Nurse-Led Research and Innovation

Grantees in alphabetical order

Breastfeeding: The impact of education on primipara women’s breast-feeding intension and exclusivity  
$5,000 grant to NYU Langone Health, 2024-2026

The purpose of this study is to determine the impact that a structured breast-feeding education program has on primipara women’s attitude towards breast feeding. The study required IRB modifications to include Spanish and Mandarin Chinese in addition to English speaking participants, recruit a front-line nurse to assist with translation and delivering the Breast-Feeding education for Mandarin speaking patients and expand the eligibility from primipara to multi-para. As of Q3 2025, 35 participants enrolled across 4 NYU Langone Health sites. A secondary objective of this study is that primipara women will make an informed decision on whether to breast feed exclusively.

Collaborative Care Grant Program
$223,000 grant to the American Society of Health-System Pharmacists Foundation (ASHP) Foundation supported three studies through its Collaborative Care Grant Program:

Feasibility Study for the Comprehensive Overweight/Obesity Management Pre-Kidney Transplant (COMPKT) Program (Virginia Commonwealth University, 2024-2026)

Implementation of a Standardized a Patient-Centered, Team-Based Deprescribing Assessment within Community Based Palliative Care Program: A Feasibility Study (MedStar Health: University of Maryland School of Pharmacy, 2023-2025)

An Innovative Medication Optimization Clinic to Enhance Outcomes for
Patients with Heart Failure (University of Pittsburgh, 2021-2023)

CONCERN 3.0: Optimization of Pediatric CONCERN EWS to non-AMC settings
$499,984 grant to Columbia University (2025-2027)

The CONCERN 3.0 study (Optimization of Pediatric CONCERN EWS to non-AMC settings) will result in a well-performing predictive Early Warning Score (EWS) for community-based pediatric hospitals and inform future spread to other types of lower-resourced, non-academic settings. Our original CONCERN EWS was evaluated in a randomized clinical trial at 4 adult hospitals and successfully reduced risk of in-patient mortality by 35.6% and sepsis by 7.5%. We know of no other all-cause deterioration EWS with this magnitude of influence across several key patient outcomes. The success of CONCERN EWS is attributed to the very early identification of subtle signals of deterioration based on expert nursing surveillance and the resulting action of early ICU transfers. CONCERN EWS models expert nursing surveillance by analyzing statistical signals in nursing documentation patterns. Early identification and escalation of care is particularly critical at community-based pediatric hospitals that may lack specialist expertise and require a transfer to a tertiary academic medical center. An early transfer is typically the best chance for survival, however, due to the resources required the decision to transfer a patient very early in their deterioration requires confidence in the subtle early clinical indicators of deterioration – an EWS can provide valuable role informing this decision. A well-designed EWS may also help to ensure decisions are equitable.

An EWS that was validated at a high-resourced tertiary care setting needs to be validated separately when applying it to non-academic, community-based, lower-resourced environments due to differences in documentation patterns and models of care, such as constrained resources (eg., limited access to specialists), lower staffing, and inadequate infrastructure (eg., insufficient ICU beds and advanced monitoring systems). CONCERN EWS maintains high predictive performance even with the use of minimal model features; therefore, we believe CONCERN EWS has high potential in modeling the documentation patterns and models of care in low-resourced environments for early prediction of deterioration. Specific aims are: 

Aim 1. Optimize the pediatric model of CONCERN EWS for non-academic, community-based inpatient pediatric settings. 
Aim 2. Develop, implement in silent mode, and evaluate the optimized pediatric version of CONCERN 3.0 EWS at 2 non-academic, community-based inpatient pediatric hospitals that are part of Children’s Hospital Colorado Health System for significantly improved lead time in predicting increased risk of deterioration and other predictive performance measures compared to the PEWS. 

Methods include performing calibrations of the model to fit local EHR configurations and feature selection and optimization of model thresholds for our pediatric deterioration outcomes of in-hospital mortality, cardiopulmonary arrest, sepsis, and escalation of care. We will identify potential sources of model bias by analyzing variability in nursing documentation patterns and intervene on those using feature engineering approaches. The CONCERN Implementation Toolkit will guide stakeholder engagement and implementation. Prospective evaluation will include the primary outcome of significantly improved lead time in predicting increased risk of all-cause pediatric deterioration compared to the PEWS. Secondary outcomes are a) improved model performance for all cause pediatric deterioration compared to PEWS and b) variability in lead time and predictive model performance across different pediatric patient demographic groups. Knowledge gained from achieving these aims will provide the potential for building capacity to spread CONCERN to other non-academic rural settings - both adult and pediatric given our team’s work in both populations - as well as other types of low-resourced settings, including urban community hospitals. 

