Spotlight
A PART OF ORPCS DISCOVERY NEWSLETTER
ORPCS Nurse Scientist Appointed as a Board Fellow with the American Academy of Ambulatory Care Nursing!
The Office of Research Patient Care Services at Stanford Health Care is proud to announce that Nurse Scientist, Dr. Chrystal Lewis, , has been selected as the 2024-2025 Emerging fellow by the American Academy of Ambulatory Care Nursing’s (AAACN). In her role as a fellow, Dr. Lewis will offer her insights on pressing issues facing ambulatory care nurses and the association to the AAACN Board of Directors . She aims to deepen her understanding of the complexities and scientific needs across the U.S., and to enhance her leadership skills with the goal of further developing the leadership capabilities of nurses in her team. Dr. Lewis is excited to explore how national nursing organizations can impact health policy to better advocate for patients. The AAACN, founded in 1978, is a leading not-for-profit organization dedicated to advancing the art and science of ambulatory care nursing. It offers educational programs that advance holistic and evidence-based patient care, and advocates for thew critical role of nurses and nursing leaders in shaping future of health care. Congratulations Dr. Lewis!
Written by: Briana Williams
Stanford Health Care Holds Inaugural Health Equity Symposium
Stanford Health Care's inaugural Health Equity Symposium, coordinated by Stanford Medicine and the Martin Luther King Jr. Research and Education Institute, took place on January 17th, 2024. Coinciding with the observance of Martin Luther King Jr. Day, the symposium featured Dr. David Williams, an internationally renowned social scientist and Chair of the Department of Social and Behavioral Sciences at Harvard University, as its keynote speaker. Dr. Williams' address illuminated the ways in which factors such as education, income, and race contribute to the exacerbation of health disparities in society.
The symposium facilitated in-depth conversations among leading health experts and interactive workshops, fostering a collaborative environment where innovative ideas were shared to set new standards in healthcare.
Dr. Williams, who has published over 500 papers on social determinants of health and received numerous esteemed awards, focused his presentation on "The House that Racism Built." He described racism as a societal system influenced by and influencing various social forces, including politics, legislation, and the economy. He emphasized institutional racism as a mechanism through which society is structured to benefit the dominant group while systematically disadvantaging racial minorities.1
Dr. Williams poignantly likened segregation to "a burglar at midnight," subtly infiltrating communities and leading to the erosion of quality schools, employment opportunities, and safe housing. This, he argued, is a manifestation of a "rigged system" that has persistently disadvantaged Black communities.
The sentiments were echoed by Dr. Lerone Martin, Director of the King Institute, and Dr. Joyce Sackey, MD, Stanford Medicine's inaugural Chief Equity, Diversity, and Inclusion Officer. They stressed the importance of not only researching and disseminating solutions within the Stanford community but also inspiring policymakers to enact meaningful changes that significantly impact the broader community.
During the symposium's second half, participants engaged in breakout groups to address various aspects of health inequity, including clinical care, education, policy, research, and social determinants of health. This collaborative effort served as a think tank, where equity-focused educators, researchers, and practitioners brainstormed strategies to eradicate health disparities. Recommendations included expanding the network of professionals dedicated to health equity, incorporating diversity into hiring and training practices, and enhancing visibility and success within impacted populations.
Dr. Martin Luther King Jr., at the Annual Meeting of the Medical Committee for Human Rights in Chicago in 1966, poignantly remarked, "Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death."2 This symposium served as a critical call-to-action, urging the integration of policymakers, researchers, and evidence-based strategies to improve the lives of marginalized groups and dismantle racism, thereby paving the way for an equitable healthcare system for all.
1 Williams, D. R., Lawrence, J. A., Davis, B. A., & Vu, C. (2019). Understanding how discrimination can affect health. Health services research, 54 Suppl 2(Suppl 2), 1374–1388. https://doi.org/10.1111/1475-6773.13222
2 Galarneau, C. (2018). Getting King's Words Right. Journal of Health Care for the Poor and Underserved 29(1), 5-8. https://doi.org/10.1353/hpu.2018.0001.
Written by: Jonathan Dinh
Stanford Health Care Attends 46th Annual ACNL Conference
Over 60 nurses and others from Patient Care Services at Stanford Health Care attended the 46th Annual ACNL Conference in Monterey, CA, from February 4th to 7th 2024 with the theme of “Navigating the Changing Tides.” Dr. Dale Beatty (V.P. Patient Care Services), the outcoming President of ACNL, opened the conference with the Presidents Address and a warm welcome. Several ORPCS and SHC Patient Care Services staff had 10 poster and 2 podium offerings, including Gretchen Brown’s (Chief Nursing Information Officer) Virtual Nursing’s state of the science and how it will shape healthcare of the future. ORPCS Nurse Scientist Dr. Chrystal Lewis mentored Ambulatory Care staff nurses in their abstract submissions, which generated various posters. Dr. Cecelia L. Crawford (Former ORPCS Research Program Manager) presented on the quantitative and qualitative results of a EBP Readiness study.
