Nursing News

The University of Rochester School of Nursing is making plans to return to fully in-person classroom learning beginning with the fall 2021 semester.

The school has remained in operation since the COVID-19 outbreak hit New York, but it closed Helen Wood Hall classrooms and shifted to remote didactic instruction mid-semester in March of 2020. Labs and clinical experiences for students continued to be held in person.

All School of Nursing undergraduate and graduate students who plan to enroll for the 2021-22 academic year will be required to be vaccinated against COVID-19. The University of Rochester has determined that vaccination is the most effective approach to limiting or eliminating the spread of COVID-19, and the safest and most manageable way to increase in-person operations, instruction, and activities on campus. “While none of us can be certain what the future might bring, we’re excited to welcome our faculty, staff, and students back into the building on a full-time basis. These halls have been too quiet for too long,” said Kathy Rideout, EdD, PPCNP-BC, FNAP, dean of the UR School of Nursing. “I am extremely proud of the work our faculty and academic leadership team has done to transition to remote learning and develop new and innovative ways to deliver content, and I am just as amazed at the resilience and adaptability of our students, who have carried on with their learning among extraordinary conditions.”

Helen Wood Hall, which operated at 25 percent capacity for most of the 2020-21 year, is undergoing a facelift with the vertical expansion above the Loretta C. Ford Education Wing underway. The project began in the fall of 2020, and the beginning phases required closing off large classrooms in the education wing, further limiting the amount of available space within the building. The education wing is back open, and other frequent student gathering places, such as the atrium, student lounge, and Evarts Lounge, are expected to re-open for fall.

UR Nursing in the News

What’s new in the School of Nursing? Here are some recent media reports involving UR Nursing faculty, staff, and alumni.

Associate Dean Renu

Singh, MS, CEO of the UR Medicine Employee Wellness Program, gave a TV interview to 13WHAM ABC in Rochester about wellness programming on Christmas morning. Singh was co-author of an op-ed in a recent issue of JAMA Internal Medicine disputing claims that employee wellness programs were ineffective at improving workers’ health.

Feng (Vankee) Lin, PhD,

RN, the Marie C. Wilson and Joseph C. Wilson Professor of Nursing, was mentioned in an article in The New Yorker. The article, “Is It Really Too Late to Learn New Skills?” examines our ability to master new skills as we age and cites a 2017 paper co-authored by Lin that proposes six factors needed to sustain cognitive development as people age.

Loretta Ford, EdD, RN, PNP, NP-C, CRNP,

FAAN, FAANP, founding dean of the UR School of Nursing, was featured in Becker’s Hospital Review and Scrubs Magazine in January for being recognized with the Surgeon General's Medallion. The award, announced the day before Ford’s 100th birthday, is the highest honor civilians can receive for their service to public health (see story, page 22).

A March CBS This Morning story marking the one-year anniversary of the COVID-19 pandemic featured alumna Kimberly Ellis ’93N. Ellis had been among the nurses shown in early 2020 when health care workers struggled to find sufficient PPE while working at the epicenter of the virus in New York City. Reporter David Begnaud returned to New York City to interview the same nurses and health care workers—including Ellis, a nurse at the Brooklyn Hospital Center—and look back on progress made in the past 12 months. Professor of Clinical Nursing Mary Tantillo,

PhD, PMHCNS-BC, FAED,

CGP, made multiple local media appearances over the past several months. She appeared on WXXI’s Connections radio show, alongside parent peer mentor Michelle Morales, to discuss eating disorder recovery. She also did several interviews with Rochester media outlets to discuss plans to open a new residential eating disorders treatment facility in Pittsford. Tantillo was also quoted in a WXXI radio story on how the COVID-19 pandemic creates a “perfect storm” for eating disorders.

Dean Kathy Rideout, EdD, PPCNP-BC, FNAP

and Paige Steiner, a student in the Accelerated Bachelor’s Program for Non-Nurses were interviewed for a story in Diverse: Issues in Higher Education. The story documented how the pandemic has sparked increased interest in nursing and has helped drive enrollment to nursing schools.

Mitchell J. Wharton, PhD, RN, FNP-BC, CNS, an accomplished educator, researcher, and clinician, was named associate dean for equity and inclusion at the University of Rochester School of Nursing in January.

The appointment of Wharton, an associate professor of clinical nursing and faculty diversity officer at the school, shattered glass ceilings at the school. When they began their new duties on a part-time basis on February 1, Wharton became the first male and the first person from a group underrepresented in nursing to serve the school at the associate dean level of senior administration. “I am honored to have the opportunity to serve students and colleagues by leading the mission to enhance equity and inclusive practices within our school,” said Wharton, who transitioned to this position full time in July after fulfilling clinical and educational responsibilities for the spring semester. “I look forward to engaging members of the School of Nursing and Rochester communities as we work together to thoughtfully and respectfully develop strategies to increase diversity throughout the nursing workforce and academic nursing pipeline.”

Wharton has been an integral figure in the school’s diversity, equity, and inclusion efforts for the past several years. They have been co-chair of the Council for Diversity, Equity, and Inclusiveness since 2018 and the faculty advisor for the student-led Leading with Integrity For Tomorrow (LIFT) program since 2014. They have also been a co-facilitator for the school’s Racial Equity Series, served on the University of Rochester Medical Center’s Executive Committee for Diversity and Inclusion, and served as the School of Nursing’s representative to the Academic Community Engagement Collaborative. Wharton was honored with the School of Nursing’s Mary Dombeck Diversity Enhancement Faculty Award in 2020.

As associate dean, Wharton joined the UR Nursing senior leadership team, where they will work to more fully integrate issues of diversity and inclusion in all aspects of the school. “I am thrilled that Mitchell has accepted our offer to be our new associate dean,” Dean Kathy Rideout, EdD, PPCNP-BC, FNAP said of the appointment. “I am confident that Mitchell’s thoughtfulness and genuine caring approach will help to lead us forward together.”

A 2013 graduate of the UR Nursing PhD program, Wharton has taught undergraduate and graduate courses at the school and is a member of the Interdisciplinary Sexual Health and HIV Research (INSHHR) group. Their research scholarship focuses on identifying asset-based modalities of HIV prevention and health maintenance in marginalized populations by examining the intersections of age, race, sexual identity and behaviors, and human rights.

