Brief Bio

Dr. Anderson is Virginia Stone Professor of Nursing and a Senior Fellow in the Duke University Center for Aging and Human Development. She is also a Research Development Coordinator in the Office of Research Affairs in the School of Nursing. She earned a BSN from Stockton State College in New Jersey, a Master of Science in Gerontological Nursing and Master of Arts in Social Gerontology from the University of Pennsylvania, and the PhD in nursing with a business minor from The University of Texas at Austin. She has extensive experience teaching graduate courses in managing complex healthcare systems, chronic illness, and outcomes in health care.

Dr. Anderson's scholarship is dedicated to improving management of nursing homes, an area of rapidly growing need. Her research has been interdisciplinary from its inception, and she has collaborated with scholars at Duke and across the country in schools of nursing, business, economics, engineering and medicine. She pioneered the application of complexity theory and management science in nursing in analysis of the institutional environment of the nursing home. Her studies that show the relationships between patient outcomes and organizational structure, interpersonal relationships of staff and families, patterns of staff communication, and employee turnover have given researchers new tools for implementing evidence-based changes in the care delivery practices in long term care facilities.

Academic Program Affiliations

PhD in Nursing Program
Doctor of Nursing Practice Program

Education

PhD	The University of Texas at Austin School of Nursing
MA	University of Pennsylvania, Faculty of Arts and Sciences
MSN	University of Pennsylvania, School of Nursing
BSN	Stockton State College (NJ)

Research Interests

My research program is concerned with understanding and improving nursing management practices and their impact on outcomes, with a particular interest in resident outcomes in nursing homes. I use complexity science, organizational and nursing theory to bring together the constructs of communication and decision processes, relationship and interaction, organizational structures, context, resource allocation and health care outcomes. In my previously NIH/NINR funded study, Outcomes of Nursing Management Practice in Nursing Homes, I worked with a multidisciplinary team to explore relationship patterns and management practices that enable nursing homes to attain high quality resident outcomes in a series of eight comparative case studies, identifying management practices that are distributed through all levels of workers and appear to build capacity for high quality outcomes. From these findings, we developed a new intervention for improving staff interactions and information exchange in long term care settings. In a competing continuation NINR-funded R01, my team and I are now testing this intervention in 16 community nursing homes for its impact on reducing patient falls; our team is also funded by the VA (Colón-Emeric, PI) to test the intervention in four Community Living Centers. I have expertise in both quantitative and qualitative research methods.

Awards and Honors

• 2012 Outstanding PhD Faculty Award, Duke University School of Nursing

• 2011 Distinguished Contributions to Nursing Science Award, Duke University School of Nursing

• 2010 Virginia Stone Professor of Nursing, Duke University School of Nursing

• 2004 Science Advisory Board, The Plexus Institute

• 2003 Fellow, American Academy of Nursing

• 2002 Annual Meeting Best Paper Award (top ten percent of submissions), Academy of Management

• 2000 Member, Council for the Advancement of Nursing Science

• 1997 Ed and Molly Smith Fellow in Nursing, The University of Texas at Austin, School of Nursing

• 1997 Virginia Henderson Fellow, Sigma Theta Tau, International Honor Society of Nursing

• 1991 Luci Baines Johnson Fellow in Nursing, The University of Texas at Austin, School of Nursing

• 1990 Faculty Research Award, The University of Texas at Austin, School of Nursing

• 1989 American Organization of Nurse Executives’ Scholar, The American Nurses’ Foundation

• 1989 Luci Baines Johnson Fellow in Nursing, The University of Texas at Austin, School of Nursing

• 1987 Member, Academy of Management

• 1985 Inducted, Beta Gamma Sigma, National Scholastic Honor Society (Business & Administration)

• 1985 Inducted, The Honor Society of Phi Kappa Phi

• 1981 Inducted, Sigma Theta Tau, International Honor Society of Nursing

Areas of Expertise

• Gerontology
• Nursing and Health Care Leadership
• Translational Research

Areas of Interest

• Care Systems for Chronic Illness

Representative Publications

• 2013 -- Corazzini, K. N., Anderson, R. A., Mueller, C., Hunt-McKinney, S., Day, L., Porter, K. Understanding RN and LPN patterns of practice in nursing homes. Journal of Nursing Regulation. April, 2013; 4(1); 14-18

