in homes, longer and more independently.”

Bowles and her colleagues in Penn Nursing’s interdisciplinary NewCourtland Center for Transitions and Health are expanding their research to study the effects of motion sensors and voice-automated response technology on home care.

“No one is trying to take away services from patients,” Dr. Bowles emphasizes. “We’re trying to extend the reach of scarce resources. We can have more contact with patients using technology. Patients feel more secure, like someone is watching out for them, and they take better care of themselves. People who never get out of their pajamas get dressed and put on lipstick for a telehomecare video ‘visit’ with a nurse.”

Telehomecare may extend prescribed home healthcare for a patient by providing welldocumented need for care and attention. “The healthcare provider may be more aware that the patient is unstable,” she says. “The technology provides frequent monitoring of clinical indicators and permits the home healthcare nurse to detect changes in health status and intervene when necessary.

“Technology is here to stay,” says Dr. Bowles, “and we are working to maximize it for patients at every stage of their lives.”

The Promise of mHealth Oral rehydration therapy (ORT) to prevent dehydration during diarrheal episodes is one of the most effective and affordable interventions to reduce child mortality and morbidity. Yet ORT has yet to be widely adopted in underdeveloped nations. In a pilot study funded by the Penn Global Health Partnership, Assistant Professor Alison Buttenheim, PhD, MBA, is investigating whether mobile health (mHealth) technologies can encourage more widespread use of ORT.

“The expansion of cell phone ownership around the world has created an unprecedented opportunity to improve healthcare delivery and public health interventions for underserved populations, particularly women and children,” says Dr. Buttenheim.

The work of Dr. Buttenheim and colleagues, including global mHealth leader Ernesto Gozzer of Universidad Peruana Cayetano Heridia, will aim to determine the potential of mHealth to address ORT in a community of 30,000 in Cono Norte, Peru. Research shows that mHealth can strengthen efforts

in disease monitoring, remote diagnosis, medication adherence, appointment reminders, and health education and promotion, says Dr. Buttenheim.

Through a cell phone, mothers would receive timely and targeted text messages about treatment of diarrheal symptoms (including learning the closest retail location for ORT packets) and then provide information about the health status and treatment outcomes of the child to a local health clinic.

Dr. Buttenheim and colleagues would like to extend their work to other areas of maternal, newborn, and child health. www.nursing.upenn.edu

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Two Penn Nursing juniors huddle together with several Penn Engineering students in Weiss Tech House, a technology and innovation center across campus from Fagin Hall. Their conversation ranges from “coding” (as in computers, not hospitals) to high blood pressure (as in vital signs, not academic anxiety). They’re talking about inventing a digital healthcare application – a project that brings both their worlds together.

“From a nursing standpoint, I think it should be free, since it’s a health promotion tool,” says Nursing junior Jenny Wang, Nu’13.

“How about a Web app?” suggests computer science junior Max Guo. “I think it’s a really great idea. I would use it,” replies Weiss Tech House Director Anne Stamer.

It’s a meeting of health and tech minds. And it’s just what Penn President Dr. Amy Gutmann intended when she announced the Year of Games at Penn last fall. With games as the theme of this academic year, the President invited Penn’s schools to consider novel approaches to blending games into academics and innovation.

Is There an App for That?

In September, Penn Nursing Dean Afaf I. Meleis launched Game Solutions for Healthcare, a competition open to all students, faculty, and staff to build or enhance tools and applications to solve healthcare problems. Nancy P. Hanrahan, GR’04, PhD, RN, FAAN, a self-described “gamer,” is leading the initiative.

“Games are a means of discovery and entrepreneurship and can be used to transform our understanding of our health and lifestyles.

Game technology is a tool for expanding our notions of what it means to be healthy,” says

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Dr. Hanrahan, the Dr. Lenore H. Kurlowicz Term Associate Professor of Nursing. “Depending on our generation, we may think of board games like Scrabble, video games like Pac-Man, or virtual reality games like Portal. Today, games represent a whole new way of accessing information in innovative ways to, for example, improve health, extend access to care, and bridge levels of care from hospital to home.”

The Penn Nursing competition and the Year of Games are inspired by the 2011-12 Penn Reading Project book Reality Is Broken by Jane McGonigal, which all incoming freshman read. “Reality Is Broken illuminates values of game-playing that are important concepts in nursing practice – making connections and sound judgments, fostering engagement, teambuilding, problem-solving, and planning,” says Dean Meleis.

Now, 10 Penn Nursing teams are hard at work developing their prototypes. The interdisciplinary teams crisscross the campus with Nursing partners in biotechnology, systems engineering, education, communication, law, medicine, and The Children’s Hospital of Philadelphia. At Weiss Tech House, a partner with Penn Nursing in the Game Solutions for Healthcare project, Anne Stamer coaches each Penn Nursing group, offering smart business counsel alongside technological angles. Dr. Meleis will announce the winners in April, with monetary prizes for three top teams.

Light Bulbs Recent clinical rotations inspired Debbie Yiu, Nu’13, and Jenny Wang. “Patients would pull out scraps of paper to write down their lab values and vital signs,” says Ms. Yiu. “We thought it would be great if they could see what we see in their health records.”

    

“Game technology is a tool for

EXPANDING OUR NOTIONS

of what it means to be healthy.”

DR. NANCY HANRAHAN

Teaming up with Penn Engineering students, Ms. Yiu and Ms. Wang are developing an app that would give patients an accurate way to record and monitor their own healthcare status electronically. “We had talked about it casually at first,” says Ms. Yiu. “Then we realized this is really do-able.”

Similarly, light bulbs are sparking all over Fagin Hall. On the fourth floor, a team of faculty, two staff members, and a BSN student is developing an interactive game to shine a spotlight on urban women’s health for students in the health professions. “It can be very challenging for students to understand the barriers to safety, healthy foods, exercise, and healthcare that many urban women face,” says team member Gabriela de Hoyos, Nu’12. “Through this virtual experience, students can put themselves in the shoes of urban women as they make the difficult decisions that affect their health and the health of their children. In this way, we hope to increase students' awareness and also increase the potential for better health outcomes in community-based care.”

Doctoral student Molly Kreider, BSN’06, is enthusiastically developing two games for the competition. The first, with Dr. Hanrahan, would demonstrate a model of psychiatric care intended to lower hospital admissions and

readmissions. Ms. Kreider believes using a gaming structure to elucidate this textured issue will help policy researchers and policymakers better understand the complexities of psychiatric care and hospitalization.

Part of a Penn family, Ms. Kreider is working with her brothers – one an MD/PhD student at Penn and one a resident at the Hospital of the University of Pennsylvania, to develop a calorie estimation game to help fight obesity in children.

“We may use an avatar [a virtual character] or a virtual pet that would get healthier or sicker based on how nutritious its food is,” she explains. To Ms. Kreider, it’s more than a game. “This is an awesome opportunity,” she says. “My nursing background here encourages working across disciplines. I’m planning to have a collaborative career, so this project really hits the mark.”

Dr. Hanrahan encourages the teams to think big.

“Students are partnering and teaming up as they would in the real world,” she says. “The entrepreneurial component of nursing isn’t commonly considered by students or by the public. With Game Solutions, we’re calling attention to this important area of our School and to the interdisciplinary nature of nursing. Nurses are ideal partners for innovation with technology because they understand the ‘real world’ experience of healthcare.”

Winners!

At press time, Penn Nursing master’s students Antonette Shaw, BSN’11, Mackenzie Mapes, BSN’11, and Kristen van der Veen, BSN’11, learned they had won PennVention’s Startup Challenge, hosted at the Weiss Tech House of Penn’s School of Engineering and Applied Science. In January, 25 teams of student entrepreneurs went head-to-head making an “elevator pitch” – the quick chance to tell judges about their business models in 90 seconds. The winning project, initially generated in Community Health Nursing, taught by Associate Dean Eileen Sullivan-Marx, PhD, CRNP, FAAN, earned the $500 grand prize. The project is an interactive game called “Body Wars” which uses seminars, trivia, and physical activities to teach teenagers about anatomy and the effects of drugs, alcohol, and sexually transmitted diseases on the body. In April, the project vies for an award in the School of Nursing’s competition Game Solutions for Healthcare.

A meeting of health and tech minds: 10 interdisciplinary teams are vying for the top prize in Penn Nursing’s Game Solutions for Healthcare.

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SCIENCE IN ACTION Autism Linked to Low Birthweight Autism researchers at Penn Nursing have found a link between low birthweight and children diagnosed with autism, reporting that premature infants are five times more likely to have autism than children born at normal weight.

The children, some born as small as about a pound, were followed for 21 years, making this study, published in Pediatrics, one of the most remarkable of its kind. The infants were born between September 1984 through July 1987 in Middlesex, Monmouth, and Ocean counties in New Jersey at birthweights from 500 grams to 2,000 grams or a maximum of about 4.4 pounds. The research results were named among the “Top 10 New Findings in Parenting” of 2011 by TIME magazine.