A 2015 recipient of the school’s Outstanding Scholarly Practitioner Award, Wharton has maintained an active clinical practice in the Center for Perioperative Medicine at Strong Memorial Hospital and a wellness coach for the UR Medicine Center for Employee Wellness.

Wharton is also treasurer of the Association of Nurses in AIDS Care, a guest editor for the Journal of the Association of Nurses in AIDS Care (JANAC), and member of the Rochester Black Nurses Association. In 2020, they were awarded the Civilian Service Award from the Monroe County Sheriff’s Office.

Wharton earned his bachelor’s and master’s degree in the science of nursing from Widener University, and completed a post-doctoral fellowship in HIV epidemiology and prevention sciences at the Johns Hopkins University Bloomberg School of Public Health.

The University of Rochester School of Nursing has renamed its Center for Research Support in memory of Harriet Kitzman, PhD, RN, FAAN.

The area will now be known as the Harriet J. Kitzman Center for Research Support.

The move is a fitting tribute to the legacy of Kitzman, who passed away in March 2020. A prolific researcher in her 60plus year career as a nurse, professor, mentor, and leader, she was known on campus as much for her groundbreaking work with nursehome visits as she was for encouraging and supporting others in their own lines of research.

“For many years, Harriet really was synonymous with research at the school,” said Dean Kathy

Rideout, EdD, PPCNP-

BC, FNAP. “I can’t think of any better way to honor her legacy.”

Kitzman served the School of Nursing in many roles over a 45year period, but she was most associated with the school’s research mission. She was the school’s longtime senior associate dean of research, serving in that capacity into her 80s.

She was instrumental in the development of the Center for Research Support, which helps facilitate the research and scholarly development of UR Nursing faculty and advances research dissemination and evidencebased practice. The area comprises two groups: the Administrative, Proposal, and Financial Support Group, a team of administrators and accountants who work closely on grant proposals, post-award financial management, and the dissemination of research findings; and the Research Facilitation Group, a team of biostatisticians, data analysts,

and health project coordinators that provides consultation, project design and management, data gathering, and technical support. Housed on the 2nd floor of Helen Wood Hall, the new Harriet J. Kitzman Center for Research Support will be officially dedicated at a later date. New signage commemorating Kitzman and a portrait of her will be installed in a prominent location. A brilliant and internationally renowned researcher, Kitzman’s body of work in pediatrics helped to reshape how health care is provided to young mothers and their children. Her investigations related to the effects of nursehome visitations for first-time mothers and children, focusing on economically disadvantaged families, was the basis for the Nurse-Family Partnership, which now serves more than 38,000 families across 41 states. At the School of Nursing, Kitzman developed the pediatric nurse practitioner program and was the first clinical chief/ chair responsible for nursing services at the UR Medical Center. She was also one of the key drivers in the development of the Unification Model. Kitzman earned a vast number of awards and accolades over her Harriet Kitzman career, including the Rochester Business Journal Health Care Achievement Award and the University Award for Lifetime Achievement in Graduate Education. In 2019, she was awarded the Dean’s Medal, the School of Nursing’s highest honor. She held graduate degrees from the University of Rochester and the esteemed Loretta C. Ford Professorship.

School remains at No. 26 among U.S. News master’s programs; 12th in adult gerontology primary care NP rankings

For the second straight year, the University of Rochester School of Nursing ranks 26th among the nation’s best master’s nursing programs, according to the 2022 Best Graduate Schools guide produced by U.S. News and World Report.

The UR School of Nursing ranked tied for 12th among adult gerontology primary care nurse practitioner programs in the issue’s rankings of individual master’s specialties. UR Nursing also tied for 44th among Doctor of Nursing Practice (DNP) programs, making it the only school in Upstate New York to rank among the top 50 for both its master’s and doctoral programs.

“Without a doubt, the past year was one of the most difficult anyone could ever imagine for a multitude of reasons, not the least of which was how it impacted how we educate our future health care providers, leaders, and scientists of tomorrow. But I am exceedingly proud of how our faculty and staff was able to pivot and continue to deliver high-quality instruction and support to all of our students despite unforeseen challenges presented by the pandemic,” said Kathy Rideout, EdD, PPCNP-BC, FNAP, dean of the UR School of Nursing. “These rankings just affirm the innovative and thoughtful approach the school takes to nursing education, research, and practice.”

The U.S. News rankings are conducted annually, and each school’s overall score is based on indicators in categories such as: student selectivity and program size, faculty resources, and research activity. The largest factor in the ranking is a quality assessment ranking provided by nursing school deans and health care professionals. A total of 597 nursing schools with master's or doctoral programs accredited by either the Commission on Collegiate Nursing Education or the Accreditation Commission for Education in Nursing were surveyed for this year’s rankings. In total, 258 nursing programs responded to the U.S. News nursing statistical data collection survey sent in fall 2020 and early 2021. Of those, 220 provided enough data to be included in the rankings of nursing master's programs and 163 provided enough data to be included in the ranking of Doctor of Nursing Practice programs.

Additional information on the nursing program rankings can be found at www.usnews.com.

UR Nursing ranked in top 30 in research support from NIH

The University of Rochester School of Nursing remains in the top 30 in the annual rankings of research funding from the National Institutes of Health (NIH).

The UR School of Nursing ranks 29th in research support from the NIH for the fiscal year 2020, the 12th time in the last 15 years the school has secured a spot in the top 30 of all nursing schools, according to data compiled by the Blue Ridge Institute of Medical Research.

The UR School of Nursing received over $2.5 million in research support for six grants in areas that cover cognitive aging, eating behaviors, HIV/AIDS research, and maternal and child health.

Titles of the NIH-funded grants include: • Targeting autonomic flexibility to enhance cognitive training outcomes in older adults with mild cognitive impairment • Validate a shared neural circuit underlying multiple neuropsychiatric symptoms • Longitudinal changes in weight and biology in the

pregnancy-postpartum period and subsequent cardiometabolic risk • Multilevel determinants of HIV pre-exposure prophylaxis (PrEP) utilization and health disparities among Black and

Hispanic women • Delineation of the biopsychosocial risks of obesogenic eating behaviors

“Research has always been at the forefront of the UR School of Nursing’s mission. I’m proud of our faculty and staff who are committed to positioning our school at the cuttingedge of discovery,” said Dean Kathy Rideout, EdD, PPCNPBC, FNAP. “I look forward to seeing what next year brings for the Harriet J. Kitzman Center for Research Support.”

