7/21/2017 Rebecca Culver Clark, PhD, RN & Deborah Hodges, BSN, RN Carilion Clinic, Roanoke, Virginia The presenters for this presentation have disclosed no conflict of interest related to this topic 1. Discuss strategies to secure grants to fund research and evidence-based practice endeavors 2. Discuss an exemplar for writing and implementing a successful grant application 1
7/21/2017 Who has written a grant application? Who has been successful? Biggest fears? Identify your general goals or those of grantor You might just want to get funded ◦ Professional development, post-doc work ◦ Bucket list item Your professional organization has call to action You are working with a clinical area of interest (sepsis, immunizations, etc) You receive an RFP from an organization asking for submissions on a topic Circular process Write often Be comfortable with feedback Work with someone who has experience Consider being a reviewer for grant applications You can’t get funded if you don’t write/submit the application 2
7/21/2017 Research or not-research Academic or clinical Consider your education, expertise, and resources Educational criteria (MSN, PhD, RN) Previous funding success Facility infrastructure to manage grant funds Decide why you need the money Hardware/software? Postage? Etc Salary (PI, data collection, data analysis) Travel Meets criteria (for PI, organization, type of work) Submitted on time, page/word limit, key components included Generally graded on rubric by busy people! Looking for: ◦ New and different ◦ Significant and applicable to broad population ◦ Realistic ◦ Well written Aims match grant expectations Strategies consistent with aims Budget realistic and justified Addresses implementation and dissemination Start early Highlight/bullet important areas Charts to detail complex components Outline/matrix your application ◦ Aims match the goals ◦ Strategies are consistent with aims ◦ Budget is realistic and justified 3
7/21/2017 Timeline Goal Goal Aims Aims Strategies Strategies Budget Budget Coincidence ◦ Approached by employee of company (investigator-initiated funding) ◦ Priority funding area: pneumococcal immunizations Analysis of web site and criteria ◦ Much of focus on biological/bench science related to drugs, ◦ Window that looked at increasing immunization rate ◦ Did not specify “research” ◦ Asked for concept paper first 4
7/21/2017 Ensured that goal (increasing pneumococcal immunization rates) supported by organization Met with team of nursing leaders ◦ Was there interest in topic, clinical need? ◦ Were there areas that could serve as sites for study? ◦ Could we implement a study, track data? ◦ Did we have resources for managing/distribution of funds? ◦ PI with expertise and experience? What did we need money for? Primarily salary support 1. Type of work—Quality improvement study 2. Significance– Improve immunization rates 3. New and different—Ambulatory setting (Health education not so new!) 5
7/21/2017 Literature review: ◦ Gaps in knowledge: Affecting adult immunizations in ambulatory settings Project goal: Develop interventions to improve immunizations that can be implemented and sustained in ambulatory settings ◦ Aims: measurable ◦ Focus on patients and provider behaviors ◦ Educational flyer/health literacy considerations ◦ Scripting for providers Need for theory-based interventions, not one-off ◦ Planned change (Ajzen) ◦ Gained framed messages (Bartels, Kelly, Rotherman) ◦ Feedback and audit for providers Sample and setting ◦ Adult immunization levels for pneumococcal in VA 68%; Recommended – 90% ◦ Approximately 30,000 patients seen annually in pre-surgical testing site ◦ Screened 90%, immunized only 20% of at-risk patients Use of quality improvement data analysis ◦ Two years of data—baseline and intervention ◦ Controlled for seasonal variation ◦ Track impact of additive interventions (staff education and patient education) Project aims realistic and specific ◦ From 24% to 50% ◦ Sample size consistent with volume in PST Electronic medical record for data collection and reports Strong data analysis team & department for managing funding Budget ◦ Careful consideration of salary and time ◦ Did not request vaccines ◦ Money for participants in focus groups ◦ F & A Consultant (in-house) with expertise, reader, advice, great resume with lots of funding 6