How Nurse Leaders Understand and Address Bullying in the Workplace
$20,000 grant to the Association for Leadership Science in Nursing (ALSN), 2024-2026

The American Nurses Foundation has provided a $20,000 grant to the Association for Leadership Science in Nursing (ALSN) to conduct the research project, “How Nurse Leaders Understand and Address Bullying in the Workplace,” led by Laura Cox Dzurec and Jennifer Hehl at Hartford Hospital. The purpose of the study is to support nurse leaders’ effectiveness in addressing workplace bullying. Researchers have conducted focus groups and piloted a survey with nurse leaders as part of this investigation. Analyses to date suggest that bullies’ power in the workplace resides in their ability to commit norm violations and to justify them through emotionally confusing story telling. Findings were then used to categorize types of offensive and bullying behaviors into six areas: 1. classically-recognized affronts like name calling or cursing; 2. efforts to exert social control or punish, for example, pushing a colleague to discuss personal issues or blaming others for personal mistakes; 3. lying; 4. intrusively meddling in others’ work; 5. maliciously competing; and 6. manipulating relationships for personal advantage. These findings are being applied to link nursing leadership and workplace bullying science to strengthen nurse leader empowerment. Investigators will finalize their survey instrument in the next few weeks and share it electronically with nurse leader members of the American Organization for Nursing Leadership (AONL). Then, they will analyze psychometric properties of the instrument through exploratory and confirmatory factor analysis.  The study team presented a podium presentation of their work at Sigma’s Creating Healthy Workplace Environments in 2025. A manuscript in process for submission to Advances in Nursing Science. 

Nurses Address Perinatal Mental Health Inequities among Black Women: A Feasibility Study
$200,000 grant to the University of California, Los Angeles (UCLA), 2022-2025

The American Nurses Foundation (ANF) and the Collaborative Alliance for Nursing Outcomes (CALNOC) established the CALNOC Research Fund to support and foster health services research in the ambulatory setting with a focus on the nursing profession’s contribution to improving health care delivery. Co-Principal Investigators Kortney Floyd James, PhD, RN and Kristen Choi, PhD, PMHNP-BC, FAAN collaborated to address perinatal mood and anxiety disorders (PMADs), including depression and anxiety, as these disorders are the most common complications of pregnancy and childbirth. Left untreated, they contribute to poor outcomes for mothers and infants, including preterm birth, impaired bonding, and maternal suicide. Black women are disproportionately affected, facing both higher rates of PMADs and greater barriers to screening and treatment. This project addressed these gaps through two approaches: testing the feasibility of a provider training program called Black Maternal Mental Health 360 (BMMH 360) and evaluating perinatal mental health screening using electronic health record (EHR) data within the same health system.

NurseAssist-AI: Leveraging AI to Minimize Documentation and Maximize Decision Support in Home Healthcare  
$466,590 grant to Columbia University, 2025-2027

Home healthcare (HHC) serves over 5 million patients annually in the United States, and demand is projected to grow substantially in the coming decades. However, HHC nurses face significant barriers, including excessive documentation burdens that consume up to 40% of their clinical time, inconsistent documentation quality, and limited access to real-time decision support tools. These barriers strain nurse productivity and compromise patient care outcomes.
NurseAssist-AI aims to address these challenges through an innovative, nurse-centered AI application that automates clinical documentation and provides real-time clinical decision support. Using state-of-the-art Retrieval-Augmented Generation (RAG) and multimodal AI technologies, NurseAssist-AI will integrate video, audio, and electronic health record data to generate actionable, evidence-based recommendations and accurate clinical documentation in real time.

The project will focus on three specific aims:

Development: Design and develop NurseAssist-AI with robust data integration and validation methodologies to ensure accuracy, usability, and clinical safety.

Pilot Testing: Implement NurseAssist-AI within a large HHC agency, measuring impacts on documentation efficiency, clinical accuracy, nurse adoption, and patient satisfaction through mixed-methods evaluation.

Scalability Strategy: Formulate a comprehensive toolkit for scaling NurseAssist-AI across diverse HHC agencies, leveraging expert advisory input for seamless integration and sustainability.

The multidisciplinary project team, led by Dr. Maxim Topaz, brings together expertise in AI, nursing, biomedical engineering, and clinical informatics. Our longstanding partnership with VNS Health, the US’s largest non-profit home healthcare agency, ensures real-world applicability and scalability of the NurseAssist-AI system. This project aligns with the Reimagining Nursing Initiative’s goals by placing nurses at the forefront of technology-driven healthcare transformation. NurseAssist-AI is poised to revolutionize home healthcare delivery by reducing documentation burdens, enhancing decision-making accuracy, improving patient outcomes, and advancing equitable, high-quality care for diverse patient populations.