• 2013 -- Pubmed # 23445182 Corazzini, K. N., Mueller, C., Anderson, R. A., Day, L., Hunt-McKinney, S., Porter, K. Pain medication management in nursing homes and nursing scope of practice. J Gerontol Nurs. April, 2013; 39(4); 40-6

• 2013 -- Pubmed # 23375523 Hall, R. K., O'Hare, A. M., Anderson, R. A., Colón-Emeric, C. S. End-Stage Renal Disease in Nursing Homes: A Systematic Review. J Am Med Dir Assoc. January 31, 2013;

• 2013 -- Pubmed # 23281623 Simpson, K. M., Porter, K., McConnell, E. S., Colón-Emeric, C., Daily, K. A., Stalzer, A., Anderson, R. A. Tool for evaluating research implementation challenges: A sense-making protocol for addressing implementation challenges in complex research settings. Implement Sci. January, 2013; 8(1); 2

• 2012 -- Pubmed # 23164251 Siegel, E. O., Anderson, R. A., Calkin, J., Chu, C. H., Corazzini, K. N., Dellefield, M. E., Goodman, C. Supporting and promoting personhood in long term care settings: contextual factors. Int J Older People Nurs. December 1, 2012; 7(4); 295-302

• 2012 -- Pubmed # 22929379 Toles, M., Barroso, J., Colón-Emeric, C., Corazzini, K., McConnell, E., Anderson, R. A. Staff interaction strategies that optimize delivery of transitional care in a skilled nursing facility: a multiple case study. Fam Community Health. October, 2012; 35(4); 334-44

• 2012 -- Bailey Jr., D. E., Docherty, S. L., Adams, J. A., Carthron, D. L., Corazzini, K., Day, J. R., Neglia, E., Thygeson, M., Anderson, R. A. Studying the clinical encounter with the Adaptive Leadership framework. Journal of Healthcare Leadership. August, 2012; 2012(4); 83-91

• 2012 -- Hunt, S. R., Corazzini, K.., Anderson, R. A. Top nurse management staffing collapse and care quality in nursing homes. Journal of Applied Gerontology. August 2012, Online first;

• 2012 -- Pubmed # 22037647 Hunt, S. R., Probst, J. C., Haddock, K. S., Moran, R., Baker, S. L., Anderson, R. A., Corazzini, K. Registered nurse retention strategies in nursing homes: a two-factor perspective. Health Care Manage Rev. August, 2012; 37(3); 246-56

• 2012 -- Pubmed # 22663140 Adams, J., Bailey Jr, D. E., Anderson, R. A., Galanos, A. N. Adaptive Leadership: A Novel Approach for Family Decision Making. J Palliat Med. June, 2012 Epub ahead of print;

• 2012 -- Mueller, C., Anderson, R. A., McConnell, E. S., Corazzini, K. N. Licensed nurse responsibilities in nursing homes: a scope of practice issue. Journal of Nursing Regulation. April, 2012; 3(1); 1-8

• 2012 -- Pubmed # 22376375 Anderson, R. A., Corazzini, K., Porter, K., Daily, K., McDaniel Jr, R. R., Colon-Emeric, C. CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes. Implement Sci. February, 2012; 7(1); 11

• 2012 -- Pubmed # 22166907 Corazzini, K. N., Anderson, R. A., Mueller, C., Thorpe, J. M., McConnell, E. S. Jurisdiction Over Nursing Care Systems in Nursing Homes: Latent Class Analysis. Nurs Res. January, 2012; 61(1); 28-38

• 2011 -- Pubmed # 21994831 Adams, J. A., Bailey Jr, D. E., Anderson, R. A., Docherty, S. L. Nursing Roles and Strategies in End-of-Life Decision Making in Acute Care: A Systematic Review of the Literature. Nurs Res Pract. October, 2011; 2011(4); Article ID 527834, 15 pp. PMCID: PMC3184494

• 2011 -- Pubmed # 22229086 Day, J. R., Anderson, R. A. Compassion fatigue: an application of the concept to informal caregivers of family members with dementia. Nurs Res Pract. September 8, 2011; 2011(408024); 1-10, doi 10.1155/2011/408024

• 2011 -- Pubmed # 21757079 Toles, M., Anderson, R. A. State of the science: Relationship-oriented management practices in nursing homes. Nurs Outlook. Jul-Aug, 2011; 59(4); 221-7

• 2011 -- Corazzini, K.N., Anderson, R. A., Mueller, C., McConnell, E. S., Landerman, L. R., Thorpe, J. M., Short, N. M. Regulation of LPN scope of practice in long-term care. Journal of Nursing Regulation. July, 2011; 2(2); 31-36