Dr. Michelle Y. Williams delivers welcome and introduction
A highlight of the conference was the Awards Luncheon, which features two SHC staff. Leah Bailey (Patient Care Manager, AAU B2 Medicine) was selected for the prestigious ACNL Humanitarian Award. Nominated by Shaquille Tillman (M6 PCM), the award program stated: "Leah's exceptional dedication to fighting indifference, intolerance, and injustice, along with her remarkable contributions in promoting health equity and supporting individuals and systems, make her an exemplary candidate for this prestigious recognition. Her selfless acts and extraordinary heroism consistently align with ACNL's core goals."
The Friend of Nursing Award was presented to Elidia Tafoya (Manager Implementation Science, Culture, & Equity, ORPCS), recognizing her vast contributions to DEI ORPCS programs/projects. Although not a nurse, Elidia collaborates on a daily basis to support frontline staff nurses in their research and EBP efforts. “She played a key role in securing and awarding nurses funding for groundbreaking DEI projects through research grants, resulting in 14 innovative initiatives receiving vital seed funding and driving health equity within her organization.”
The event theme of “Navigating The Changing Tides” was featured in the Pirates of the Pacific Gala. All SHC attendees wore their pirate costumes, with included eye patches, hats, and a variety of shoulder parrots and parrot costumes. You could almost hear the birds squawk, “Pieces of Eight, Pieces of Eight!” Dr. Beaty, as Head Pirate, led us into the Gala with a grand entrance and giant banner. We had a wonderful time - Arg
Written by: Cecelia Crawford, DNP, RN, PHN, FAAN
2023 Cycle II Legacy Grant Recipients
The Stanford Nurse Alumnae awards Legacy Grants to 8 recipients Cycle II of 2023. The grants are intended to perpetuate the Stanford University School of Nursing’s tradition of excellence in nursing practice, leadership, education, and research. These grants provide up to $10,000 to advance innovative research and demonstration projects that improve health care outcomes, the patient experience, and health system efficacy.
Awardees for Cycle II of 2023 include:
Recipient: Alexis Brake, MSN, RN, CNRN
Research Project: Addressing Housing, Food, and Water Insecurity: The Impact of Revised Admission Questionnaires and Community Resource Connections on 30-Day Readmission
The purpose of this project is to look at the unhoused inpatient population and explore if the use of a revised admission questionnaire with the provision of targeted discharge resources versus current practice reduces 30-day readmission rates.
Recipient: Annette Nasr, PhD, RN, MPA, NE-BC
Research Project: The Adolescents’ Perspectives of Life after Metabolic Bariatric Surgery: A Mixed Method Study
The purpose of this mixed-method study is to deep the understanding of the long-term effects metabolic and bariatric surgery (MBS) has on the adolescent patient and to generate new knowledge that can be shared with patients, families, and the community of clinicians working in the field of adolescent MBS. This work will fill an existing gap in the literature on the social behavioral effects MBS can have on the adolescent patient.
Recipient: Carlene Lugtu, MS-CIM, RN
Research Project: Exploring the Potential Impact of Generative AI and Large Language Models (LLM) on Care Teams within Stanford Healthcare Ambulatory Clinics
The purpose of this research is to explore the potential impact that Generative Artificial Intelligence (AI) and Large Language Models (LLM) may have on burnout, workload, and administrative burden for care team members at Stanford Health Care (SHC) Ambulatory Clinics. Generative AI refers to a type of AI that can create new content, like images, text, or music. LLMs are a type of Generative AI designed to understand and produce human-like text. This new and innovative technology will be integrated into current systems with almost absolute certainty and imminently. This research will include the perspectives of Registered Nurse Coordinators (RNC), Patient Care Coordinators (PCC). PCCs are SHC’s name for medical assistants. PCCs are essential supportive team members to RNCs within the care team model. Understanding the current state perspectives of these distinct stakeholder groups will facilitate and support the transformation and implementation of this technology. Current publications on this technology's potential impact and discussions of integration into standard work have mainly included licensed independent practitioners (MDs, NPs, and PAs) leaving out a significant volume of the ambulatory clinic workforce.
Recipient: Cassendra Munro, PhD, BS, RN, RNFA, CNOR, FAAN, FAORN
Research Project: Convergent validity of six pressure injury risk assessment scales for perioperative patients
The purpose of this research is to investigate the convergent validity of a risk assessment scale, the Munro Perioperative Injury Risk Assessment Scale (Munro Scale) for adult patients undergoing surgery.
Recipient: Colleen Bonnett, RN, BSN, CV-BC, AMB-BC
Research Project: The Feasibility and Effect of Cardiac Rehabilitation on Activity Levels in Individuals with ICDs and Low Activity Levels
The purpose of this project is to determine the feasibility of providing cardiac rehabilitation (CR) to individuals with implantable cardioverter defibrillators (ICD) and examine the effects of cardiac rehabilitation program on decreasing anxiety, improving activity and QOL in patients with known low activity levels.