The NIH is the largest public funding source for biomedical research in the world, investing more than $32 billion annually to enhance health, increase life spans, and reduce illness and disability.

Call it a clean sweep for the University of Rochester School of Nursing. All three nursing recipients of the Health Care Heroes awards presented by the Rochester Business Journal are graduates of UR Nursing programs.

The 2021 honorees in the Nurse category are: • Rebecca Alley, ’11N (MS), MS, RN, vice president and chief nursing officer for ambulatory services for Rochester

Regional Health • Kathy Hiltunen, ’78N, MBA, RN, manager of public health nursing services for Monroe County and an assistant professor of clinical nursing at the UR School of Nursing • Kate Valcin, ’18N (MS), ’20N (DNP), DNP, RN, CCRN-K,

NEA-BC, CNL, director of critical care nursing at Strong

Memorial Hospital

A total of 41 winners across 14 categories were announced with winners being honored during a virtual celebration on May 11. Rochester Business Journal created the Health Care Heroes awards to recognize excellence, promote innovation, and honor the efforts of organizations and individuals making a significant impact on the quality of health care in the Rochester area.

“Health Care Heroes are making a significant impact on the quality of health care in our area. When it comes to meeting the needs of their patients, there is no challenge too great or task too big,” said Suzanne Fischer-Huettner, group publisher of the Rochester Business Journal. “Often described as miracle workers, this year’s honorees really are heroes in our community.”

Alley has taken on increasing leadership responsibilities for Rochester Regional over the past eight years. She joined the system in 2012 as a nurse manager and practice administrator for the Rochester General Medical Group. She was named director of quality in 2015, and in 2018 became chief nursing officer. She previously worked for eight years as an RN and nurse manager at the University of Rochester Medical Center. She earned a bachelor’s degree in nursing from Nazareth College in 2005 and received a master’s from UR Nursing’s Leadership in Health Care Systems program in 2011.

Hiltunen leads the public health nursing services division, which aims to protect and promote the health of Monroe County residents though support, education, empowerment and direct nursing care services. In that position, Hiltunen played a key role in Monroe County’s COVID-19 response, leading the county health department’s isolation and quarantine group. In addition, she continued to serve as a clinical instructor at the School of Nursing, a role she has held since 2010. She earned her bachelor’s degree in nursing from the school in 1978 and in 1991 received an MBA from the Simon School.

In more than a quarter-century of work at Strong, Valcin has developed into one of the region’s most respected nurse leaders. She currently leads a team of nurse managers from eight intensive care units and nearly 550 staff members. She is also the president of the Finger Lakes Organization of Nurse Executive and Leaders, and was honored with a 2017 Circle of Excellence Award from the American Association of Critical Care Nurses. During the COVID-19 crisis, Valcin was among the URMC response team that helped to make crucial decisions regarding visitation and nurse staffing. She was also co-chair of the Highly Infectious Disease Unit (HIDU) steering committee and helped implement sweeping changes in staffing, such as floating nurses to different units on a temporary basis to help handle the outsized number of severe COVID cases. For her work during the crisis, she was nominated for the American Academy of Nursing’s COVID-19 Courage Award. Prior to taking on her leadership role in 2015, Valcin served as a nurse manager, and then senior nurse manager, for a medical intensive care unit. She has also served as a clinical nurse specialist and staff nurse on an MICU. She began her career in 1997 as a staff nurse on a med-surg unit. Valcin earned her bachelor's degree in nursing from Roberts Wesleyan College in 1996 and a master’s in nursing (with a concentration in education) from Duke University in 2007. She earned a clinical nurse leader post-master’s certificate from the University of Rochester School of Nursing in 2018 and a doctor of nursing practice (DNP) degree in 2020.

Throughout her career as a nurse scientist, Jinjiao Wang, PhD, RN, assistant professor at University of Rochester School of Nursing, has sought to improve the quality and outcomes of post-acute care and home health care for older adults with complex medical conditions who take multiple medications.

In May, Wang received a one-year pilot award from the U.S. Deprescribing Research Network (USDeN), an NIH R24 research center dedicated to developing and disseminating evidence about deprescribing and improving medication use among older adults. She was the only nurse scientist selected to receive pilot funding this year from the USDeN.

In the home health care arena, a routine nursing visit requires the documentation of all the medications a patient takes. Usually, patients older than 65 experience a lot of chronic conditions such as diabetes, hypertension, heart disease, depression, and arthritis and take more than five medications (i.e., polypharmacy). Each medication could have a list of side effects that require more medications to offset these side effects.

“There’s often a lot of crossover when an older person takes on average 10 medications for five or more chronic conditions,” said Wang. “But if we can achieve better or equivalent treatment outcomes with five meds, why take 10?”

One cause of over-prescribing and polypharmacy is a lack of communication among the multiple health care providers of the patient. Home health care nurses conduct comprehensive medication reviews during home visits, but they don’t have the authority to change prescriptions. The patient’s primary care provider (PCP) can deprescribe but rarely has access to the complete home-based medication review data that home health nurses have. Additionally, clinical pharmacists—professionals who are trained to review medications and suggest deprescribing targets—mostly work in the hospital and are often not accessible in the community. Rarely, do the parties interact, let alone communicate what each other is prescribing to the patient, leading to medication duplicates, errors, and unncessary use of certain medications.

“That kind of conversation is rarely initiated, also because the word 'deprescribing' may be associated with abandoning of care,” said Wang. “We’re trying to break the stigma associated with deprescribing. In fact, most patients would agree to stop taking certain, potentially inappropriate or unnecessary, medications if their PCP recommends it. The goal of this study is to empower each party with complete information and help the multiple parties collaborate efficiently about medication issues, so as to help the patient successfully transition back to the community after hospital discharge.”

Wang’s study aims to simplify and optimize the patient’s medication regime with a more unified interdisciplinary care team and through the use of telehealth, which will help reduce the cost of medications and burden of symptoms.