• 2011 -- Pubmed # 21577182 Castle, N. G., Anderson, R. A. Caregiver staffing in nursing homes and their influence on quality of care: using dynamic panel estimation methods. Med Care. June, 2011; 49(6); 545-52

• 2010 -- Pubmed # 21114860 Kitzmiller, R. R., Anderson, R. A., McDaniel Jr, R. R. Making sense of health information technology implementation: A qualitative study protocol. Implement Sci. November 29, 2010; 5: 95 PMCID: PMC3001692

• 2010 -- Pubmed # 20479137 Colón-Emeric, C. S., Plowman, D., Bailey, D., Corazzini, K., Utley-Smith, Q., Ammarell, N., Toles, M., Anderson, R. Regulation and mindful resident care in nursing homes. Qual Health Res. September, 2010; 20(9); 1283-94 PMCID: PMC2918733

• 2010 -- Corazzini, K. N., Anderson, R. A., Rapp, C. G., Mueller, C., McConnell, E., Lekan, D. Delegation in long-term care: Scope of practice or job description? Online Journal of Issues in Nursing. May, 2010; 15(2, Manuscript 4);

• 2010 -- Corazzini, K. N., McConnell, E. S., Anderson, R. A., Reed, D., Champagne, M. T., Lekan, D., Preisser, J. S.,, Bailey, D., Zimmerman, S. The importance of organizational climate to training needs and outcomes in long-term care. Alzheimer’s Care Today. Apr.-Jun., 2010; 11(2); 109-121

• 2010 -- Pubmed # 20367840 Jordon, M., Lanham, H. J., Anderson, R. A., McDaniel Jr, R. R. Implications of complex adaptive systems theory for interpreting research about health care organizations. J Eval Clin Pract. February, 2010; 16(1); 228-31

• 2009 -- Pubmed # 19643409 Thornlow, D. K., Anderson, R., Oddone, E. Cascade iatrogenesis: factors leading to the development of adverse events in hospitalized older adults. Int J Nurs Stud. November, 2009; 46(11); 1528-35

• 2009 -- Pubmed # 19649311 Utley-Smith, Q., Colón-Emeric, C. S., Lekan-Rutledge, D., Ammarell, N., Bailey, D., Corazzini, K., Piven, M. L., Anderson, R. A. The Nature of Staff - Family Interactions in Nursing Homes: Staff Perceptions. J Aging Stud. August, 2009; 23(3); 168-177 PMCID: PMC2711636

• 2009 -- Pubmed # 19322050 McDaniel Jr, R. R., Lanham, H. J., Anderson, R. A. Implications of complex adaptive systems theory for the design of research on health care organizations. Health Care Manage Rev. July, 2009; 34(2); 191-9

• 2009 -- Pubmed # 19182546 Corazzini, K., Rapp, C. G., McConnell, E. S., Anderson, R. A. Use of a handheld computer observational tool to improve communication for care planning and psychosocial well-being. J Nurses Staff Dev. Jan.-Feb., 2009; 25(1); E1-7

• 2008 -- Pubmed # 18390825 Piven, M. L., Anderson, R. A., Colón-Emeric, C. S., Sandelowski, M. Certified nursing assistants' explanatory models of nursing home resident depression. West J Nurs Res. October, 2008; 30(6); 653-72 PMCID: PMC2562910

• 2008 -- Paparone, C. R., Anderson, R. A., McDaniel, R. R. Where military professionalism meets complexity science. Armed Forces & Society. April, 2008; 34(3); 433-449

• 2008 -- Pubmed # 18350742 Anderson, R., McConnell, E., Gilliss, C. Elizabeth C. Clipp, PhD, RN, FAAN. J Gerontol Nurs. March, 2008; 34(3); 7-9

• 2008 -- Anderson, R. A., McDaniel, R. R. Taking complexity science seriously: New research, new methods. In On the edge: Nursing in the age of complexity, edited by Lindberg, C. and Nash, S. and Lindberg, C. 2008; pp. 73-95. Allentown, NJ: Plexus Institute.

