Summer 2011 Building Better Health A Farewell to Dean Melnyk In this issue... 2 6 Retrospective: Dean Melnyk leaves legacy of innovation, interprofessionalism and inspiration. 1 The Dean’s Farewell 2 Retrospective on the Dean Melnyk Years The State of Nutrition at ASU 6 Nutrition Program Opens New Downtown Kitchens 10 Alumni Look Back and Forward Building Better Health: The Nutrition Program moves up by moving down (town). 14 Student View on Program Value 16 National Nutrition Leader Evaluates Profession Prospects The Focus on Better Mental Health 24 17 Obesity and Mental Health Imperil America’s Children 19 NIMH Selects ASU as only Outreach Partner for Arizona Health Promotion: The college’s Health Promotion program offers a unique interdisiciplinary PhD option second to none. 21 Nursing Course Project Inspires Seniors to Form “Active Minds” 24 One More than Most: The Third PhD Option 28 Exporting Evidence-Based Practice to China 32 35 30 Helping Advance Nurse Education and Healthcare in Cambodia 32 A Legacy of Class: Ann and Tom Van Slyck Alumni Legacy: Ann and Tom Van Slyck leave a legacy of 34 Student Nursing Spotlight: Erica Saunders class for future nursing students. 35 Turning the Tables on Pneumonia among the Elderly 37 Nursing and Design Students Learn “Built Design” Together 39 Lactation Education Makes for Healthier Children Turning the Tables on Pneumonia among the Elderly 41 A Celebration of Your Giving 42 News that Matters... On the Cover: The building blocks for improved health outcomes are more interprofessional and integrated than ever. Arizona State University College of Nursing & Health Innovation Innovations in Nursing & Health is published twice a year by the College of Nursing & Health Innovation at Arizona State University for alumni, friends of the college, national nursing and health promotion leaders, students, faculty, and the media. MISSION Our mission is to produce a publication of high-quality editorial news content and creative design to communicate the educational, research, and evidence-based initiatives of the College of Nursing & Health Innovation to its key audiences. Dean and Distinguished Foundation Professor in Nursing Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN Editor R. Terry Olbrysh Director of Marketing 500 N. 3rd Street Phoenix, AZ 85004-0698 602-496-0877 nhimarketing@asu.edu Senior Editor/Graphic Design Juliana Murphy Campbell WEBSITE http://nursingandhealth.asu.edu The College of Nursing & Health Innovation at Arizona State University is fully accredited by the Commission on Collegiate Nursing Education (CCNE) for its baccalaureate and master’s degree nursing programs through June 2014. Its new Doctor of Nursing Practice Program recently achieved a full, five-year accreditation from CCNE (the maximum years available for a new program) through June 2016. The Arizona Board of Nursing has also approved these programs. The Dietetic Concentration of the BS in Nutrition has been granted Accreditation by the Commission on Accreditation for Dietetics Education of the American Dietetic Association (ADA). The Dietetic Internship program also is currently Accredited by the Commission on Accreditation for Dietetics Education of The American Dietetic Association (ADA), 120 S. Riverside Plaza, Suite 2000. Chicago, IL, 60606-6995, 312/899-0040 ext. 5400. Dean’s Message T his is the most challenging or what I call “character-building” message that I have had to write in my 6½ years as dean of this phenomenal College of Nursing & Health Innovation. As I reflect upon my tenure here as dean, I am overwhelmed by a flood of intense mixed emotions as I think about leaving a college and team of superb faculty, staff, students, alums and community partners who has accomplished so many dreams together and, at the same time, filled with tremendous gratitude for the time that we have had together. About a year ago, an alumnus brought me a picture of a flying pig and said that, when I first came to our College and talked about all the innovative big dreams that we were going to accomplish together, there were skeptics who said, “That will happen when pigs fly!” She then went onto say, “Pigs are now flying—we believe.” For those of us who are big dreamers, the road is often lined with people who try to take our dreams away by focusing on the obstacles and how tough it is going to be to accomplish those dreams. However, I have always said and mentored you to “keep your dreams bigger than your fears and the negative comments surrounding you, stay focused on those dreams every single day, and persist through the “character-builders” until your dreams come to fruition.” We have done exactly that here at our College and have accomplished so many dreams in such a short period of time that others thought were impossible. Risk is an inherent part of accomplishing big dreams. I have encouraged you to take many risks throughout my time here as dean. The most successful individuals in this country are the ones who have taken the biggest risks. I personally have risked a lot and often in my career. Six years ago, I took a risk to leave a place where I had a great team and wonderful friends to come here with my family to the “wild west.” In reflecting back over the years here, it was definitely the right decision at the right time for it blessed me with the opportunity to work with all of you in meaningful and impactful ways. I have grown tremendously personally and professionally as a result of my time with all of you. Now, although it was a tremendously difficult and bittersweet decision, it is time for me to risk again and pioneer a new role of Associate Vice President for Health Promotion, Chief Wellness Officer and Dean of the College of Nursing at The Ohio State University. Although some corporations and health systems across the country have created the position of Chief Wellness Officer, this is believed to be the first one of its kind at a University. The launching of this role could not come at a better time with the rapidly rising rates of overweight/obesity, work place stress, and mental health disorders along with escalating healthcare premiums in Universities and communities across the nation. It has been a long time dream of mine to create the healthiest University in America and to demonstrate positive outcomes with innovative initiatives that could become a national model to improve health and wellness outcomes for University faculty, staff and students. Although I was not looking to leave ASU when this opportunity knocked at my door, it is a risk that I need to take despite the fact that this was the most gut wrenching decision of my career. In these times of risk and change, I like to remember Andre Gide’s quote, “Man cannot discover new oceans unless he has the courage to lose sight of the shore.” We all must have courage and optimism that new oceans will be discovered as a result of the winds of change currently facing us. We have risked a lot and achieved tremendous accomplishments together—those for which we can be very proud. I often told you in meetings that success is going from one failure to the next with enthusiasm, and to get excited when a door was closed or someone said “no” to us because we had to hold firm in the belief that success was right around the corner. Each of you has enriched my life and this college in a special and meaningful way, and for that, I will always be very appreciative. For those of you who have been with me throughout this journey, I am especially grateful for your belief in me and us as a team along with your willingness to embark on a continuous whirlwind of change. As a pediatric nurse practitioner, I have humorously commented that the only person who likes change is a baby with a wet diaper. Although not easy for you, I give you tremendous credit for embracing the changes that were implemented in my tenure here as dean and for always placing the greater good of the College before your own individual preferences. Our culture here is the best I have ever experienced in my career as it is not only one of innovation where people believe they can indeed accomplish their dreams and goals, but one in which there is a family of individuals who truly care about and support each other. I am not going to say goodbye. I will only say “so long” and be your best fan from afar. I am confident that you will continue to dream, discover and deliver wonderful new dreams for this College and each other as well as care about and support one another through the changes that lie ahead. Remember, with change also comes opportunity. I believe in you and your ability to stay together as the terrific supportive team that you are today. A quote by Flavia Weedn says, “Some people come into our lives and leave footprints on our hearts and we are never ever the same.” I want you to know that I will never be the same as a result of the many footprints that you have left on my heart, which have helped me to grow tremendously, both personally and professionally. Words can never express my never-ending gratitude to each of you for those footprints and for all of your tremendous efforts during my tenure as dean. I will always wish you life’s very best and hold you close in heart. Fondest regards, Bernadette Mazurek Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN Dean and Distinguished Foundation Professor in Nursing 2005-2011 Summer 2011 1 Retrospective: n Building Better Health Dean Bernadette Melnyk’s Achievements at ASU A Mountain, Not a Mark... Providing care at the new downtown clinic With College's 1st dean, Loretta Bardewyck The First EBP Center team Toasting move to downtown campus M ost deans leave their mark on the colleges they lead. But Dean Bernadette Melnyk left a mountain in terms of achievements during her six-year tenure at the College of Nursing & Health Innovation at Arizona State University. Hailed as “Monsoon Melnyk” shortly after arrival, she put in place a five-year strategic plan within 90 days and led her team to complete it in three years. During her time at ASU, the strong winds of innovation with impact never waned. With “Bern” Melnyk leaving for The Ohio State University as Associate Vice President for Health Promotion, Chief Wellness Officer and Dean of the College of Nursing, now is the appropriate time to take an accounting of what she accomplished at ASU since January 2005. As the fifth dean in the 53 year history of the college, Dean Melnyk was first and foremost a visionary. She was true to her own definition of a visionary as “someone who sees innovations and solutions before others realize the problems.” With that definition, she touched every part of the college and many parts of ASU. She would be the first to say that everyone else deserved the credit but everyone else would say that only Bern could see what accomplishments were there for the making. The pediatric and child psychiatric-mental health nurse practitioner cum dean started off with a flash. She spearheaded the college’s move to the new ASU Downtown Phoenix campus in August 2006 to take advantage of larger, more modern facilities. In 2007, she was the life of the party by celebrating the 50th anniversary of the college and celebrated by inaugurating the Dream, Discover and Deliver awards for healthcare leaders. By April 1, 2008, she was breaking ground for an 84,000 square foot building by operating an industrial grade back hoe… Hence the name, “Back Hoe Bern.” In whatever she did, the dean was memorable. Academic Impact Bern’s impact on academic programs in the college alone could fill an article. She first started by expanding faculty ranks and recruited 42 new members. She imbued newcomers with the risk-taking culture of “Dream, Discover, Deliver” and going through ‘character-building’ times with persistence to success. Research Impact She pioneered so many national firsts that the list seems endless: the first interdisciplinary Master of Healthcare Innovation program, the first graduate certificate to prepare Child and Adolescent PsychiatricMental Health Intervention Specialists, the first on-line faculty mentored continuing education program in child and adolescent mental health, and the first graduate certificate in Evidence-Based Practice and a nationally renowned EBP Mentoring Program with long-time colleague Dr. Ellen Fineout-Overholt to name just a few. In 2007, the College received one of only nine Hartford Centers of Geriatric Nursing Excellence with a mission of building geriatric nursing faculty. Under her leadership, the college launched a hybrid distance learning Doctor of Nursing Practice (DNP) Program with baccalaureate entry in January 2009. It grew to more than 140 students in three years and counts among its graduates the current President of the American Academy of Nurse Practitioners. With its first two years, the program expanded by adding Psychiatric-Mental Health and Geriatric Advanced Practice Tracks. Just before this magazine went to press, the College received notification that its DNP program had been accredited by CCNE through 2016. Bern Melnyk’s middle name could have been interdisciplinary given those types of programs that she launched during her tenure. For example, she opened the PhD in Nursing program to other disciplines, added innovation to its curriculum, and dubbed it the PhD in Nursing & Healthcare Innovation. A CEO and an MD were soon enrolled. She formed the only academic collaboration with the Food and Drug Administration for a college of nursing in the U.S. to prepare master’s candidates in Regulatory Science and Health Safety. She partnered with Phoenix College to keep a Medical Science Laboratory program that would have otherwise closed. Under her tutelage, academic programs grew from 6 to 26 and clinical teaching facilities for the nursing simulation center tripled in size and added a pediatric wing. The net result of this plethora of efforts is that the College of Nursing & Health Innovation graduate nursing program moved up to 21st in the 2012 U.S. News & World Report peer-rated rankings of 467, or in the top 4 percent in the U.S. In total, the college advanced 18 positions in the rankings during her tenure. Research Impact It is impossible to know Bernadette Melnyk without knowing that Research with a capital “R” is one of her greatest passions. She is all about improving health outcomes through evidenced-based practice and data. While dean, she has served as one of 16 members of the United States Preventive Services Task Force, which makes gold standard evidence-based screening and behavioral counseling recommendations for primary care providers across the country, and a standing member of a NIH/National Institute of Nursing Research grant review study section. Her personal research track record is an inspiration to others – more than $11 million in extramural research and educational funding, including grants from the National Institutes of Health (NIH), the Agency for Healthcare Research & Quality, and HRSA. To improve ASU’s research funding, the dean recognized the need to build an infrastructure that freed up researchers from administration and faculty responsibilities to do what they do best – research. With that done, she recruited several nationally recognized research faculty and built seven centers of excellence that cover the lifespan, as well as evidence-based practice, clinical trials, and world health. Dean Melnyk also added endowed professorships in pediatrics and geriatrics to honor revered former faculty “B” Steffl and Nancy Melvin. Healthcare research is about numbers and improving patient outcomes. Dean Melnyk achieved both. The College of Nursing & Health Innovation at Arizona State University did not have any NIH funded grants when she arrived in 2005 and, therefore, no NIH ranking. The dean is leaving the College with a robust research program with NIH rankings in the Top 15 overall and #1 for a college of nursing that is not part of a medical center for 2009 and 2010. Cumulative funding for federal government grants from 2006 to June 30, 2011 is $28.7 million compared to just under $2.1 million in 2005. The total of funded research grants increased from 9 to 75 for the same time range while the total for all kinds of grants funded went from 17 in FY06 to 131 in FY11. In addition to $11.6 million in NIH-funded grants, the College has been awarded more than $17 million in grants from HRSA, other government agencies, private foundations, and corporations since 2005. The size of grants also increased with the largest ever NIH grants of $2.5 and Dean’s Melnyk’s $2.3 million grant respectively. The Dean Team Bern’s own research was recently recognized with the NIH/National Institute of Nursing Research Director’s Inaugural Research Lectureship Award, which was delivered at NIH in January of 2011. Bern and her research also will be recognized as she is inducted into Sigma Theta Tau International’s researcher hall of fame this summer. Broad Range of Research Projects The range of faculty research grew in breadth, depth and diversity from 2005 to the present, all the while focused on improving health outcomes. Active NIH funded research studies include the study and prevention of co-morbidities of obesity and depression among adolescents, working with Mexican-American families to care for elders in the home, removing barriers to exercise and physical activity among older Hispanic women, interventions to address increasing obesity among Hispanic women that puts them at high risk for major diseases, and research of asthma disparities of Latino children in the Southwest and the Bronx in New York. Despite the fervid pace, the dean still found time to mentor young researchers as well as PhD and DNP students as well as post-doctoral fellows. Bern ushers in new college era Toasting the Opening of NHI2 Building Clinical Initiatives Dean Melnyk’s passion for research has a purpose to transfer findings to improve patient outcomes in NIH grant study team Unveiling Major Donor wall With 17th US Surgeon General Richard Carmona, MD 2011 EBP workshop in China 50th Anniversary Reception kickoff event Healthy AZ NOW 2010 Hosting weekly radio show KYSS Dance-a-Thon KYSS Dance-a-Thon Homecoming 2009 In NICU for COPE research n clinical practice. Consequently, Bern’s achievements in clinical initiatives were intertwined with her research. In 2006 with the college’s move to the new downtown campus, the dean launched a nurse practitioner managed health center to provide primary care for students, faculty and staff. It ranks as the first time in ASU history that the college was responsible for student care. She and Associate Dean Denise Link, PhD, RN, WHNP, also worked together to assure the health center offered integrated physical and mental healthcare – a model of how Dean Melnyk believes primary healthcare should be delivered. She expanded on this belief by founding the Southwest Health Center for the Prevention and Treatment of Child & Adolescent Depression and Anxiety Disorders within the downtown center. This string of clinical and research initiatives and partnerships earned the College selection as an NIMH Outreach Partner for Arizona – another first for a US college of nursing. Innovation, Entrepreneurship and Transdisciplinary Woven through Initiatives Whether academic, research or evidence-based practice, innovation became a cardinal principle for degree program directors and researchers to weave into their studies. The word and innovation workouts were ubiquitous in the college. It was in the college name and programs such as the Master of Healthcare Innovation, the PhD in Nursing & Healthcare Innovation, and the Center for Healthcare Innovation & Clinical Trials. Bern carried innovation into work with strategic partners such as the Macy Foundation interprofessional education planning project, which is creating a curriculum to educate nurse practitioners, physicians and pharmacists for a substantial portion of their curriculum together. The first research based community network for clinical trials in the nation was formed during her tenure as dean and is now partially funded through a partnership with Quintiles, the largest contract research organization in the country. She also led the successful integration of the nutrition, exercise/wellness, kinesiology and health sciences units into the College. 4 The Melnyk Years: Building Better Health A Personal Assessment Then there is Bern Melnyk the person. Bernadette Melnyk was as good a person as she was a dean. Born a Pennsylvania coal miner’s daughter, she has never forgotten her beginnings. She astounded superiors, peers and subordinates with her work ethic, energy, passion and compassion. A born optimist, she had a smile for everyone and words of encouragement on even the most difficult days. Anger was not part of her make-up. Like Will Rogers, she never met a person she didn’t like. Selected College and Personal Accomplishments Certainly the strengths which most marked Bern Melnyk’s tenure at ASU are optimism, risk taking, and persistence. The most provocative words that you could utter to her were ‘You can’t do that.’ For her six years at the ASU College of Nursing & Health Innovation, she could, and she did. Dean Melnyk’s time at Arizona State University was momentous—from the first to the last minute. She will long be remembered as the dean who in partnership with an exceptional faculty, staff and group of community and external partners led a major transformation of the College to one of high profile innovation with impact across research, education and practice. n Groundbreaking with Mayor Phil Gordon Make Just 1 Change for Healthy AZ Now • Five-year strategic plan created and implemented • Established Center for the Advancement of Evidence-Based Practice • Launched the Arizona Consortium for Advancement of EBP (first statewide EBP consortium). • 23 new faculty recruited to the college 2006 FDA partnership for Regulatory Science and Health Safety degree program • Established Center for Improving Healthy Outcomes in Aging • Established the Center for Improving Health Outcomes in Children, Teens & Families • Launched the nation’s first Master in Healthcare Innovation degree • Moved to the new ASU Downtown Phoenix Campus; name of college changed • Technical Cooperative Agreement with the Pan American Health Organization established • Received HRSA $1.3 million grant for a new child-family psychiatric nurse practitioner program (Melnyk, PI) • First ASU Health Center under administration of the college opened on the downtown campus 2007 Pan-American Health Org. Partners Edgerunner Award for program that helps parents 'COPE' Innovations in Nursing & Health First MHI cohort ASU College of Nursing & Health Innovation 2005-2011 2005 As one of the first senior faculty that Dean Melnyk recruited to ASU, Colleen Keller, PhD, RN-C, FNP, FAHA, FNAP, Foundation Professor in Women’s Health and Director, Hartford Center of Geriatric Nursing Excellence and the Center for Healthy Outcomes in Aging is in a good position to evaluate the Dean’s contributions to the College and University. “Dean Melnyk has consistently served as a role model in implementing ideas that embodied the highest standards of professionalism, integrity and consideration of faculty and staff,” Professor Keller said. “She brought us recognition, raised expectations of faculty achievements, developed leadership in amazing quarters of the college, and accomplished her vision with optimism and kindness.” dream • discover • deliver With Governor Janet Napolitano With former deans Durand and Murphy at 50th Anniversary Gala • Approval granted to change the DNS program to a PhD program • Center of Healthcare Innovation & Clinical Trials launched with funding from the Kaufmann Foundation • First-of-kind innovative online Graduate Certificate for Child & Adolescent Mental Health Intervention Specialist offered • Agency for Healthcare Research & Quality funds first pediatric evidence-based practice leadership summit (Melnyk, PI) • First Evidence-Based Practice Graduate Certificate in the nation offered • College celebrates its 50th anniversary • Hartford Foundation Awards college grant to fund the Center of Geriatric Nursing Excellence — one of only nine in the US • Dean Melnyk named to the U.S. Preventive Services Task Force • First Latin American Summit on Evidence-Based Practice held 2008 • Launched Doctor of Nursing Practice program with baccalaureate entry option • Ground broken for $32 million NHI2 Building • First annual Dream • Discover • Deliver national awards presented • Indian Health Service renews $1.7 million grant for American Indian Students United for Nursing (ASUN) program • HRSA funds the nation’s first online faculty mentored mental health continuing education KySSsm Fellowship Program in Child and Adolescent Mental Health for primary care providers (Melnyk, PI) 2009 • College changes name to reflect integration of Health Promotion programs and broader mission • 'New Era Dawns' for ASU College of Nursing & Health Innovation with opening of 84,000 sq. ft. NHI2 building • First cohort of masters-prepared DNP students graduates • Southwest Mental Health Center opened to treat increasing rates of mental health disorders among Arizona’s children and teens • Access for RNs to ASU baccalaureate programs expanded through innovative All Online Option 2010 • ASU Nursing Cracks Top 15 in NIH Research Funding for first time • NIH awards ASU $2.3 million grant to study the COPE Healthy Lifestyles TEEN program to reduce teen obesity and improve mental health (Melnyk, PI) • Center for Healthcare Innovation & Clinical Trials receives ASU President’s Award for Innovation • Unique partnership with the FDA formed to offer Regulatory Science and Health Safety MS program — the FDA’s first academic partnership with a college of nursing • Funded alliance formed with largest global Clinical Research Organization (CRO) to accelerate clinical trials in Arizona • ASU and Phoenix College collaborate to offer innovative Medical Laboratory Science Program • Dean Melnyk selected to receive the inaugural NINR Director’s Lectureship award at NIH • Josiah Macy, Jr. Foundation funds planning grant to develop an integrated curriculum to prepare primary care nurse practitioners, physicians and pharmacists • Dean Melnyk recognized by American Academy of Nursing with Edgerunner Award for her COPE program for parents of preterm infants • Southwest Consortium for Health Promotion & Behavior Change established • 2010-2015 Strategic Plan completed and implementation began 2011 • US News & World Report peer-reviewed rankings place college 21st or in top 4 percent of graduate nursing programs in US, highest ranking in its history • ASU and college hold high profile Child Health Forum in Washington at the National Press Club • Dean Melnyk hosts a weekly radio show on health topics to bring the best and latest evidence to the public on a variety of health issues • College selected as National Institute of Mental Health Outreach Partner—the only college of nursing with this status • College receives its first NIH-T32 Training Grant in Health Disparities • DNP program receives full 5-year CCNE accreditation • Dean Melnyk selected to Sigma Theta Tau International’s Research Hall of Fame Summer 2011 5 n dream • discover • deliver Building Better Health Nutrition Moves Up By Moving Down(town) The kitchen design and construction project was completed in only five months, Johnston said. The kitchens have a sustainable “green” design that provides natural daylight and direct sight lines between the students and the instructor. Wall insulation was made from recycled blue jeans. According to Lecturer Simin Levinson, MS, RD, the kitchens contain state-of-the-art professional-grade large and small appliances that are built to withstand years of use while being aesthetically pleasing. “The instructor station in the instructional kitchen is wired with two ceiling mounted cameras that can project images from the instructor’s stove and countertop to the flat screen monitors mounted at each lab station,” Levinson explained. “Each flat screen monitor is mounted on a swivel arm allowing it to be moved for optimal viewing. In addition, the instructor can plug in a laptop computer or other HDMI (High-Definition Multimedia Interface) device to project images and video/sound content to the monitors. There is a high-quality wireless microphone that projects sound throughout the room, allowing the instructor to walk around the kitchen lab space while talking to the entire class.” The new instructional kitchens are particularly important to the professional development of students in the Dietetics concentration. Executive Dean Craig Thatcher, DVM, PhD, said the undergraduate Didactic Program in Dietetics is the second largest in the U.S. in terms of enrollment, representing 60 percent of Nutrition students. “The integration of the program into the College of Nursing & Health Innovation combines health promotion and healthcare in one academic unit, which are both essential for keeping people healthy and improving patient outcomes,” the executive dean said. D ifficult times can make for strange bedfellows. Reductions in state funding led Arizona State University to seek organizational efficiencies by combining various schools and academic programs into other existing colleges. Such was the case in May 2009 when the Nutrition program, along with Exercise and Wellness and Health Sciences, were consolidated into the then named College of Nursing & Healthcare Innovation. Kinesiology joined the three programs a year later. What may have been born of economic necessity has blossomed and sparked enrollment growth in the Nutrition program, a greater emphasis on intra-professional education for the college, and expanded opportunities for research and community service projects. Investment in Instructional Labs The most recent and visible outcome of the merger has been the opening of new Nutrition Instructional Kitchens on the ASU Downtown Phoenix Campus. The state-of-the-art facilities and equipment are used to educate 300 students annually and replace kitchen labs 6 Innovations in Nursing & Health More than Bricks and Mortar at the ASU Polytechnic Campus that were more than 50 years old. “We envision the new kitchens being a landmark on the downtown campus,” said Carol Johnston, PhD, RD, Nutrition Program Director.” “Not only are these kitchens state-of-the-art, energy efficient and environmentally sound, they are spectacular and visually bold. Needless to say, we are ecstatic.” It is not just new facilities that define the relationship between health promotion and healthcare. There are other factors that also have come into play that paint a positive future for Nutrition and the college as a whole. With time, the various programs in the expanded college have found more in common that makes for close collaboration. Nutrition Enrollment Growth Continues The last complete kitchen renovation occurred in the 1950’s when the ‘home economics’ building was constructed on the ASU Tempe Campus. When the nutrition program was moved from the Tempe to the Polytechnic campus in 2000, only minor renovations were made to these kitchens - basically updating the stoves/ovens and fume hoods. While undergraduate nursing enrollment has been capped at 220 due to costs of clinical instruction and a national shortage of nursing faculty, Nutrition enrollment has continued to grow after the merger of the programs two years ago. Nutrition enrollment stands at 700 compared to 570 in 2009. The annual growth rate of 20 to 30 percent is unabated. The new 5,100 square foot facility houses an instructional food laboratory with computer monitors at the student stations, instructional retail and commercial kitchens, a multi-purpose room, and offices. The kitchens are located on the ground floor of the NHI1 building on the downtown campus. Students also benefit from the move of Nutrition into the College of Nursing & Health Innovation and to the ASU Downtown Phoenix campus. The campus is more centrally located allowing greater access to students across the Valley, according to Nutrition Program Director Johnston. “The centralizing of all health Summer 2011 7 dream • discover • deliver majors to one college also strengthens cross-discipline interactions for students and faculty,” Johnston added. The Nutrition program also added a new MS degree option with an emphasis in Dietetics in fall 2009. This degree was developed to address needs expressed by nutrition professionals in the community. In May 2011, Nutrition will graduate its second MS Dietetics student and anticipates graduating 2-3 students per year as this program becomes established. In addition, a second Dietetic Internship option has been added for ASU graduates pursuing the credential of Registered Dietitian. The stature of the Nutrition Program has become more recognized since its incorporation in the College of Nursing & Health Innovation, Associate Dean Linda Vaughan said. The program has had a strong national reputation for its rigor, depth, and breadth. Students who complete the dietetics concentration are extremely well prepared for their Dietetic Internships, and Dietetic Internship directors across the country comment on how well prepared ASU students are. ASU Dietetic students recently competed in a “College Bowl” and were very successful in the competition, coming in fourth. Students who use the Human Nutrition concentration as their route to graduate school, medical/dental/osteopathic and other professional schools are also very well prepared. The program emphasis remains on applied nutrition as opposed to specializations such as cellular metabolism. As part of a college of nursing ranked in the top 4 percent by its peers, the ASU nutrition program has enjoyed a higher degree of awareness. It was recently listed as the sixth most popular nutrition program in the country in a recent survey that can be read at: http:// www.campusexplorer.com/colleges/ major/FE9B340E/Nutrition/EE31E679/ Foods-Nutrition-and-Wellness-Studies/. 8 Innovations in Nursing & Health Nutrition Research Initiatives Complement Nursing ASU nutrition researchers focus on practical aspects of healthy diets and have developed intervention strategies that can be implemented immediately by individuals to reduce disease risk. In this respect, Johnston said nutrition research complements the preventive objectives of nursing science. Nutrition research focuses on practical aspects of healthy diets, such as simple food substitutions to enhance diet quality and reduce risk for disease: pinto beans for reducing blood cholesterol, vinegar or almonds for reducing blood glucose concentrations in diabetics, mushrooms for reducing cancer risk, and cherry juice for reducing blood triglyceride concentrations. Vitamin C research at ASU has demonstrated the antihistamine properties of supplemental Vitamin C (useful for reducing cold and allergy symptoms) as well as the ability of Vitamin C supplements to promote the oxidation of body fat, a property that may influence weight loss success and exercise tolerance. Strategies to improve diet and nutrition knowledge among low-income Phoenix residents represent another focus of nutrition research. One ASU investigator is currently funded by the U.S. Department of Agriculture to develop a farmer’s market network across Arizona to promote local foods. Linda Vaughan, PhD, RD, associate dean for health promotion programs, sees even more benefits in the future. “Nutrition also is a healthcare profession and the term ‘medical nutrition therapy’ reinforces this relationship, Vaughan explained. Registered Dietitians (RDs) are key members of healthcare teams, whether they are hospital- or community-based. They are critically important in the care of pre-term babies, burn and post-surgical trauma patients, recovering cancer patients, and those with kidney, heart, infectious and other diseases.” in preventing and/or blunting the development of chronic diseases such as obesity, type 2 diabetes, heart disease, certain cancers, stroke, age-related disorders of the eyes, etc. Many nutritionists in health promotion work side by side with nurses in community/public health clinics, community-based agencies and programs that serve the elderly, children, the homeless, and other vulnerable populations. Nutrition Gives Back to the Community Like nurses, nutritionists give back to the community. Carol Johnston, director of the Nutrition program, said the community and general public benefit from ASU nutrition programs because a large segment of the nutritionists and registered dietitians who work in healthcare and for food service enterprises in Maricopa County are educated locally. In addition, nutrition faculty conduct many hours of community service in the county, including speaking engagements for various public and private agencies/programs and serving on advisory boards or other local committees to promote healthy lifestyles. In addition, several faculty members hold national leadership roles in prestigious professional organizations. ASU faculty are extremely active as leaders in the Arizona and American Dietetic Associations. As RDs, these faculty are aware of the breadth of job opportunities and many themselves have come to academia after working in clinical, community, foodservice management, and other fields of dietetic practice. Students are also mentored into other professional organizations that are related to the field of dietetics such as the American College of Nutrition, the American College of Sports Medicine, the American Society of Parenteral and Enteral Nutrition, and the American Diabetes Association. Future Opportunities Vast From Linda Vaughan’s perspective, nutrition students will benefit n the near future from their involvement with intra-professional education, e.g., taking courses on medical/health ethics, research, cultural aspects of health, and other courses with a range of students from the other four disciplines in the college. In addition, college support services have helped nutrition faculty in their research initiatives, something that was lacking in their former School of Arts and Applied Sciences. The Simulation Labs used to clinically prepare nursing students also offer numerous learning opportunities for nutrition students in the Dietetics concentration. These students typically pursue the Registered Dietitian (RD) credential, a process that mandates completion of an accredited Dietetic Internship. During the internship, students complete a certain number of practice hours in clinical settings such as hospitals, long-term care centers, community health clinics, and similar patient/client service sites. The simulation lab provides undergraduate dietetics students with the opportunity to assess or evaluate “patients” that are programmed to reflect disease states such as heart disease, trauma, diabetes, high blood pressure, or intestinal diseases. They will be able to develop or enhance skills related to measurement of blood pressure, observe the process of placing feeding tubes, develop skills related to palpation, a technique used to assess sites of tenderness, organ enlargement, skin texture, etc., and other measures related to nutritional status. In addition, dietetics students will be able to interact with nursing students to develop interprofessional communication skills that will prepare them for their future work place. Conclusion While a recession brought the nutrition program into the college of nursing at ASU, it is turning out to be a marriage quite possibly of heavenly origins. And now back to the new kitchens…Who eats the nutritious foods the students prepare? “They do!” Simin Levinson said. “Most of the food is consumed by the chronically hungry students. Students sample each other’s prepared recipe for evaluation, and will usually devour anything that is left over.” n As a health promotion program, Nutrition emphasizes the role of healthful diets Summer 2011 9 In Their Own Words: Contributed by Kristen Rasmussen, MS, RD (Class of 2009) Kristen Rasmussen originates from the Northern California coastline, graduated from the University of California at Berkeley with a BS in dietetics, then went on to obtain a Master’s in Human Nutrition from Arizona State University. Kristen currently resides in San Francisco where she works as a dietitian consultant in many capacities including the University of California Berkeley’s faculty and staff wellness program, Laguna Honda Hospital, and Bon Appetít Management Company. Kristen has a strong passion for nutrition and food sustainability and believes a healthy lifestyle necessitates the enjoyment of great food. She currently acts as President-Elect for the Bay Area Dietetics Association, was recently named as part of a team awarded the ASU President’s Award for Sustainability, as well as receiving the Recognized Young Dietitian of the Year award by the American Dietetic Association. Rasmussen completed her Master of Science in Human Nutrition through ASU’s Department of Nutrition in May of 2009. I did not know what to expect when I applied to the MS in Human Nutrition program at ASU and still was unsure when I decided to attend. Despite being well-traveled and having lived in several countries apart from the U.S. for stints of up to six months, Arizona was a completely unique experience. There were many in my program who 10 Innovations in Nursing & Health had attended ASU as undergraduate students and still more that originated from Arizona, but for me the appeal of the program was not only the department itself, but the entire Arizona experience and access to the community that the program provided. During my last year as an undergraduate, post-graduation plans concentrated upon whichever dietetic internship I was accepted into. My program, similar to most other dietetic programs, heavily focused on dietetic internships and less on other opportunities, such as masters or doctoral programs related to nutrition. Given my personal and departmental focus, I applied to the ASU graduate program solely because the second year included a dietetic internship, with the graduate degree being an afterthought. Interestingly enough, due to another opportunity that arose while in Arizona, the graduate degree was what I departed with and the internship was completed at a later date. ASU Nutrition Compares Well On my first day of orientation into the ASU MS program in Human Nutrition, I remember walking into the competency exams with confidence. My BS in nutrition was completed through the UC Berkeley nutrition department, which has a reputation for being very rigorous, especially in the sciences. As a graduate of the program I was taught that I would be well, if not overly, prepared for any future educational endeavors, which was true. However, the competency exams given on that orientation day and a majority of the future course curricula and assignments at ASU were equally, if not more challenging than what I encountered at UC Berkeley. One requirement of the MS program in Human Nutrition is that each student completes a thesis project. A portion of our coursework was dedicated to developing our research expertise and additional credits were allotted to the development, execution, and write-up of our thesis topic. As previously mentioned, Berkeley was heavy in the sciences, but we were not well-versed in the research arena and I was amazed at how much I would learn about nutrition research in such a short amount of time through the required courses in the program. at ASU at ASU NUTRITION PROGRAM NUTRITION PROGRAM Nutrition program graduates share their insights. As anyone who has completed a thesis or a dissertation knows, having a passion for, or at least an interest in, the thesis topic is essential. For this reason I was ecstatic that there was a faculty member present with experience researching polyphenols, granting me the opportunity to complete a thesis on the health effects of organic wine. With my newly acquired research expertise and guidance from my thesis mentor, I was commissioned to develop and run the study as well as analyze the results. Although I definitely had my “thesis ups and downs,” the experience greatly expanded upon my critical thinking skills and fine-tuned my ability to delve deeply into a given topic, then extract information, and present it in such a way that it is accessible to the public. Faculty Saw Value of Community Connections Outside of coursework, I was able to work as a nutritionist for ASU’s on-campus dining services provider, work as a teaching assistant, act as logistics coordinator for a grant-funded farmers’ market program, and participate as a highly active volunteer and board member for a community-based group, Slow Food Phoenix. A majority of the Nutrition faculty were not only tolerant of my other roles but extremely encouraging and supportive because they understood the value of connecting the campus with the surrounding community. Although extremely busy throughout my graduate experience, every role I held was related to my passion for food sustainability, making it a productive and inspiring two years. After graduation, I went on to complete a dietetic internship through the University of Northern Colorado’s distance program in order to obtain Registered Dietitian (RD) status. Currently, I hold a variety of positions in Northern California, all of which relate to my passion for sustainable food. I have often thought of how my life would be if I had chosen a different path but am grateful that it turned out the way that it did. ASU was where I learned to make the most of my skills and to give my all. Hard work may follow, but it will always be worth it if you are working for a cause that is worth it to you. n Contributed by Stephanie Moya, MS, RD (Class of 2002, 2004) Stephanie Moya is a Registered Dietician (RD) with a BS in Human Nutrition and an MS in Dietetics from Arizona State University. She began her professional career at Phoenix Children’s Hospital after completing graduate school in 2004 at ASU. In the fall of 2006, she joined the food service department at the Veterans Affairs Medical Center (VAMC). She graduated from a VA regional leadership program in 2008 and was appointed Chief of Hospitality and Food Service at the Phoenix VAMC, supervising 70 staff members. C heering at ASU football games, gathering at Manzanita Hall, sneaking into Chemistry Class five minutes late because I had French Class on the opposite side of campus right before hand and could never quite make it across campus in less than 15 minutes, the weight of my backpack, fraternity parties, figuring out a path from one class to the next where I could sneak into a building to get just a minute of air-conditioning while I trekked across campus to get to class, endless study guides, endless lab courses, endless lines at the Registrar Office, the relief when finals were over, “Penny Drinks” at Minder Binders when finals were over, the excitement of picking a new semester of classes, did I mention the weight of my backpack?... These are just some of the memories I have when I look back at the seven years I spent as an undergraduate and graduate student at …continued on page 13 Summer 2011 11 NUTRITION PROGRAM NUTRITION PROGRAM dream • discover • deliver Building Better Health both levels of education, I found my interests changing with each new experience. It ranged from food science, to management, to research, to clinical care. The classes and professional contacts with the ASU instructors were so extremely impactful in maintaining my interests in nutrition. I enjoyed learning each and every aspect of what were potential career opportunities. The classes were not the only tools that ASU provided: I was also provided work experience opportunities as part of