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NURSING OUTLOOK MAY/JUNE 2000 127
SchmiedingMinority Nurses in Leadership Positions: A Call for Action
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The National Institute of Nursing Research has entered the21st century with the momentum of a 28.5% increase in
budget. This increase will allow us to capitalize on opportuni-ties identified by the scientific community of nurseresearchers. The next fiscal year’s budget activities began withthe release of the President’s budget for 2001, which providesa 3.3% increase or $2.9 million (total acquired immunodefi-ciency syndrome and non–acquired immunodeficiencysyndrome) funding for NINR. The overall average increase forall Institutes and Centers of NIH is 5.6%.
In testimony before the House Appropriations Subcommittee*on March 2, 2000, I emphasized that in this period of rapid tech-nologic and demographic change, it is critical that nursingresearch grow to meet the present and future health care needsof Americans. I presented achievements and goals for fiscal year2001 related to these concerns, especially in the areas of chronicillness, end of life, and health disparities.
Regarding chronic illness, NINR plans to expand researchto help patients manage their conditions. Progress in this areais encouraging. In one recent accomplishment, nursingresearch has further tested and confirmed the value of a tran-sitional care model with a multidisciplinary team andadvanced practice nurses. The results of this study clearly indi-cate that 6 months after discharge, the intervention group, inthis case older adults with common medical and surgical prob-lems, spent fewer days in the hospital and had fewer rehospi-talizations, at a total savings of nearly $600,000 to the healthcare system. Widespread use of this model could save signifi-cant health care dollars and improve quality of care.
Most nursing research is clinical in nature and is carried outin settings that range from the hospital to the community.Nurse investigators are studying concerns the use of feedingtubes that are required to provide nutrition in many conditionsof acute or chronic illness. They have discovered that a simple
rapid chemical test of aspirated feeding tube contents is a moreaccurate alternative to use of a stethoscope, and a safer and lessexpensive alternative than radiographs. Clearly, it is also moreconvenient for use in homes or long-term care facilities.
Just as biomedical advances are changing the way we livewith illness, they are also changing the way we die. The dura-tion of both chronic illness and the dying process is nowprolonged. NINR is the lead institute for coordinating end-of-life/palliative care research at the NIH. Studies that werefunded in response to the Request for Applications for researchon end of life last year will form a basis on which to build animportant, growing effort. In fiscal year 2001, we plan toexpand our focus on end of life to better understand andimprove symptom management, decision making, andcommunication between patient, family, and the health team.
With regard to health disparities, our efforts are directedtoward closing the gap. Historically, nursing research hasfocused on minority health issues. Currently, about 20% ofour budget is directed toward this area. In fiscal year 2001 wewill focus particularly on diabetes self-management and theinfluence of ethnic and cultural differences on health. Anexample of progress in our efforts to reduce health care dispar-ities is a study in which nurse researchers adapted an arthritisself-help questionnaire for Hispanic patients. Throughout a 1-year period of follow-up, patients experienced significantimprovements in mobility, pain, fatigue, and depression.Another version of this program is currently being tested inHispanic populations with other chronic illnesses, and it hasthe potential to be expanded throughout the United States.
Finally, we continue to emphasize training and careerdevelopment. Building nursing research capacity remains animportant challenge.
In conclusion, continued growth of nursing research is vitalto meet public demands and pressing national health needs.Our contributions to the scientific foundation for the work ofhealth care practitioners, including the 2.5 million nursesthroughout the United States, are already making a differenceand have further significant potential to do so. ■
Patricia A. Grady, PhD, RN, FAAN, Director, NINR, NIH
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*The complete opening statement may be accessed on the NINR Web site(www.nih.gov/ninr).