“As survival of the smallest and most immature babies improves, impaired survivors represent an increasing public health challenge,” wrote lead author Jennifer A. Pinto-Martin, PhD, MPH, director of the Center for Autism and Developmental Disabilities Research and Epidemiology and Viola MacInnes/Independence Professor of Nursing. “Emerging studies suggest that low birthweight may be a risk factor for autism spectrum disorders.”

Links between low birthweight and a range of motor and cognitive problems have been well-established for some time, but this is the first study to show those problems may mask the increased risk for autism spectrum disorders (ASD).

The researchers followed 862 children from birth to young adulthood, finding that five percent of the children were diagnosed with autism, compared to one percent of the general population in what researchers called “the first study to have estimated the prevalence of ASD…using research-validated diagnostic instruments.” The $3 million study was funded by the National Institute of Mental Health.

In future studies, Penn researchers will investigate possible links between brain hemorrhage, a complication of premature birth, and autism by examining brain ultrasounds taken of these children as newborns.

View Dr. Pinto-Martin’s video (37:42)

Making Pain Control Safer Efforts to effectively control pain in hospitalized patients with opioid analgesics can lead to unintentional sedation and respiratory depression, which are serious adverse events affecting the quality of recovery for patients.

These unintended consequences may be avoided with individualized patient care plans, safe administration of these drugs, and appropriate monitoring practices, reported Rosemary C. Polomano, HUP’74, Nu’76, GNu’79, PhD, RN, FAAN,

associate professor of pain practice, and colleagues on a panel appointed by the American Society for Pain Management Nursing (ASPMN).

Opioid analgesics, the standard of care for managing pain in hospitalized patients, are increasingly successful in reducing pain. At the same time, the common and effective practice of using combinations of multiple analgesics that target different causes of pain, referred to as “multimodal analgesia,” calls for more 16

UPfront | Spring 2012

aggressive approaches to assessment and monitoring, the ASPMN panel stated in Pain Management Nursing.

“Multimodal analgesia is extremely important to the effective control of pain,” said Dr. Polomano, a senior author on the paper. “Nurses have important roles in understanding this therapy.

They are in the best position to detect changes in patient status. Nurses need to be knowledgeable about the pharmacological properties of analgesics to maximize pain control and be more proactive in monitoring patients, especially those at high risk for adverse events.”

The recommendations, the panel noted, are intended to reflect “the uniqueness of patients, autonomy in nurses’ judgments and decisionmaking, and foundations of professional nursing practice.”

Means to Prevent Violence May Start In Utero Attention to health factors as early as the prenatal stage could prevent violence in later life, reported Associate Professor Jianghong Liu, PhD, RN, FAAN, in Aggression and Violent Behavior.

Recent research demonstrates a biological basis of crime, said Dr. Liu. “As a society we should invest in better healthcare for early life – as early as a growing fetus – in order to minimize health risk factors for violence,” she said. “It is never too early to intervene in the development of violent tendencies.”

“Nurses can take an active role in not only caring for the victims of violence, but also in the prevention of violence,” she said. “In primary care and community health settings, nurses are in an excellent position to provide education to parents about proper prenatal care and early childhood care, such as good nutrition and how to minimize exposure to environmental toxins.”

Dr. Liu’s study emphasized the prenatal, perinatal, and postnatal periods, critical times for both a child’s neurodevelopment and for environmental modifications. Among the early health risk factors Dr. Liu identifies are prenatal and postnatal nutrition, lead exposure, tobacco use during pregnancy, maternal depression and stress, birth complications, traumatic brain injury, and child abuse.

Sickness and Foreclosure The national housing downturn is creating a public health crisis. Homeowners in default or foreclosure exhibited poorer mental health and more physical symptoms than renters, homeowners with moderate housing strain, and homeowners with no housing strain,

reported Terri H. Lipman, GNu’83, GRN’91, PhD, CRNP, FAAN, the Miriam Stirl Endowed Professor of Nutrition and Professor of Nursing of Children, with colleagues in Nursing Outlook.

Based on their 2008 Internet survey of nearly 800 residents in Arizona, California, Florida, and Nevada – the states accounting for 51 percent of all foreclosure filings that year – the researchers recommended “bundling” services at one site of intervention, such as foreclosure courts or housing counseling agencies, for this vulnerable population. Nurses in particular, the researchers noted, “are wellsuited to provide screening, counseling, care, and referrals for distressed homeowners whose health is impaired.” More broadly, the authors emphasized, nurses can be “important advocates for health-relevant policy responses to the housing crisis.”

www.nursing.upenn.edu

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SCIENCE IN ACTION Ensuring HIV Patients with Mental Illness Get the Care They Need Assigning HIV-positive adults with serious mental illness to the care of advanced practice nurses (APRNs) reduces depression and improves their overall physical health, reported Nancy P. Hanrahan, GR’04, PhD, RN, FAAN, in Nursing Research and Practice. Her study found positive results when APRNs helped these patients navigate the healthcare system and maintain adherence to drug regimens.

Term Associate Professor of Nursing. “This study suggests that APRN care management should be a central component of the redesign of healthcare delivery to this vulnerable population.”

Penn Medicine faculty also participated in the study.

“Implementation of community-based nurse management using APRNs for complex patient populations may improve long-term outcomes and reduce the high costs of care,” said Dr. Hanrahan, who is the Dr. Lenore H. Kurlowicz

An Influential Look at Nurse Staffing In a comprehensive analysis comparing nurse staffing in California hospitals to similar hospitals in the U.S. over nearly a decade, Penn Nursing researchers have found that controversial legislation setting nurse-to-patient ratios added more registered nurses to the hospital staffing mix, not fewer as feared.

The Robert Wood Johnson Foundation (RWJF) selected this study, published in Health Affairs, as one of the five “Most Influential Research Articles of 2011.” In October, lead researcher Matthew D. McHugh, GNC’94, GNu’98, GR’04, PhD, CRNP, MPH, JD, assistant professor of nursing, had

been named one of 12 U.S. nurse educators to

receive a three-year Nurse Faculty Scholar award from RWJF. The study focuses on California as the first state to pass legislation setting staffing levels.

However, mindful of the ongoing nurse shortage, California legislators determined that hospitals could employ licensed practical nurses as well as registered nurses to meet the requirements of the law.

Nevertheless, “California’s state-mandated nurse staffing ratios have been shown to be successful in terms of increasing registered nurse staffing. From a policy perspective, this should be useful information to the states currently debating legislation on nurse-to-patient ratios,” wrote Dr. McHugh.

Previous Penn Nursing research showed that nurse overload affects patient safety. For every patient added to a nurse’s workload of four, the patient’s risk of dying goes up by seven percent, even for everyday surgeries. If New Jersey and Pennsylvania had enacted the same legislation as California, there would have been 14 percent fewer patient deaths in New Jersey and 11 percent fewer deaths in Pennsylvania, saving hundreds of lives for the period studied.

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Protecting Adolescent Girls from Unwanted Unprotected Sex Getting out of an abusive relationship should be considered an HIV prevention strategy, recommended Anne M. Teitelman, PhD, FNP-BC, FAAN, FAANP, in Advances in Nursing Science.

Dr. Teitelman is the Patricia Bleznak Silverstein and Howard A. Silverstein Endowed Term Chair in Global Women's Health and assistant professor of nursing.

In the study, 46 percent of African-American adolescent girls reported that their partner did not use a condom the last time they had sex – often because of partner abuse. The girls described physical and sexual abuse and threats as preventing them from having their partner use condoms. The relationship between HIV and partner abuse is significant: In the U.S., at least 12 percent of HIV infections among women are a result of partner abuse.

“Promoting healthy relationships among youth and preventing partner abuse in adolescent relationships should become a public health priority,” Dr. Teitelman wrote. “This is necessary for primary prevention of the intersecting epidemics of partner abuse and HIV/STIs.” Dr. Teitelman and her co-authors advocated the need for novel strategies to increase condom use among adolescents and are developing a clinic-centered intervention for girls based on their findings.

View Dr. Teitelman’s video (3:23)

A War Inside: Saving Veterans from Suicide Therese S. Richmond, GRN’95, GNC’97, PhD, CRNP, FAAN, was part of a research team that

discovered veterans who have attempted suicide not only have an elevated risk of further suicide attempts, but face mortality risks from all causes at a rate three times greater than the general population. This research, published in Biomed Central Public Health, was based on the largest sample of people in the United States who attempted suicide and is also unique among the relatively few studies on veteran suicide.

“Veterans who have attempted suicide face elevated risks of all-cause mortality, with suicide being prominent,” said Dr. Richmond, the Andrea B. Laporte Endowed Term Associate Professor of Nursing. “This represents an important population for prevention activities.”

The study authors urged rigorous efforts to identify and support at-risk veterans, especially those who have previously attempted suicide.

With military personnel now facing combat in numbers not seen since the Vietnam War, the authors emphasized that developing better strategies for suicide prevention is more important than ever.

www.nursing.upenn.edu

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’  

Breaking the ‘Tribal Culture’ in Healthcare It’s time for a revolution in healthcare. It’s the way to truly meet the needs of patients. It’s the way to healthcare reform. It’s the way to cut through the devastating health crises around the world.