the program. One such student experience was supporting the initial data collection of the “Woman’s Health Initiative,” a 10-year prospective research study that has become an internationally recognized project. Taking an “In-depth Dive” Contributed by Michael Welsh, MS, RD (Class of 1995, 1998) Michael Welsh is a Registered Dietitian (RD) and currently the Chief of Nutrition, Hospitality and Food Service for the Phoenix Veterans Administration Health Care System. He graduated from Arizona State University with his BS and MS in Human Nutrition. He has worked for the Veterans Administration for 13 years and has been involved in many local, regional and national project improvements. He has held numerous board positions in the Arizona Dietetics Association and Central Arizona District Dietetics Association, and is currently the Chair of the Nutrition Advisory Board for Arizona State Universities Nutrition Program. E arly in life, I joined the military thinking it might be my career choice or at least a starting point to a career. While I enjoyed the travel and camaraderie of the military, I was not content with the work and challenge that it presented. After my initial four-year tour, I was drawn to returning to school and receiving a higher education. I was able to use the military GI Bill to support that decision and began taking classes at the local community college. I took my very first Nutrition class as part of my Associate Arts Degree and felt an instant connection. A career counselor directed me to ASU’s Nutrition program, and that is where my career truly began. My passion for nutrition grew as I became more engrossed in education and the possibilities that nutrition could open for me. While at ASU, I completed my bachelor’s degree in human nutrition and was accepted into the master’s/internship program. Throughout 12 Innovations in Nursing & Health at ASU at ASU n As part of the master’s degree I completed a thesis that challenged me with an “in-depth dive” into tissue research to examine the effects of methyl alcohol using an animal model. Not having spent a great deal of time in a lab, I found it both extremely challenging and interesting as I pursued the results of the study. Adding to the stress of research, I also started my internship rotations associated with the master’s program. My first rotation was at the Maricopa County Hospital where I rotated through a variety of dietetic specialties and learned nearly every facet of clinical nutrition care. There were a variety of other rotations throughout my internship, including a food service management rotation with the Phoenix VA Health Care System. Throughout my education at ASU, the faculty encouraged students to get involved in local Dietetic Boards. As an involved student, I quickly accepted this challenge and became a member of the Central Arizona District Dietetic Association. Being involved in so many different areas as a student, a researcher and in the dietetics associations, I was driven to find the most challenging position where change and action are the norm. As I was finalizing my thesis, I was offered a position within the VA hospital as the Training Dietitian. This position was responsible for ensuring that excellent patient care was provided through a well trained staff. I quickly became involved in creating a hospitality program for the hospital and was hired as the Administrative Dietitian to oversee the program and manage the day-to-day operation. Education Provides Tools for Today Reflecting on my transition from student to professional, it astounds me on how much of what I learned at ASU has come back to support my professional growth. As a manager in the field of nutrition, the classes and experiences I had at ASU continue to provide tools I am able to utilize to this day. The well-rounded Nutrition program prepares students for a variety of career opportunities. When a student is ready to settle in on one career choice or decides to change direction, he/she will have the skills necessary to succeed. ASU’s influence not only drove my career, it continues to drive me in numerous ways. I am an active supporter of student education, participate in guest lecturing, mentor students, and continue to support internship rotations in Clinical Nutrition, Food Service Management, and Nursing Home Care as part of the ASU master’s program. Supporting ASU students is a professional as well as personal goal. Through the upcoming generations, I hope to indirectly impact my profession in a positive manner. The direction and focus of my career has already surpassed my expectations. I am very blessed to be in the position I am now, one that positively affects staff, my military veteran patients, peers, students, and co-workers. Where it goes from here is anyone’s guess, but with the strong and stable base of knowledge and skills I have gained and the continuous networking I am privileged to be engaged in, I can only hope my career continues to be as positive in the future. n Stephanie Moya, cont. ... Arizona State University. I completed my ASU experience with a Master’s Degree in Nutrition. I currently work for the Veteran Health Administration as the Chief of Hospitality and Food Service at the VA Medical Center in Phoenix. I am a Registered Dietitian and love being part of the progressive healthcare world. I would not be here if it were not for the outstanding education and extraordinary guidance I received from my educators in the Nutrition Department at ASU. I feel strongly the Nutrition Program’s structure gave me continuous access to cutting-edge research projects and up-to-date, thought provoking class material, which played a key role in expanding my knowledge of the field. ASU’s program gave me the confidence I needed to start my career as a new graduate of the program and, of course, it gave me the skills I required to pass the RD board exam in order to become a Registered Dietitian. The true keys, however, to my success as a new graduate, as my career began to develop, were the leadership skills and networking opportunities that came from my classmates and instructors in the Nutrition Program. When I was nearing the end of my undergraduate degree I was enrolled in a class taught by a professor who was known to teach some of the toughest classes in the program. Rumor had it that she had failed more students than Palm Walk on Main Campus had palm trees. Okay, that is not verified, but it did scare me enough to lose a night or two of sleep before the semester began. Fear Turns into Inspiration I arrived on the first day of her class with a blank notebook and was ready to write down every word she spoke, just in case it showed up on the exam. What was interesting to me is that I realized very quickly her class was not unreasonably difficult if you really listened to what she was saying. She knew her course material inside and out. She gave ample time for questions and told many stories to make the material really sink in. She gave applicable examples to draw links between chapters and really made an effort to ensure the class understood the topic. Her passion for the field of nutrition excited many of my fellow students and this is really what inspired me to fall in love with the field. The professor encouraged us to study in groups and to get involved in the nutrition community through the local and national chapters of the American Dietetics Association and through student-run groups like the Nutrition Council. These group study sessions built friendships and mutual respect among my classmates that still impact me today since many of my former classmates are now my co-workers in the field. The professor was not alone in her efforts either. There were countless other professors and lecturers who exuded the same energy and affection for the field. They led by example! ASU Experience more than Formal Learning Overall, my ASU experience was not just about formal learning but, in fact, was about learning to develop the confidence, critical thinking skills, and professional acumen I needed to become a leader. I learned how to gain from being part of a network and community, as well as how to give back to it. The Nutrition faculty taught me how to have and how to be a mentor, which has served me very well in my career at such a mighty healthcare organization like the Veterans Health Administration. Today, I am still involved with Arizona State University through the Alumni Association. In addition, I am an active member of the American Dietetics Association and sit on their state board. I am a guest lecturer at ASU for a career building course for undergrads in the Nutrition Program and serve as a Preceptor for ASU’s Dietetic Internship Program. I am happy to give back to the community and to the field of dietetics because my experience at ASU prepared me so well to do so! I could not be happier that the Nutrition Program joined forces with Nursing as part of the College of Nursing & Health Innovation collaboration on ASU’s downtown campus. Nutrition is now centrally located which gives students greater access to the large number of hospitals located near the downtown area, including the VA Medical Center. This access increases students’ opportunities for employment, either paid or volunteer positions. Working in the field as a student makes for more experienced Dietetic Interns on day one and makes the knowledge being taught in the classroom more applicable. In addition, having nursing related classes more available to nutrition students and vice versa leads to more well-rounded healthcare professionals. We are really a healthcare team here at the VA Medical Center and the more a dietitian knows about the other healthcare professions like nursing, the more synergetic our team is. I look forward to seeing the College of Nursing & Health Innovation grow. n Summer 2011 13 NUTRITION PROGRAM dream • discover • deliver Building Better Health An Inside Look at ASU Nutrition Innovations in Nursing & Health asked current students in Nutrition to provide their perspectives and experiences in the program at the College of Nursing & Health Innovation. Kyle Lynch, junior ASU Nutrition Undergraduate Student Wesley Tucker, ASU Nutrition graduate student is from the small town of George on the southern coast of South Africa. His grandfather had the biggest influence on his education by encouraging him to read at a young age and instilling a thirst for knowledge. Wesley’s personal interest has been sports, which provided him the opportunity to come to US after high school to attend North Carolina State University on a golf scholarship. He first majored in Meteorology but changed when he took a nutrition course as an elective. He changed his major to nutrition, earned a bachelor’s degree, and enrolled in the MS, RD at ASU. Innovations: What motivated you to enter the ASU Nutrition Program? Lynch: At my old job, I helped create a 3-D anatomical database that was used for educational purposes. Learning the anatomy of the human body really got me interested in how the body works, but mostly 14 Innovations in Nursing & Health classes that met on campus. Those were great classes, but I love taking the classes online. Being able to re-watch lectures of tricky concepts has really helped me out. Innovations: What ‘aha’ moments have you had in the program? Lynch: This past fall, I had the opportunity to attend the national conference of the American Dietetic Association (ADA) in Boston. The expo at this Food and Nutrition Conference was a huge venue for vendors to display their products. I remember seeing half of a convention center filled with corporate booths of companies and just packed full of people. That was the first time I realized how big the field of nutrition is. You can read about it in the textbooks but seeing it first-hand like that was a real eye-opener. BSc in Nutrition Sciences. However, this did not allow me to enter a dietetic internship, which is necessary to become a Registered Dietitian (RD) because NCS’s undergraduate program did not have an accredited didactic program in dietetics. My advisor at the time advised me to look into graduate schools that would give me the chance both to complete a master’s degree and a dietetic internship. My motivation for pursuing a graduate degree in nutrition was fueled by a desire to understand and conduct my own research. I chose the ASU MS, RD program because it was the best fit for me in terms of research opportunities and financial assistance. Tucker: I have had countless ‘aha’ moments in the program. The biggest benefit of my graduate studies so far has been to learn that ‘absolutes’ are few and far between in health sciences. I entered the program with the idea that obesity was a problem because people simply ate too much and were not active enough, but this attitude quickly changed. A graduate seminar in my first semester introduced me to a multitude of new factors that I had never even considered when thinking about weight control. It also made me realize that the whole notion of “calories in = calories out” mantra makes for a snappy motto but really has no meaningful clinical significance and does not work at the individual level. The graduate program has also given me the necessary tools to understand and interpret research studies, which is invaluable when trying to assess whether or not nutrition information is true or false. I have learned to not just take nutritional claims at face value and instead have developed a sense of rational skepticism. Innovations: What is unique to you about the Nutrition graduate pro- Innovations: How do you plan to use your degree in your career? the role nutrition plays. I had always been interested in fitness and eating well, so after I moved back to Phoenix, I decided to go back to school and pursue my interest in nutrition. Tucker: I graduated from North Carolina State University with a Kyle Lynch, Junior, ASU Nutrition undergraduate student, was born in Binghamton, NY, and has spent most of his life in Arizona. He is pursuing a second bachelor’s degree in Food and Nutrition Management after obtaining a psychology degree from the University of Arizona. After graduation, he worked at a start-up company for five years, becoming its general manager. When his wife was offered a position in Phoenix, they decided to relocate. Kyle is a member of the ASU Downtown Student Nutrition Council and volunteers at AGAPE Network, an organization that supplements the nutritional needs of individuals and families infected and affected by HIV/AIDS. He also works part-time at a fitness center to educate children (grades K-8) about the importance of exercise and leadership. at ASU at ASU n NUTRITION PROGRAM gram at ASU? Tucker: The wide variety of research interests held by the faculty members makes the program attractive and unique. And within the classroom, graduate students often sit side-by-side with students from other programs, in particular Exercise & Wellness. This gives nutrition students a different perspective on issues discussed in class and allows us to learn about interesting research in the field of athletics and exercise performance. Also, graduate seminars offered through the Nutrition Program allow us to interact with RDs who have often already been working in the field for several years, but are back to pursue masters’ or PhD degrees. This gives us wonderful insight into what the dietetic internship process. These students also bring an invaluable, pragmatic approach to the table because they have witnessed which theories work best in the field. Lynch: I was surprised to see how many classes were online at ASU. From the time I started the program I have had about two Lynch: I am really interested in school lunch reform and promoting physical activity in youth. I would love to be able to work with school districts, helping them find affordable ways to increase the nutritional value of school lunches and integrate more physical activity into the school day. Tucker: I plan to use my master’s degree to apply to the Interdisciplinary Physical Activity, Nutrition, and Wellness PhD program at ASU. This will allow me to build upon my existing research skills and make me better-rounded in the areas of physical activity and wellness. My future research interests lie within how nutrition affects chronic disease risk. By the time I enter the PhD program, I hope to have developed an interesting line of research that can significantly contribute to this important area of research. My career goal is to work with elite athletes, helping them understand the impact that good nutrition can have on their level of performance Wesley Tucker ASU Nutrition Graduate Student through evidence-based recommendations. I am fortunate enough to have grown up with several of the world’s top golfers, such as Louis Oosthuizen and Charl Schwartzel. I have good insight into how elite athletes operate and what their expectations of me as their advisor might be. My hope is to combine these athletic experiences with my graduate and professional training in nutrition. My dream job would be to work with the South African Rugby Team or another professional sports organization as a dietitian, because most athletes do not receive the evidence-based information that they require in order to maximize their athletic potential. Innovations: What would you say to another person considering Nutrition as a career and enrolling at ASU? Lynch: I highly recommend majoring in Nutrition to any student because healthcare is consistently a strong field to be in and Nutrition is such a universal degree. I’d also recommend getting involved as a student. The more involved you get in the program, the more opportunities will become available to you. I like the flexibility in career choices that I have available and I am confident I will find a job I love when I graduate. Tucker: If you are considering nutrition as a career, the ASU Nutrition program is an excellent place to start because the faculty are very receptive to students. If you display a good work ethic and willingness to learn, doors will open for you as a graduate student. Opportunities to assist faculty members with teaching and research offer experience in academia and financial help with tuition. n Summer 2011 15 Building Better Health NUTRITION PROGRAM at ASU n The Right Time… The Right Place… America’s Children IN PERIL A Call for Integrated Physical and Mental Healthcare For a Great Career in Nutrition and Dietetics by Glenna McCollum-Cloud, DMOL, MPH, RD Speaker, House of Delegates, American Dietetic Association R eaching out to all future professionals in the field of nutrition and dietetics - this is an exciting time for our profession. With many changes on the healthcare horizon, there are exciting opportunities to create new career pathways that carve out an expanding future for Registered Dietitians (RD) and Dietetic Technicians, Registered (DTR). From the implementation of the American Recovery and Reinvestment Act of 2009 (Healthcare Reform) to the American Dietetic Association’s Council on Future Practice Career Development Guide 2011, this is the ‘Right Place’ and the ‘Right Time’ to have a great career in nutrition and dietetics. The timing is advantageous with the passing of healthcare reform legislation. Although there are many questions still unanswered, its passage has already started a wave of change that will impact the nutrition/dietetics profession. For example, the healthcare reform bill states that “$650 million shall be provided to carry out evidencebased clinical and community-based prevention and wellness strategies.” In addition, chronic disease prevention and community wellness are targeted for additional funding, opening doors for those trained in the nutrition/dietetics profession. What opportunities can be mined as the new focus towards prevention and wellness find nutrition as a center focus? Perhaps it is as a community case coordinator for the medical home, a tele-nutrition practitioner working with insurance companies, or a childhood obesity expert working with schools and school districts. Regardless, the passage of this bill challenges nutrition/dietetics professionals to reconsider how and what we think about health, wellness, and prevention, opening the career doors of opportunity wide to those who think creatively toward their own future. The career doors of opportunity also are impacted by geography. Although the actual implementation of the Affordable Care Act for each state is yet to be fully determined, one thing for sure is that leaders in healthcare across Arizona have already begun brainstorming. In 16 Innovations in Nursing & Health dream • discover • deliver January 2011, the Arizona Chamber of Commerce and Greater Valley Area Health Education Center (GVAHEC) provided the opportunity for educators, legislators, healthcare-related associations, and businesses to have a roundtable discussion addressing the future training and workforce needs of healthcare and public health in our state. Significantly, collaboration, flexibility, interdisciplinary, and teamwork were common themes throughout the discussions. With prevention and wellness at the core, the RD and DTR have an important opportunity to bring their knowledge and skills to these newly described high-functioning interdisciplinary teams to solve tough challenges and manage complex health-related issues in Arizona and the nation. As the discussions continue and solutions emerge, employment and advancement opportunities will belong to those who think creatively, act assertively, think multidisciplinary, and work collaboratively. Career Guide Developed The right time, the right place, and a great career in nutrition and dietetics also are supported by those leading the profession. To ensure the viability and relevance of the profession, the American Dietetic Association (ADA) supported the work of the Phase 2 Future Practice and Education Task Force and the Council on Future Practice. What emerged from the task force and council was the 2011 Dietetic Career Development Guide, providing a multidimensional professional development plan and a flexible pathway to life-long learning. The guide assists new practitioners in identifying their entry-level “firststep” and provides a career ladder for the experienced practitioner. For example, a practice role for an entry-level RD could easily be as a generalist. “A general RD practitioner is an individual whose practice includes responsibilities across several areas of practice including community, clinical, consultation and business, research, education, and food and nutrition management” (Council on Future Practice Visioning Report 2011). Additional entry-level opportunities could … continued on page 44 T he foundation for a healthy adulthood is a healthy childhood. Despite the nation’s prosperity, increasing numbers of American children are plagued with two chronic and intractable health challenges —obesity and compromised mental health. Approximately 32 percent of children between the ages of 2 and 19 years of age are overweight and nearly 17 percent are obese in the United States. Being overweight predisposes children to adverse health outcomes compared to their non-overweight counterparts, including Type 2 diabetes, hypertension, dyslipidemia, sleep apnea, asthma, and a shortened life span. Overweight and obese children and adolescents, in comparison to their normal weight counterparts, also have a higher prevalence of school and mental health problems that include poor academic performance and self-esteem, depressive disorders, and a greater number of reported suicide attempts. Moreover, approximately 15 million children and adolescents in the U.S. have a mental health problem that impairs their functioning at home or at school, but less than 25 percent receive treatment. Our bodies are designed to be physically active, not only for good physical health, but