• 2007 -- Pubmed # 17710200 Piven, M. L., Ammarell, N., Lekan-Rutledge, D., Utley-Smith, Q., Corazzini, K. N., Colón-Emeric, C., Bailey, D., Anderson R. A. Paying attention: A leap toward quality care. Director. Winter, 2007; 15(1); 58-60, 62-63 PMCID: PMC1948878

• 2007 -- Pubmed # 17767682 Colón-Emeric, C. S., Lekan, D., Utley-Smith, Q., Ammarell, N., Bailey, D., Corazzini, K., Piven, M. L., Anderson, R. A. Barriers to and facilitators of clinical practice guideline use in nursing homes. J Am Geriatr Soc. September, 2007; 55(9); 1404-9 PMCID: PMC2276683

• 2007 -- Pubmed # 17406020 Castle, N. G., Engberg, J., Anderson, R. A. Job satisfaction of nursing home administrators and turnover. Med Care Res Rev. April, 2007; 64(2); 191-211

• 2007 -- Pubmed # 17440124 Castle, N. G., Engberg, J., Anderson, R., Men, A. Job satisfaction of nurse aides in nursing homes: intent to leave and turnover. Gerontologist. April, 2007; 47(2); 193-204

• 2007 -- Pubmed # 17077708 Colón-Emeric, C. S., Lekan-Rutledge, D., Utley-Smith, Q., Ammarell, N., Bailey, D., Piven, M. L., Corazzini, K., Anderson, R. A. Connection, regulation, and care plan innovation: a case study of four nursing homes. Health Care Manage Rev. Oct.-Dec., 2006; 31(4); 337-46 PMCID: PMC1952654

• 2006 -- Pubmed # 17099107 Utley-Smith, Q., Bailey, D., Ammarell, N., Corazzini, K., Colón-Emeric, C. S., Lekan-Rutledge, D., Piven, M. L., Anderson, R. A. Exit interview-consultation for research validation and dissemination. West J Nurs Res. December, 2006; 28(8); 955-73 PMCID: PMC1636585

• 2006 -- Pubmed # 16585806 Piven, M. L., Ammarell, N., Bailey, D., Corazzini, K., Colón-Emeric, C. S., Lekan-Rutledge, D., Utley-Smith, Q., Anderson, R. A. MDS coordinator relationships and nursing home care processes. West J Nurs Res. April, 2006; 28(3); 294-309 PMCID: PMC1472871

• 2006 -- Pubmed # 16394208 Colón-Emeric, C. S., Ammarell, N., Bailey, D., Corazzini, K., Lekan-Rutledge, D., Piven, M. L., Utley-Smith, Q., Anderson, R. A. Patterns of medical and nursing staff communication in nursing homes: implications and insights from complexity science. Qual Health Res. February, 2006; 16(2); 173-88 PMCID: PMC1474048

• 2005 -- Pubmed # 16221876 Anderson, R. A., Ammarell, N., Bailey Jr, D., Colón-Emeric, C., Corazzini, K. N., Lillie, M., Piven, M. L., Utley-Smith, Q., McDaniel Jr, R. R. Nurse assistant mental models, sensemaking, care actions, and consequences for nursing home residents. Qual Health Res. October, 2005; 15(8); 1006-21 PMCID: PMC2211272

• 2005 -- Pubmed # 15839289 Anderson, R. A., Ammarell, N., Bailey, D. E., Colon-Emeric, C., Corazzini, K., Lekan-Rutledge, D., Piven, M. L., Utley-Smith, Q. The power of relationship for high-quality long-term care. J Nurs Care Qual. May, 2005; 20(2); 103-6 PMCID: PMC1993898

• 2005 -- Pubmed # 15802542 Anderson, R. A., Crabtree, B. F., Steele, D. J., McDaniel Jr, R. R. Case study research: the view from complexity science. Qual Health Res. May, 2005; 15(5); 669-85 PMCID: PMC1822534

• 2005 -- Pubmed # 17334452 Corazzini, K. N., Lekan-Rutledge, D., Utley-Smith, Q., Piven, M. L., Colón-Emeric, C. S., Bailey, D., Ammarell, N., Anderson, R. A. "The Golden Rule": Only a starting point for quality care. Director. 2006; 14(1); 255-293 PMCID: PMC1636677

• 2004 -- Corazzini, K., McConnell, E. S., Rapp, C. G., Anderson, R. A. A conceptual framework for understanding the decision making processes of nursing assistants in providing dementia care. Alzheimer’s Care Quarterly. July-September, 2004; 5(3); 197-206

• 2004 -- Pubmed # 15197292 Anderson, R. A., Corazzini, K. N., McDaniel Jr, R. R. Complexity science and the dynamics of climate and communication: reducing nursing home turnover. Gerontologist. June, 2004; 44(3); 378-88 PMCID: PMC2271037