Richard Horton, editor-in-chief of the internationally renowned journal The Lancet, called for a “patientcentered revolution…in the way we think about health professionals and the delivery of care” during his visit to Penn Nursing in November. His lecture, “A Bonfire of the Professions: Prospects for Global Health,” was sponsored jointly by Penn Nursing and Penn’s Perelman School of Medicine.

“We are living through a health crisis in the majority of the world today,” said Dr. Horton, with child survival, maternal health, and the infectious diseases malaria, tuberculosis, and AIDS still rampant in parts of the world that are the poorest and have the fewest healthcare resources. “The current status quo simply cannot continue.”

Interprofessionalism – bringing seemingly divergent healthcare professions together to respond to need – could remedy the disparity of “a desperate lack of professionals in Africa and Asia and a relative abundance of professionals in countries like our own,” said Dr. Horton. “We as professionals surely do have a responsibility to think very carefully and thoughtfully about our obligations within this notion of interdependence to these other countries. The way we have thought about training…is that we rapidly become enveloped within our particular tribal culture, whether it’s within medicine, nursing, public health, or an allied health profession.

Conversations about interprofessionalism have been on the fringe of healthcare for decades, said Dr. Horton, but in the truly global 21st century, the time has come to turn the concept into reality.

During his visit to Penn Nursing in November, Dr. Richard Horton of The Lancet advocated “interprofessionalism,” based on the report of a Lancet-Institute of Medicine commission, which included Penn Nursing Dean Afaf Meleis.

The Lancet and the Institute of Medicine advocated interprofessionalism in a landmark 2010 report co-authored by Penn Nursing Dean Afaf I. Meleis and international colleagues.

The report advocated that “all health professionals in all countries should be educated to mobilize knowledge and to engage in critical reasoning and ethical conduct so that they are competent to participate in patient- and population-centered health systems as members of locally responsive and globally connected teams.”

During his lecture, Dr. Horton proposed that Penn join The Lancet in a formal project to examine approaches to reach this vision. A Penn-Lancet partnership, now under consideration, would identify human resources in health to unite nurses, midwives, community health workers, and doctors to address global needs and inequities in healthcare today.

There is no better partner than Penn for this work, said Dr. Horton. “You have a remarkable institution at Penn, an institution like no other I have been

View Dr. Horton’s video (1:09)

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A Penn-Lancet partnership would unite the health professions to address global health inequities.

at…I’ve never seen the collaborative spirit that I’ve seen here between different professions in health.

It is truly unique what you have,” he said. “It’s actually the work that you do together that I can see defines you as something very, very special.”

that address the needs of the patient irrespective of professional cadre.…

In particular, said Dr. Horton, Penn Nursing’s LIFE (Living Independently For Elders) practice serves as a model. “Rarely have I seen a healthcare team work in such harmony to such good effect,” he said. LIFE is an example of your local commitment to integrating the University, the Nursing School, and the Medical School in your own community.”

“This brings us back to the question of people. As much as we need a vaccine for AIDS and a vaccine for malaria, as much as we need to have new drugs to treat tuberculosis, as much as we need to roll out technologies where technologies are not available, as much as we need to get antiretrovirals to those who need them, how is any of that going to happen? It’s only going to happen by people like you and me. It’s going to happen through health professionals.”

Dr. Horton emphasized the need for more models of interdisciplinary collaboration around the world, beginning with the education of healthcare professionals. “Only after we have thoroughly gone through our hazing procedures in our professions do we emerge and then think about how or whether we are going to work as a team,” Dr. Horton said. An interprofessional model instead addresses “competencies that are required – demanded – by the patient and how we put together a curriculum and an educational system

Nurses will be key providers of that care around the world, said Dr. Horton. He pointed to South Africa where the Ministry of Health reports the country is “20,000 staff nurses short, 22,000 professional nurses short, a few thousand doctors short, more medical specialists short, and a large number of community health workers short. That’s the scale of the gap that we have to fill…If every institution like Penn in high-income countries worked in partnership in countries like South Africa, what might we achieve?”

In The Lancet, Dr. Horton said of Penn Nursing’s LIFE practice: “Rarely will one witness such a successful juxtaposition of practice, research, care, and inquiry.”

The full article can be found in the November 19, 2011, issue at: www.thelancet.com/

At left, Dr. Pamela Cacchione gives an eye examination to Barbara Goodwin at LIFE. Above, LIFE members socialize over dominos.

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Women’s Health and the World’s Cities From the favelas of Brazil to the vacant lots of Philadelphia to the shacks of Manila, the health of women and the cities where they live are inextricably linked.

Addressing women’s health today means understanding where women live. As the 21st century unfolds, the answer ever more frequently is cities. According to the United Nations, more than half the world’s population – approximately 3.5 billion people – lives in cities. By 2030 this number is expected to increase to almost 5 billion.

Most of the increase in urban populations will take place in emerging countries where cities face unprecedented challenges in providing opportunities and a safe and healthy living environment for women. This development makes the effects of urbanization on women’s health one of the century’s most pressing global

Holding Grandmother’s Quilt, designed by community residents and the Philadelphia Mural Arts Program, is featured in Women’s Health and the World’s Cities.

© 2004 City of Philadelphia Mural Arts Program/ Donald Gensler and Jane Golden. Photo by Jack Ramsdale.

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UPfront | Spring 2012

Global urbanization is “a revolutionary force, easily one of the most important transformations in human history. It is, at once, responsible for both an unprecedented increase in the standard of living for many and also systemic inequality.”

DR. SUSAN WACHTER public health questions, writes Penn Nursing Dean Afaf I. Meleis in the new book Women’s Health and the World’s Cities.

“Healthy women create healthier and more productive families, communities, and societies,” says Dr. Meleis. “Women are the connective tissue, playing critical roles as mothers, caregivers, voters, decision-makers, and leaders, and guiding the health of their families. Lacking the necessary infrastructure and resources undermines the ability of women to fulfill these roles.”

Women’s Health and the World’s Cities, edited by Dr. Meleis, Dr. Eugenie Birch of Penn’s School of Design, and Dr. Susan Wachter of Penn’s Wharton School, offers case studies and recommendations on what citizens, policymakers, and urban planners can do to improve conditions for women and girls in the planet’s growing cities and towns.

“The effects of urban development and gender have received little attention,” says Dr. Meleis.

“There is a world movement toward healthy cities and age-friendly cities, but consideration of gender in urban planning and development is new.”

In 2011, the U.S. Department of Housing and Urban Development reported in ScienceNOW that “neighborhoods matter,” demonstrating lower rates of obesity and diabetes in middleclass areas than in lower-class areas. Another recent study in the American Journal of Preventive Medicine found that women throughout the U.S. are more likely to walk where they have access to safe sidewalks.

The chapter “Transforming Urban Environments” resonates with this recent research. Penn Nursing’s Jeane Ann Grisso, MD, MSCE, professor of public health, and colleagues identify women from Philadelphia to Manila who have led community change. “They organize, demand services, and support one another,” they write. “The tenacity and commitment of women leaders, in partnership with diverse stakeholders, can lead to profound urban transformation.… In spite of daunting realities, women in poor urban communities continue to organize to create better lives for themselves and their children.”

To improve women’s lives, urban planners should consider five factors in planning and developing urban areas, writes Dr. Meleis in Women’s Health and the World’s Cities: Developing cities with women’s needs in mind.

Women want to live in safe environments with better lighting, lower population density, and space that permit connections and allow them to provide the care their roles demand to meet the needs of their children, friends, partners, elders, and other family members.

Focusing attention on the sociocultural context and religious mores.

These drive, and often dictate, women’s movements, education and employment options, space configurations, and housing needs.

Including women’s voices in planning decisions.

Involving women in policies related to urban planning and development ensures that their perspectives, needs, and voices are included in designing spaces with women’s needs in mind.

Women’s Health and the World’s Cities is a collection of 14 essays by scholars and practitioners in the fields of urban planning, global studies, and public health.

This framework would drive the design and translation of research programs into gendersensitive urbanization development plans.

Edited by Penn Nursing Dean Afaf Meleis; Dr. Eugenie Birch of Penn Design; and Dr. Susan Wachter of Penn’s Wharton School, the book is part of the City in the 21st Century series from Penn’s Institute for Urban Research.

Understanding that all of these points empower women and give them voice.

To learn more, visit www.upenn.edu/pennpress.

Developing a conceptual framework to understand gender and its impact on urban environments, health, and well-being.

As the 21st century unfolds, urban planning must be sensitive to defining and investigating the nature of gender disparities and health outcomes that are characteristic of those who live in urban areas.

Says Dr. Meleis: “Careful urban planning provides momentum and direction to enhance the health of women and enrich the quality of their lives and naturally the health and lives of their families, communities, and societies.”

Hear an audio podcast of Dr. Meleis and Dr. Wachter on why gender matters in public health and urban planning at www.upenn.edu/pennpress/ podcast/.

“Improving women’s health demands collaborative work among a variety of professionals, extensive consultation, education at all levels, and, most important, a belief in the power of linking research and practice in the field of urban planning and design to research and practice in the field of women’s health.”