also for positive mental health. Innovative strategies including coordinated efforts among healthcare providers, schools, academic and research institutions, federal agencies, funders and policy makers are urgently needed to reverse these alarming trends in child and adolescent health. Experts in the field, health policymakers, and national leaders need to tackle these epidemics and offer cuttingedge solutions to reduce them. Taking a proactive approach to the integration of physical and mental health has been an important strategy for the College of Nursing & Health Innovation at Arizona State University for several years. The col- lege has built extensive academic and research programs, especially in the area of mental health. The list includes: • the launch of the nation’s first Psychiatric-Mental Health Intervention Specialist certificate, • obtaining a Health Resources Services Administration grant to build a Child-Family Psychiatric-Mental Health Nurse Practitioner track as part of its Doctor of Nursing Practice Program, • the establishment of the Southwest Health Center for the Prevention and Treatment of Child and Adolescent Depression and Anxiety Disorders, • the KySSsm Child and Adolescent Mental Health Fellowship Online CE Program, • obtaining NIH-funding for a school-based study and intervention to prevent teen obesity and adverse mental health outcomes, and • Being named the NIMH Outreach Partner for the state of Arizona With evidence of such a strong commitment, it was natural to take the show on the road — in this case to the nation’s Capitol. The college joined Arizona State University in hosting America’s Children in Peril: Solving the Child Obesity and Mental Health Epidemics, a forum that attracted more than 200 healthcare leaders and media to the National Press Club earlier this year. National Experts on Panel The forum took a panel format with eight nationally prominent partici-​ pants, headed by Richard Carmona, MD, MPH, FACS, 17th Surgeon General of the U.S. (2002-2006), who presented opening remarks. Summer 2011 17 n Deborah Kotz, Boston Globe senior health reporter and blogger, moderated the panel. Panelists who offered their solutions to the child health epidemics included, Kyu Rhee, MD, Chief Public Health Officer, Health Resources and Services Administration (HRSA); Peter S. Jensen, MD, president, REACH Institute and Professor of Psychiatry, Mayo Clinic; Bernadette Melnyk, PhD, RN, CPNP/ PMHNP, FAAN, Dean and Distinguished Foundation Professor, ASU College of Nursing & Health Innovation; Marie Morilus-Black, MSW, Director, DC (District of Columbia) Department of Mental Health: Children/Youth Services; Russell R. Pate, PhD, FACSM, Director, Children’s Physical Activity Research Group, University of South Carolina Arnold School of Public Health; Joanne Kenen, Founding Editor, New Health Dialogue blog, New America Foundation; and Madelyn Clark, one of 25 national Youth Advisors for the Alliance for a Healthier Generation. In his opening remarks, Dr. Carmona said there is “no choice but to act” today to find solutions to the child obesity and mental health epidemics in the nation. Obesity is embedded as a cause in every portfolio of disease and affects nine million children,” Dr. Carmona said. “Obesity, mental health and national security interest are the number one causes for people not being retained in the military… Obesity is our terror within.” The former Surgeon General said that America would not have a cohort of young men and women who were able and physically ready to take on military, first responder and other essential jobs. He related how a CDC epidemiologist had told him in 2003, “Surgeon General, this could be the first generation of children that lives fewer than its parents because of the disease burden inflicted by this epidemic of obesity.” “...if you’re an obese child, you have a higher incidence of mental health problems,” Dr. Carmona said. “If you’re obese, you have the accelerator of chronic diseases, or the cause of diseases — cardiovascular disease, asthma, and low birth weight babies. The list is endless when you see how pervasive it is as it relates to disease and economic burden in our society.” Call for Integrating Physical and Mental Healthcare Dean Bernadette Melnyk noted child obesity and mental health statistics were frightening but probably even higher due, in large part, to inadequate screening by primary care providers. Dr. Melnyk, a pediatric and child-family psychiatric nurse practitioner, has long advocated for the integration of physical and mental healthcare. “We are funded now by the National Institutes of Health/ National Institute of Nursing Research to test a 15-session cognitivebehavioral skills building healthy lifestyle intervention called the COPE 18 dream • discover • deliver Building Better Health Innovations in Nursing & Health National Institute of Mental Health Healthy Lifestyles TEEN (Thinking, Emotions, Exercise and Nutrition) Program with 800 teenagers in 12 Phoenix area high schools,” she stated. “Multi-component interventions, typically consisting of nutrition education, physical activity and behavior modification have not usually resulted in long-term positive sustainable change; what our team believes is that we are missing the cognitive behavior skillsbuilding piece, the mental health piece, which is emphasized in our COPE program.” taps college as Outreach Partner for Arizona The dean explained that research has shown that how teens think is directly related to how they feel and how they behave. Our research has also shown when a teen has higher depressive and anxiety symptoms or they have poor self-esteem, they don’t engage in healthy behaviors; they see them as more difficult. The ASU dean called for more dually-prepared providers (e.g., pediatric nurse practitioners and psychiatric mental health nurse practitioners) in primary care and school-based healthcare settings to eliminate referral time. “Right now, we have children waiting three, four, and five months to get psychiatric evaluations,” Dr. Melnyk added. “If you have dually prepared providers in primary care, the process of identification and treatment will be seamless and in a setting that is not stigmatized.” Dr. Peter Jensen, President, REACH Institute and Professor of Psychiatry, Mayo Clinic, called for an approach built into the fabric of how you think about health. “As soon as you basically say, ‘You’re in a special category,’ you stigmatize it,” Dr. Jensen said. “So, if you say, ‘You’re a mental health kind of kid,’ or, ‘we’ve got a class for the fat kids,’ well, you can definitely be sure that that’s going to be a group no one wants to be part of.” But that means training of the janitor, to the receptionist, to the school clerk, to the principal, to the teacher, to the student body. And, with that kind of strategy, we see some very important turnarounds in schools where the climate changes and then children change as well as a function of that climate, Dr. Jensen added. Solutions Start with Primary Care Several panelists identified changes in primary healthcare as essential to finding solutions to the obesity and mental health epidemics. Drs. Jensen and Melnyk cited lack of screening in primary care practices, inadequate preparation of providers to accurately assess and treat common mental health problems in primary care, and the shortage of mental health providers and systems to treat children as major barriers to improving these conditions. “The primary care provider must be involved to fix these problems and be reimbursed adequately for their services,” Dr. Jensen said. …continued on page 20 T he Arizona State University College of Nursing & Health Innovation has been selected as the National Institute of Mental Health (NIMH) Outreach Partner for 2011 through 2013 for the state of Arizona. It is the only college of nursing and health in the U.S. selected as a NIMH Outreach Partner [http://www.nimh.nih.gov/outreach/ partnership-program/index.shtml]. The College of Nursing & Health Innovation joins a nationwide network of 55 mental health organizations across the nation that disseminate research from NIMH about the causes, diagnosis, treatment, and prevention of mental disorders, and promote public involvement in research studies. “The ASU College of Nursing was selected through a competitive process as an NIMH Outreach Partner because of its vast networks for broadly informing individuals, families, healthcare providers, nursing students, and others about NIMH research findings and evidencebased mental health interventions and services, as well as its ability to conduct science-based mental health education in the community, particularly among children and youth,” said Diana Morales, director of the NIMH Outreach Program. Since 1990, through its Outreach Partnership Program, NIMH has supported organizations from every state, the District of Columbia, and Puerto Rico to educate the public about mental disorders, and help to reduce the stigma of mental illness. “It is an honor and important responsibility to be named the NIMH Outreach Partner for such a significant health issue in our state in these times,” Dean Bernadette Melnyk, PhD, RN, CPNP/PMHNP, FNAP, FAAN, said. “One of 10 adults over Pam Lusk, DNP, RN, FPMHNP-BC, director of the Southwest Health Center for the Treatment and Prevention of Child & Adolescent Depression and Anxiety Disorders at NP Healthcare— Downtown Phoenix, reviews Dean Melnyk's COPE Program with a teen patient. age 18 in Arizona reports being currently depressed and one in five children has a mental health problem. The majority of individuals with mental health conditions do not receive treatment.” Shortage of Mental Health Professionals Dire Arizona has a severe shortage of mental health providers with only 120 child psychiatrists and none in five of Arizona’s 15 counties, as well as only 47 family psychiatric-mental health nurse practitioners. The shortage results in a much lower healthcare provider-to-patient ratio than the national average. Starting in 2007, the ASU college has made a major commitment to the mental health area to make up for the major shortage of mental healthcare providers. The college added the only psychiatric-mental health nurse practitioner doctoral program in the state, including the only graduate certificate for psychiatric-mental health intervention specialists in the U.S. More recently, it also added the KySS Fellowship self-paced online continuing education program and the Southwest Health Center for Prevention and Treatment of Child and Adolescent Depression and Anxiety Disorders in 2010 so that more youth can get needed evaluations and treatment. The college also integrates physical and mental health services in its nurse-practitioner managed health centers. As the NIMH Outreach Partner, the College of Nursing & Health Innovation will function as the chief coordinator for several key collaborators who will work together to disseminate NIMH research throughout Arizona. Dean Melnyk, who is a certified Child-Family Psychiatric Mental Health Nurse Practitioner, is the primary contact and executive Summer 2011 19 n dream • discover • deliver Building Better Health director of the partnership. The ASU College of Nursing & Health Innovation has the capability of disseminating NIMH research far beyond the downtown campus area through its students, evidence-based practice network, nursemanaged health centers, and professional networks across the state. Its extensive network is possible in large part due to established relationships within the community and more than 700 contracts for student clinical education and practice in place with clinical agencies across the state. Dean Melnyk said the college is broadening its network to reach a diverse population of all age groups that could benefit from more timely and wider exposure to NIMH research. The proposed network will include representation from the community, including TERROS, a community-based behavioral health organization that helps people recover from substance abuse, mental illness and other behavioral health problems; the Arizona Department of Health Services; other ASU colleges and institutes; and professional organizations, such as the Arizona Chapter of the American Academy of Pediatrics and the Arizona Chapter of Pediatric Nurse Practitioners. Strengths as Outreach Partner Significant The College of Nursing & Health Innovation is positioned strongly on an operational basis to serve as the Arizona NIMH Outreach Partner. It also is conducting a $2.3 million NIH-funded four-year study in 12 Phoenix high schools to test interventions to solve the nationwide epidemics of depression and obesity among at-risk youth with Dean Melnyk as principal investigator. Research is a strength of the college, which has 55 research active faculty who are continually advancing research in all aspects of healthcare. Placing in the Top 15 in NIH funding among colleges of nursing in the country for two consecutive years, the college’s research involves professional collaborators from other academic disciplines and community organizations throughout the state. “NIMH hopes its partnership with the College of Nursing & Health Innovation at Arizona State University will promote more widespread and timely access to the latest research advancements in mental health for people throughout the state of Arizona,” Outreach Program Director Morales said. “NIMH further hopes this partnership will increase awareness of the opportunities to benefit from participation in NIMH and NIH funded studies among the residents of Arizona.” The National Institute of Mental Health is one of 27 components of the National Institutes of Health (NIH), the Federal government’s principal biomedical and behavioral research agency. NIH is part of the U.S. Department of Health and Human Services. n 20 Innovations in Nursing & Health Nursing Project Spurs Students Children in Peril, continued from page 18 to Form Campus Mental Health Chapter Dr. Rhee of HRSA said he was optimistic that the Affordable Healthcare Act recognizes the need for more primary providers in community health clinics across the nation. The AHA plans for the doubling of providers to 250,000 to meet the needs of more than 19 million patients, which will enable providers to spend more time with patients and track key indicators such as Body Mass Index. Other panel members focused on family involvement and the home environment as solutions to the child health crisis in the United States. Marie Morilus-Black, Director, District of Columbia Department of Mental Health: Children/Youth Services, noted a correlation between parents’ involvement and prevention and treatment of behavioral problems. “Our latest results in the District are encouraging in that they indicate a 51 percent increase in parental involvement in our programs,“ she said. “Parental influence remains high despite what people think and parental involvement has reduced the numbers of children who need help.” People with serious mental health conditions live 25 years less than the average American, MorilusBlack said. Public Health Solution Needed According to Russell R. Pate, Director, Children’s Physical Activity Research Group, University of South Carolina Arnold School of Public Health, a minority of children meet physical health guidelines. “Children are heavily influenced by examples parents model in the home environment,” Dr. Pate said. “We have to turn our thinking to one that says being sedentary and overweight is not acceptable. We need a public health solution to influence parenting behavior.” The forum is one of a series sponsored by ASU on key challenges facing the nation. For more information, go to www.asu.edu/childhealthforum/. The forum is available as a webcast at the above link to the ASU web site and also at the PBS forum site http://forumnetwork.org/login/. Visitors to the PBS site will need to register at no charge to access and search for the forum. Transcripts of the forum may be obtained by e-mailing nhimarketing@asu.edu/. ASU and the College of Nursing & Health Innovation plan a second forum titled Arizona’s Children in Peril: Solving the Child Obesity and Mental Health Epidemics in Tucson on Tuesday, June 21 at the Doubletree Hotel at Reid Park. n M ost Community Health nursing student projects begin and end. Students assess community health needs and develop a plan to meet those needs. Knowledge and community involvement are gained and then students go on to other courses. However, in the case of 10 students, the commitment is continuing beyond the completion of the project and could leave a legacy at the ASU Downtown Phoenix Campus. Jane Fawcett, RN, MScN and Clinical Assistant Professor and Coordinator of the Community Health (CH), explained that the project started as a community health assignment but quickly expanded into something much larger and that has gained the interest and support of community partners on campus and beyond. The 112 students taking the course spring semester were divided into 12 clinical groups of 8-10 individuals. Each clinical group took two CH courses — the Theory and then the associated clinical component in which they were in their small groups of 8-10 with a faculty member. “My Community Health students identified mental health as a significant issue among university students today,” Fawcett explained. “The traditional difficulties of being a student and the stressors of our economic times make being a student very challenging, and this can be overwhelming.” Tina Violetta, a student in the course, said the group was overwhelmed when it discovered data that indicated the high prevalence of mental health needs among ASU students. “According to an ASU Campus Care survey of students in 2009, 83.6 percent responded that they felt overwhelmed and another national survey reported that 44 percent or its respondents said they were depressed during the past year,” Violetta said. “Further research found that persons with mental health needs felt a stigma in admitting their needs and often did not know where to obtain help.” When the group discovered that there was no ASU student group focused solely on the problem, it decided that a grassroots approach was needed to create awareness to reduce the misperceptions about mental health. The 10 students committed to an evidence-based intervention to address the problem at ASU that will last beyond their community health course. Marissa Reyes, another student involved in the project, said the Tucson shootings in January and her personal experience with mental health issues were factors that motivated her and others to seek a contribution beyond the completion of a course assignment. Another group member, Tara Mihalec, mentioned a non-profit organization named Active Minds from the experience of a family she knew Summer 2011 21 n dream • discover • deliver Building Better Health that has suffered through a son’s bi-polar disorders. They contacted the organization which informed them that there was no active chapter in Arizona and that it would be able to provide immediate help to start one. The group had found a potential partner to help in the project and achieve its long-term goals. Students Find Active Minds Active Minds, a Washington, DC-based nonprofit organization, has 300 chapters on campuses across the nation. The organization’s purpose is to increase students’ awareness of mental health issues, provide information and resources regarding mental health and mental illness, encourage students to seek help as soon as it is needed, and serve as a liaison between students and the mental health community. Active Minds was founded in 2001 by Alison Malmon, then a junior at the University of Pennsylvania, following the suicide of her older brother Brian one year earlier. Her brother, also a college student, had been experiencing depression and psychosis for three years but had concealed his symptoms. In the middle of his senior year, he returned to the family’s Maryland home and began receiving treatment for what was later diagnosed as schizoaffective disorder. In March 2000, as Alison Malmon was completing her freshman year, her brother ended his life. Recognizing that few students talked about mental health issues though many were affected, Alison was motivated to change that culture on the Penn campus. She wanted to combat the stigma of mental illness, encourage students who needed help to seek it early, and prevent future tragedies like the one that took her brother’s life. Malmon created her own model and formed what has become Active Minds. In a decade, the organization has grown to be respected as the voice of student mental health advocacy. With the help of Sonya Weisbund, Active Minds director for the western region, the nursing students have formed an ASU chapter that is off to a fast start. The chapter has 30 members and recruits regularly outside downtown campus buildings. In late April, it held a National Stress Out Day on campus. Members also have been writing legislators urging more funding for campus mental health as well as receiving news coverage in the student newspaper. Weisbund of Active Minds said she has been impressed with the initiative and commitment of the students who formed the new chapter. Weisbund said ASU has the only active chapter in Arizona and is off to a strong start for such a new organization. Common Experiences Provide Focus The three seniors and officers of the ASU chapter who were interviewed had common interests and experiences that sensitized them to mental health needs. Violetta, who serves as chapter president, is interested in a career in behavioral health and is considering the Psychiatric-Mental Health Advanced Practice Specialty in the ASU 22 Innovations in Nursing & Health is required for an assignment,” Clinical Instructor Jane Fawcett said. “They have demonstrated exactly what we in the College of Nursing foster in our students—empowerment, leadership, commitment to patient-focused care, education, and partnering with the community. We encourage our students to be involved in and initiate policy development and reform and this project is an excellent example of a sustainable initiative, which benefits the student population here at ASU enormously.” approach the clinic for help, as well as lower the stigma in the university population. Ruth Flucker, MS, RN, RNMH, CNE, assistant clinical professor of nursing, has provided information and encouragement to the chapter. It is a role for which she is well suited since she is a Doctor of Nursing Practice student in the Family Psychiatric/ Mental Health Nurse Practitioner Specialty Track. Recognition of the nursing students’ initiative also has spread beyond the college. “It is so wonderful to see students take the time and initiative to spearhead an organization that helps people be aware of mental illness and the stigma associated with it,” Flucker said. “The content on their Facebook page is wonderful and these students are easily accessible and approachable by e-mail. They have regular meetings and tabling events to increase the awareness of available resources on campus.” Flucker said that the NP Healthcare – Downtown Clinic on the ASU Downtown Phoenix Campus sees at least one or two new students daily at the clinic with complaints of anxiety and/or depression. She feels the ASU Active Minds chapter will help students to feel they can Fawcett also feels very privileged as their faculty advisor to be a small part of this extremely important initiative started by her community health students. “These individuals are an example of the quality of students in our program who set the bar for performance and exemplary commitment to increase the quality of mental health care for our community here at ASU,” she added. Freddy Roman, assistant director of ASU Wellness, serves as advisor to the new student organization. The department has a grant that focuses on stress, suicide and depression and provides educational programs for students and training to staff and faculty on these topics, Roman said. “The students contacted our department and expressed interest in having an Active Minds chapter at ASU,” Roman explained. “The group is very enthusiastic and they are eager to plan and implement programs and initiatives to educate the campus community with great ideas in the areas of education and advocacy. We look forward to working with them and providing support as their work is very relevant to our campus.