• 2004 -- Pubmed # 14974517 McConnell, E. S., Lekan-Rutledge, D., Nevidjon, B., Anderson, R. Complexity theory: a long-term care specialty practice exemplar for the education of advanced practice nurses. J Nurs Educ. February, 2004; 43(2); 84-7

• 2003 -- Pubmed # 12930459 Issel, L. M., Anderson, R. A., Kane, D. J. Administrative characteristics of comprehensive prenatal case management programs. Public Health Nurs. November, 2003; 20(5); 349-60

• 2003 -- Pubmed # 12744450 Anderson, R. A., Allred, C. A., Sloan, F. A. Effect of hospital conversion on organizational decision making and service coordination. Health Care Manage Rev. June, 2003; 28(2); 141-54

• 2003 -- Pubmed # 12552171 Anderson, R. A., Issel, L. M., McDaniel Jr, R. R. Nursing homes as complex adaptive systems: relationship between management practice and resident outcomes. Nurs Res. February, 2003; 52(1); 12-21 PMCID: PMC1993902

• 2001 -- Pubmed # 11746066 Issel, L. M., Anderson, R. A. Intensity of case managers' participation in organizational decision making. Res Nurs Health. October, 2001; 24(5); 361-72

• 2001 -- Corcoran, D. K., Anderson, R. A. Smart cards: Nurses at the forefront of radical advances in health care. Policy, Politics, and Nursing Practice. February, 2001; 2(1); 40-47

• 2000 -- Pubmed # 10710732 Anderson, R. A., McDaniel Jr, R. R. Managing health care organizations: where professionalism meets complexity science. Health Care Manage Rev. Winter, 2000; 25(1); 83-92

• 1999 -- Pubmed # 10047975 Anderson, R. A., McDaniel Jr, R. R. RN participation in organizational decision making and improvements in resident outcomes. Health Care Manage Rev. Winter, 1999; 24(1); 7-16

• 1999 -- Pubmed # 10435545 Anderson, R. A., Su, H. F., Hsieh, P. C., Allred, C. A., Owensby, S., Joiner-Rogers, G. Case mix adjustment in nursing systems research: the case of resident outcomes in nursing homes. Res Nurs Health. August, 1999; 22(4); 271-83 PMCID: PMC1993889

• 1999 -- Pubmed # 10463108 Issel, L. M., Anderson, R. A. Avoidable costs of comprehensive case management. Health Care Manage Rev. Summer, 1999; 24(3); 64-72

• 1998 -- Pubmed # 9679807 Anderson, R. A., Hsieh, P. C., Su, H. F. Resource allocation and resident outcomes in nursing homes: comparisons between the best and worst. Res Nurs Health. August, 1998; 21(4); 297-313 PMCID: PMC1993888

• 1998 -- Pubmed # 9499657 Anderson, R. A., McDaniel Jr, R. R. Intensity of registered nurse participation in nursing home decision making. Gerontologist. February, 1998; 38(1); 90-100

• 1997 -- Anderson, R. A., Issel, M. I., McDaniel, R. R. Nursing staff turnover in nursing homes: A new look Public Administration Quarterly. 1997; 21(1); 69-95

• 1996 -- Pubmed # 8700264 Issel, L. M., Anderson, R. A. Take charge: managing six transformations in health care delivery. Nurs Econ. September, 1996; 14(2); 78-85

• 1996 -- Pubmed # 8606985 Torkelson, D. J., Anderson, R. A., McDaniel, R. R. Interventions in response to chemically dependent nurses: effect of context and interpretation. Res Nurs Health. April, 1996; 19(2); 153-62

• 1994 -- Pubmed # 7882095 Hughes, L. C., Anderson, R. A. Issues regarding aggregation of data in nursing systems research. J Nurs Meas. 1994; 2(1); 79-101

• 1992 -- Pubmed # 1643575 Anderson, R. A., Dobal, M. T., Blessing, B. B. Theory-based approach to computer skill development in nursing administration. Comput Nurs. September, 1992; 10(4); 152-7

• 1992 -- Pubmed # 1574134 Anderson, R. A., McDaniel Jr, R. R. The implication of environmental turbulence for nursing-unit design in effective nursing homes. Nurs Econ. June, 1992; 10(2); 117-25

• 1992 -- Pubmed # 1389462 Anderson, R. A. Nursing administration education. Annu Rev Nurs Res. 1992; 10 165-81

• 1992 -- Anderson, R. A., Ashmos, D. P. Nurses’ participation in strategic decision making In Practice and inquiry for nursing administration: intradisciplinary and interdisciplinary perspectives, edited by Henry, B. 1992; pp. 72-75. Kansas City. MO: American Academy of Nursing.