Starting this fall, home health care patients in the Rochester area will be selected for their age and the number of medications they’re taking and invited to participate in the study. In each home visit, Wang’s team will conduct comprehensive medication review, collect complete medication data, have it reviewed by the clinical pharmacist, and then convene with the patient’s PCP via telehealth to discuss any opportunities to simplify the medications. The patient will also provide feedback on their experience.

Wang hopes the promising results of the study can be used across other home health care organizations and in future efforts to deprescribe, which is a relatively new research sphere.

“I think part of the reason I received this funding is that I'm in a unique field. In nursing, we learn to care for patients in a holistic way and that is the very foundation of deprescribing,” said Wang. “I wouldn’t be in this position if it weren’t for the support of Dean Kathy Rideout, Sally Norton, Kathi Heffner, and Ying Xue at the School of Nursing. So, instead of being the only nurse scientist to receive this recognition, I’d like to think of us as the only school of nursing recognized by this institution. It really is a great honor.”

Wang

Sally Norton, PhD, RN, FNAP, FPCN, FAAN, University of Rochester School of Nursing’s associate dean for research and the Independence Foundation Chair in Nursing and Palliative Care, was honored by the University of Iowa recently.

Norton received the College of Nursing’s Distinguished Alumni Award in December 2020. She was one of three alumni honored by the college for their hard work and dedication to nursing and health care.

A nationally recognized expert in palliative care research, she is a fellow of the Hospice and Palliative Care Nurses Association (HPNA) and the American Academy of Nursing, and was named a Distinguished Practitioner by the National Academies of Practice. She was honored with the Distinguished Researcher Award from HPNA in 2017 and was named Palliative Care Nurse of the Year by the March of Dimes in 2013.

In a career dedicated to improving the care of patients with advanced illness, Norton’s research has focused on palliative care and end-of-life decision-making with emphases on the communication processes and practice patterns of care delivery in acute and long-term care settings. She has also worked successfully across professions to improve communication and understanding surrounding systems of palliative care and hospice delivery, and to pinpoint the approaches most meaningful to patients and families that lead to the highest quality outcomes. Over the past two decades, she has been a principal or co-investigator in dozens of funded research studies on palliative care and has authored or co-authored nearly 100 papers. In 2019, she assumed a leadership role at the UR School of Nursing, taking over as associate dean for research. She also serves as a co-director of research for the Division of Palliative Care in the Department of Medicine at the University of Rochester and holds a secondary appointment in the School of Medicine and Dentistry. She earned her BSN from the University of Iowa in 1983 and her master’s and doctorate of nursing from the University of Wisconsin-Madison. She Norton joined the UR Nursing faculty in 2001.

Flannery Poster Claims Top Prize at Oncology Symposium

Marie Flannery, PhD, RN, AOCN, an associate professor of nursing, claimed the top prize for her poster at the National Institute of Nursing Research-Oncology Nursing Society-National Cancer Institute Symptom Science Advances in Oncology Nursing symposium held virtually in February.

The poster, “Using Sankey Flow Diagrams to Visualize the Symptom Experience in Older Adults with Cancer,” was named first place abstract in the Palliative and Psychosocial Care category. Among Flannery’s co-presenters was SON PhD student Zhihong Zhang.

The School of Nursing was well-represented at the conference.

Assistant professor Meghan Underhill-Blazey, PhD, APRN, AOCNS, was a co-presenter for two presentations: “Perceived Patient-Centered Communication is Associated with Ovarian Cancer Symptom Burden,” and “Symptom Management after Risk Reduction for Inherited Cancer Risk,” the latter she co-presented with associate dean Sally Norton, PhD, RN, FNAP, FPCN, FAAN. Underhill-Blazey also co-led a networking segment at the event.

Flannery

Starks, Hudson Receive Student Honors

A pair of UR Nursing students were recognized with regional honors. Mary Starks ’17N, was selected as Nurse Practitioner Association (NPA) student of the year, while Khaleeyah Hudson ’20N received a Rochester Area Colleges Continuing Education (RACCE) Outstanding Adult Student award.

Starks, a student in the Family Nurse Practitioner to Doctor of Nursing Practice program, is an operating room nurse at Strong Memorial Hospital and one of the founding members of the Rochester chapter of the Black Nurses Association. She is also the inaugural recipient of the School of Nursing’s Student Diversity Engagement Award. She was honored by the NPA as a student exemplifying educational excellence both academically and clinically.

Hudson graduated from the UR Nursing Accelerated Bachelor’s Program for Non-Nurses in December 2020. As a student she was nominated by William Clark, EdD, RN, CDP, assistant professor of clinical nursing, for an award from RACCE. Each year, the group honors three outstanding adult students from participating schools who have achieved academic success while juggling other responsibilities, such as family, job, or community service.

Hudson was among the honorees recognized at an awards celebration in April.

Andrew Wolf, UR Nursing Among Finalists for 2021 Learning Impact Awards

A collaboration between the University of Rochester School of Nursing and AEFIS, an education technology company, was among the finalists for a global award recognizing transformative, high-impact solutions for K-12, higher education, and lifelong learning.

Andrew Wolf, EdD, RN, AGACNP-BC, director of educational effectiveness and assistant professor of clinical nursing at the UR School of Nursing, worked closely with partners at AEFIS (Assessment, Evaluation, Feedback, and Intervention System) to design a Comprehensive Learner Record (CLR) for the school’s RN to BS program. The project allowed UR Nursing to integrate information on student learning and achievement across the curriculum—from its student information system (Workday), learning management system (Blackboard), computer-based testing platform (ExamSoft), as well as other learning systems—into a single location. The CLR captures evidence of student learning through formative and summative assessment and enables students to reflect on their experiences and feedback from faculty.

The project was named a finalist in May for the 2021 IMS Global Learning Consortium Learning Impact Awards, presented annually to recognize outstanding, innovative applications of educational technology that address the most significant challenges facing education.

The UR School of Nursing began work on developing a CLR in early 2020 as part of a shift from a traditional to a competency-based model of education. The initiative required an innovative approach to assess that students were developing the core skills necessary for safe and effective patient care and tracking student learning and achievement across the curriculum. A dynamic portfolio of student learning, the CLR captures data in real time, giving academic leaders an opportunity to see where students are falling and provide academic interventions just in time. Students can also pinpoint areas of improvement, engage with learning resources provided by faculty, and progress on time with skills that make them better practitioners, better employees, and more successful leaders.