“ The career journey is just about to begin for these senior nursing students. However, their experience in the community health course has prepared them well for their futures in healthcare. n Below: The ASU Active Minds chapter participated in a campus-wide wellness event this spring as part of their effort to increase awareness of mental health needs on campus. Marissa Reyes (left) and Tina Violetta work together to plan an event promoting Active Minds on campus. Doctor of Nursing Practice Program. Marissa Reyes, vice president of the Active Minds chapter, said her interest in nursing resulted when she observed the psychological impact her grandfather’s death had on her family. Kristin Larson, chapter research liaison, witnessed patients’ struggles to overcome mental health disorders during a clinical rotation in a mental health clinic. The three ASU seniors took divergent paths from other areas to nursing. Violetta studied business and worked in human resources. Reyes earned a degree in Global Studies and Larson in Chemistry. Regardless of their different paths, they have quickly earned the respect of faculty and others in and outside ASU. Other senior nursing students on the project team and who serve as officers in the ASU Active Minds Chapter include Chelsea Blazer, Alexandra Keil, Toneth Keo, Candace Mansour, Cyndi Moore, and Michele Valera. Student Initiative Recognized “I am so very proud of this particular group of nursing students who have done a phenomenal amount of work above and beyond that which Summer 2011 23 dream • discover • deliver Building Better Health n College of Nursing & Health Innovation has a trifecta of Doctoral Programs (This is the third and last of a series of articles on the doctoral degree programs offered at the College of Nursing & Health Innovation at Arizona State University. The first two parts covered the Doctor of Nursing Practice and PhD in Nursing & Healthcare Innovation.) M ost U.S. colleges of nursing and health have, at most, two doctoral degrees – a PhD in Nursing for researchers and nurse educators and a Doctor of Nursing Practice (DNP) for clinicians. Given the broad scope of its curriculum, the College of Nursing & Health Innovation is one of a few to offer a third choice with its interdisciplinary PhD in Physical Activity, Nutrition and Wellness (PANW). There is an interesting story behind this difference at ASU. The story goes back 23 years to 1988 when the Exercise and Wellness Education Concentration in the Interdisciplinary PhD program in Curriculum and Instruction was developed by Professors Charles Corbin and Nelson Haggerson (now Faculty Emeriti). Twelve years later, the programs in Exercise and Wellness and in Nutrition were moved from the Tempe Campus to the ASU Polytechnic Campus in east Mesa. Over time, these programs increased their research collaborations while becoming less connected with Curriculum and Instruction in the Tempe-based College of Education. The Exercise and Wellness and Nutrition programs began to develop their own interdisciplinary PhD program in 2003, using Professor Corbin’s program Pamela Swan 24 Innovations in Nursing & Health as a model. In 2005, the Arizona Board of Regents approved the interdisciplinary PhD in Physical Activity, Nutrition and Wellness, which launched in fall semester 2005. The integration of health promotion academic and research programs into the College of Nursing & Health Innovation in May 2009 created three doctoral programs within Charles Corbin one college. Ahead of the Times The integration of wellcare and healthcare was not as prevalent when ASU’s interdisciplinary PhD in PANW was launched. Today, the healthcare reform act calls for more preventive health education and holistic care to lessen the incidence and expense of obesity, type II diabetes, and cardiovascular diseases. The doctoral program in PANW is well positioned to educate health professionals to address these and other disease risks. It is designed to foster research and promote healthy lifestyles in order to reduce the physical, social and economic costs of unhealthy living for Americans. Associate Dean of Health Promotion Programs Linda Vaughan, PhD, RD, feels the college has the right PhD program at the right time for the right need. “Our commitment to the PANW doctoral program was strengthened by a Centers for Disease Control and Prevention survey that ranked Arizona 50th in the proportion of adults who were living sedentary lifestyles, Vaughan said. Based upon these national data, we knew that a doctoral program combining nutrition and physical activity could help to address these health problems. The continued growth of physical activity, nutrition and wellness in a variety of settings, including corporate, educational, governmental, medical, community and private programs, has created a demand for qualified scholars.” Purpose and Mission The Doctor of Philosophy (PhD) degree in Physical Activity, Nutrition and Wellness is an interdisciplinary program designed to prepare research scholars, academic faculty and professionals who study physical activity promotion, nutrition science, healthy eating and lifestyles, and exercise sciences. The program integrates graduate courses from several academic units to provide a sound foundation for research leading to a dissertation. It focuses on issues that contribute to healthy living through the reduction of disease risk, quality of life promotion, enhancement of well being, and understanding mechanisms that underlie disease processes. Additionally, the program emphasizes community or clinical practices that promote physically active living, sound nutrition, and disease and injury risk reduction and prevention. Graduates are prepared for research careers in higher education, governmental agencies, and health-related positions in private industry. Students may tailor a course of study that focuses on active living and wellness, nutrition science, or exercise science. PANW Second to None The Interdisciplinary PhD Program in Physical Activity, Nutrition and Wellness is one of only a handful of programs in the U.S. that fully integrates both exercise and nutrition research with health promotion research. In contrast to similar programs, the ASU PhD blends research and disciplinary /concentration courses in Nutrition and Physical Activity to prepare research scholars who contribute to public health through the delivery of effective health promotion, physical activity and nutrition programs to all segments of society. According to Pamela Swan, PhD, FACSM, associate professor and director of the PANW Program, ASU is the only university in the nation that offers a doctoral degree emphasizing health promotion and combining core courses in physical activity (i.e., exercise and wellness) and nutrition. “Baylor University offers the only program similar to ASU but it is in the School of Education while we are located in an integrated healthcare and health promotion environment in the College of Nursing & Health Innovation,” Swan said. “Being part of the college aligns our program with the preventive health and patient advocacy nature of nursing. In addition, the integration into the college has enabled us to expand the depth and breadth of our faculty by adding three senior nursing researchers as well as providing our interdisciplinary program with a more extensive research infrastructure.” Swan also pointed out that the PANW program is classroom based while Baylor’s program is mostly online. “The PANW program is designed to foster research and promote healthy lifestyles to reduce the physical, social and economic costs of unhealthy living.” Summer 2011 25 n dream • discover • deliver Building Better Health student learning a specific research skill or conducting a faculty-directed research study to learn from the faculty mentor. Examples of the research experience may include learning specific biochemical assays or research techniques, learning statistical packages, helping with data collection, verifying and/or analyzing data, manuscript writing, and/or developing a research presentation. Each year, students develop a contract with their mentors regarding their scholarly goals and objectives. A detailed proposal of the first and second year experience/ project must be submitted and approved along with the annual contract. The students are prepared to discuss the completion status of each research experience/ project at their annual reviews. By the second year, the student must complete and be first author on at least one project written and submitted for publication and/or as a presentation at a scholarly meeting. It is also expected that doctoral students will present their research results and/or proposals as part of the Research Seminar. Teaching Internship a New Component PANW a Rigorous Program Most graduates of the Interdisciplinary PhD program in Physical Activity, Nutrition and Wellness would attest that it is a rigorous and challenging doctoral program that requires a minimum of three years of full-time study after the master’s degree. The program has five core areas, including statistics and research, applied research, professional development, courses in the student’s concentration, and the dissertation. It is designed to provide students with both a breadth of foundational knowledge and depth in research inquiry methods as well as their specific concentration content areas. Research Intense Students are actively involved in research at all stages of their doctoral study through their participation in research courses, independent research projects, research technical and skill building experiences, seminars, and colloquia. Each student is expected to complete first and second year skill building research experiences, or mini-theses, and research projects leading to the dissertation. A total of 20 credit hours of elective research-related courses and experiences are required. The first year project typically involves the 26 Innovations in Nursing & Health While the PANW program is not in a college of education as at Baylor, it does include a Teaching Internship (TI) to increase student teaching competency. Typically completed in the second year of study, a student’s past teaching experience cannot be used to fulfill the TI requirement. Students identify upper level undergraduate courses that they would like to teach in order to gain additional experience. Typically the early part of the TI experience will include observing and consulting with the supervising/master teacher but later it is expected that the doctoral student will prepare for and teach class sessions independently. There are four required elements for the teaching internship, including a) a teaching portfolio including lesson plans, exams, assignments, etc., b) a self-evaluation/reflection on the teaching experiences, c) a teaching evaluation from the supervising teacher, and d) completion of a series of Blackboard workshops on methodology or other professional development workshops as appropriate. Culture of Scholarship A goal of the PANW program is to create a culture of scholarship by having all students listed as an author on three or more research articles or presentations and to be first author on at least one article before graduation. Students are expected to hold regular “office hours” in the Graduate Student Office, and regularly attend supplementary research seminars, journal clubs, colloquium and conferences. Thus, PANW students must “be involved” in all aspects of the professional and research culture of the program during its 3-year duration. Students are expected to be on campus (in their office, class or lab), to be available to their mentors and to participate fully in the program every semester. PANW Ideal Students in an area without traditional guideposts. “They see healthcare as a continuum and a belief structure without silos,” the program director added. “Our program does not offer classic algorithms but expects students to develop them through their research.” the delivery of self-management workshops, and provides resource assistance and technical support for partner agencies, as well as managing and reporting outcomes data to the Administration on Aging. PANW Alumni Succeed in Enriched Careers Melissa Benton was the first graduate of the PANW PhD in 2006. She is now an associate professor in the Valdosta State University College of Nursing in Valdosta, Georgia. “To my knowledge, I am the only Registered Nurse that has graduated from the program,” Benton said. “I looked long and hard for an exercise-based PhD program that was not focused on sports. I was fortunate to find the ASU program. It proved to be a superb program that provided me with the precise information I needed about the health benefits of exercise, exercise preparation, and specific patient populations.” Melanie Mitros graduated in summer 2010 with an Interdisciplinary PhD degree in Physical Activity, Nutrition, and Wellness. Upon entering the program, she had a Master’s in Health & Exercise Science from Wake Forest University and a Bachelor’s in Athletic Training from Middle Tennessee State University. She was a Certified Exercise Specialist from American College of Sports Medicine, a Certified Strength and Conditioning Specialist from the National Strength and Conditioning Association, and a Certified Athletic Trainer from the National Athletic Trainers Association. “I chose to apply to ASU’s interdisciplinary PANW program because I wanted to advance my education and career beyond the classroom and traditional settings of cardiac rehabilitation,” Dr. Mitros said, “I was very interested in community-based interventions for older adults but quickly realized I needed a better understanding of not only epidemiology and statistics but also health promotion to successfully implement these challenging interventions. I was able to tailor my doctoral work at ASU to accommodate these goals while working in collaboration with students from ASU and NAU, and in partnership with the Greater Valley Area Health Education Center and senior residential communities across the valley.” Mitros is currently director of the Arizona Living Well Institute, part of the health education and wellness programs offered by Empowerment Systems, Inc., a nonprofit organization serving Arizona communities. The Arizona Living Well Institute is a statewide collaboration of individuals, business, and organizations committed to developing an efficient and effective system of delivering Healthy Living, Stanford University’s chronic disease self-management program throughout Arizona. Mitros said the Living Well Institute centralizes leader training, coordinates In terms of her nursing education and career, Dr. Benton said the interdisciplinary degree provided greater breadth and depth as well as an appreciation of health promotion that she didn’t receive in her traditional MSN degree. “As we can recognize, nursing education continues to have a strong focus in acute care, hospital-based settings, despite evidence (i.e., the recent Institute Of Medicine Report on Nursing Education) that we need to move rapidly into the community,” the ASU alumna added. “The PANW program literally pushed me out there and I’ve benefited tremendously from it.” Final Assessment Professor (emeritus) Charles Corbin, the architect of the original interdisciplinary program on which PANW is based, is in a unique position to assess the current degree program. He has maintained close contact with the program and its faculty since retiring in 2004. “It is very satisfying to witness the refinements and growth of the Physical Activity, Nutrition and Wellness PhD program,” Corbin observed. “It is testimony to the vision and efforts of Pam Swan, Carol Johnston, and other PANW faculty that the program meets the ever growing health promotion research needs of these times.” n “Our program does not offer classic algorithms but expects students to ” develop them through their research. Like the PANW program, prospective students are different from most doctoral candidates. According to Program Director Pamela Swan, ideal PANW students are open-minded and willing to work Summer 2011 27 n dream • discover • deliver Building Better Health Exporting EBP to W e read countless news stories in these times about China’s exports to the U.S. but few about America exports to there. The College of Nursing & Health Innovation is reversing that trend with the export of Evidence-Based Practice (EBP) expertise to clinical nurses in Chinese hospitals. Sponsored by Dual Crane Pharmaceuticals of China, Dean Bernadette Melnyk and Associate Dean David Hrabe made the 13,000 mile roundtrip journey from Phoenix to Beijing, China to introduce EBP to nurses in three Chinese hospitals. The visit was arranged by IMD Consulting, a Beijing-registered firm licensed to provide professional training in China and the Callaway Leadership Institute, an international consulting company. Melnyk and Hrabe presented full-day EBP workshops to nursing staff of the three hospitals in Beijing. The hospitals were large by American standards with the military hospital having 5,000 beds. Presentations to the primarily bedside nurses were translated into Mandarin for the attendees. Hospitals among Top 10 Beijing Chao-Yang Hospital, founded in February 1958, is one of the top-ranked hospitals in China. It is part of the Beijing Municipal Health Bureau and also the third clinical medical school of Capital Medical University. The hospital, consisting of a complete spectrum of specialties, conducts medical treatment, teaching, scientific research and disease prevention programs. It is an “A” designated hospital in the Beijing municipal medical insurance system and one of the designated hospitals for the 29th Olympic Games. Above: Chen Wei, Deputy-General Manager of Beijing Double-Crane Pharmaceutical Business Co., Ltd., Associate Dean David Hrabe, and Dean Bernadette Melnyk enjoy a light-hearted moment at the workshop. Right: Dean Melnyk reviews EBP materials with clinical nurses in China. 28 Innovations in Nursing & Health CHINA The General Hospital of the People’s Liberation Army (PLAGH) occupies an area of nearly 33 million square feet and a floor space of more than 830,000 square feet. Since its founding in 1953, PLAGH has developed into a large general hospital that integrates medical care, healthcare, education and research with all disciplines. The military hospital has 5,000 patient beds, more than 150 clinical, medical and technology departments and more than 3,000,000 outpatient visits a year. Peking Union Medical College Hospital (PUMCH), an institutional Faculty of Clinical Medicine affiliated with both Peking Union Medical College (PUMC) and the Chinese Academy of Medical Sciences, is a renowned general hospital in China with a prestigious historical background. PUMCH is the national medical technical support center for diagnosis and treatment of severe and complicated diseases. Founded by the Rockefeller Foundation in 1921, the hospital, with its notable physicians, medical professionals and scientific researchers, has maintained its leading position as one of the top-ranked hospitals in China for over 80 years. Nursing Profession Disparities The majority of Chinese nurses are educated during high school but there has been some progress to associate degrees with few achieving a BSN or advanced degrees. The nursing profession is relatively low paid and is not as highly regarded as American nursing. Despite the differences, Dean Melnyk was struck by the common concern for patients expressed by the Chinese nurses. “The Chinese nurses are warm and caring and demonstrated a sincere desire to learn about evidence-based practice to improve their patient outcomes,” the dean said. David Hrabe was impressed by the openness and hospitality of the Chinese encountered on the week-long trip. “Everyone we met was helpful and courteous and eager to learn about the United States,” Hrabe said. “It was very much a collegial exchange.” IMD President Assesses Results Douglas Wang, president of IMD, felt the workshops were fruitful because they initiated promising training for EBP in Chinese nursing. “The hospitals we chose for these EBP workshops are among the Top 10 in China: Peking Union Medical Hospital, ranked No. 1 and regarded as the ‘best of the best’ in China, General Hospital of the People’s Liberation Army, the best in the Chinese Army, and Beijing ChaoYang Hospital, the designated hospital for 2008 Olympic Games,” Wang said. “All the presidents responsible for hospital nursing, nurse managers, and chief nurses attending felt the workshops presented very achievable EBP theories and application in real practice.” An estimated 600 nurse managers participated in the workshops and most provided either positive responses or a desire to receive Y more workshops in EBP, according to the IMD post-training survey. As an observer and participant of the EBP workshops, Wang sensed the passion of the trainees to learn EBP. “The interaction between them and the ASU nursing leaders indicated what the promotion of EBP training will bring to Chinese nursing development as a healthcare profession,” Wang said. The EBP workshops presented by Drs. Melnyk and Hrabe of the ASU College of Nursing & Health Innovation introduced new ideas to Chinese nursing on EBP, which is of major interest as Chinese medical reform moves forward, the IMD president said. He also expressed confidence that the cooperation between ASU and IMD on EBP advancement in China was strengthened by the strong start. The value of the trip to Beijing was an opportunity to help improve healthcare in another nation, Dean Melnyk said. Next Step Plans are underway to formalize the educational collaboration. Upon completion, the ASU college leaders will return to Beijing to train 10 advanced practice nurses in evidence-based practice who in turn will educate their fellow Chinese nurses. “It turns out both cultures speak the same language when it comes to nursing and EBP,” Dean Melnyk said. n discover your potential 12th Annual Evidence-Based Practice The Heart of Leadership: Inspiration and Guidance for Leading Healthcare* July 15, 2011 Teaching Excellence in Simulation Education* August 9-11, 2011 Certified Lactation Educator Program September 9, 23 & October 7, 2011 explore lifelong learning with the Academy for Continuing Education • expert faculty 2nd Annual State of the State: A Symposium of Breastfeeding Research in Arizona September 30, 2011 • innovative programs Ethical Wisdom: The Key to Leadership, Influence & Power* October 28, 2011 • continuing education credits * Discounts for alumni, preceptors, and faculty are now available for many of our programs. Online programs are listed at http://nursingandhealth.asu.edu/ACE/ • relevant content • outcomes oriented Academy for Continuing Education Email: ACE@asu.edu Ph: 602-496-7431 Arizona State University College of Nursing & Health Innovation’s Academy for Continuing Education is an approved provider of continuing nursing education by the Arizona Nurses Association, an accredited approver by the American Nurses Credentialing Center’s Commission on Accreditation. Summer 2011 29 dream • discover • deliver Building Better Health n Helping Healthcare in CAMBODIA by Joan Dodgson, PhD, MPH, RN Associate Professor ASU College of Nursing & Health Innovation D