DR. EUGENIE BIRCH

View Dr. Meleis’ video (5:30)

www.nursing.upenn.edu

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KAITLIN BEST, Nu’12, PhD’16 To meet intense national challenges to improve healthcare delivery for vulnerable patients, Penn Nursing and the Rita and Alex Hillman Foundation have partnered for an innovative program to mentor more nurse scholars along a streamlined BSN-to-PhD pathway.

Above: Drs. Boullata and Curley mentor Kaitlin Best (center), a Hillman Scholar in Nursing Innovation.

The Hillman Scholars Program in Nursing Innovation sets select academically talented nursing students planning careers as nurse leaders and researchers on a well-supported educational trajectory from student to researcher in seven years or fewer. The program is designed to mentor a unique cadre of nurse scholars to develop and implement healthcare innovations to improve patient care.

Kaitlin Best, N’12, PhD’16, is in the inaugural cohort of

Hillman Scholars in Nursing Innovation. She chose Penn Nursing because she hoped to combine her interests in patient care, research, and teaching in the pursuit of a BSN, and ultimately a PhD. “Penn's focus on evidence-based nursing practice and research resonates deeply with me, both because of my own research background and because of my belief in a holistic approach to individual patient and community healthcare needs.”

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UPfront | Spring 2012

As a Hillman Scholar in Nursing Innovation, Ms. Best can delve into her research interests, which focus on outcomes in critically ill children who require multiple powerful medications while in intensive care units.

“The program gives you experiences you would not normally get as an undergraduate,” says Ms. Best. “You have the opportunity to integrate graduate coursework and intensive research into your undergraduate career, all with one-on-one guidance from your faculty advisers. Lots of undergraduates express an interest in doing research, but Penn Nursing has given me the opportunity to have a poster presentation at a national conference, be published as a first author, and have a hand in another publication, while writing my own grants.”

THE NEXT NURSE SCIENTISTS Dr. Therese Richmond directs the Hillman Scholars in Nursing Innovation program.

The program’s diverse and demanding educational experience incorporates interdisciplinary education with research career development and guidance starting at the undergraduate level. Students work closely with faculty mentors and collaborate with established research teams in Penn Nursing’s research centers.

“We are working on skill-building in research methods right from the start,” says Martha A.Q. Curley, PhD, RN, FAAN, the Ellen and Robert Kapito Professor in Nursing Science and a mentor to Ms. Best. In addition to their undergraduate coursework, the scholars are immersed in relevant research, meet regularly with their mentors, and participate in research colloquia, meetings, and research activities.

The work Dr. Curley and Ms. Best are conducting together builds on Dr. Curley’s pioneering research in the clinical management of critically ill infants and children and their families. With upwards of $20 million in research awards, Dr. Curley is renowned for her contributions to the field of pediatric critical care nursing. Her team created the Withdrawal Assessment Tool (WAT 1) for clinicians to better assess patient status and risk for iatrogenic sedative withdrawal in the pediatric acute care setting.

Ms. Best is studying Dr. Curley’s data on the ways different clinicians manage the titration process of sedative drugs with the goal of learning how best to manage this activity in very sick infants and children. Results will be published and serve as pilot data for the development of a clinical prediction tool for iatrogenic withdrawal syndrome Rounding out Ms. Best’s mentorship team is Joseph I. Boullata, PharmD, RPh. As associate professor of pharmacology and therapeutics, Dr. Boullatta brings expertise in pharmacotherapy and the benefit of Penn Nursing’s basic science lab to Ms. Best’s experience. “Any bedside drug questions that benefit from in vitro pharmaceutical analysis can be addressed in our lab,” says Dr. Boullata. “I also will offer guidance as Kaitlin navigates the demands of developing her career through coursework, projects, meetings, presentations, and other scholarly pursuits.”

With mentoring, says Dr. Curley, “we are exposing Kaitlin to qualitative and quantitative research

The Rita and Alex Hillman Foundation, a New York-based philanthropy dedicated to improving the lives of patients and their families through nurse-led initiatives, has awarded a grant to the University of Pennsylvania School of Nursing to establish the Hillman Scholars Program in Nursing Innovation. The first Hillman Scholars began the program in September.

Kaitlin Best, focusing on critically ill children. Mentors: Dr. Martha Curley and Dr. Joseph Boullata

Whitney Eriksen, focusing on cognitive dysfunction and autism. Mentors: Dr. Jennifer Pinto-Martin and Dr. Margaret Souders Hayley Germack, focusing on health of immigrant populations. Mentors: Dr. Salimah Meghani and Dr. Linda Aiken

Linda Kang, focusing on health policy and the nursing workforce. Mentors: Dr. Matthew McHugh and Dr. Linda Aiken

Kaori Sakanashi, focusing on vulnerable non-English-speaking immigrants. Mentors: Dr. Terri Lipman and Dr. Jianghong Liu

methods that we hope will help guide her future independent studies in how clinicians can improve the way pain is managed in the most vulnerable patient populations. She is also participating in multidisciplinary team science, which will be a hallmark of any future research career.”

The Hillman program offers an opportunity not only for nursing students but for the nursing profession broadly, says Dr. Boullata. “Students with an interest in eventually pursuing an academic research career can get a significant head start through this program. Early introduction to the research community will allow them to become independent leaders in nursing science much earlier in their careers. This will simultaneously benefit the profession as their work offers solutions to healthcare issues, even as they become integrated into faculty positions where they can share their cutting-edge work with the next generations of students.”

www.nursing.upenn.edu

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PENN NURSING NEWS New Steps for Alzheimer’s Currently, one in five elderly patients discharged from a hospital is readmitted within a month and patients with Alzheimer’s disease comprise one in four of all hospital patients aged 65 and older. Seeking to address the personal and financial burdens of revolving-door hospital readmissions, the Affordable Care Act proposes a number of initiatives to improve care and health outcomes and reduce costs for the growing population of chronically ill people in the U.S. Transitional care – short-term services that bridge gaps between hospital and home – is a central theme in these provisions. Mary Naylor, PhD, RN, FAAN, the Marian S. Ware Professor in Gerontology, is a primary architect of the transitional care model.

Transitional care focuses on identifying and addressing patients’ and family caregivers’ goals, as well as needs for education and support, such as access to community services, to prevent poor outcomes.

To address this issue among people with Alzheimer’s Disease, Dr. Naylor is co-chairing an international research conference at Penn in June, supported by a grant from Carol Elizabeth Ware, Nu’73.

The International Invitational State of the Science Conference, led by Penn Nursing and Penn’s Perelman School of Medicine through the Marian S. Ware Alzheimer Program, will bring together 50 renowned experts in the Alzheimer’s-related areas of biomarkers and drug discovery; clinical care and health services research and delivery; and health economics, policy, and ethics. The researchers expect to craft a strategic report with that will provide national and international health policy leaders with new decision-making tools.

“The good news is that available evidence provides a strong foundation upon which to build transitional care programs and achieve better care and better outcomes while reducing costs,” said Dr. Naylor, who directs the NewCourtland Center for Transitions and Health at Penn Nursing.

“If we capitalize on what we know, the real beneficiaries will be those living with complex chronic conditions such as Alzheimer’s Disease and their caregivers.”

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New Leader in Biobehavioral Research Barbara J. Riegel, DNSc, RN, FAAN, FAHA, professor of nursing and the Edith Clemmer Steinbright Chair of Gerontology, has been appointed director of the Center for Biobehavioral Research at Penn Nursing. As a national and international scholar and leader in the field of heart failure and self-care, Dr. Riegel has advanced knowledge about the management of patients with heart failure and has contributed to the national guidelines that have changed the care provided to the more than one million Americans suffering acute myocardial infarction. Through her activities as a Fulbright Scholar and her consultative collaborations with scholars in other countries, Dr. Riegel has established an international reputation that further supports her ability to build networks globally. Dr. Riegel has served on the University Senate Executive Committee, chaired the School’s Faculty Senate, and served as interim chair of the Biobehavioral and Health Sciences Division.

First Penn Fellow in Nursing Patricia D’Antonio, GRN’92, PhD, RN, FAAN, chair of the Family and Community Health

Department, has been named a 2012 Penn Fellow. Dr. D’Antonio is the first Penn Nursing faculty member to be chosen for this honor and joins just seven faculty colleagues across campus in the new slate of fellows for this two-year appointment. The University developed the Penn Fellows program in 2009 to provide mid-career Penn faculty the opportunity to build University-wide networks, meet academic leaders inside and outside Penn, and enhance their interdisciplinary influence by interacting with colleagues and University administration.

Diversity Leadership Nancy C. Tkacs, Nu’75, GNu’77, GNC’05, GNu’06, PhD, RN, associate professor in Biobehavioral

Health Sciences, has been appointed assistant dean for diversity and cultural affairs at Penn Nursing. In her new role, she will help in the development of the School diversity action plan in response to the University Action Plan for Faculty Diversity and Excellence, established by President Amy Gutmann and Provost Vincent Price. She will be the official diversity search advisor while continuing in her faculty role in the department of Biobehavioral Health Sciences.

www.nursing.upenn.edu

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PENN NURSING NEWS

Welcoming Global Health Ambassadors The School of Nursing has named two student Global Health Ambassadors, newly created roles giving students global health leadership opportunities. As Global Health Ambassadors, the students work with Assistant Dean Marjorie Muecke, PhD, RN, FAAN, and Associate Director Geralyn Grosso of the Office of Global Health Affairs to enrich outreach to international students and alumni, provide curriculum support, and participate in guiding such activities as the School of Nursing Task Force on Haiti and Global Health Reflections Week.