“I would like to thank Suzanne Carbonaro at AEFIS for her partnership and Margaret-Ann Carno and all the faculty in the RN to BS program at the University of Rochester School of Nursing,” said Wolf. “Their work created the infrastructure for this innovation in assessment.” Wolf

The University of Rochester Medical Center has launched a new center to study the relationship between emotional well-being and dementia-related diseases, such as Alzheimer’s.

Ample research has uncovered links between emotional well-being in older adults and Alzheimer’s disease and related dementias. But little is known about the direction of the relationship.

The Network for Emotional Well-Being (NEW) and Brain Aging is a collaboration between researchers from the UR School of Nursing, the Del Monte Institute for Neuroscience, the Department of Psychiatry, the UR Aging Institute and their colleagues at other universities across the country. It is one of five networks funded by the National Institutes of Health (NIH) to examine the topic from different angles.

The NEW Brain Aging Center at URMC, established with a four-year, $2.5 million grant from the NIH’s National Institute on Aging, focuses on clarifying two separate mechanistic relationships: the impact of an aging brain on emotional well-being in older adults, and the influence of emotional well-being on brain function and cognitive aging.

“People have been studying aspects of emotional well-being, such as how to be happy or finding a purpose in life, for hundreds of years. But in terms of understanding how emotional well-being is linked to aging and dementia pathologies, this is really new. Nobody has studied it in this way,” said Feng Vankee Lin, PhD, RN, Marie C. Wilson and Joseph C. Wilson Professor in Nursing at the UR School of Nursing, who is the principal investigator on the grant.

“Fully 30 percent of the patients we see in our system, in inpatient and ambulatory settings, are older adults. They are the fastest growing segment of the population and the most frequent consumers of health care,” said Yeates Conwell, MD, UR professor of psychiatry, who is a lead investigator on the grant. “The UR Aging Institute, now with the addition of NEW Brain Aging, will help meet the challenge of assuring not only the health care needs of our older patients are met, but that the quality of life is optimized, as well.”

The NEW Brain Aging Center is guided by an eight-member executive committee made up of researchers from four universities (University of Rochester, Duke University, Johns Hopkins University, and the University of California Santa Cruz), headed by Lin, Conwell, and Kuan Hong Wang, PhD, UR professor of neuroscience, who is also a lead investigator. “We knew we needed to know more about the link between emotional well-being and aging, but the COVID-19 pandemic has put a particular urgency into understanding this relationship,” Wang said. “The pandemic is a stressor particularly threatening to older adults. Some people are already having either mild cognitive impairment or are having Alzheimer’s disease progression. This center will hopefully lead us to a better understanding of the interplay between emotional

well-being and aging brain diseases.”

Other URMC co-investigators on the committee include Benjamin Chapman, PhD, MPH, an associate professor of psychiatry, and Jianhui Zhong, PhD, a professor of imaging sciences. Together, the group is organizing activities around five core areas: investigator engagement, strategic priority workshops, a resource repository, evaluation, and pilot project grants. All of the core functions will serve to disseminate the products of the network.

Building an inter-university and transdisciplinary network of investigators with complementary areas of expertise is crucial, said Lin, noting that the network is taking a cross-species approach and conducting research on both human and animal subjects in order to broaden understanding of brain mechanisms and develop therapeutic targets for addressing aging-associated concerns of emotional well-being.

Using behavioral and brain imaging measures in animal models and comparing those findings to humans, researchers will look to match the observable biomarkers in both, ultimately linking those back to the emotional states. “There are technical challenges to this, we must consider the constraints of the evolutionary distance between the different brain systems, and there must be constant dialogue between the human and animal researchers,” Wang said. “But if we do this, it will allow us access to a more subjective aspect of emotional well-being, something that has not been achieved before.”

Alzheimer’s disease and other related dementias affects more than 5 million people in the U.S. and more than 47 million people worldwide, according to the NIH. There are no known treatments to prevent or stop the progression of dementia, and the toll on individuals, caregivers, and society will continue to increase as the population ages unless effective interventions can be developed.

Previous research has established an association between emotional well-being and select aspects of Alzheimer’s and other forms of dementia, but it’s unclear whether dementia pathologies are a cause, byproduct, or consequence of declines in mental and emotional health.

“Many people don’t realize that older adults on average are more satisfied with their lives than younger people, in spite of the inevitable stressors that aging brings,” said Conwell. “NEW Brain Aging will help us understand the neural mechanisms underlying that resilience and yield insights into how best to help those who are in distress.” “The objective of the network is to engage a wide range of investigators in collaborative thinking and research in order to build the field,” said Lin. “We want to be the leaders in the study of the neuromechanisms of emotional well-being and accumulate resources, data, and expertise that can then be provided to networks or other individuals interested in further developing this area of research.”

Deep Roots

UR Nursing researcher receives grant to cultivate healthy eating habits for local migrant workers

A leading researcher at the University of Rochester School of Nursing is aiming to improve the nutrition of the people who help put healthy food on our tables.

Karen Stein, PhD, RN, FAAN, UR School of Nursing’s Ruth Miller Brody and Bernard Brody Endowed Professor, received approval for a grant, “Extending our Reach: A mHealth Intervention to Promote Healthy Eating in Mexican Immigrant Farmworker Families,” from the Mother Cabrini Health Foundation. The foundation provides grants to improve the health and well-being of underserved, vulnerable, and disadvantaged individuals within New York state.

Mexican Immigrant Farmworkers (MIFW)—though vital to the Western New York economy—are considered to be among the poorest, most isolated, and marginalized populations in the state. Access to nutrition preventative care is limited in the MIFW population due to lack of health insurance, work conditions, and overburdened health services. Of these MIFW, up to 70 percent of children and 80 percent of adults are overweight, 30 percent of adults are hypertensive, 40 percent have metabolic syndrome, and 38 percent of women have type-2 diabetes.

Women, in particular, stated their dietary intake changed dramatically after moving to the United States. Several factors include limited budgets, demanding work schedules, and high stress and pressures from children for American foods. These changes have led to significant weight gain and a high prevalence of weight-related diseases.