uring winter break, I had the good fortune to travel to the Kingdom of Cambodia as a volunteer nurse educator through the Health Volunteers Overseas (HVO) program. HVO is a non-governmental organization (NGO) sponsored by the American Association of Colleges of Nursing, among other professional health organizations, which has on-going international health projects in a variety of countries. I chose Cambodia because I have had both a professional and personal long-standing connection with the Cambodian (Khmer) people, since 1979 when I worked in one of the refugee camps set up on the Thai-Cambodian border for the hundreds of thousands of refugees fleeing the Pol Pot holocaust (“The Killing Fields” in 1979). I was part of a medical team that was there at the beginning of the humanitarian crisis. During the subsequent years, I have continued my connection with Cambodian refugees living in the US and traveled in Cambodia as a tourist. The Kingdom of Cambodia is a small Southeast Asian country with a population of over 14.5 million, over half of whom are under 25 years of age. High rates of poverty (35 percent) particularly in rural areas exist. It is a place of great contrasts, which I observed both in the capital city, Phenom Penh, and in the rural country-side. Great wealth has been amassed by Khmers and expatriates doing business during the rapid national growth of the past 10 years. Traveling down the street, it was common to see an enormous mansion within a walled compound next to slums constructed of discarded construction materials. High-end luxury cars filled the streets along with hundreds of motor- 30 Innovations in Nursing & Health ized rickshaws and bicycles. It is an uncomfortable juxtaposition with little middle ground. The healthcare system in the Kingdom of Cambodia had over 20 years of changing regimes with continual reorganization and restructuring prior to the government stabilizing into its current form. According to the World Health Organization rankings of healthcare systems, Cambodia ranks 174 out of 191 nations. As a result, healthcare infrastructure has taken form only since the late 1990’s and remains in its infancy. Healthcare is available in major urban areas (Phenom Penh, Battenbang, and Siem Reap) and most often paid out-of-pocket by those who can afford it. Government subsidized care for the poor is not well funded and of limited effectiveness. Cambodian healthcare infrastructure relies heavily on assistance from many NGOs, (e.g.; the World Health Organization, the International Red Cross, Medicine sans Frontiers, Red Crescent) and from direct government-to-government aid, including US AID, to provide healthcare services and technical assistance. Anyone who has studied the history of this area of the world and of Cambodia in particular quickly realizes that the horror and chaos from which these people recently have emerged was facilitated by global disregard. It is fitting and just that the rebuilding of this country’s infrastructure has been and continues to be a global endeavor. Raising Standards for Nursing Education Most nurses receive training that focuses on an apprenticeship model with 1-2 years of didactic courses being taught by physicians. Nurses’ pay is so low that they frequently need to have a second job just to make ends meet. Nurses are credentialed but there is no standardized licensing exam. According to Mr. Virya Koy, Chief of Bureau of Nursing and Midwifery at the Ministry of Health, nursing education at the baccalaureate level is new to Cambodia within the past five years. He is very interested in raising the standard of nursing care through improving nursing education countywide. Mr. Koy and his colleagues have many good ideas on how to accomplish their goal, but resources are very limited. We have spoken about the areas of greatest need in nursing, which are community health, administration and management, neonatal and pediatric nursing education. My assignment was to work with the nurse educators at Sihanouk Hospital Center of HOPE and to provide in-service education to the nursing leadership group and to the nursing staff. This is a very unique hospital in Phenom Penh, established in 1996 through collaboration between the Japan Relief for Cambodia, World Mate and HOPE Worldwide (US based). Their missions are to provide quality health- care for the poor and to improve the health of the country by providing extensive training for all levels of providers through outreach staff development and post graduate in-hospital education programs. Over 350 patients are seen every day in the hospital wards, out-patient and mobile clinics, and emergency department. Over 670 health professionals are trained each year in a number of specialty areas, including infectious disease, laboratory science, administration and nursing. The hospital has a good medical library, which has been stocked through donations, which are always welcome. All nursing staff are required to take classes in English. The Director of Nursing requested that I give classes in English without a translator because she expected her staff to be able to learn in English. I provided several seminars for the nursing leadership, who had good English language skills, addressing their concerns about promoting and monitoring best practices. Tuesday and Thursday afternoons, I presented seminars on topics selected by the nurse educators for staff nurses. Participants asked good questions and engaged with the material. We discussed how they problem-solved difficult situations, such as scarcity of resources and uncomfortable interactions with patients. These dialogs were rewarding experiences and I probably learned more than the participants did. Building from the Bottom Up The health issues in Cambodia are many and severe. In addition to high infant and maternity mortality rates and tropical infectious diseases, chronic illness is also widely prevalent. During my time in country, I saw wide-spread malnutrition, tropical infectious diseases (infant tetanus, malaria, amoebic dysentery) and illness more commonly seen in Arizona (HIV, heart disease, diabetes). The nursing staff spoke about how difficult it was to convince people to seek and continue treatment for chronic conditions, such as diabetes or hypertension, because most people had little health literacy and use traditional folk medicines when they felt sick. Treatment by physicians occurred only for dire emergencies or surgeries, despite access to subsidized healthcare. Cambodians are accustomed to finding solutions on their own, without relying on infrastructure that we take for granted in the US. I did notice one exception to this norm -- mothers would bring their sick children into the clinic for healthcare. I saw this first hand when I accompanied staff from Sihanouk Hospital’s mobile clinic in one of the city’s slums located on the edge of a garbage dump. The team included a physician, a nurse and several aides. We set up in a small one room building. Mothers brought children into the clinic that had respiratory and diarrheal illnesses, malnutrition and parasites. Through an interpreter, I obtained a brief history and conducted a physical assessment, recorded my findings, and then passed the patients on to the physician. Medical records were kept on all patients, medications were dispensed, and dressings were applied. All care was provided free of charge. One older woman in hypertensive crisis was transported to the hospital. I was impressed with the team’s organization and efficiency – they did so much with so little. There was a positive energy toward improving the quality of nursing care and healthcare in general expressed by everyone with whom I came in contact during my stay. People worked very hard in a variety of capacities to create a healthier nation. I was privileged to be able to experience all the positive changes that have happened in the rebuilding of this country, after having experienced the devastation of the culture so many years ago. It felt like Cambodia is coming full circle with a brighter future awaiting. Others may volunteer by contacting Health Volunteers Overseas through their website www.hvousa.org/. n Summer 2011 31 n A Touch of Class The legacy of Ann & Tom Van Slyck A nn (Maresca, BSN 1968, MS 1973) and Tom Van Slyck, longtime benefactors and advocates of the College of Nursing & Health Innovation at Arizona State University, recently made a substantial legacy gift for nursing scholarships. The following interview tells of their life journey together and speaks to their admirable qualities and standards, for which we also strive. Ann Van Slyck, RN, MSN, CNAA, FAAN, received the first Dream Award presented by the college in 2008. Innovations: Ann, you wanted to be a nurse from an early age. How old were you when you first considered nursing, and what influenced you to become a nurse? Ann: I really didn’t ever want to be anything else. I have come to believe that many people in nursing possess “the power to heal” within their souls. Nursing is both a blessing and a privilege. I appreciate and am grateful to say ‘I am a nurse.’ When I was a child, the only career choices women had were teacher, nurse, secretary and beautician. I don’t remember looking into any of the other options. When I was younger and sick at home, I tried to read one of my grandmother’s nursing books. Also, in Girl Scouts, I earned my nursing badge by volunteering at Lennox Hill Hospital in Manhattan. I later learned this is where my grandmother earned her nursing diploma! So, synchronicity was clearly at work. Innovations: You started your career as a bedside nurse, advanced to become a Chief Nursing Officer at a major hospital, and then established a successful, international consulting firm. What were a couple of your most satisfying accomplishments? Ann: This was definitely my career path, and the piece that I want to resonate especially with the students at ASU is the entrepreneurship in my career. With clients in 46 states and offices in five, we provided consulting services and software products to both acute care and specialty hospitals. In working with our clients, our core value was “it’s always about the patient.” The most satisfying accomplishment personally and professionally was that I knew I touched patients directly and indirectly. Also, I am proud both as a woman and a nurse to have led a consulting firm when women entrepreneurs were few and far be- 32 dream • discover • deliver Building Better Health Innovations in Nursing & Health tween. My competitors were Ernst & Young, Price Waterhouse and others that were male-dominated financial firms. The 1980s was a time that when I wanted to meet a bank president or negotiate a large contract, then I had to take a male along. Finally, my best personal accomplishment was saying "yes" to Tom! Innovations: Ann, who were the mentors who most influenced your career and who you are as a person today? Ann:I have had different mentors at different stages of my life. Although my mother died when I was only 16, she was my most significant mentor. It was so difficult to handle her loss at such a young age. I cooked, cleaned and shopped, and later became the sole breadwinner. I worked full time while in school, because my father became disabled and I had a younger brother. People who gave me strength included my school nurse at Mesa High School, Alice Keiline, RN. She encouraged me to become active in the Future Nurses Club in high school, which led me to receive a nursing scholarship to ASU. Then, at ASU, Professor 'B' Steffl, RN, was my greatest influence in staying the course. I was not sure that I could finish. 'B' called me into her office one day, and that was really the first time I truly cried about my mother’s death. She comforted me and gave me strength. As my career matured, Nancy Higgerson, RN, who preceded me as the VP of Patient Services at St. Luke’s in Phoenix, greatly influenced my professional executive development. Later, as my company grew nationally and internationally, Tom mentored me in the development of strategic partnerships and financial planning. He also taught me that to achieve fiscal viability, it was essential that I learn to talk the language of CFOs, attorneys, bankers and board members. This skill is necessary for success both in for-profit and not-for-profit healthcare organizations. to the patient. There was no boat rocking…nurse colleagues didn’t want to make each other unhappy. Situations that are not in the best interests of the patient should not be tolerated and are inexcusable. Innovations: Tom, you had your own successful career. Tell our readers how your career was intertwined with Ann’s. Tom: In the early years of our marriage, we worked for competing hospitals in administration. I was the CFO of Mesa Lutheran and Ann was the CNO at St. Luke’s, so we did not discuss much specifically about work. However, there is a funny story about when Ann was going to see the St. Luke’s board to present her nursing budget. At that time I was into hunting. She accidentally took my briefcase. She laid out her budget sheets, and then asked, “Are we ready to begin?” After she gave her presentation, she pulled out my revolver, which I'd stored in the briefcase, set it on the table and said, “Any questions?” But seriously, her budget was approved, and it included significant evening, night and week-end shift salary differentials for nurses. nerable times. There is a part of nursing that is soul driven. I believe the patients inspired me to pursue health quality. They have a right to the best quality healthcare we can provide. For example, I was invited to give remarks when I received the American Organization of Nurse Executives’ Lifetime Achievement Award. I was nervous about what to say. I stood at the podium and then discarded my notes. I was impassioned to share that we are privileged to be in the nursing profession. We can operate from our scientific knowledge base and operate from our hearts with compassion, touching a patient gently. We become part of their life’s journey. It is essential that we respect that and each other. Being in the positions I held, it was apparent to me that some hospitals suffered from quality issues that were self-inflicted and preventable by hospital staff. Some nurses incorrectly placed the relationship with their peers first, that is above their legal, moral and ethical responsibility Addiction is more common in healthcare professions than others. Part of my journey is and will be more outreach to nursing and healthcare colleagues in their recovery. Too often in healthcare, addiction is the silent disease, because there are legal implications that require anonymity. I see a greater need for those with successful recovery to reach out to colleagues. For me, retirement is busy. While I was working I lost sight of the human experience, and so I am working now on what I am passionate about. Innovations: Other than the obvious career connection, what brought you to the decision to invest in the future education of nurses at the ASU College of Nursing & Health Innovation? Ann: The college’s mission; the dream, discover, deliver philosophy; its innovation in healthcare delivery; the college’s responsibility to give back to the community, through its health centers for example. These values brought us to our decision. There are too many examples of university leaders who expect the community should support the university in a one-way relationship. That is not the case at Arizona State University. Innovations: You were very active in healthcare quality issues as a nursing leader. What drove you to invest your time and energy? Ann: We as nurses interface with other humans at their most vul- after 25 successful years. We sold it to a publicly traded company. Following that, the combination of being physically compromised and the dependence on substances to survive having taken over, I entered rehab. These days I am occupied with recovery and service related to my recovery, going on three years. I am volunteering in the US and in other countries where needed. I am so grateful that I received help and can give back to others. The quality of my life and what I can do for others are influenced by my being a nurse. Tom’s and my life together is better now. After Ann left St. Luke’s in 1981 to start her consulting firm, we were mopre free to collaborate about our work considerations and issues. In 1996, I left St. Joe’s as Director of Managed Care Contracting to become the CFO of Ann’s consulting firm. Even though earlier we couldn’t talk about our institutions, Ann has stated that she is a better executive because she learned from me. Nursing and finance do not always make strange bedfellows. Innovations: You both have had incredible journeys. Tell about what you are doing today in retirement. Tom: In retirement, I am the Treasurer (unpaid) of the property owners’ association in Pinetop, Arizona, where we have a second home. If my time permits, I golf, fly fish and downhill ski. Ann: One of my strengths is that I am driven to do better and I believe learning never ends. Physically, I developed COPD. I self-medicated with alcohol and drugs to continue my journey and face new challenges. At that time we were negotiating to sell the consulting firm I remember my tour of the college and how open and accessible all of the faculty and staff were to the students and each other. Plus, the work that Dean Melnyk is doing in Washington is tremendously impressive. She knows the national players in healthcare, and strategically positions the college for success. For example, the relationship the College of Nursing & Health Innovation has with the FDA is very significant and everybody wins. The college gives and it gets. Innovations: What is your message to those students who will benefit from your investment in them, their careers, and their impact on improving quality of healthcare in Arizona and America Ann: With all of the major challenges we are facing politically, economically and socially, and with all of the noise and ‘‘busy-ness’’ around us, we in the nursing profession need to never lose sight that we are all about the patient. It is easy to lose sight of the patient, when going to committee meetings, picking up kids, and narrowing budgets. These are only distractions if we individually allow them to be. A patient never needs to know you are busy — your ‘‘busy-ness’’ is about you. ASU Nursing Professor Dorothy Carona, RN, taught me in the late 1960s always to pause before entering a patient’s room and take a deep breath, so that when you enter the room, it is all about them! n Summer 2011 33 n Name: Erica Saunders Hometown: Sacramento, Calif. Major: Nursing Degree/Graduation date: BSN, December 2011 Why did you choose nursing? Before I ever thought I would be a nurse, I graduated from the University of California at Davis with a BS in Exercise Biology and was working as a personal trainer for an organization that ran a corporate fitness program for Microsoft employees. I was part of the lifestyles program that targeted obese clients, emphasizing metabolic disease management through exercise, nutrition, physical therapy, behavioral changes, and medical supervision. During this time, I was able to work closely with each client as well as with his or her family on a continuous basis, and was frustrated that I could only do so much about their health within my scope of practice as a trainer. I could not do anything about the medical management aspect of the program and I wasn’t able to individually prescribe exercise programs for clients with unique disease conditions. I loved that I could provide education that would effectively create change with my clients’ habits and that I could observe their improvement over time. I wanted to be able to do more with an even greater clientele that included not only education, but medical insight and disease management on an individual level. Why did you choose ASU Nursing over other programs? I was interested in applying to a nursing program with a competitive application process, a high passing rate of NCLEX, illustrated a good balance of clinicals and didactics, and had a variety of student organizations in which to become involved. Arizona State University 34 dream • discover • deliver Building Better Health Innovations in Nursing & Health Spotlight Student Ambassador Erica Saunders Describe your activities at ASU. My involvement with ASU includes a current membership and executive positions for the College Council of Nursing Students (CCNS), Student Nurses Association (SNA), and Student Ambassadors for the College of Nursing & Health Innovation. I have been the Vice President of CCNS for two consecutive semesters and joined the student group as council secretary. I also am concurrently the treasurer for SNA, which is a position I have held since I first entered ASU. As a student ambassador, I was appointed by the university to attend alumni and donor functions and assist with donor stewardship activities, such as writing thankyou cards to donors, networking with faculty and alumni, and participating on committee boards for university-wide fundraisers. I have had the amazing opportunity to volunteer with the Team of Physicians for Students (TOPS), giving physicals to middle school students, Project C.U.R.E., sorting medical supplies for underserved countries, participating on the committee for the KySSsm Dance-a-Thon, raising $500 through a student-run fundraiser, and being a member of the Healthy Arizona Now Initiative. Within these organizations, I also have had the opportunity of organizing Faculty Appreciation Day, a bi-annual book scholarship for nursing students, and participate on multiple panels for incoming freshman to ASU. Tell us something interesting about you. nursing is a highly regarded professional program, nationally ranked because of its amazing faculty and the hard work of Dean Melnyk who has a passion for innovation through evidence-based practice. ASU fit the criteria I was looking for in a nursing school, was affordable, and turned out to be one of the best experiences I could have ever hoped for in working towards my future career. Before I moved to Arizona, I was living in Seattle, Wash., where I was working as a personal trainer for two years. While in Seattle, I ran three half marathons, completed the Portland Marathon, and ran the Bridger Ridge Run in Bozeman, Mont., which is a 20 mile mountain race over the treacherous ridge. I worked this past summer in Washington, D.C., teaching leadership to middle school scholars. While I was applying to nursing school, I worked as a nanny for three little girls, all under the age of 5. When I’m not studying or working on nursing care plans, I enjoy running, hiking, kickboxing, snowboarding, cooking, and coffee. n Turning the Tables on Pneumonia among the Elderly P neumonia has been around for a long, long time. Hippocrates wrote about it in 460-370 BCE. One would think we would have the disease well in hand by now. Such is not the case as it is the leading cause of death by infection for the elderly today. It accounts for six per cent of age 65 and over deaths annually, according to the CDC’s National Center for Health Statistics. Pneumonia is a lung disease. Pneumococcal pneumonia, a kind of pneumonia, can infect the upper respiratory tract and can spread to the blood, lungs, middle ear, or nervous system. The disease mainly causes illness in children younger than 5 years old and adults 65 years of age or older. The elderly are especially at risk of getting seriously ill and dying from it. Fast forward to today’s modern healthcare…How do you address what Hippocrates called the ‘disease of the ancients’ to improve home healthcare for geriatric patients today? Fortunately, there are organizations committed to developing geriatric nursing leadership skills to improve the quality of care for older Americans at-risk due