Volunteering at an orphanage in Cordoba, Argentina, inspired Junior Global Health Ambassador Natalie Ball, Nu’14, to choose a nursing career. She has studied abroad in Australia, New Zealand, and Peru, focusing on environmental sustainability and outdoor leadership.

Doctoral student Lisa Hilmi, Nu‘97, Gr’16, is the senior global health ambassador. She has directed and managed major humanitarian crises over the past two decades for such international organizations as AmeriCares, CARE, International Medical Corps, the Peace Corps, and the World Health Organization. Earlier in her career, she managed a refugee health and HIV/AIDS project in Rwanda for CARE in Tanzania. She has authored numerous publications on disaster preparedness.

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Global Health Engagement Awards Three faculty from the University of Pennsylvania School of Nursing received Global Engagement Fund awards from the Office of the Provost. This fund supports projects that reach across schools and disciplines; involve multiple faculty members; engage regions in which Penn has active academic partnerships and collaborative ventures; or represent academic priorities. A faculty committee reviewed proposals according to criteria of scholarly merit and significance for global research, teaching, and service.

Global Engagement Fund awards went to these Penn Nursing researchers: • Linda H. Aiken, PhD, RN, FAAN, FRCN, is collaborating with Katholieke Universiteit Leuven in Belgium on the impact of nursing on patient outcomes in 16 countries. Dr. Aiken is the Claire M. Fagin Leadership Professor in Nursing, professor of sociology, and director of the Center for Health Outcomes and Policy Research.

• Alison M. Buttenheim, PhD, MBA, is researching the use of incentives to increase participation in control programs for Chagas disease, which is spread by insects and, if untreated, can become chronic and potentially fatal. Assistant Professor Buttenheim is a public health researcher and social demographer who focuses on parent behavior and child health.

• Marilyn Sommers, Nu’72, PhD, RN, FAAN, will lead a conference on “Food Security in a Rapidly Urbanizing World” with Penn colleagues Eugenie Birch, David Galligan, Mauro Guillen, Frederick Scatena, Brian Spooner, and Susan Wachter.

Dr. Sommers is the Lillian S. Brunner Professor of Medical-Surgical Nursing and directs the Center for Global Women’s Health.

RWJF Recognizes Faculty Scholarship Assistant Professor J. Margo Brooks Carthon, GNu’08, PhD, has been awarded a two-year grant from the Robert Wood Johnson Foundation (RWJF) to conduct a national survey of minority student recruitment and retention efforts in nursing schools across the U.S. Dr. Carthon is among a select group of junior investigators to receive this $75,000 grant from the foundation.

Assistant Professor Matthew D. McHugh, GNC’94, GNu’98, GR’04, PhD, CRNP, MPH, JD, has won a competitive three-year grant from RWJF to study the relationships among where people live, where they receive hospital care, and the outcomes of that care.

Dr. McHugh is one of 12 nurse educators from around the country to receive the $350,000 Nurse Faculty Scholar award. It is given to junior faculty who show outstanding promise as future leaders in academic nursing.

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 

Class Notes 



Patricia “Patty” Yocum Bloom, HUP’56,

writes, “My years at HUP, both as a student and an employee, have helped me immensely in these oh-so-challenging ‘senior’ years. As a student, I probably had more ‘lates’ than anyone ever…so I am delighted they let me graduate! I remain forever grateful! My garden is my great joy, exercise, and therapy. My son Josh is an MRI tech, and my daughter Heidi is an orthopedic hand surgeon. I enjoy the role of neighborhood nurse, and I spend time with my twin sister, who lives in the Paoli area and has dementia. My husband Marv died three years ago from the same disease. I would love hearing from any old buddies.

And we can chat about Miss Hartung reminding our patients, and now ourselves, to ‘dangle’ before bouncing out of bed!”

Dorothy Moser, Nu’58, would be

interested in knowing of other graduates who live in the Newark, Del., area. She is still active, although legally blind and does not drive. She can receive email, and she can be reached at dmoser@udel.edu. She was a member of the Nursing faculty at Penn from 1967 to 1969, and then on the faculty at the University of Delaware until she retired in 1992.

 Joan Segal Trachtenberg, Nu’65, GNu’81, recently celebrated her 25th year

on the nursing staff at Bryn Mawr Hospital’s psychiatry unit as the unit itself was marking its 25th year. She reports there will be no retirement yet, because the unpredictability of each day is keeping her young. She sends “kudos to Penn Nursing!”

Roberta Pichini, HUP’68, was named in

The Best Lawyers in America® 2012. She is a personal injury attorney and partner with the Philadelphia law firm of Feldman Shepherd Wohlgelernter Tanner Weinstock & Dodig LLP. President of the International Academy of Trial Lawyers, she has been invited to join the American College of Trial Lawyers and the American Board of Trial Advocates and is a member of the Million Dollar Advocates Forum.

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Eileen Sullivan-Marx, HUP’72, Nu’76, Gr’95,

recently received the Distinguished Alumnus Award from the Alumni Association of the Hospital of the University of Pennsylvania’s School of Nursing. She currently serves as associate dean for practice and community affairs and the Shearer Endowed Term Chair for Healthy Community Practices at Penn Nursing and is a professor of scholarly practice in Penn Nursing’s department of Family and Community Health.

Dorette "Dee" Sugg Welk, GNu'74, was elected to serve as a member of the board of directors of Sigma Theta Tau International. She remains chair of the regional chapters’ coordinating committee, a global committee of nurse leaders who work with the 500 honor society chapters around the world. Dr. Welk is faculty emeritus, department of nursing, Bloomsburg, Pa., and resides there and in St. Croix with her husband Fran Welk who was a physical therapist and athletic trainer at Penn from 1970-1975.

Nancy C. Tkacs, Nu’75, GNu’77, GNC’05, GNu’06, associate professor in the

department of Biobehavioral Health Sciences, has been appointed assistant dean for diversity and cultural affairs at Penn Nursing. (See Penn Nursing News on page 27.)

 Judith L. Bachman, GNu’81, has joined Huron Consulting Group, a Chicago-based business-consulting firm, as a managing director of its Huron education practice for academic medical centers. Previously, she was senior vice president for strategic initiatives at Thomas Jefferson University.

Anita Y. Kinney, GNu’85, received the

outstanding achievement award in medicine/health at the 23rd Annual YWCA Salt Lake City 2011 Leader Luncheon in September. She was honored for her work in cancer research where she is developing and testing

interventions for communicating genetic risk to individuals and families who are at increased risk for familial cancers, such as colorectal, breast, and ovarian cancer. She is a professor of epidemiology at the University of Utah; director-at-large and chair of the Cancer Survivorship Special Interest Group of the American Society of Preventive Oncology; editorial board member for two scientific journals; and scientific grant reviewer for the National Institutes of Health.

Diane L. Spatz, Nu’86, GNu’89, Gr’95, has been

promoted to the rank of professor in the standing facultyclinician educator track at Penn Nursing effective July 1. She is a member of the American Academy of Nursing and has served as chair of the AAN’s expert panel on breastfeeding since 2007. She introduced Dr. Regina M. Benjamin, Surgeon General of the United States, at the AAN meeting in October.

Jennifer N. Easter, Nu’87, director of the

MBA program at Lebanon Valley College, was recently appointed to the Pennsylvania State Board of Social Workers, Marriage and Family Therapists and Professional Counselors. She received MBA and MPH degrees from UCLA in 1992, and then worked in medical practice management and as an adjunct instructor of quality management prior to her current position. She lives in Lebanon, Pa., with her husband Dennis and their four sons.

 Heather Paul Mokotoff, Nu’91, GNu’01,

lives in Trumbull, Conn., with her husband and two children. She now works as a pediatric nurse practitioner at the Yale Pediatric Diabetes Program and would love to hear from her fellow classmates.

Patricia D’Antonio, GRN’92, chair of the

Family and Community Health Department, has been named a 2012 Penn Fellow. (See Penn Nursing News on page 27.)

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Mary Beth Salmonsen, GNu’94, recently

joined the medical staff of Choptank Community Health System and is seeing patients at Denton Medical Center in Maryland. Prior to joining Choptank, she was in practice with Advocare, Kennedy Care Center, in Voorhees, N.J. Matthew D. McHugh, GNC’94, GNu’98, Gr’04, recently received funding from the

Office of Behavioral and Social Sciences Research of the National Institutes of Health for his R01 proposal “Hospital Care Environment, Neighborhood, and Racial Disparities in Elder Outcomes.” In August, he won a competitive grant from the Robert Wood Johnson Foundation to support his research on the relationship between where people live, where they receive hospital care, and the outcomes of that care. He was one of only 12 nurse educators from around the country last year to receive the three-year $350,000 Nurse Faculty Scholar award, given to junior faculty who show outstanding promise as future leaders in academic nursing.