Stein’s intervention program via a smartphone app will help the MIFW community understand the factors that influence their dietary intake and eating patterns: regional food values, traditions and eating practices, culturally-based gender normalities, and economic and environmental job-related factors that would impede or facilitate healthy eating.

The app will be intuitive to use, culturally consistent, and understandable without requiring high literacy skills. Content is delivered through videos, cartoons, images, and auditory communication to maximize interest and sustained engagement.

“Our longer-term plan is to make healthy eating accessible through smartphone delivery. Further, by being self-administered at home the many barriers associated with clinic visits are eliminated and access to the intervention at times in their daily schedule is made possible,” said Stein. “With this ongoing process of collaboration and communication, we are confident that the community's dietary health needs will be identified and addressed.”

URMC Research Provides New Insights into Relationship Between Tau Protein and Cognitive Decline

A study by University of Rochester Medical Center researchers provides new insights into the relationship between Alzheimer’s disease pathology and cognitive decline.

In a paper titled “Longitudinal stability of medial temporal lobe connectivity is associated with tau-related memory decline” published in the eLife journal, URMC researchers explore the links between the measure of phosphorylated tau (Ptau) in cerebrospinal fluid and changes in brain structural connectivity over time.

“For Ptau to become a potentially meaningful therapeutic target for preventing or slowing Alzheimer’s or other forms of dementia, we needed to better understand how tau impacts structural brain networks associated with memory decline in aging,” said Quanjing Chen, PhD, a postdoctoral associate at the University of Rochester School of Nursing and the Department of Psychiatry, who was the study’s lead author.

Alzheimer’s is a disease characterized by the presence of both amyloid-beta and tau proteins that lead to neurodegeneration. Recent research suggests that the prevalence of Ptau was a better predictor of long-term cognitive deficits, but little is known about the neurocognitive mechanisms linking Ptau with memory-related declines.

In healthy neurons, tau normally binds to and stabilizes microtubules. In Alzheimer's disease, however, abnormal chemical changes cause tau to detach from microtubules and stick to other tau molecules, forming threads that eventually join to form tangles inside neurons, according to the National Institute on Aging.

Extracting data from a sample of older adults who are cognitively normal or have mild cognitive impairment, researchers found that the presence of cerebrospinal fluid Ptau at baseline was related to a loss of structural stability in medial temporal lobe connectivity in a way that matched disease progression. This loss of structural stability moderated the effect of Ptau on the rate of memory change, suggesting that structural stability in the medial temporal lobe may be an important link between the accumulation of Ptau and memory decline.

Nurse-Driven Condition Management Programs Effective in Improving Key Health Metrics

Chronic disease management programs led by nurses are effective in improving key health metrics, which may lower an individual’s risk for developing cardiovascular disease, according to a study by University of Rochester School of Nursing researchers.

The study, presented to the Eastern Nursing Research Society, found that participants in UR Medicine Employee Wellness condition management programs in diabetes, high blood pressure, and high cholesterol improved their blood pressure and blood glucose levels, which are important factors in preventing cardiovascular disease (CVD). Participants were also able to make sustained changes in medication adherence, time spent exercising, and in lowering their body mass index (BMI), which contributes to better overall health.

“Our nurses and coaches are remarkably effective in working with people to achieve positive health behavior changes,” said

Lisa Norsen, PhD, RN, ACNP-

BC, professor of clinical nursing at the UR School of Nursing and chief wellness officer for UR Medicine Employee Wellness. “These findings support the study that we did last year which showed actual reduction in CVD risk for people who participate in our programs.

“Employers play a pivotal role in helping people improve their health by having quality wellness programs available to their employees and by supporting employee participation in such programs.”

CVD is the leading cause of death for men, women, and people of most racial and ethnic groups in the United States, according to the most recent statistics from the Centers for Disease Control and Prevention. About 655,000 Americans die – 1 in every 4 deaths – each year from heart disease. Diabetes, hypertension, and high cholesterol are recognized as major risk factors for CVD.

Developed by a multidisciplinary team from the UR School of Nursing, UR Medicine Employee Wellness employs a team of registered nurses, nutritionists and fitness trainers to provide customized wellness programming and coaching to organizations and their employees. In addition to basic health assessments, it offers condition management programs that

integrate strategies to help employees incorporate healthy habits and lifestyle choices to effectively manage chronic health conditions such as asthma, lower back pain, and congestive heart failure. In this study, researchers evaluated the impact of condition management programs in diabetes, high blood pressure, and high cholesterol on a cohort of more than 700 participants, most of whom attended seven or more coaching sessions over the course of 11 weeks or more. Participants in these programs saw significant improvement in biometric values, including weight loss with nearly 20 percent dropping one full BMI category. In addition, 94 percent reported having zero days of missed medication. “For anyone who has weight to lose, any amount is a great step in improving health,” Norsen said. “Our study shows that people who participated in our program not only lost weight, but 10 percent actually moved from being overweight to being normal weight, and 10 percent moved from being obese to being overweight. This progress is consistent with reducing the health risks associated with obesity and being overweight.” Participants also averaged an increase of an additional 60 minutes of exercise per week, though the change was even more dramatic among those who reported doing no exercise before taking the program. Those participants averaged more than 100 minutes per week by the end of the program. “That is truly remarkable,” Norsen Norsen said. Several other UR School of Nursing researchers were investigators on the study, including: • Elizabeth Anson, MS, research associate • Holly Lavigne, PhD, research associate • Irena Pesis-Katz, PhD, associate professor of public health sciences and clinical nursing • Renu Singh, MS, UR Medicine Employee Wellness CEO and senior associate dean, operations and assistant professor of clinical nursing • Joyce Ann Smith, PhD, RN, ANP, assistant professor of clinical nursing

The UR School of Nursing announced changes to its leadership team for the 2021-22 academic year. • Linda Schmitt, MS, RN, NPD-BC, CNL, has taken over as sole specialty director of the Leadership in Health Care

Systems program. She previously was co-specialty director with Kristin Hocker, EdD. Schmitt is also serving as interim specialty director of the Clinical Nurse Leader program, replacing Luis Rosario-McCabe, DNP, RN, CNE, CNL,

WHNP-BC. Hocker and Rosario-McCabe stepped down to pursue other responsibilities within the school. • Sue Stanek, PhD, MSN/Ed, RN, has been named director of the Center for Lifelong Learning. She had been serving as interim director of the CLL. • Hocker and Peter Bertoldo, education business analyst at the school, have been named Faculty Diversity Officer and

Staff Diversity Officer, respectively. Both have previously served on the Council for Diversity, Equity, and Inclusion. • Jinjiao Wang, PhD, RN, has been selected to serve in a newly created position: post-doctoral program director. In this new role, Wang will help to facilitate the success of the school’s post-doctoral fellows and help steer them through their transition into the faculty.

