Applying Knowledge

Jona Ely and Mary McAfee

Members of the first cohort of a specialized nursing program at UNC are directly applying evidence-based knowledge from the final research projects required to earn their doctorates. And it's their patients who will now benefit.

UNC's online post-master's Doctor of Nursing Practice program enrolled its first students in 2010. Those students recently completed or are in the process of completing clinic-based research projects that have real-life implications.

For the Health of It
Jona Ely's research project is helping her patients quit smoking, and the results could help legitimize the smoking cessation method she's using.

Ely's a registered nurse practitioner at the Kinder Family Clinic in Craig, Colo., the Moffat County seat. When an April report issued by the Colorado Department of Public Health and Environment named Moffat County one of the unhealthiest areas in the state - with smoking rates higher than both the state and national averages - she decided to use her research project to do something about it.

She'd heard from ex-smokers that electronic cigarettes - an electrical inhaler that vaporizes a glycerin-based liquid solution into an aerosol mist, simulating the act of smoking - worked better than other smoking cessation methods they'd tried.

And she knew that smoking is often just as much about the psychological and social ritual as it is about the addiction to nicotine.

Plus, they provide nicotine at a lower level than cigarettes, and they don't contain any of the cancer-causing tars and toxins found in tobacco products.

That led her to theorize that e-cigarettes might be a better way to break the smoking habit: They allow would-be quitters to maintain their smoking rituals while they wean themselves off nicotine, which other nicotine-substitution methods such as gum and patches don't do.

Since e-cigarettes are a relatively new product, there's little research on their effectiveness as a smoking cessation method. Ely saw an opportunity to undertake research for her degree that would fill that void, and at the same time, help some people improve their health.

The clinic was more than glad to support her efforts, so Ely developed and successfully defended her research proposal for the DNP program. She spread the word about the study among the clinic's patients and in stories in the local daily newspaper. By the end of August, 40 smokers had enrolled in the six-month study.

There's no cost to participate in the study, but participants pay for their own electronic cigarettes, which have the additional benefit of being less expensive than those containing tobacco.

Ely said she was pleased with the response and is looking forward to seeing if the final results of the study support her contention that e-cigarettes can improve a smoker's chances of successfully becoming an ex-smoker.

The end of the study will also mean Ely will graduate in May, and she had nothing but positive things to say about the DNP program.

"The fact that it's an online program has been wonderful," said Ely, who earned her masters' in Nursing from UNC in 2002 and has been a nurse practitioner for 10 years, "It's very flexible; I wouldn't have been able to do it otherwise."

Simplified Reporting
For her capstone project in the DNP post-master's program, Mary McAfee studied how to reduce the time people struggling with mental health problems are admitted into the hospital after being evaluated.

The idea was to cut down on delays experienced by the at-risk group when supplying information such as medical history — often more than once to more than one person.

With support of her employer, Mountain Crest Behavioral Healthcare Center in Fort Collins, the nurse practitioner helped implement the new program last spring. The result has been simplified reporting that can be shared among health care professionals using a standardized assessment sheet during initial screenings by therapists at Mountain Crest. The form can later be forwarded to hospital staff.

McAfee, who graduated this summer, helped lead the effort to become an early adopter of the business model. She made it the focus of her capstone project because it was something that could serve as a model to "eliminate waste, control costs, maintain quality and help patients" to benefit the entire organization within University of Colorado Health, formerly Poudre Valley Health System.

"I learned a lot that will help me professionally," McAfee said.

Assistant Professor Rhonda Squires, who coordinates the DNP program, said the goal of the capstone is putting research into practice "to make changes that help lots of people."

For more about the DNP program, visit its website.

- UNC News Service