Recipient: Hannah Miller, RN, BSN, CV-BC
Research Project: Exploring LVAD Driveline Dressing Care from the Patient’s Perspective
The overarching purpose of this pilot study is to explore left ventricular assist device (LVAD) patient and caregiver experiences around driveline exit site care. This project aims to provide pilot study level data that correlates LVAD driveline dressing care procedures, dressing care supplies, and patient lifestyle/environmental factors (including hygiene practices) with patient reported infections. These are distinct patient care areas which can be improved by nursing-led interventions. Furthermore, this study aims to use a community-based participatory approach to explore what an ideal LVAD driveline dressing kit might contain from the patient and/or caregiver perspective.
Recipient: Michelle Y. Williams, PhD, RN, FAAN
Research Project: Prospective Clinical Study to Evaluate the Accuracy of Pulse Oximeters in Children with Darker Skin Pigmentation
The primary purpose of this study is to evaluate if current FDA-cleared, peripheral pulse oximeters overestimate SaO2 in children with darker skin pigmentation and exceed the FDA standard of +/-3% (error rate). Additionally, the study will evaluate if clinical and/or technical factors, such as a dampened perfusion amplitude, impaired light transmittance, or temperature can explain any observed bias currently attributed to increased skin pigmentation. The study will determine whether the observed bias (error) in pulse oximetry is amplified in children with hypoxia, a large and important subset of pediatric patients because of the high prevalence of cyanotic congenital heart disease. Ultimately, the study seeks to minimize the delays in timely and urgent clinical evaluation and interventions and minimize systemic bias that contribute to poor outcomes and perpetuate health disparity across a range of childhood conditions.
Recipient: Natalie Pinna, MSN, RN
Research Project: Understanding 90-day Readmissions: A Study on Adult Aging-Services Patient Engagement and the Predictability of Readmission Risk Tools
The purpose of this study is to evaluate patient characteristics related to the frequency of post-discharge contacts with Adult Aging Services (AAS) and evaluate the relationship between the nature and frequency of these contacts with AAS staff and the likelihood of unplanned readmission within 90-days. Furthermore, the study will compare the efficacy of the Transition of Care (TOC) Risk Score and the AAS Readmission Tool in predicting readmissions post-acute hospitalization. The study findings will be evaluated to develop targeted interventions to reduce readmissions among this vulnerable population.
Written by: Regine Lopez, MPH
36th ANNUAL NATIONAL BLACK NURSES DAY on CAPITOL HILL
Theme: A Call for Transformative Health Equity Globally
"Nurses Deserve a Seat at the Table in National Healthcare Policy Discussions"
The National Black Nurses Association (NBNA) Day on Capitol Hill, an essential annual event held in Washington D.C., brings together African American nurses from across the nation each February. For over three decades, this forum has consistently attracted more than 350 nurses, providing them with a unique opportunity to engage directly with lawmakers and advocate for public health issues that significantly affect black and marginalized communities. The NBNA plays a crucial role in shaping legislation and policies that promote comprehensive strategies to address these critical health issues with our nation's congressmen and women.
In an effort to cultivate early interest in health policy among nursing professionals, the NBNA annually collaborates with nursing students from across the country, facilitating their participation in the Day on Capitol Hill. This year, the Stanford Medicine Black Nurses Association chapter proudly sponsored five new graduate nurses and one nursing student to attend the event, under the leadership of Dr. Michelle Y. Williams, Ph.D., RN, and with the mentorship of Christie Davis, MSN, RN, and Hillary Duncan, MSN, RN.
During their time on Capitol Hill, members of the SMBNA engaged in meaningful discussions with two prominent California Congressional leaders: Congressman Mark DeSaulnier of Contra Costa County and Congresswoman Zoe Lofgren of Santa Clara and Monterey County. They presented compelling data on the seven legislative priorities slated for consideration in 2024, seeking support for the sponsorship or co-sponsorship of bills that align with these priorities. Moreover, the team leveraged their expertise as nurses to advance the conversation on a wide range of public health issues.
The significance of the Day on Capitol Hill extends beyond advocacy; it underscores the vital role of nurses as healthcare experts capable of offering insightful recommendations on healthcare policy initiatives. This event not only allows nurses to engage with legislators about healthcare policies but also ensures that their voices are heard in the corridors of power.
We extend our heartfelt gratitude to Dr. Dale Beatty, Chief Nurse Executive of Stanford Medicine Healthcare; Dr. Michelle Y. Williams, President of the Stanford Medicine Black Nurses Association; and Dr. Grissel Hernandez for their invaluable support, which enabled our delegates to represent the Stanford Medicine Black Nurses Association in Washington DC effectively.
The American Nurses Association (ANA) believes that advocacy is a pillar of nursing. Nurses instinctively advocate for their patients, in their workplaces, and their communities; but legislative and political advocacy is no less important to advancing the profession (ANA).
Written By: Hillary Duncan, MSN, RN, CPHQ, PHN, AMB-BC, CCTC
Dr. Michelle Y. Williams and Christie Davis from Stanford Health Care with sponsored students for Day on Capitol Hill.
Dr. Michelle Y. Williams, Christie Davis, Hillary Duncan of Stanford Health Care with sponsored students meet with legislators.