Schmitt

Stanek Hocker Bertoldo

Wang

Alcéna-Stiner, Yu Join Tenure-Track Faculty

The School of Nursing have added two familiar faces to its tenure-track faculty.

Danielle (Dani) Alcéna-Stiner, PhD, RN, and Yang Yu, PhD, MPH, MSN, have been named assistant professors as of July 1.

Alcena-Stiner earned a PhD in microbiology and immunology from the University of Rochester in 2012 before turning to nursing a few years later. She graduated from the UR Nursing Accelerated Bachelor’s Program for Non-Nurses in 2018 and then joined the school faculty as a clinical instructor. A member of the Interdisciplinary Sexual Health and HIV Research (INSHHR) group, Alcena-Stiner decided to leave the clinical track to pursue her research interests.

Yu joined the UR School of Nursing in 2019 as a post-doctoral fellow. She completed her fellowship on June 30 and immediately moved into a tenure-track faculty position. Yu obtained her master’s degree and PhD from the University of Pittsburgh, where she studied weight management and behavior change theories and practices. Her work has been published in peer-reviewed journals such as Surgery for Obesity and Related Diseases and Obesity and American Journal of Health Behavior.

The school also added three new post-doctoral fellows: • Tanya Wallace-Farquharson, PhD, RN, formerly of the

University of Miami. Her area of research includes clinical science for health disparities populations with a focus on the language of asthma; pediatric asthma and sickle cell disease. • Rose Matemba, PhD, RN, formerly of the University of

Miami. Her area of research includes socioecological factors that influence development of sexual behaviors in young adolescent girls. • Sukardi Suba, PhD, RN, formerly of the University of

California, San Francisco. He was hired on the post-doctoral fellow to tenure-track faculty track. His area of research includes leveraging ECG data from physiologic monitors to inform better alarm management at the bedside, reduce

“alarm fatigue” and to inform future development of

“smarter” ECG monitoring.

The School of Nursing held its annual year-end celebration, handing out awards to faculty and staff for their dedication and service to the school. The 2020-21 event was held virtually on May 10.

Among this year’s awardees were:

Most Promising New Investigator

Chen Zhang, PhD, MPH, assistant professor

Professional Advancement Award

Jinjiao Wang, PhD, RN, assistant professor

Outstanding Scholarly Practitioner

Beth Palermo, DNP, RN, ANP-BC, ACNP-BC, assistant professor of clinical nursing Meghan Underhill-Blazey, PhD, APRN, AOCN, assistant professor

Outstanding Faculty Colleague

Joseph Gomulak-Cavicchio, EdD, MSEd, assistant professor of clinical nursing Tara Serwetnyk, EdD, RN, NPD-BC, teaching associate

Mary Dombeck Diversity Enhancement Faculty Award Kristin Hocker, EdD, assistant professor of clinical nursing

Mary Dombeck Diversity Enhancement Staff Award Cesar Nunez, assistant, School of Nursing administration

Outstanding Staff Colleague

Kim Starken, associate director of admissions operations and systems

Outstanding Staff Member of the Year

Erin Malley, assistant to the associate dean for research Brian Harrington, director of information technology

Josephine Craytor Nursing Faculty Award

Kaitlyn Burke, MS, RN, CCRN, CNE-cl, instructor of clinical nursing Mary Carey, PhD, RN, FAHA, FAAN, associate professor Lynne Massaro, DNP, RN, FNP-C, ANP-BC, FAANP, assistant professor of clinical nursing

Drs. Jeremy A. Klainer and Pamela York Klainer Endowed Dean’s Discretionary Award in Nursing Wellness Taskforce (Susan Blaakman, PhD, RN, PMHNPBC, FNAP; Patty Corbett-Dick, PPCNP-BC, PMHNP-BC; Mike Fisher, MBA; Julia Mitchell, PMHNP-BC; Lisa Norsen, PhD, RN, ACNP-BC; Aaron Pollard; Natalie Thompson; Kate Tredwell, DNP, RN, PMHNP-BC)

Dean’s Appreciation Award

Karen Keady (Davis), PhD, RN, NEA-BC, chief nursing executive, URMC Sally Norton, PhD, RN, FNAP, FPCN, FAAN, associate dean for research Lydia Rotondo, DNP, RN, CNS, FNAP, associate dean for education and student affairs Renu Singh, MS, senior associate dean for operations Kelly Talarczyk, MBA, chief financial officer Mitchell Wharton, PhD, RN, FNP-BC, CNS, associate dean for equity and inclusion

The school also honored several staff members celebrating service anniversaries at the University:

40 years Liz Gajary-Coots 15 years Judy Brasch

20 years Karen Cokeley Tracy Korts Deb Thayer 10 years Christopher Foote Margaret Lubel Linde Mull Eunyoung Wong

Zhang Palermo Underhill-Blazey

Building A Bridge

Study Led by DNP Graduate Links Transition of Care to Reduced Hospital Readmissions

The transition of care from hospital to home can make all of the difference in a patient’s recovery from a stroke.

Ann Leonhardt-Caprio, DNP, RN, ANP-BC, FAHA, a recent University of Rochester School of Nursing Doctor of Nursing Practice (DNP) graduate and a member of the UR Nursing faculty, led an initiative to improve the systems of stroke care for patients discharged from the hospital after an ischemic stroke (IS).

The complicated transition of care from hospital to home can contribute to hospital readmissions, which are correlated with a higher risk of death and disability as well as increased health care costs to patients and the health care system. There may also be an increased risk of recurrent stroke in patients whose transition from hospital to home does not go smoothly.