to pneumonia. The Honor Society of Nursing Sigma Theta Tau International and The John A. Hartford Foundation have formed a partnership that established the Geriatric Nursing Leadership Academy (GNLA) which has become the premier opportunity to develop the leadership skills of geriatric nurses in positions of influence in a variety of healthcare settings. Fellows of GNLA become active participants in the national network of geriatric nursing leaders. This growing group of experts has begun a collective movement toward national influence in changing care for older adults. GNLA is an exciting, intense, and career-changing experience for nurses who are committed to leading healthcare practice changes for older adults. This academy prepares geriatric nurses to effectively lead interprofessional teams to improve the quality of healthcare for older adults and their families. Fellowship recipient Karen Smith (left) and mentor Kimberly Shea review research results on tele-health home care project for elderly patients diagnosed with pneumonia. In 2010, the partners issued a call for students interested in a GNLA Fellowship. The College of Nursing & Health Innovation as one of the nine colleges of nursing in the US to have a Hartford Center of Geriatric Nursing Excellence (HCGNE) responded to that call. Mentorship is a key part of the GNLA Program so Kimberly Shea, PhD, RN, assistant professor of nursing, contacted Donna Egnatios, RN, MSN, CCM, NEA-BC and manager, Home Health for Scottsdale Healthcare to ask if she wanted to nominate one of her nursing staff for a fellowship. Egnatios recommended Karen Smith, RN, MSN, CRRN and a home health nurse at Scottsdale Healthcare since 1998. The match of mentor and mentee could not have been better. Smith and Shea both have experience with caring for geriatric patients and tele-monitoring. “Dr. Shea’s combination of academic, leadership, technology, and home health skills are just the proper components to make her an extremely effective mentor for me and for this fellowship,” Smith said. ‘‘We share a vision that simple innovations in home care can have tremendous impact. Kim has been able to see clearly the areas in which I need the guidance due to inexperience and the areas in which I may already have the strengths to independently lead.” Project Purposes Clear Given their common experience in tele-health home care for the elderly, the mentor and mentee quickly agreed on the GNLA project subject, purpose and design. Since pneumonia is the leading cause of death from infection in the elderly, the project’s purposes are to implement and evaluate the effects of providing remote health monitoring that is specific to the needs of elderly community patients diagnosed with pneumonia. Summer 2011 35 n dream • discover • deliver Building Better Health Fellows Receive Intensive Preparation The Geriatric Nursing Leadership Academy provides more than just an individual project and mentoring. The 12 members of the cohort of GNLA fellows also have attended intensive workshops in Little Rock, Ark. last fall and Scottsdale, Ariz. in March 2011. In addition, the cohort will attend a third GNLA workshop at the 41st STTI Biennial Conference near Dallas next October and make poster presentations. “GNLA is an exciting, intense, and career-changing experience for nurses who are committed to leading healthcare practice changes for older adults,” Karen Smith noted. “I spend an average of eight hours each week on the project and feel every minute is worth it. I feel my leadership knowledge growing as the project proceeds.” GNLA Fellow Karen Smith with home care patient. Tele-monitored patients with pneumonia have been using COPD (Chronic Obstructive Pulmonary Disease) programs that often result in patient and provider confusion. Home health and tele-health nurses often must intervene to clarify the misleading or partially accurate information. The project’s value takes on even more value given the 2010 initiative from the Centers of Medicare & Medicaid Service to update pneumonia reporting and monitoring. “My goal for this leadership project is to take the lead in expanding the use of tele-health for chronic disease management to using the same technology for acute illnesses such as pneumonia,” Smith said. “With Kim Shea’s mentorship, I have researched and developed selection criteria, enrollment process, clinical content, technology requirements, and evaluation criteria. An additional goal would be to work with home health case managers and nurse management to educate and lead the staff RN’s who may be involved with these particular patients and caregivers on the value of the information being received and interventions that are being taken as a result of the technology being used on the caregiver.” Methodology To develop and prove out guidelines for tele-monitoring for elderly pneumonia patients in home settings, Karen Smith plans a research study of 52 tele-monitored Scottsdale Home Health patients in their homes. All of the patients will receive usual tele-monitored care from their home health nurse; however 26 patients will also receive a newly developed pneumonia protocol. Questionnaires delivered by home tele-monitoring stations will compare patients understanding and management skills of their disease. The proposed research has been submitted for review in the ASU Institutional Review Board (IRB) process with approval expected in August. According to Smith, data collection will take from six months to one year. 36 Innovations in Nursing & Health As mentor, Kim Shea is highly impressed with Karen Smith’s performance on the GNLA project. “Karen is incredibly motivated and takes the initiative to get and keep things moving,” Shea said. “She is about patient care first and does an amazing amount of work.” Colleen Keller, PhD, RN-C, FNP, FAHA, FNAP, director of the ASU Hartford Center for Nursing Excellence, said the partnership between Sigma Theta Tau and the John A. Hartford Foundation has created the “perfect storm” in assuring geriatric leadership opportunities across the nation for geriatric nurses. “We are proud of Dr. Shea and Karen’s Smith’s work on the leadership project and that Karen is now an active participant in ASU Hartford Center activities and a leader in her institution,” Professor Keller added. Benefit to the Employer Career development is important to healthcare organization but at the end of the day benefit to patients is what counts most of all. From Scottsdale Healthcare’s perspective, the GNLA project had been a win-win according to Donna Egnatios, manager, Scottsdale Healthcare Home Health. “The GNLA program has been a great opportunity for Karen Smith to increase her leadership skills and increase her knowledge of using evidence-based practice to improve patient care,” Egnatios said. “Scottsdale Healthcare is a Magnet organization and encouraging leadership at the bedside is extremely important to both home health and the organization as a whole. Karen’s project will establish an EBP guideline and telehealth program that hopefully will lead to improved outcomes for our patients. I also hope that more of our nurses will follow Karen’s lead, and decide to do an EBP project of their own.” Donna Egnatios’ comment would certainly bring a smile to Hippocrates’ face if he was alive today. n T oo often, collaboration between professions is not the norm. Professionals work in “silos” doing what they do well, and it is rare for people from different disciplines to work directly with one another. For example, what does architecture have to do with nursing? Most people would suggest, ‘Not much.’ However, when it comes to designing buildings for use in the healthcare industry, the over-arching vision is to create an environment that supports the best possible outcome for patients by providing spaces that are safe, efficient, and conducive to delivering the highest quality patient care. So the question becomes, ‘What does an architect know about patient care?’ Clearly, collaboration between two disparate disciplines is needed in order to achieve the vision. The Case for Collaboration The ASU College of Nursing & Health Innovation strongly supports evidence-based practice (EBP)—integrating research into practice to achieve the best possible outcomes. Evidence-based design (EBD) is a means of bringing together the considerations of designers and users to produce the best possible end result. It is logical then that the college is on the forefront of promoting interprofessional collaboration in the design of healthcare spaces which incorporate the use of EBP and EBD. An important example is the work being done by the college in collaboration with the College of Liberal Arts’ Health and Healing Environments (HHE) Program. Associate Professor Gerri Lamb, PhD, RN, FAAN, has been a key figure in developing the HHE interprofessional program, working with Professor James R. Shraiky, MARCH, director of Healthcare Initiatives at ASU’s Herberger Institute for Design and the Arts, bringing together nursing students with design students. Shraiky is as committed as Lamb to the importance of working collaboratively. He commented, “In the healthcare industry, research Design students work with nursing students at the design charrette. Interprofessional Collaboration builds strength Nursing and the Built Environment continues to detail how the built environment impacts patient measurable health outcomes. As a result, a wave of change is rolling through the US healthcare system as hospitals remodel and redefine themselves by integrating the paradigm shift toward evidence-based design.” It is this vision of improving healthcare delivery and outcomes that drives the work of Shraiky as a designer and educator. Real-Life Experiences ASU is leading the way for collaborative practice to become the norm rather than the exception, but it must begin with education. For example, students from both nursing and design disciplines entered together as a team in a design charrette at a conference hosted in Las Vegas by the American Institute of Architects and the STERIS Corporation that included students from all over the country. The team from ASU was the first interprofessional team to participate in the design charrette. Lamb related, “To some extent, our team created chaos and consternation in people’s thinking. Their product was not the typical product—a health and healing facility in Las Vegas in which visitors could exercise with Cirque du Soleil. Architects alone would not have come up with this solution. It took the nurse and designer on the team to help create this synergy.” Collaboration Drives Innovation Typically, healthcare design programs are single disciplines in which students are introduced to the tools of other disciplines but don’t actually work with people from other disciplines. In contrast, the interprofessional programs at these ASU colleges encourage face-to-face collaboration. Nursing students work alongside design students to approach a challenge, bringing the strengths of their individual backgrounds to bear, developing a solution that draws on the best of both disciplines. To reinforce that it makes sense for healthcare professionals and designers to collaborate and address contemporary health issues, James Shraiky explained, “Healing environments fail with a defective delivery system and healthcare delivery fails in inadequate healing environments. Now more than ever, healthcare facilities and systems are turning Summer 2011 37 n dream • discover • deliver Building Better Health she works with architects to determine how a home environment can best support patient’s health. Currently, Shea is co-investigator on a study that examines how a low-income housing community’s renovations influence the health of the residents. to evidence and innovation in design, such as those produced by allowing design to join forces with medicine and clinical delivery research.” Daniel Cheetham, who is a Master’s candidate in Healthcare Design, has found working with students from the College of Nursing & Health Innovation to be positive. “Working with nursing students has broadened my horizons on many levels,” the graduate student said. “It has exposed me to many aspects and skills that aren’t commonly available to designers. There is a barrier to communication between designers and healthcare professionals in that designers/architects and clinicians historically think and practice in two very different ways. This inter-professional approach to post-graduate education is critical to increasing the quality of the healthcare delivery environment.” Inter-professional Collaboration in Academia and Research Emphasis on inter-professional collaboration at the college continues to expand. Nursing faculty are serving on thesis and dissertation committees for students in healthcare design. Lamb commented, “What a wonderful gift for me as a nurse and a scientist to help shape the thinking and research of architects and designers, and have them expand my thinking, the models I create as a scientist, and my research methods.” Lamb described one example where she is serving as chair on the master’s committee of design student Emily Newcomb, who is studying nursing communication in the ICU and the impact of the built environment. Lamb noted that she is providing Newcomb depth and rigor in healthcare research methods and insights into nursing practice, working intensively with the student on her analysis. But Lamb also remarked that Newcomb has used tools of analysis to illustrate her concepts that aren’t part of the nursing research toolkit, with Newcomb’s results and her analysis as a designer in turn, teaching Lamb to look at communication in new ways. 38 Innovations in Nursing & Health Mother Nature Knows Best Key to Quality Ellen Fineout-Overholt, PhD, RN, meets with graduate design student Daniel Cheetham. Newcomb, whose thesis committee included a healthcare architect and an industrial design professor in addition to Lamb, shared her perception of working with an inter-professional team: “Each master thesis committee member was able to enhance the research by bringing perspective and insight from their respective fields. Professor Lamb, as my thesis committee chair, represented the nurse perspective, and she provided significant research guidance and helped me to understand healthcare issues within a clinical setting.” Ellen Fineout-Overholt, PhD, RN, director of the college’s Center to Advance Evidencebased Practice, serves on the master’s committee for Daniel Cheetham. Fineout-Overholt remarked, “The synergy that is created and experienced when working together as a nursing faculty member and a design student has been phenomenal. Dan’s work has helped me to see where EBD is grounded and where the paradigm has room to grow.” The college’s support of interprofessional collaboration includes crossovers in research. Assistant Professor Kim Shea, PhD, is heavily involved in interprofessional research, a result of her focus on the use of technology for health. Crossing many disciplines, Shea works with design engineers to make sure human factor components are consistent with home-based patients’ capabilities, and Interprofessional collaboration holds an important key to improving quality healthcare in this country. From a design student’s perspective, Cheetham said the defining factor in the success of the design of a healthcare facility is how that structure helps providers give care effectively in a safe, healing and stress-reducing environment, which can only be accomplished by involving nurses and other front-line staff in the design process alongside planners, architects, interior designers, and others. Achieving the Vision It is clear that the vision of an efficient, effective healthcare system requires collaboration between numerous professionals to produce the most effective outcomes. “ASU is building interprofessional programs that ultimately give students real-world experiences in working together for better, more creative, more innovative solutions that only are possible when you work across professions,” Lamb noted. Shraiky added, “In the healthcare industry, research continues to detail how the built environment impacts the patient healing experience and measurable health outcomes. Now more than ever, healthcare facilities and systems are turning to evidence and innovation in design.” Vision can become a reality that overcomes traditional barriers by gathering the strengths of all available resources. Healthcare can only be strengthened and improved by the power of interprofessional collaboration. This inclusive approach will continue to push the envelope in achieving the vision of a healthcare environment that produces the best possible outcomes. n Enhancing Health through Clinical Lactation Education W hen it comes to the choice between breastfeeding and formula-feeding a baby, scientific research has proven that breastfeeding is best for the health of the infant. Although the evidence leaves little room for debate, the actual rate of breastfeeding in the US remains low. The College of Nursing & Health Innovation at ASU has a goal of increasing breastfeeding infants in this country through its new Southwest Clinical Lactation Education Program. so-distant past, and remember my frustration and anxiety in those first days when I could not get my son to latch on to the breast. It took two days and three visits from the hospital consultant before I could successfully breastfeed. I had everything going for me—I was highly educated and had lots of social support and friends who were breastfeeding…yet if I hadn’t had the support of a lactation consultant, I might never have gotten my son to the breast.” Comprehensive lactation education programs are rare in this country, and the ASU college’s program is a first in the Southwest. It offers entry-level preparation for healthcare workers who work directly with breastfeeding mothers, as well as providing the continuing education requirements for those who are International Board Certified Lactation Consultants (IBCLC). IBCLC is the standard credential for lactation professionals. This continuing education program addresses clinical management, public health issues, and socio-environmental contexts. Research Proves Need Support and Resources Inadequate Support for breastfeeding mothers ranges from inadequate at best to virtually absent, according to Nursing & Healthcare Innovation PhD student Amanda Watkins, RD, IBCLC. “The birth of my first child in July 2000 was quite an eye-opening experience,” Watkins said. “Everything from the prenatal care and education I received from the obstetrician’s office to the care I received at the hospital left me confused.” Watkins wasn’t asked how she planned to feed the baby until the prenatal classes late in the pregnancy. However, she received plenty of free formula at her first OB appointment when she was just six weeks pregnant. Watkins added that information in the hospital was conflicting and confused her. “I had more education and support than most mothers, yet I found it difficult to know who to listen to and I felt pressured to give formula although I resisted and did not,” the doctoral student observed. Assistant Research Professor Jennie Bever, PhD, IBCLC, related her own personal experience. “I was a new mother myself in the not- In 2007 the Agency for Healthcare Research and Quality (AHRQ) conducted a comprehensive review of current research on the subject of the relationship between breastfeeding and maternal and child health outcomes in developed countries. The AHRQ report detailed clear evidence, citing 43 primary studies and 29 systematic reviews or meta-analyses that covered approximately 400 individual studies that proved breastfeeding plays an important role in maternal and child health outcomes. According to the AHRQ, breastfeeding was a key factor in reduced rates of diabetes, sudden infant death syndrome (SIDS), and obesity, among others. Focusing on just one of these key benefits, a meta-analysis on the research of Breastfeeding and Reduced Risk of Pediatric Overweight published by the Centers for Disease Control (CDC) reveals there is a 15 to 30 percent reduced risk for an exclusively breast-fed infant to become overweight, even as an adult. Considering the lifetime health risks posed by overweight or obesity, and the high rate of overweight/obesity plaguing this country, this alone is a significant factor. Mothers who breastfeed have a lower risk of breast and ovarian cancers, and have reduced risk for developing Type 2 diabetes. Additionally, the AHRQ analysis reveals that early cessation of breastfeeding or not breastfeeding at all is associated with increased risk for maternal post-partum depression. Associate Professor Kathryn Records, PhD, RN, whose research focus includes interventions to improve the health outcome of women during childbearing, ob- Summer 2011 39 n dream • discover • deliver Building Better Health served, “From my experience, mothers who are depressed also find that breastfeeding is just one more thing that they are expected to do while they aren’t feeling well… So they really need extra encouragement to continue.” Despite evidence supporting the benefits of breastfeeding, the percentage of mothers who breastfeed their babies for what is considered the optimal length of time, is still very low. According to data from the CDC National Immunization Survey, just 33 percent of infants born in 2007 were exclusively breastfed for three months, and a mere 13.3 percent were exclusively breastfed for six months -- considered the minimum optimal length of time by the American Academy of Pediatrics. Creating Long-term Impact This ASU lactation program also will play a key role in educating healthcare providers who can offer support needed to increase the prevalence of breastfeeding and create a long-term impact on healthy outcomes. Program development was led by Joan Dodgson, PhD, MPH, RN, who joined the college in 2010. Dodgson is a perinatal and lactation clinical specialist and has been an International Board Certified Lactation Consultant (IBCLC) for 15 years, practicing clinical breastfeeding management and teaching breastfeeding and childbirth classes for parents. She has been deeply involved with breastfeeding research, including NIH-funded projects that focused on disparities in breastfeeding in minority communities. As Dodgson commented, “Education for physicians, nurses and dietitians has very little, if any, content on supporting and/or managing breastfeeding issues. Our program fulfills that need.” Doctoral student Amanda Watkins and Assistant Professor Jennie Bever (seated) Amanda Watkins concurred, saying, “I began my career in public health working as a High Risk Nutritionist for the Maricopa County WIC Program. I was shocked at the lack of preparedness I had regarding breastfeeding and basic health education/promotion. How are health professionals supposed to provide competent health education and support to breastfeeding families if they are not expected to gain a basic level of competency in school?” It is exactly that question that the College of Nursing & Health Innovation program seeks to answer and to solve. 