Center for Health Policy
Research Projects

Research Grants

Prevention of Nosocomial Infections and Cost-Effectiveness Analysis in Nursing Homes
Principle Investigator: Patricia W. Stone, RN, PhD, FAAN Columbia University School of Nursing
Funding Agency: National Institute of Nursing Research R01 NR013687
Study Period: 2012-2016

The aims of this study are to: 1) Describe the incidence of Healthcare Associated Infections (HAI) in Nursing Homes (NH); 2) Identify NHs that have persistently high and low HAI rates and the relationship between the HAI rates, state and facility level characteristics and resident care processes; 3) Describe the phenomenon of infection control in NHs; 4) Determine the comparative effectiveness of current infection control structures and processes in preventing HAIs in elderly residents; and 5) Determine the cost-effectiveness of efficacious infection control processes in NHs.
Qualitative Study of Legal Interventions to Reduce Healthcare-Associated Infections
Principle Investigator: Patricia W. Stone, RN, PhD, MPH Columbia University School of Nursing
Funding Agency: Centers of Disease Control and Prevention (CDC) and the Robert Wood Johnson Foundation as part of their Public Health Law Research Initiative
Study Period: 2012-2013

Researchers from the Columbia University School of Nursing and The Keystone Center in collaboration with the Centers for Disease Control and Prevention (CDC) and the Association of State and Territorial Health Officials (ASTHO), are identifying stakeholders nationwide and conducting interviews to understand how public reporting laws are influencing the work of the state and local health departments and their daily activities aimed at preventing HAIs. The specific aims of the study are to: 1) Explore how HAI reporting mandates and other legal interventions influence public health departments and policy-makers; 2) Identify public health and workforce efforts aimed at enforcing HAI reporting mandates and improving prevention and 3) Discuss how data on HAIs collected from mandated reporting influence both government agencies and community partners.
Validation of Nurse Practitioner Primary Care Organizational Climate Questionnaire
Principle Investigator: Lusine Poghosyan, PhD, MPH, RN
Funding Agency: Agency for Healthcare Research R03 HS020999
Study Period: 2011-2013

The purpose of this study is to examine the psychometric properties of the NP-PCOCQ, and further refine and validate this survey instrument in primary care settings from nurse practitioners’ perspectives. The NP-PCOCQ may be used with various groups of nurse practitioners for conducting meaningful comparisons of organizational climates across practice sites and states increasing the utility of the instrument.
Prevention of Nosocomial Infections and Cost-Effectiveness Analysis Refined
Principle Investigator: Patricia W. Stone, RN, PhD, FAAN Columbia University School of Nursing
Funding Agency: National Institute of Nursing Research R01 NR010107
Study Period: 2010-2013

This is a competing continuation project and the aims are 1) Use a descriptive exploratory approach to qualitatively describe the phenomena of infection prevention, surveillance, and control in hospitals; 2) Assess the impact of the intensity of infection control processes on device associated and organism specific HAI rates in adult and pediatric ICUs across the nation; and 3) Determine the impact of state regulated mandatory reporting on infection control processes and HAI rates.
Off-Shift Nursing and Quality Patient Outcomes
Principle Investigator: Pamela B. de Cordova under the mentorship of Patricia W. Stone, RN, PhD, MPH, Columbia University School of Nursing
Funding Agency: Agency for Healthcare Research and Quality Dissertation Funding R36HS018216
Study Period: 2009-2011

The purpose of this mixed-methods dissertation is to examine off-shift nursing nurse staffing patterns and nursing workforce characteristics (e.g. experience and education) and their relationships to patient outcomes.
Changing Role of Infection Preventionists
Principle Investigator: Patricia W. Stone, RN, PhD, MPH Columbia University School of Nursing
Funding Agency: Blue Shield of California Foundation 2490932
Study Period: 2008-2010
http://cumc.columbia.edu/studies/pnice/chaipi/
The California Healthcare-Associated Infection Prevention Initiative (CHAIPI) seeks to reduce and eliminate HAIs through clinical and technological innovation. The purpose of CHAIPI is to reduce unnecessary morbidity, mortality and costs associated with HAIs in California hospitals. The Columbia University School of Nursing team, in partnership with the Association for Professionals in Infection Control and Epidemiology (APIC), designed a two year study to evaluate the effects of CHAIPI on infection control procedures, infection rates, and changes in the roles of infection prevention staff. This important study informs understanding of what institutional, procedural, and technological innovations can assist health professionals to reduce and eliminate morbidity, mortality, and the high costs associated with hospital-associated infections. Infection preventionists in California have a unique opportunity to contribute to the understanding of their profession. The research team compares CHAIPI and non-CHAIPI hospitals, and provides an overall picture of infection prevention programs in California via a pre and post survey design. This design permits the evaluation of changes in infection preventionists roles as well as infection prevention and control programs over the course of two years.
The Impacts of Nurse Staffing, Skill Mix, and Experience on Quality and Costs in Long-Term Care
Principle Investigator: Patricia W. Stone, RN, PhD, MPH Ciaran S. Phibbs, PhD
Funding Agency: Robert Wood Johnson Foundation and VA Supplement
Study Period: 2008
http://www.inqri.org/research-project/impacts-nurse-staffing-skill-mix-and-experience-quality-and-costs-long-term-care
This research team studied whether a causal relationship exists between nursing input (i.e. staffing and human capital characteristics) and patient outcomes in long-term care (LTC) facilities, and examined the tradeoffs of improved patient outcomes on nursing personnel costs and cost savings (Interdisciplinary Nursing Quality Research Initiative, 2008).

Pilot Grant Projects

Using the Outcome and Assessment Information Set Dataset to Study Healthcare Associated Infections in Home Care Settings
Principle Investigator: Jingjing Shang, PhD
Funding Agency: CUSON Center for Health Policy
Study Period: 2012-2013
Dr. Shang received funding from the Center for Health Policy for her pilot study which will describe the epidemiology of healthcare-associated infections (HAIs) in home care settings, thereby addressing an important challenge in clinical practice.
Evaluation of the Implementation of the NY State HIV Testing Law in the Emergency Department
Principle Investigator: Rebecca Schnall, RN, PhD
Funding Agency: CUSON Center for Health Policy
Study Period: 2011-2012
The goal of this pilot grant project is to understand the implementation of the new HIV testing law in the ED by examining the workflow and information needs of ED clinicians, staff and administrators.
Development of Nurse Practitioner Primary Care Organizational Climate Questionnaire
Principle Investigator: Lusine Poghosyan, PhD, MPH, RN
Funding Agency: CUSON Center for Health Policy
Study Period: 2011-2012
Policy makers, health care organizations, and health professionals are calling for expansion of nurse practitioner workforce in primary care to assure timely access for the American public. However, many obstacles to effective nurse practitioner primary care practice exist, including barriers at the organizational level, and there is a lack of reliable and valid instruments to measure organizational climates to identify those barriers from nurse practitioners’ perspectives. The purpose of this study is to develop the Nurse Practitioner Primary Care Organizational Climate Questionnaire (NP-PCOCQ) through literature review, investigation of existing instruments, nurse practitioner focus group data, content validation, and pretesting.

K Awards

Using Queuing Theory to Improve HIV testing in the Emergency Department
Principle Investigator: Rebecca Schnall, RN, PhD
Study Period: 2012-2014
The goal of this study is to understand the implementation of the New York State HIV testing law in the ED by examining the workflow and information needs of ED clinicians, staff and administrators. Careful consideration of the cost of various HIV testing delivery models is necessary to best implement the NYS testing legislation; as a result this study seeks to compare the cost efficiencies of different HIV testing delivery models.