Thirty-day hospital readmission rates count toward quality ratings from the Centers for Medicare and Medicaid Services (CMS) and may be part of reimbursement contracts with other insurers which impact hospital reimbursement. High readmission rates can lead to financial penalties or decreased reimbursement to hospitals.

Available research surrounding 30-day readmission of stroke patients demonstrates that multi-component interventions are more successful in reducing readmissions.

“The transition of care is not a one-size-fits-all approach. Every patient is a little different, and every patient’s reason for coming back to the hospital is not the same,” said Leonhardt-Caprio, who was recently named a Fellow in the American Heart Association. “Some patients don’t comprehend or didn’t get enough education before they left the hospital to understand what they need to know to prevent infections or how to manage their medications. They could have difficulty swallowing, which can lead to pneumonia. They may be on a new blood thinning medication and need follow-up education on how to

take it and what side effects to be cautious of. A lot of problems could be prevented if there is more support at home before anything serious happens that requires readmission to the hospital.” As the program coordinator at the UR Medicine Comprehensive Stroke Center (CSC), Leonhardt-Caprio ensures the center engages in evidence-based practice of stroke care and quality improvement processes across the institution. The CSC is a participating hospital in the Paul Coverdell National Acute Stroke Program, which is a Centers for Disease Control (CDC) sponsored program that emphasizes quality improvement focusing on stroke systems of care. When Leonhardt-Caprio learned of New York State’s participation in a transitions of care pilot program which emphasized the formation of partnerships, she recognized this aligned with what she wanted to do as part of her DNP project. A three-month audit of the transition of care process from hospital to home identified that less than half of stroke patients were being referred to a certified home health agency (CHHA). Leonhardt-Caprio reached out to As her DNP project, Ann Leonhardt-Caprio, a UR faculty member and program coordinator at the UR Jane Shukitis, president and CEO Medicine Comprehensive Stroke Center, developed of UR Medicine Home Care, and a pilot program to improve the systems of stroke initiated a partnership that would care for patients discharged from the hospital after play a key role in both the New an ischemic stroke. The exemplary partnership with UR Medicine Home Care was one of three programs York State Coverdell pilot program in the country selected by the Centers for Disease and her DNP project. Control for a case study evaluation to improve the Starting in July 2019, Leonquality of stroke care. hardt-Caprio implemented a multi-component improvement intervention to bridge the transition from hospital to home through increased CHHA referrals, post-discharge telephone calls, and enhanced communication with outpatient providers through more timely discharge summaries. In the reimagined home care referral process, UR Medicine Home Care coordinators were involved earlier in a stroke patient’s hospital course, which allowed eligibility and needs assessment to be placed in the hands of the home care

expert. Leonhardt-Caprio went on home visits with a CHHA nurse to experience for herself the benefits of home care services and “was truly impressed by how important it is to see a patient in their home environment. Nurses in the home can check what medications the patient was discharged on and compare that to what they have in their home. Nurses and therapists would also evaluate risk factors in the patients’ homes like throw rugs they could easily trip on, which is critically important in patients who have new deficits from a stroke.” Leonhardt-Caprio worked to educate the inpatient team on these benefits to help with increasing CHHA referrals.

Instead of the prior practice of one-week, unscripted telephone follow-ups, nurses would call two to three days after discharge using a script that assessed transition of care needs and provided the nurses with some guidance for different scenarios that may be problematic: transportation, prescriptions, outpatient appointments, understanding of discharge instructions, etc. Providers were asked to complete discharge summaries within two days of hospital discharge to ensure the communication with outpatient providers was timely.

For months, Leonhardt-Caprio and others, including UR School of Nursing’s Craig Sellers, PhD, RN, AGPCNP-BC, GNP-BC, FAANP, Elizabeth Palermo, DNP, RN, ANPBC, ACNP-BC, Thomas Caprio, MD, chief medical officer for UR Medicine Home Care, and University of Rochester School of Medicine and Dentistry’s Robert Holloway, MD, MPH, measured readmission rates of IS patients who were discharged from one of UR Medicine’s stroke units at Strong Memorial Hospital.

After six months, they saw a 54 percent decrease in hospital readmissions for all IS patients and a 62 percent decrease in readmissions for those patients who were discharged to home, which was the group the initiative specifically focused on.

As a result of the impressive results and the partnership with UR Medicine Home Care, Leonhardt-Caprio’s project was nominated by the New York State Coverdell team as an exemplar of a partnership to improve stroke systems of care. The partnership was selected by the CDC as one of three programs in the country to participate in a case study evaluation to gather information regarding efforts within a stroke system partnership. The CDC conducted a virtual site visit in late March to interview participants who were involved in the implementation and execution of the project. The CDC will use the findings to provide an in-depth understanding of how partnerships improve the quality of stroke care and ultimately contribute to the public evidence of effective stroke systems of care.

While the study demonstrates the importance of improving transitions of care to reduce avoidable readmissions, Leonhardt-Caprio emphasizes that readmission rates for stroke patients should never be zero.

“After a stroke, we expect that about 3 percent of patients are going to have a recurrent stroke within the first 30 days, and no matter how good the overall education and prevention strategies are, some patients will still have a recurrence. We’re never going to prevent all of the strokes or serious medical conditions that require hospitalization. So, it’s really important for us to focus on improving that transition of care to reduce the preventable readmissions, but not discourage patients from getting acute care when they need it,” she said.

In March, Leonhardt-Caprio presented the project results— one of six oral abstracts presented as a part of the State of the Science Nursing Symposium— at the International Stroke Conference. Leonhardt-Caprio also spoke about the project at the NorthEast Cerebrovascular Consortium 14th Annual Summit, and to the CDC’s Coverdell Post-Hospital Work Group in late 2019.

Two PhD Students Selected to Receive Oncology Nursing Foundation Scholarships

Two UR Nursing PhD students were notified in April that they were selected as recipients of the Oncology Nursing Foundation Doctoral Academic Scholarship for 2021-22.

Melanie Bobry and Zhihong Zhang were among the winners of the competitive scholarship, given to registered nurses pursuing a research doctoral degree who are interested in and committed to oncology nursing. The scholarships, ranging from $5,000 to $7,500, are supported by the Oncology Nursing Foundation and the Oncology Nursing Certification Corporation.