7/21/2017 Read by many people Flow chart for writers/readers to understand relationships Use of charts to clarify complex flow of patients Cover letter that summarizes key points Goal Aim Strategies 1.Budget •Increase •Integrated •Focus group •Incentives for immunization education feedback participants rates •Pt ed flyer, • Role-playing •Staff 3rd grade education; education literacy scripting for time; snacks messaging •Gain-framed messages 7
7/21/2017 Implementation ◦ Fidelity to grant components ◦ Meet timelines for implementation, volume of participants ◦ Meet expectations for reports, both internal and external Dissemination ◦ Poster presentations ◦ Publications The next steps ◦ This grant was for $130,000 ◦ Based on this work, we wrote another grant application and received $170,000 Federal resources ◦ Health Resources and Services Administration (bhpr.hrsa.gov/nursing/ ◦ National Institute of Nursing Research (www.ninr.nih.gov/researchandfunding/dea/desp/oep/fundingopportunities#.V3VUD7g rLIU) Professional organizations (not inclusive) ◦ AONE ◦ Oncology ◦ AACN ◦ AORN Lists of/links to grant sources ◦ American Association of Colleges of Nursing (www.aacn.nche.edu/faculty/funding- opportunities) ◦ Sigma Theta Tau (www.nursingsociety.org/advance-elevate/research/research-grants) Foundations ◦ Robert Wood Johnson (www.rwjf.org/en/how-we-work/grants/funding- opportunities.html) ◦ American Nursing Foundation (ANF) Investigator-initiated grants, Drug and product evaluations Organizational supports (internal grants) 8
7/21/2017 Deborah Hodges BSN, RN, CAPA Rebecca Clark, PhD, RN Dr. Rebecca Clark, PhD, RN, Principal Investigator Julie Jackson, RN IV Project Leader Deborah Hodges BSN, RN CAPA – Project Leader Brenda Gilliam MSN, RN MS HCA, CAPA, Unit Director ORS A Me Merck P Pharm armaceu ceuticals icals g grant s ant supported orted t this is IRB-determ termined ined quality i ality improv ovemen ement p t projec ect. t. Discuss key components of a grant funded project implemented in a Pre-surgical Testing setting. Discuss strategies to aid in staff motivation and participation in the project. 9
7/21/2017 CDC R Recommendatio mmendations: ns: Adults 65 years of age and older, adults age 19-64 with chronic diseases and/or smokers should receive a pneumococcal vaccination. Pre-surgic e-surgical V al Volume: me: Approximately 2500 patients per month seen prior to surgical procedure. Vacci Vaccination R Rate: te: In 2012, our pneumococcal vaccination rate was 24%, with a significant number of eligible patients not successfully immunized (76%). Centers for Disease Control and Prevention. Epidemiology and Prevention of Vaccine-Preventable Diseases. Accessed November 20, 2015 Departmental and Individual Goal: Increase immunizations to 50% of eligible patients Develop evidence-based tools and processes for improving immunization rates Share effective strategies with other ambulatory settings Educa Educatio ion n for Pre- for Pre-surgic ical al St Staff aff CDC guidelines for pneumococcal vaccination Common misconceptions regarding the vaccine Role playing with scripted answers Use of gain-framed messages emphasizing health promotion Review of proper completion of pneumococcal screening tool in EMR. 10
7/21/2017 Reinforcement an forcement and Fe Feedback back Leadership established departmental and individual goal of immunizing 50% of eligible patients Immunization rates tracked monthly, reported to staff highlighting individual and group achievements Gift cards awarded to nurses with highest vaccination rates Targeted e eted education f ation for p patient ents Created informative flyer developed from focus group feedback Placed pneumococcal vaccine promotion posters in PST visit rooms and check-in area Engaged clerical staff to provide flyer and encourage patients to read information while waiting for visit with nurse 11
7/21/2017 An Annual pneumococca eumococcal immuniza l immunization rat tion rates 2012-2 2012-2015 2012 = 2012 = 24% 24% 2013 = 2013 = 43% 43% 2014 = 42% 2014 = 42% 2015 = 2015 = 53% 53% 2015 focus: Re-engag 2015 focus: Re-engage e staff staff in in initia initiative Merck Pharmaceuticals provided updates on current CDC recommendations for pneumococcal vaccination. Interactive staff conference to solicit staff input for declining rates Monthly individual vaccination rates were emailed to staff by leadership 12
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