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Multilevel Panel Study of Effects of Changes in Nursing on Health Equity and Patient Outcomes

Award Number: R01NR014855
ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 09/15/2014
PERIOD OF PERFORMANCE END DATE: 01/31/2025

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Multilevel Panel Study of Effects of Changes in Nursing on Health Equity and Patient Outcomes - Determining the association of nursing on patients with intellectual or developmental disabilities in the acute care setting The NIH recently designated persons with disabilities as a health disparities population. The disparities experienced by those with intellectual and developmental disabilities (IDD) include a greater incidence of physical and mental ailments, increased morbidity and mortality, barriers to high quality care, stigma, biases, social disadvantage, and marginalization. However, there is a gap in the literature about approaches to reducing health disparities in the IDD population. Most research focuses on parents of IDD children, parents who have IDD, care for those who have dual diagnoses of IDD and another health problem, challenging behavior, and IDD caregiver burnout. To close the gap, we are proposing a supplement to R01NR014855 to utilize data collected in the parent grant to undertake novel methods to create individual risk profiles, using comorbidities, social determinants of health (SDOH) and IDD diagnoses, and to quantify the association of nursing resource factors on the risk adjusted outcomes of adult patients with IDD. Intersecting comorbidities, SDOH, and IDD diagnoses are expected to contribute to meaningful variation in clinical risk in the hospitalized IDD population. Quantifying the variable risk arising at the intersection of IDD, comorbidities, and SDOH is important because a particular challenge for this population is diagnostic overshadowing—when symptoms are misattributed to IDD rather than comorbidities and social determinant factors. Diagnostic overshadowing reduces quality of care and has been shown to lead to poor outcomes including increased mortality. Diagnostic overshadowing occurs more frequently when providers face time pressures, have poor teamwork, and lack resources. There is promising evidence that outcome disparities are reduced for other vulnerable populations, such as patients with serious mental illness and those with opioid use disorder, when they receive care in hospitals with better nursing resources, including increased nursing education, improved staffing, and more supportive work environments. The extent to which nursing resources are associated with IDD hospital patient outcomes is not known. The proposed study expands upon previous studies by: (1) quantitative research methods to specify pathways by which nursing resources might decrease adult IDD length of stay or readmission rates; (2) utilizing the secondary nursing data in the process of exploring adult IDD outcomes; and (3) ultimately using comorbidities, SDOH and IDD risk profiles to estimate which adult IDD patients may significantly benefit from greater nursing resources. Results will greatly improve our ability to target which nursing resources may benefit adult IDD patients. The central hypothesis is that an investment in nursing resources for the highest risk IDD inpatients will improve patient outcomes.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = $0 )
2025	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	8	4/23/2025	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $0

Issue Date FY: 2024 ( Subtotal = $867,792 )
2024	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	004	8	4/30/2024	SUPPLEMENT FOR EXPANSION	$84,959
2024	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	002	8	2/1/2024	NON-COMPETING CONTINUATION	$704,550
2024	2024	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	005	8	5/2/2024	NON-COMPETING CONTINUATION	$78,283
2024	2023	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	003	7	2/1/2024	SUPPLEMENT FOR EXPANSION	$0
2024	2023	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	001	7	2/1/2024	NON-COMPETING CONTINUATION	$0
2024	2023	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	7	1/23/2024	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $867,792

Issue Date FY: 2023 ( Subtotal = $1,020,853 )
2023	2023	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	7	1/11/2023	NON-COMPETING CONTINUATION	$793,353
2023	2023	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	002	7	9/14/2023	NON-COMPETING CONTINUATION	$0
2023	2023	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	001	7	6/20/2023	NON-COMPETING CONTINUATION	$0
2023	2023	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	003	7	9/14/2023	SUPPLEMENT FOR EXPANSION	$227,500
														Subtotal = $1,020,853

Issue Date FY: 2022 ( Subtotal = $815,404 )
2022	2022	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	6	3/31/2022	COMPETING CONTINUATION	$815,404
														Subtotal = $815,404

Issue Date FY: 2021 ( Subtotal = $0 )
2021	2018	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	5	2/1/2021	SUPPLEMENT FOR EXPANSION	$0
														Subtotal = $0

Issue Date FY: 2020 ( Subtotal = $0 )
2020	2018	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST STE 440A	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	5	6/25/2020	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2019 ( Subtotal = $0 )
2019	2018	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	5	1/8/2019	NON-COMPETING CONTINUATION	$0
														Subtotal = $0

Issue Date FY: 2018 ( Subtotal = $895,696 )
2018	2018	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	001	5	9/14/2018	SUPPLEMENT FOR EXPANSION	$406,403
2018	2018	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	5	6/4/2018	NON-COMPETING CONTINUATION	$489,293
														Subtotal = $895,696

Issue Date FY: 2017 ( Subtotal = $489,293 )
2017	2017	TRUSTEES OF THE UNIVERSITY OF PENNSYLVANIA, THE	3451 WALNUT ST	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	4	6/29/2017	NON-COMPETING CONTINUATION	$489,293
														Subtotal = $489,293

Issue Date FY: 2016 ( Subtotal = $577,827 )
2016	2016	UNIVERSITY OF PENNSYLVANIA	3451 WALNUT STREET	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	3	6/15/2016	NON-COMPETING CONTINUATION	$577,827
														Subtotal = $577,827

Issue Date FY: 2015 ( Subtotal = $654,229 )
2015	2015	UNIVERSITY OF PENNSYLVANIA	3451 WALNUT STREET	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	2	6/24/2015	NON-COMPETING CONTINUATION	$654,229
														Subtotal = $654,229

Issue Date FY: 2014 ( Subtotal = $679,904 )
2014	2014	UNIVERSITY OF PENNSYLVANIA	3451 WALNUT STREET	PHILADELPHIA	PA	19104	PHILADELPHIA	USA	Nursing Research	000	1	9/12/2014	NEW	$679,904
														Subtotal = $679,904

Grand Total All Awards = $6,000,998

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Multilevel Panel Study of Effects of Changes in Nursing on Health Equity and Patient Outcomes

Award Number: R01NR014855

ORGANIZATION: NATIONAL INSTITUTE OF NURSING RESEARCH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 09/15/2014

PERIOD OF PERFORMANCE END DATE: 01/31/2025

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