Therese S. Richmond, GRN’95, GNC’97,

has been promoted to professor in the standing faculty at Penn Nursing effective July 1. She is internationally recognized for her expertise in research on physical injury and violence. Her work addresses the correlation between physical injury, age, and the psychological aftermath of the injury as an indicative contributor to decreased post-injury function. She partnered with C. William Schwab, MD, of Penn’s Perelman School of Medicine to cofound the Firearm & Injury Center, where she serves as research director. She is a fellow at Penn’s Center for Public Interest; the research core co-director for the Philadelphia Collaborative Violence Prevention Center; a fellow in the Jerry Lee Center of Criminology at Penn; and a senior fellow at Penn’s Leonard Davis Institute of Health Economics.

Kathryn H. Bowles, Gr’96, has been

promoted to professor in the standing faculty at Penn Nursing effective July 1.

She was also appointed the Ralston House Endowed Term Chair in Gerontological Nursing. She is internationally recognized for her program of research and publications in nursing

informatics and telehomecare, using information technology to improve the care of older adults. Her current study, funded by the National Institute of Nursing Research, focuses on decisionmaking and the development of decision support for hospital discharge referrals.

She is also an active senior fellow at Penn’s Leonard Davis Institute; the Beatrice Renfield Visiting Scholar for the Visiting Nurse Service of New York; on faculty in Penn’s Ackoff Center for Advancement of Systems Approaches; and director of the health informatics minor at Penn Nursing.

Eileen V. Lake, G’96, GNu’97, Gr’99, CGS’01,

American Nurses Credentialing Center’s Pediatric CNS Exam and Role Definition Study. She also serves as clinical faculty for APN students from Ursuline College and Kent State University; is co-president of the Ohio chapter of the Association of Pediatric Hematology/Oncology Nurses; and is a lecturer at Case Western Reserve University and Ursuline College.

 Katherine Hostvedt Marchese, Nu’01, GNu’03, Gr’08, and her husband Phillip

joyously announce the birth of their daughter, Pennington Grace Marchese, on July 26, 2011. The Marchese family lives in Doylestown, Pa.

has been appointed the Jessie M. Scott Endowed Term Chair in Nursing and Healthy Policy at Penn Nursing. Her work advances the instruments and methods of outcomes research as she investigates nurse staffing, practice environments, and patient outcomes. She gained national recognition for the development of the Practice Environment Scale of the Nursing Work Index, an instrument measuring the extent that work environments support professional practice. She is the associate director of the Center for Health Outcomes and Policy Research at Penn Nursing and holds an appointment in the department of Sociology in Penn’s School of Arts and Sciences.

Wendy Stevens, GNu’03, has joined Southwest Colorado Community College, a branch of Pueblo Community College. She moved to Durango from Denver, where she worked as a trauma intensive care unit and emergency room nurse. Originally from the East Coast, she worked at HUP and St. Luke’s Hospital after receiving her master’s degree from Penn Nursing. She has participated in several international medical missions.

Jacqueline McGrath, GNC’98, Gr’99, was named Neonatal Nurse of the Year by the March of Dimes at the inaugural Central Virginia Nurse of the Year awards gala in November.

Jaclyn M. Lange, Nu’07, wed Tom Whittle

Meredith Lahl, Nu’99, GNu’02, was

recently promoted to senior director of advanced practice nursing for the Cleveland Clinic Health System. She joined the clinic in 2004 as a staff nurse in the pediatric intensive care unit and became a pediatric clinical nurse specialist in 2005. Prior to her promotion, she was serving as CNS coordinator. She has acted as chair for the Cleveland Clinic Coordinating Council, where she led the Cleveland Clinic Shared Governance Council, and is a content expert for the

Clare Cunningham, GNu’07, gave birth to a son, Kieran Daniel, in September, 2011.

on August 26, 2011, in Perkasie, Pa.

 Erika Papenfuss, Nu’11, was recently featured in her hometown paper, the Brookfield Patch. One of only four classmates to be commissioned by the University of Pennsylvania Naval Reserve Officer Training Corps in May 2011, she is currently a nurse corps officer at the National Naval Medical Center in Bethesda, Md.

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In Memoriam Jeffrey J. Lee, Nu’12, W’12

Nursing and Wharton senior Jeffrey Lee died at age 21 after running the Philadelphia Half Marathon on November 20, 2011.

A native of Cerritos, Calif., Mr. Lee graduated from Whitney High School as a valedictorian. Mr. Lee was in the Nursing & Healthcare Management dual-degree program and in the Nursing Administration master’s program. Mr. Lee is survived by his parents, Mr. and Mrs. Howard Lee; and his brother, Matthew.

Although still an undergraduate, Mr. Lee had collaborated on faculty research projects. He was anticipating publication of an academic paper, Health Reform and the Constitutionality of the Individual Mandate in Policy, Politics & Nursing Practice, in which he was first author in collaboration with health policy expert Dr. Matthew McHugh. He had also worked with Dr. Mary Naylor on research involving improving outcomes for cognitively impaired older adults. With his advisor, Dr. Eileen Lake, he had examined nurse-patient ratios in more than 100 neonatal intensive care units across the U.S. Mr. Lee’s undergraduate clinical work at LIFE (Living Independently For Elders) brought him in contact with LIFE driver Walter Pearson, a certified emergency medical technician.

Mr. Pearson was serving as an EMT at the Philadelphia Half Marathon and stationed at the finish line. As Mr. Lee crossed the finish line, he made his way to Mr. Pearson and collapsed in his arms. Mr. Pearson and his partner began emergency treatment immediately.

Among many other notable accomplishments, Mr. Lee was named to the 2009 TYLENOL Health Care Scholarship as only one of 40 recipients in the U.S., won a National Student Nurses Association scholarship in 2011, and was a co-founder of Alpha Iota Gamma, Penn’s first professional healthcare fraternity.

To honor Mr. Lee’s legacy at Penn, his family, fellow students, and friends have established a memorial scholarship fund in his name. To support this effort, visit www.nursing.upenn.edu/giving.

Thelma Burke, HUP’34, Stephens City, Va.,

January 1, 2006. Notified November 29, 2011.

Louise N. Kershner, HUP’40, Doylestown,

Pa., July 9, 2011. Ms. Kershner was a 1936 graduate of Lehighton High School and was married to Dr. William R. Kershner, DDS, for 59 years before his death in 2003.

Ms. Kershner enjoyed bird-watching, traveling, and was an avid Philadelphia Phillies fan. She is survived by her sons, Rusty of Fort Collins, Colo., and Jonathan of Wellington, Colo.; and daughter Betsy Carlson of Doylestown. Louise is also survived by 11 grandchildren and 10 greatgrandchildren. She was preceded in death by sons, Jeffrey and Steven.

Ellen “Libby” Arnold, HUP’41, Frederick,

Pa., October 27, 2011. Ms. Arnold practiced visiting nursing until moving with her husband during his military service from 1943 to 1946. She was office manager and nurse for her husband’s veterinary practice near Kennett Square, Pa., for 51 years. She 32

UPfront | Spring 2012

is survived by two sons, David Rockwell Arnold of Cave Creek, Ariz., and Timothy H. Arnold of Collegeville, Pa.; six grandchildren; and six great-grandchildren.

Thelma Stach Reimer, HUP’41, Vero Beach,

Fla., April 1, 2010. Notified October 26, 2011.

Mary Elizabeth Breslin Chabalko, HUP’42, January 19, 2010. Notified

October 14, 2011.

Lavona Roof Hoover, HUP’46,

Chambersburg, Pa., November 30, 2011.

Ms. Hoover attended Shippensburg University where she received her BSN and her master’s in elementary counseling.

Ms. Hoover was once employed by the emergency department at Chambersburg Hospital, and from 1962 to 1968 she was employed as a school nurse by the Chambersburg Area School District. She retired in 1968 as the supervisor of nursing.

She was an active member of the Central Presbyterian Church, participating in the church choir, women’s association, and sewing group, among other activities. She

also was a member of the HUP Alumni Association, the Pennsylvania Association of School Retirees, and AARP. Ms. Hoover is survived by four daughters, Cynthia A. Dinsmore of Chambersburg; Jenine H. Grove of Shippensburg, Pa.; Nancy I. H. Hershey of Shippensburg; and Harriett Peters of Chambersburg; two grandchildren; and a sister.

Marguerite E. Rothrock, HUP’47,

Harrisburg, Pa., August 15, 2011. She was a retired nurse.

Arline Rose Patton Towne, HUP’47,

Ocean Isle Beach, N.C., January 2, 2011.

Jeanne Nordstrom Baldino, HUP’48,

Wyndmoor, Pa., June 18, 2011. An expert in the homecare field, Ms. Baldino worked with the Visiting Professionals and Home Health Corporation and often was seen visiting patients on her motorcycle with her nursing cape trailing behind her. She was involved in patient care and research at Penn for many years.

Gretchen Genz, HUP’48, Warminster, Pa., December 30, 2010. Notified October 4, 2011.