Stress + First Aid Expansion
$498,499 grant to BayCare Health System, 2025-2027

BayCare Health System (BCHS) is requesting $498,499.20 to expand its IRB-approved pilot program, “Nurse Well-Being: Building Peer and Leadership Support with Stress First Aid (SFA) for Nurses.” This expansion builds on the successful implementation of the pilot in six acute care units across three hospitals. This project adapts the SFA model, initially developed for military settings, to address nurses’ unique challenges. SFA empowers nurses to assess and monitor their well-being, recognize signs of stress in their peers, provide team-based support, and access mental health resources earlier and more effectively.

BCHS encompasses a diverse array of facilities and services, including 16 acute care hospitals, 31 behavioral health practices, acute care centers, outpatient rehab facilities, physician offices, urgent care centers, imaging facilities, and one of Florida’s largest home care agencies. Due to this extensive network, BayCare was selected by the American Nurses Foundation (ANF) as a pilot site and successfully implemented SFA in six diverse units, including oncology, medical-surgical, and an emergency department. Initial data from the pilot demonstrated its feasibility and potential for positive outcomes, including a 0% turnover rate in the first year for four pilot units, a 66% reduction in burnout, improved peer support/communication, and enhanced utilization of mental health/well-being resources among nurses.

This grant will expand SFA across all 16 hospitals, 14 inpatient acute care rehab locations, seven behavioral health acute care centers, a free-standing emergency department, four ambulatory surgical centers, and home health services throughout the health system. These expansions will cover all locations where nurses work. The SFA expansion will create a consistent, system-wide approach to stress management and nurse well-being. In the first year, BayCare plans to implement the program in 131 in-patient units across its 16 hospitals, which will include approximately 10,000 team members. In the second year, the program will expand to the ambulatory division, which includes behavioral health, surgical centers, home health, and rehabilitation services.

SFA is a framework designed to enhance resilience and self-care, helping individuals and coworkers recover from stress and prevent future harm.1 Using the Plan-Do-Study-Act method, BayCare adapted the SFA program into eight in-person small-group micro-sessions led by unit champions. Each session centers on one of the key topics within the SFA program, encompassing a shared language, sources of stress, challenging conversations, seven actions for supporting peers, and resources within BayCare and the community. The same topic is revisited multiple times throughout the month, allowing team members to engage in learning during their regular shifts. Additionally, micro-learning distribution in groups over eight months enhances team building, promoting unity and loyalty among members. This approach is evidenced by a 54% increase in the perception of having an excellent manager.2 Results are evaluated through metrics such as turnover rates, pre-post Mini-Z surveys, and outcomes from the yearly BayCare Team Member as a Customer (TMAC) survey.

By proactively supporting mental health and well-being, new graduate nurses can focus on developing clinical expertise, providing the foundation for transitioning to practice and aligning with ANF’s priority of preparing practice-ready nurse graduates. Addressing stress management early in a nurse’s career helps new nurses build resilience, navigate workplace challenges, and develop strategies to maintain their well-being. By facilitating peer-to-peer support, the program increases the likelihood that new nurses will feel supported and remain in the profession, reducing turnover and strengthening the nursing workforce.

Workplace Racism, Perceived Stress, and Health Promoting Lifestyle Behaviors Among African American Registered Nurses
$339,000 to Southern University and A&M College (4/1/2024 - 3/31/2027)

Southern University and A&M College was awarded a grant to expand the registered nurse workforce with more minority nurses. Increasing the diversity of the nursing workforce, represents an important step in reducing health disparities through the delivery of culturally competent, unbiased care. However, while African American (AA) nurses play an important role in addressing health equity and reducing health disparities, they are also more likely to experience racism in the workplace, negatively impacting their professional well-being. High and prolonged levels of stress undermine nurse retention rates and can jeopardize the safety and well-being of the nurse and the patient. Further, while nurses advocate for the health of their patients and others, many do not participate in self-care practices themselves. The purpose of this mixed methods explanatory-sequential design is to examine relationships between work-place racism, perceived stress, and health promoting life-style behaviors among AA RNs employed in acute care settings. Additionally, this study seeks to gain a more in depth understanding of the participants’ personal experiences with work-place racism, factors that contribute to their overall perception of stress, and that facilitate or serve as barriers to health promoting behaviors. The main goals are to:

Examine relationships between work-place racism, perceived stress, and health promoting life-style behaviors among AA RNs employed in acute care settings. Gain a more in-depth understanding of the participants’ personal experiences with work-place racism. Gain a better understanding of factors that contribute to the participants’ perception of stress, as well as factors that facilitate or serve as barriers to health promoting behaviors among this population of AA RNs.

This research will expand the School of Nursing’s (SON) research capacity through increasing involvement of early and mid-career minority faculty, as well as AA minority doctoral nursing students, in research endeavors. Student scholarships for minority male undergraduate nursing students will provide financial support to offset some of the expenses incurred. All efforts will be informed by the National Commission to Address Racism in Nursing. Proposals involving interdisciplinary research with teams from the College of Nursing and Allied Health (CNAH) will be encouraged.