School of Nursing
What are your general research interests?
My general research interest is in nursing interventions and their effect on outcomes. Specifically, my focus is on nursing interventions and outcomes in chronic heart failure and post bariatric surgery patients.
What are your current projects and how are they funded?
As part of an INBRE grant, I designed an undergraduate research course where faculty conducting research volunteered to mentor students, providing students with hands-on experience in research and faculty with assistance in moving their research agenda forward. In my first outcome study on chronic heart failure (CHF), students called patients with CHF using a telephone protocol I developed. They reinforced the treatment management with the hope of preventing emergency room visits and hospital readmission. From the CHF study, I designed my current study (post-bariatric surgery patients’ adherence to follow-up care) also using a telephone intervention.
For the morbidly obese (BMI 40 kg/m2), surgery is the only treatment that has been proven to have positive long-term effects. Studies show that there is a high rate of complications after discharge with inadequate adherence to follow-up care.
Not keeping follow-up appointments can lead to late diagnosis of complications, loss of support network, and lack of reinforcement to follow management care.
The purpose of this research was to determine whether regular telephone interventions would increase compliance with follow-up appointments and therefore lead to improved post-bariatric care outcomes. Patients undergoing pre-operative counseling were assigned to the control or experimental group. The experimental group received weekly telephone interventions (by nursing students) after surgery encouraging them to attend follow-up appointments and addressing any questions. The control group received standard care post-bariatric surgery with no telephone intervention. Preliminary results showed that the experimental group went to more appointments and for longer length of time than control group.
Using secondary data analysis, I have been able to do research that provided basic information leading to outcome research. I was able to design my bariatric research study after a database analysis of bariatric patients showed that almost half of the patients did not return for their follow-up visits. I have also compared the complication rates between laparoscopic Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding using a database. Another research project with two colleagues is looking at a database from Union Hospital to describe the characteristics of patients who use the emergency room frequently. We will then design a possible intervention based on the findings.
Who are your collaborators on these projects?
When I first started doing my bariatric study, I collaborated with Dr. Allen Prettyman (UD), and Dr. Lenhard and Kim Tran from Christiana Care. We published our results in the Journal of the American Society for Metabolic and Bariatric Surgery and presented at their annual conference. The outcome research I am currently doing is with Dr. Gail Wynn and Mary Ellen Sparks at St. Francis Hospital. I also collaborate with Dr. Tom Hardie, Dr. Carolee Polek and the research council at Union Hospital on the study of emergency room frequent users.
What are the likely next steps in your work?
Data collection is completed on the bariatric research study. We have published and presented our findings. I have two manuscripts submitted. One is in press and another in revision.
How would you describe your work’s importance to an interested lay audience?
Nurses are vital in improving health care quality. What we do can impact the lives of patients, the cost of health care, and quality of life for everyone. Nursing interventions (telephone calls with the use of evidence-based telephone protocols) can definitely impact the outcome of care.