Helen Sankey Jordan, HUP’50, Nu’69, GNu’75, Hatfield, Pa., June 22, 2011.

She was retired director of nursing at MossRehab in Philadelphia.

Carolyn Bentz Hughes, HUP’52, Aldie,

Va., April 18, 2007. Notified October 17, 2011.

Marie Romano, Nu’52, GNu’79,

Hammonton, N.J., September 2011.

Ms. Romano devoted her career to teaching other nurses. She started as a nurse at Hammonton’s Kessler Memorial Hospital, moved up to training coordinator for nurses and then nursing administrator. A strong believer in the power of education, she returned to school for her master’s degree in nursing at the same time her daughter Janet Romano, C’78, was completing her undergraduate education in psychology.

After receiving her advanced degree from Penn, Ms. Romano became an assistant nursing professor at what is now Atlantic Cape Community College. She retired in 1992. She raised four children: Janet Romano of Haddon Heights, N.J.; Mary Triboletti of Hammonton, N.J.; Rita Weeks of Longport, N.J.; and Ralph Jr. of Georgia.

    

Dorothy Ranck Long, Nu’53, Frederick,

Md., January 1, 2011.

Margaret Gallagher Miller, Nu’53,

Dunmore, Pa., June 2, 2011.

Jill Stead Longest, HUP’53, June 26, 2011. Ms. Longest began her nursing career at the University of Florida, where she obtained a master of nursing science and a master of education after her graduation from the HUP program. She was always proud of her time at Penn and wore her pins with honor. She was a very active nurse from the time of her graduation until she was stricken with polymyositis while working at Johns Hopkins (Howard County General Hospital). She was the “nurses’ nurse,” and more than 400 people whose lives she touched over the years came to her services in July. Her career spanned more than 35 years and included the launch of MedSTAR, Washington Hospital Center’s medevac trauma center (which saw her jumping from helicopters to reach her patients on the Beltway); the Washington Hospital Center Burn Center; and long service at cardiac centers in the Washington, D.C., area. She spent much of her career working with autistic children and adolescents, a program dear to her heart. Ms. Longest took time off to have three children and raised four more stepchildren. Two of her children have followed in her footsteps in healthcare. She is also survived by 13 grandchildren.

Jacqueline Marie Whaley, HUP’55, Nu’61, GNu’68, Louisville, Ky., August 17,

2010. She retired from Spalding University after a 25-year career as an assistant professor. Ms. Whaley was a long-time member of Holy Trinity Catholic Church and a member of the Kentucky Nurses Association. She is preceded in death by her husband, Paul Joseph Whaley.

Joann Jamieson, HUP’59, Warminster, Pa., July 8, 2011. Ms. Jamieson was an operating room nurse at Abington Memorial Hospital for 32 years. She was the wife of the late William J. Jamieson, who died in 2001. She is survived by her daughters, Kathi McGill of Bethlehem, Pa., and Lori Sutherland of Myrtle Beach, S.C.; stepdaughter Beverly Haas of Quakertown, Pa.; stepsons William J. Jamieson Jr. of

Philadelphia and David A. Jamieson of Roslyn, Pa.; six grandchildren; and two great-grandchildren.

Joanne Stetz, HUP’59, Philadelphia, Pa., January 1, 2006. Notified September 20, 2011.

Vivian Lane, Nu’60, Philadelphia, Pa.,

July 20, 2011.

Joanne G. Deal, Nu’61, Annandale, Va.,

November 5, 2001. Notified October 17, 2011.

Joanne S. Bill, Nu’61, Monroeville, N.J., May 10, 2011. She was a retired epidemiologist with the state public health department.

Josephine “Josey” L. Scafidi Thompson, HUP’61, Los Altos, Calif., June 28, 2011.

Ms. Thompson worked as a nurse practitioner at Kaiser Permanente in Cleveland Heights, Ohio, for 32 years and in 2011, she moved to California to be near family. She is survived by her daughters Helena and Martha, as well as her eight grandchildren.

Gertrude J. Fuchs, Nu’62, Philadelphia, Pa., May 29, 2011. She was a retired nurse and midwife for the city health department.

Cecil R. Birch, GNu’64, Frackville, Pa.,

April 2, 2011. She was a retired director of nursing at the former Norristown State Hospital.

Andrea McClean, HUP’65, Daly City,

Calif., August 31, 2011. Ms. McClean passed away at her home after a lengthy battle with cancer. Barbara Miller West and Dianne Peters Riley, also of the class of 1965 and living in California, attended to her needs in the recent months and were great lunch buddies after many of their friend’s chemo treatments. Ms. McClean will be sadly missed by her HUP friends on the East and West coasts, as well as her many professional colleagues in California, where she worked in pediatrics until her most recent cancer battle.

Cora J. Senft Sowers, Nu’68, Warrenton, Va., January 30, 2010. She was a retired nurse who had worked for 20 years in Philadelphia.

Joan Rex Connor, HUP’69, GNu’75, April 7, 2010. Ms. Connor passed away after a courageous seven-year battle with Leiomyosarcoma (LMS). She had become a passionate advocate of those diagnosed with LMS, participating in support groups and conferences internationally. Ms. Connor was a professional vocalist, and worked as a parish nurse in Florida and as an OR nurse in Atlantic City, N.J., until the time of her death. She was preceded in death by her son Nicholas in 2007. She is survived by her husband of 30 years, Bill; her daughters Heidi and Krista; five grandchildren; and loyal friends.

Lois E. Hastings, Nu’69, Maple Valley, Wash., November 27, 2010. Notified September 21, 2011.

Andreè M. Gibson, GNu’70, Medford, N.J., June 10, 2011. She was a retired director of nurses at Methodist Hospital School of Nursing.

Eileen B. Horensky Terlecky, Nu’74,

Oaklyn, N.J., October 2, 2010. She was a retired nurse at Cooper Hospital.

Laura F. Breyfogle, Nu’04, New York City,

August 28, 2011. Ms. Breyfogle died from complications of Type 1 diabetes and Addison’s Disease at her home. She is survived by her parents, Bridget and Daniel Breyfogle of Northborough, NY; her sister, Molly Breyfogle of Manhattan; her maternal grandparents, Louis and Mary Polanski, of Nazareth, Pa.; her uncles, aunt, and cousins. While an undergraduate at Penn, she served as president of the Student Nurses’ Association of Pennsylvania. She earned a master’s in nursing administration from New York University in 2010. She previously worked as a pediatric nurse at Pediatrics of Newton Wellesley and at Boston Children’s Hospital. Ms. Breyfogle remained committed to mentoring student nurses throughout her career. She was happiest when surrounded by her friends and family, and she loved traveling the world, cooking, dining, and knitting for those she loved.

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33

From the Penn Nursing Alumni Board President As you have read in this issue, technology is an increasingly essential part of nursing care. It is present not only in learning environments, but also at the bedside – sometimes in surprising ways. As a pediatric nurse practitioner, I have used YouTube to provide distraction for patients undergoing various procedures. And what would we do without the Internet to look up information about diseases, treatments, obscure metabolic disorders, and so much more.

Technology also is intertwined in our daily lives. How many of you cannot live without your iPhone, iPad, BlackBerry, or other electronic devices? Do you stay in contact with friends and family through Twitter and Facebook?

Do you use LinkedIn for professional networking? All of these devices and social media outlets are becoming necessary to “stay connected.” I invite you to stay connected with Penn Nursing and your fellow alumni.

• Join our alumni pages on Facebook, Twitter, LinkedIn and QuakerNet. • Create a PACNet profile and offer your career expertise to fellow alumni and students.

• Visit the alumni website: www.nursing.upenn.edu/alumni.

• Take part in an alumni webinar and take advantage of the opportunity to hear from faculty experts.

Scan this QR code with your smartphone to go directly to the Penn Nursing Alumni website.

I encourage you to check us out online and keep in touch. And, I invite you to come back and visit us during Alumni Weekend to check out all Fagin Hall’s renovations – especially the ones to the A&P lab, where anatomy and physiology have gone high-tech!

Naomi H. Higuchi, Nu'86, GNu'92

  Career Networking Goes Online

Did You Vote?

Penn Nursing Alumni Board Leadership

Are you interested in helping students and fellow alumni who need career guidance? Are you looking for a Penn Nursing mentor? The Penn Alumni Career Network (PACNet) is a searchable database of alumni who volunteer to provide career-related guidance and support to current students and fellow alumni.

Search PACNet based on career field, geography, undergraduate and/or graduate degree, and more! Sign up to be a resource through Penn’s online community at www.alumniconnections.com/penn/.

The Penn Nursing Alumni Board represents you in planning events, selecting award recipients, and creating outreach and professional development opportunities. To learn more about this year’s candidates and vote, go to www.nursing.upenn.edu/alumni. Make your voice heard by voting for Board members who best represent you.

President

And, be sure to join the Penn Nursing Alumni group on LinkedIn. 34

UPfront | Spring 2012

Want to Know More?