40 Innovations in Nursing & Health Program Offerings Celebrating Success One Gift at a Time Presented as part of the college’s Academy for Continuing Education (ACE), the Southwest Clinical Lactation Education Program consists of the following courses: Certified Lactation Educator Program (45 CEUs) This entry-level program trains people to educate mothers one-on-one or in groups about breastfeeding. It provides basic information about the process of lactation and essential skills for supporting and promoting breastfeeding. A certificate is given upon successful completion, consistent with national standards for this level of lactation support. It is run twice a year as a hybrid program with three days of onsite education and two days online. Clinical Breastfeeding Management (45 CEUs) This second course is designed to provide the knowledge and develop skills practitioners need to become Board Certified Lactation Consultants. It is a hybrid course, with three in-person days and two online days. It will be offered in 2012. Mentored Clinical Experience (CEUs vary) This course allows people interested in becoming IBCLCs to obtain the required one-to-one mentored clinical hours. Certification Examination Review Course (15 CEUs) This is a review of the content knowledge needed to pass the International Board Certification of Lactation Examiners certifying exam. It will be offered in May 2012. Support in the Workplace and Beyond The college has set an example “at home” by moving quickly to comply with new federal requirements requiring accommodation of the needs of lactating mothers. Recently completed renovations provided three lactation rooms for employees and students. A committee was formed to spearhead the project, led by Dodgson, with assistance from Amanda Watkins and Jennie Bever, and additional committee members Maureen Duane, director Family Resource Center, Tempe campus; Lisa Green, RN, PNP, DNP student; and Melinda Johnson, RD, Nutrition faculty member, Polytechnic campus. Last fall, the college presented the state’s first symposium reviewing the state of research on breastfeeding in Arizona. The next symposium, “The Second Annual State of the State: Breastfeeding Research in AZ Symposium” is scheduled for September 30. For more information on the program or the symposium, email jdodgson@ asu.edu or call (602) 496-0823. Education Holds Key to Success Watkins noted, “Many of the challenges faced in the early days of breastfeeding can be prevented with basic education and support from health providers.” It is this support that is critical to increasing breastfeeding initiation and continuation rates. The Southwest Clinical Lactation Education Program should have a significant impact by training professionals to provide the evidencebased support required to increase the rate of breastfeeding and bring about healthier outcomes for mothers and babies. Mother Nature—and mothers—will be pleased. n T he College of Nursing & Health Innovation’s fundraising initiatives for the current year doubled private gifts compared to the previous year. “By the end of March 2011, we had received $1.17 million dollars in private support for a wide breadth of programs, including inter-professional education, equipment for Exercise & Wellness laboratories, undergraduate scholarships and graduate fellowships in addition to important community-based research studies,” stated Laurel Van Dromme, chief of strategic partnerships. “We are clearly experiencing an increase in philanthropy again from individuals close to the college as well as foundations such as BHHS Legacy and corporations like Reebok. This is tremendous and critically needed for our students, faculty and staff given reduced state support.” Thanks also are in order to all College of Nursing & Health Innovation annual donors. Because of their generosity, the college experienced a 28 percent increase in annual giving from 2009 to 2010. More than $85,000 were donated by individuals, corporations and foundations to support the College Investment Fund, Scholarship Funds, Learning Resource Center, and Nurse Managed Health Centers, to name a few. Nearly 10 percent of the college’s philanthropy is supported by an annual gift. Over the past year, gifts to the College Investment Fund helped a BSN and Barrett Honors College student to travel to Washington, D.C. to attend a national forum “America’s Children in Peril: Solving the Obesity and Mental Health Epidemics.” Reflecting on her experience, the student said, “This experience was outstanding. My next step in life is to become a family psychiatric nurse practitioner and I have applied to ASU’s DNP program. To hear the panelists speak on topics that are so close to my heart was so exciting.” Additionally, gifts to the Nursing Scholarship Fund have helped students purchase the majority of their textbooks and software required for the first semester of the Doctor of Nursing Practice program. One student indicated that as an out-of-state student and working in an ICU in California, the scholarship she received made a big impact. In 2012, the College Investment Fund will help several PhD students travel to the annual American College of Sports Medicine Conference. We invite you to join our donor family by making a gift today. A gift of any size is needed and appreciated. Membership in the Annual Giving Society begins with a gift of $100. We have more than 200 members now, and it will be our pleasure to welcome you into this important part of our donor family. Thanks for your thoughtful consideration. Advantages of joining the Annual Giving Society Gifts and pledges of $100 or more made before December 31, 2011, will be listed on the annual donor recognition wall of the College of Nursing & Health Innovation 2 Building on the ASU Downtown Phoenix Campus. Go to http://nursingandhealth.asu.edu/Development for gift levels, amounts and recognition. How to make a gift If you would like to make a gift, please write your check payable to ‘ASU Foundation’ and indicate Account #30002852 on the check memo line. Please mail your check to: Pamela Lowe, Assistant Development Officer Arizona State University College of Nursing & Health Innovation 500 N. 3rd Street Phoenix, AZ 85004-0698 Please call 602.496.1498 if you have questions or email pamela.lowe@asu.edu. Gifts may be made online by visiting the web site at the address above. Summer 2011 41 n dream • discover • deliver Building Better Health news that matters... Transdisciplinary Training in Health Disparities Science (T32) gram faculty members will supplement formal Usha Menon, PhD, RN, and Colleen Keller, nurses to conduct rigorous clinical research PhD, RN-C, FNP, FAHA, FNAP, recently re- that improves healthy behaviors and health ceived a five-year institutional research train- outcomes of vulnerable populations across ing grant from the National Institutes of Health the lifespan. to fund the training of pre- and post-doctoral fellows in health disparities research. One of only about 25 nursing schools to be award- Tzu-Chi College of Technology Visits to Explore Possible Collaboration coursework and seminar learning and prepare College Listed in Top 4 Percent of Graduate Nursing Programs sents the second largest group to graduate in the program’s history. The Kinesiology program was integrated into the College of Nursing & ed a T-32 grant, the program of study and The ASU College of Nursing & Health In- mentorship developed by Menon and Keller, novation has achieved the highest ranking in “Transdisciplinary Training in Health Dispari- its history and is now ranked 21st out of 467 ties Science” will prepare nurse scientists to U.S. graduate nursing programs in the 2012 design, conduct and evaluate research related U.S. News & World Report College Rankings vention, Steve Blair, PED, Arnold School of to the culture of the groups, communities, and The college’s recently completed NHI2 building has won the De- issued Tuesday. This ranking places the ASU Public Health, University of South Carolina, organizations with whom they work with the sign-Build Institute of America’s (DBIA) National Design-Build Award college in the top four (4) percent of graduate and Paul Campos, JD, University of Colorado aim of reducing disparate health outcomes. for an Education facility over $25 million, and was one of two build- nursing programs. and author of “The Obesity Myth: Why Amer- ings, out of hundreds of entries to be nominated for the Best Over- ica’s Obsession with Weight is Hazardous all Award. In addition, NHI2 has achieved Leadership in Energy and to Your Health,” addressed the connections Enironmental Design New Construction (LEED®-NC) Gold certifica- between obesity, weight loss, and mortality. tion from the United States The ranking was determined by an assessment survey completed by peers in fall 2010. The college was ranked 32nd of 396 gradu- Dr. Katherine Flegal of the CDC addresses the Building Healthy Lifestyles Conference. ate nursing programs in the previous 2008 The Building Healthy Lifestyles Conference U.S. News & World Report College Rankings. is an annual event focusing on topics con- All U.S. News & World Report health rankings are based solely on the results of peer assessment surveys sent to deans, other administrators, and/or faculty at accredited de- necting physical activity, nutrition and wellness, in order to create healthier lives. The 7th Annual Building Healthy Lifestyles Conference is tentatively scheduled for Feb- LEED®-NC Gold certified buildings in Phoenix. The five-story, 84,000 square foot, copper-clad urban building creates Science, Society, and Solutions to Obesity : The 6 Building Healthy Contributed by PANW doctoral students Jennifer Greer, MS, and Shannon Smith, MS, RD. evolving downtown core. It est health concerns in the United States and tectural character to the features classrooms, office College of Nursing & Health Innovation Hosts Largest Ever Graduating Class many countries around the world. On Febru- The College of Nursing & Health Innova- The program is built on the research exper- ary 25-26, 2011, more than 200 nurses, di- tion held convocation on Friday, May 13, 2011 tise of 17 primary program faculty, who rep- etitians, students, and health educators in at- for the largest graduating class to date. The resent several disciplines including nursing, tendance at the sixth annual Building Healthy college confered a total of 596 degrees, 289 anthropology, exercise and wellness, clinical Lifestyles Conference (BHLC) explored re- more than last year, including 546 undergrad- psychology, medicine, nutrition, sociology, cent research related to this health epidemic. uate degrees and 50 graduate degrees. Innovations in Nursing & Health making it one of just a few sdale, Ariz. really the answer? Obesity is one of the great- 42 Green Building Council, shade and adds archi- Is obesity a death sentence? Is weight loss mentorship of these interdisciplinary pro- College Building a Winner ruary 2012 at the SkySong Center in Scott- Lifestyles Conference social work, and veterinary medicine. The Wellness, 95 in Nutrition, five in Health Sciences, and 202 in Nursing. gree programs or schools in each discipline. th Colleen Keller (left) and Usha Menon Health Innovation in 2010. Graduates also included 80 in Exercise and and administrative space, a 240-seat conference center as well as a 60-seat computer classroom laboratory. College Staff Member Honored In 2010 over 3,000 SUN Award certificates were presented to ASU faculty and staff for providing excellence in their roles at the university. From the large number of recipients of these thousands of awards, four employees were recently honored as Top Multiple SUN Award recipients, based on the quantity and quality of the actions Three featured speakers, Katherine Flegal, Of the 546 undergraduate degrees con- described on their award certificates. Among the four is Lisa Graba- PhD, Centers for Disease Control and Pre- ferred, 195 were in Kinesiology, which repre- rec, administrative assistant here at the college. Grabarec has worked The Center for World Health Promotion & Disease Prevention hosted eight distinguished visitors from the Tzu-Chi College of Technology (Hualien, Taiwan) this spring. The focus of the visit was to determine potential collaborative faculty and scholarly activities between their programs and the College of Nursing & Health Innovation. The one-day visit was organized by Center Director Carol Baldwin, PhD, RN, AHN-BC, FAAN, Center Coordinator Leah McVicker, Angela Chia-Chen Chen, PhD, RN, PMHNP-BC, and Kimberly Shea, PhD, RN, a classmate with Lin, Zu-Chun, PhD, RN, who initiated the visit. The visitors included College President and Professor Horng, Dang-Ming, PhD; Associate Professor and Director of the Research and Development Center, Wang, Shu-Fang, PhD, IBCLC; Associate Professor of Nursing and Section Chief for International Academia and Industrial-Academic Cooperation Research and Development Center, Lin, Zu-Chun, PhD, RN, and five others. Administrators, faculty and staff from were treated to a traditional Hualien musical performance presented by the guests followed by a video that introduced the Tzu-Chi College of Technology. The college was established in 1989, and promotes four major missions: charity, medical care, education and culture. Academic programs in nursing aim to develop professionals who demonstrate the college’s motto, “Be kind, compassionate, joyful, and giving.” The curriculum and instruction focuses on holistic health. The multi-strategic teaching prepares students to develop problem solving abilities, to model a humanistic character of caring for the sick as if they are family, and to cultivate an unselfish attitude. The baccalaureate degrees include academic programs within the Departments of Nursing, Health Administration, Radiological Technology, Physical Therapy, and Information (computer) Engineering and Informatics. Undergraduates can apply for graduate study in public health education or related areas. The scope of academics fits the special characteristics of local areas, meets the needs of society, and promotes overall collegiate development. The visit ended on a positive note with Dean Bernadette Melnyk and President Horng discussing future faculty workshop and research collaborations and exchanges. The two academic leaders believe it will broaden the international vision of their respective faculty and programs. The college invites scholars, professionals, and experts from foreign educational institutions to visit their campus and share their academic achievements and experiences. n Summer 2011 43 n Building Better Health at ASU since 1989, gaining a broad base of Carl Yamashiro, PhD, has replaced Mottle knowledge of the university. as Acting Director for the Center. Dean Recognized for Innovative Program Dean Bernadette Melnyk was recently named an Edge Runner for the second time by the American Academy of Nursing for her COPE Program for Parents of Premature Infants. The designation of Edge Runner is applied to nurses who have pioneered innovative, nurse-led models of care that remedy a problem in health care delivery or provide a previously unmet health need for a population. The COPE (Creating Opportunities for Parent Empowerment) Program teaches parents how to appropriately care for a premature baby, which not only reduces their stress levels but also improves a preemie’s health and development. Mottle, The ASU College of Nursing & Health Innovation celebrated National Patient Safety Awareness Week in March. The ASU community was invited to the Room of Horrors and asked to identify unsafe situations in the room and mistakes in care delivery. The goal was to increase participants’ attention to occupational health and safety hazards, the national patient safety goals, infection prevention, and environmental safety. Program Selected as National Finalist The COPE/Healthy Lifestyles TEEN Path Points to Advanced Practice Some practitioners may choose to advance to the next level of Advanced Practice. An Advanced Practitioner “…demonstrates a high level of skills, knowledge and behaviors. The individual exhibits a set of characteristics that include leadership and vision and demonstrates effectiveness in planning and communicating targeted outcomes” (Visioning Report 2011). The Advanced Practitioner would have a master’s degree or higher with eight or more years experience as an RD. He/she also may possess an advanced practice credential (i.e., Board Certified in Advanced Diabetes Management). MSM- Award. The program is one of 22 finalists out HSA, RN, CCRP, director of nearly 250 applications. The US Secretary of the Center for Health- of Health and Human Services will make the care Innovation & Clinical final determination of winners based on pub- Trials, recently retired. Ms. lic votes and recommendations from the HHS Mottle came to the college Expert panel. with more than 30 years in as an administrative manager, nursing clinician, and organizational leader specializing in health program research development and intensive cardiac care. Mottle was named to head the new Center in 2007. Under her leadership, the center launched its successful MS degree in Clinical Research Management in 2009. In 2010, it formed CONECTR, a Community-Oriented Network to Enhance Clinical Trials and Research, a consortium of over 20 members which has already resulted in placing over 25 new clinical trials in six areas at CONECTR research sites. These innovative efforts won it the ASU President’s 2010 Award for Innovation. 44 Innovations in Nursing & Health An RD practitioner may choose to pursue a role as a specialist. A specialist is “a practitioner who demonstrates a minimum proficient level of knowledge, skills, and experience in a focus area of dietetics practice by the attainment of a credential” (Visioning Report 2011). Areas of practice for an RD specialist could include Gerontological Nutrition, Oncology Nutrition, Renal Nutrition, Pediatric Nutrition, or Nutrition Informatics. Over time, the opportunities for specialist credentials will expand as new markets emerge. Program selected has been selected as a fiHuman Services Healthy Living Innovation health and clinical research include health promotion/disease prevention, public policy, clinical healthcare, education, research, food production and service management, and corporate/food industry. (Thinking, Emotions, Exercise and Nutrition) nalist for the federal government’s Health and Center Director Retires Linda Patient Safety Awareness ...McCollum, continued from page 16 CCNE Accredits DNP Program The Commission on Collegiate Nursing Education (CCNE) has awarded the maximum of five full years accreditation through 2016 for the Doctor of Nursing Practice Program (DNP) at the ASU College of Nursing & Health Innovation. Dean Bernadette Melnyk credited Evelyn Cesarotti, Director, Graduate and Advanced Practice Programs, Dave Hrabe, Associate Dean for for Nursing and Healthcare Innovation Programs, and faculty and staff for their efforts through the intensive accreditation process and for implementation of the program. The program launched in January 2008 and the first cohort of Post-Master’s DNP students graduated in 2009. The program has an enrollment of 104 for the fall 2011 semester. n The 2011 Dietetic Career Development Guide from ADA helps expand the focus of the profession while providing a flexible pathway through multidimensional opportunities. It encourages practitioners to think creatively, act assertively, think multidisciplinarily, and to work collaboratively. Change is on the horizon and there are many opportunities to create new career pathways for the nutrition/dietetics profession. From the implementation of healthcare reform to the ADA’s Council on Future Practice Career Development Guide 2011, this is the Right Time and the Right Place to have a great career in nutrition and dietetics. n s c i p h To t l a e ot H H s t i H r i A the s e v a W A key part of the ASU College of Nursing & Health Innovation’s strategy focuses on improving health outcomes and promoting healthy lifestyles for Arizonans and Americans. To accomplish this mission, the college took to the airwaves with its first radio program titled Hot Health Topics, which aired at afternoon drive time Mondays from January to late April. Broadcast on KFNX-AM 1100, a 50,000 watt news talk station in Phoenix, the program also was accessible live online at www.1100kfnx.com on Mondays and the following day at http:// nursingandhealth.asu.edu/. Dean Bernadette Melnyk, a nurse practitioner, hosted the program and discussed the best and latest evidence on how to live healthier lifestyles and the best treatments for serious health conditions. A different health expert joined the dean each week to discuss topics ranging from child depression, medicinal foods, preventing and managing obesity, and caring for caregivers. Guests on the program were as varied as the topics. Dean Melnyk drew on her extensive network of national healthcare leaders and had expert guests from Mayo Clinic in Rochester, Minn., the University of Alabama in Birmingham Stroke Center, the March of Dimes in White Plains, NY, as well as senior research faculty with the college. Richard Carmona, MD, 17th Surgeon General of the US (2002-2006), now located in Tucson, also joined the dean to discuss warning signs of heart attacks. Dean Melnyk is positive about the contribution that the radio program made to educate the public about health promotion and healthcare treatment. “We need to provide the best evidence on treatment and prevention to the public,” she said. “Radio enabled us to reach health consumers who have the power to work with their primary care and other care providers to improve their health.” Radio Program Part of Healthy Arizona NOW Hot Health Topics is part of the college’s Healthy Arizona NOW initiative to improve physical and mental health outcomes across the lifespan for the people of Arizona. The goal of the program is to improve physical and mental health outcomes across the lifespan for the people of Arizona through evidenced-based healthcare and health promotion, services, community engagement, and first-class educational programs. “Behaviors, such as poor eating habits, too much TV viewing, lack of exercise, and smoking are the leading killers of Americans,” Dean Melnyk said. “In Arizona, 64.2 percent of the population is overweight, including 25.9 percent that are obese, according to the Center for Disease Control. More than 30 percent of children ages 10-17 in Arizona are overweight and of these 18 percent are obese. It is important for each of us to make the right choices and take responsibility when it comes to our health.” In a report just released from the Centers for Disease Control, it is predicted that one out of three Americans will have diabetes by 2050, in large part due to obesity. One of every three Americans today is overweight or obese. One out of four Americans also has a mental health problem, which is predicted to increase to one out of two by 2020, according to the World Health Organization. The ASU College of Nursing & Health Innovation kicked off the Healthy Arizona NOW initiative to engage students, faculty and the community in leading more healthy lifestyles at ASU’s 2010 Homecoming parade with a float with the theme “Make 1 Change for Better Health.” n Above, left: Dean Melnyk listens to a caller’s question on Hot Health Topics. Above, right: David Besst (left) of the Arizona Department of Health Services and ASU Professor David Coon discuss care for caregivers on the program. Left: Michelle King Robson, CEO of EmPowHer, a health media company for women, joined Dean Melnyk for a discussion on women’s health concerns. 500 N. 3rd Street, Phoenix, AZ 85004-0698 Save the date! Dream • Discover • Deliver Awards Event Tuesday, December 6, 2011 • 7:00 p.m. – 9:00 p.m. Tickets $35/person 2011 Honorees dream: Anita L. Owen, MA, RD discover: Patricia A. Grady, RN, PhD, FAAN deliver: Joey Ridenour, RN, MN , FAAN Desert Botanical Garden 1201 N. Galvin Parkway Phoenix, Arizona 85008 480.941.1225 • www.dbg.org discover dream Anita L. Owen, MA, RD President Owen & Owen Ltd. Patricia A. Grady, RN, PhD, FAAN Director, National Institute of Nursing Research deliver Joey Ridenour, ASU ‘69 RN, MN, FAAN Executive Director, Arizona State Board of Nursing Contact Emily Muller, Development Coordinator, at 602.496.1238 or emily.e.muller@asu.edu if you have questions or want to purchase tickets. For more information, go to http://nursingandhealth.asu.edu/ddd-awards Sponsorship opportunities available. Cash bar and hors d’oeuvres