Contact Penn Nursing Alumni Relations Monica Salvia, Associate Director of Alumni and Donor Relations, 215.898.9773 Email: nursalum@pobox.upenn.edu Web: www.nursing.upenn.edu/alumni

Naomi H. Higuchi, Nu’86, GNu’92 Cherry Hill, N.J. President-Elect

Terri Cox-Glassen, Nu’91 Glendale, Calif.

Vice President for Student and School Support

Ashley Zampini, Nu’07, GNu’10 Levittown, Pa. Secretary

Brian Bixby, GNu’97 Philadelphia, Pa.

From the HUP Nursing Alumni Association President While so much of the world has gone high-tech – and with good results – getting together in person still can’t be beat. The 125th reunion of the HUP School of Nursing was a rousing success! A wonderful group of 320 alumni attended the gala affair as part of our three-day event. Many expressed their delight in everything from the speakers on Friday night, the art installation “Nursing through the Lens of Art,” tours of the school, pictures and artifacts in the history center, to the dinner banquet with stunning centerpieces, awards to alumni, and the moving speech by alumna Dr. Marie Savard. The most appreciated aspect was, of course, reconnecting with friends from the time in our lives when we were starting on the journey into adulthood and careers. The bonds made during that time are made of strong stuff.

And the 125th is not over! Penn’s School of Nursing has joined with us in a year-long celebration honoring 125 years of nursing education at Penn.

I encourage you to look at the 125th website (www.nursing.upenn.edu/125th) and consider attending Penn Nursing’s Alumni Weekend. The weekend is always a lot of fun, and Dean Meleis holds a special Legacy Breakfast specifically for HUP alumni, taking place this year on Saturday, May 12.

After a brief respite, the HUP Alumni Board and committee chairs will start thinking about the next reunion in five years (2016). Yes, it takes that much planning to pull off such a party. In the meantime we can look forward to the spring luncheon, Alumni Weekend, and nominations and elections to the board. I encourage you to become involved with our HUP alumni association in any way you can so we can keep our history alive. You can also contribute to the HUP Legacy Fund to show your support for the archives and the art installation.

Scan this QR code with your smartphone to go directly to the HUP Nursing Alumni website.

You can see photos from the reunion and keep up-to-date by visiting our website: www.nursing.upenn.edu/alumni/networking/Pages/hup_alumni.aspx.

Candace Stiklorius, HUP’66, Nu’71, GNu’83

www.nursing.upenn.edu

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Alumni Weekend May 11-13, 2012 Celebrating 125 Years of Nursing at Penn!

For a detailed agenda or to register, call Penn Nursing at 215.746.8812 or visit our website at www.nursing.upenn.edu/alumni.

May 11, 2012 10am - 2pm Center for Global Women’s Health Inaugural Symposium

Ann L. Roy Auditorium, Claire M. Fagin Hall “Gender Equity, Peace, and Security: A Global Mandate for Women’s Health” will feature keynote speaker Zainab Salbi, founder of Women for Women International; remarks by Dr. Marilyn Sommers, Nu’72, director of the Center for Global Women’s Health; panel discussions; a student and faculty poster session; and a complimentary lunch.

4:00 - 5:30pm Celebrating Excellence: Faculty and Alumni Awards Program

Ann L. Roy Auditorium, Claire M. Fagin Hall Reception follows.

5:30 - 8:30pm Women’s Health and Midwifery Programs Reunion

Carol Elizabeth Ware Lobby, Claire M. Fagin Hall Women’s Health and Midwifery program alumni and students are invited to a reunion with current and past program faculty, featuring a poster session, awards, lecture, Fagin Hall tours, and dessert reception. Special registration rate if you stay the weekend!

May 12, 2012 8:30 - 9:30am Penn Nursing Legacy Breakfast

Claire M. Fagin Hall, 4th floor Dean Afaf I. Meleis invites Penn Nursing “legacy” alumni, including the Class of 1962 and earlier, and all HUP alumni, for an intimate breakfast and conversation in the Dean’s suite.

Seating is limited. Register early.

9:30 - 10:00am Continental Breakfast and Registration

Claire M. Fagin Hall 10 - 10:30am or 10:45 - 11:15am Experience the New A&P Lab

Ann L. Roy Auditorium, Claire M. Fagin Hall Dr. Connie Scanga will lead interactive demonstrations of the new A&P lab technology. Advance registration required.

10:30 - 11:30am Meet the Artist: “The History of Nursing as Seen Through the Lens of Art” Carol Elizabeth Ware Lobby, Claire M. Fagin Hall Alumna and artist Kathleen Shaver, HUP’76, will speak on her work “The History of Nursing as Seen Through the Lens of Art,” a new installation at Fagin Hall commissioned by the HUP Nursing Alumni Association. This event is part of the School’s celebration of 125 years of nursing education at Penn.

12:30 - 3:00pm Penn Nursing at the Picnic

Tent at 34th and Walnut Streets All Nursing alumni (undergraduate, graduate, HUP, and School of Education nursing majors) are invited to a picnic lunch and networking with fellow alumni, graduating seniors, faculty, and Dean Meleis at the Nursing tent.

President Gutmann will stop by our tent to make remarks. Register for the Nursing tent when signing up.

6:30pm Class of 1957 Reception

Class of 1957 Reception at the home of Carolyn McGrory, Ft. Washington, Pa.

11:45am - 12:30pm Penn Nursing in the Parade

Patio by Steinberg Conference Center All Nursing alumni are invited to march with the Dean, Nursing Alumni Board president, and fellow alumni. Help us uphold our tradition as the most vocal and upbeat group in the parade!

May 13, 2012 12:00pm Sigma Theta Tau Induction Ceremony and Luncheon

Ann L. Roy Auditorium, Claire M. Fagin Hall Induction ceremony of the Penn Nursing Chapter of Sigma Theta Tau. Registration begins at 11:30am. Cost per person is $20.

5:30 - 7:30pm Annual Rosalyn J. Watts Diversity Scholars Graduation Celebration

Carol Elizabeth Ware Lobby, Claire M. Fagin Hall Alumni are invited to applaud the graduation of Penn Nursing’s Diversity Scholars from both undergraduate and graduate programs during a dinner celebration with students and their families. $25 for alumni.

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UPfront | Spring 2012

Events Calendar: Spring-Fall 2012 March & April 2012

April 19, 3 - 5pm

(See www.nursing.upenn.edu/ce for dates.)

Pharmacology & Pharmacotherapeutics for APNs

Game Solutions for Healthcare Inaugural Symposium

March 24, 8:30am - 2pm

April 20-21

MSN Open House, Fagin Hall

Preview weekend for future Penn Nursing students

March 27, 1:30 - 6pm

April 21

7th Annual Preceptor Recognition Event

2nd Annual West Philadelphia Wellness Day, co-hosted by Philadelphia Councilwoman Jannie L. Blackwell, Penn Nursing, LIFE, Penn Presbyterian Medical Center, the University of Pennsylvania Health System, and Penn’s Office of Government and Community Affairs

March 28, 12 - 1:30pm

Bates Center Seminar April 5, 3 - 5pm

Claire M. Fagin Distinguished Researcher Lecture and Award with 2012 honoree Dr. Barbara Riegel April 14, 9:30am - 4:30pm

The Barbara Bates Center for the Study of the History of Nursing 25th Anniversary Symposium honoring Dr. Joan Lynaugh April 17, 1 - 5pm

Partners in Education and Practice: Stronger Teams, Better Health: Co-hosted by the Association of Academic Health Centers, Penn Nursing, and Penn’s Perelman School of Medicine

For more information on any of these events, email nursalum@pobox.upenn.edu or call 215.746.8812. www.nursing.upenn.edu/ alumni/

April 26, 6 - 8pm

Hillman Scholars Reception, New York May 11

Center for Global Women’s Health Inaugural Symposium May 11-13 – Alumni Weekend 2012

Features a Women’s Health and Midwifery reunion; the Legacy Breakfast for 50th reunion and HUP alumni; faculty lectures; and the traditional Parade and Picnic.

October 4

Dean’s State of the School of Nursing Address

April 18, 12 - 1:30pm

October 26-27

Bates Center Seminar

Homecoming Weekend featuring arts and culture programming and the Penn vs. Brown football game.

A 125-Year Legacy Continues: Support the Penn Nursing Annual Fund For 125 years, Penn has prepared nurses to provide care that improves lives. “Celebrating this milestone is incredible,” said Maureen Mahoney Ercole, HUP’75. “And I celebrate that both of my daughters are following in my footsteps.”

It was their mother’s hard work and compassion that inspired Maureen’s daughters to become nurses, and it is the legacy of cutting-edge education that brought them to Penn Nursing.

To learn more about the Penn Nursing Annual Fund, contact: DESIRÉE D. CARR Assistant Director of Annual Giving and Major Gifts 215.898.1665 carrd@nursing.upenn.edu

The Penn Nursing Annual Fund ensures our students are ready to improve the lives of their patients. Join us today in supporting our current students as they prepare to walk in your footsteps.

Non-Profit Org. U.S. Postage P A I D Permit #2563 Phila., PA

Claire M. Fagin Hall 418 Curie Boulevard Philadelphia, PA 19104-4217 www.nursing.upenn.edu

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