• 1992 -- Anderson, R. A., Henry, B., McDaniel, C., Redman, R., Issel, M., Tumulty, G., Crouch-Ruiz, E. Assigned discussion groups In Practice and inquiry for nursing administration: intradisciplinary and interdisciplinary perspectives, edited by Henry, B. 1992; pp. 113-134. Kansas City. MO: American Academy of Nursing.

• 1991 -- Pubmed # 10112953 Anderson, R. A., Thomas, J. B. The thinking hospital. Health Prog. September, 1991; 72(7); 16-7, 21

• 1991 -- Pubmed # 1991677 Thomas, J. B., McDaniel Jr, R. R., Anderson, R. A. Hospitals as interpretation systems. Health Serv Res. February, 1991; 25(6); 859-80 PMCID: PMC1065671

• 1990 -- Pubmed # 10104997 Anderson, R. A. Riding out the storm of environmental turbulence. Health Prog. June, 1990; 71(5); 22-4

• 1989 -- Pubmed # 10295920 McDaniel Jr, R. R., Anderson, R. A. Demystifying the boardroom. Tips for timid trustees. Health Prog. November, 1989; 70(9); 32-6

• 1989 -- Pubmed # 2723791 Scalzi, C. C., Anderson, R. A. Dual degree. Future preparation for nurse executives? J Nurs Adm. June, 1989; 19(6); 25-9

• 1989 -- Pubmed # 2723784 Anderson, R. A., Scalzi, C. A theory development role for nurse administrators. J Nurs Adm. May, 1989; 19(5); 23-9

• 1989 -- Scalzi, C. C., Anderson, R. A. Conceptual model for theory development in nursing administration In Dimensions of nursing administration: Theory, research, education, and practice, edited by Henry, B. and Arndt, C. and DiVincenti, M. and Marriner-Tomey, A. 1989; pp. 137-141. Cambridge: Blackwell Scientific Publications.

• 1988 -- Pubmed # 3412663 Rea, R. E., Anderson, R. A., Scalzi, C. C. Collaborative learning method: enhancing excellence in nursing administration doctoral programs. Nurs Adm Q. Summer, 1988; 12(4); 63-8

• 1985 -- Pubmed # 3852113 Anderson, R. A. Products and product-line management in nursing. Nurs Adm Q. 1985; 10(1); 65-72

Grant Funding (selected)

• Center for Adaptive Leadership in Cognitive/Affective Symptom Science  
  National Institutes of Health
  1P30-NR014139-01
  09/2012-06/2017
  The proposed Center of Excellence (P30), “Adaptive Leadership for Cognitive/Affective Symptom Science (ADAPT) at Duke University School of Nursing (DUSON), will promote biobehavioral research to advance symptom science using a new lens—the Adaptive Leadership (AL) framework—to conceptualize and study cognitive/affective symptoms, and/or intervene in ways that promote patients’ and their family caregivers’ adaptive abilities.

• Administrative Core  
  National Institutes of Health
  1P30-NR014139-01
  09/2012-06/2017
  

• Outcomes of Nursing Management Practice in Nursing Homes  
  National Institutes of Health
  2R01-NR003178-09A2
  09/2011-06/2016
  Role: co-PI
  This research will test the benefit of a new staff interaction intervention (CONNECT) over and above a falls quality improvement intervention in reducing patient fall rates in nursing homes.

• Family Perceptions of Strategies to Facilitate End-of-Life Decisions  
  NIH, National Institute of Nursing Research
  1F31NR013327-01A1
  08/2012-07/2014
  Role: Co-Mentor
  Project Goal: Pre-doctoral study to explore how family members respond to nursing strategies to support EOL decision-making.

• Evaluation of the Nursing Culture Assessment Tool as a basis for improving prevention of pressure ulcers in long-term care  
  John A. Hartford Foundation Building Academic Geriatric Nursing Capacity: Claire M. Fagin Fellowship award
  07/2012-06/2014
  Role: Co-Mentor
  The purpose of the research is to refine the previously developed Nursing Culture Assessment Tool (NCAT) by administering it to nursing staff in contextually different long-term care settings, to determine the clinical relevance of the NCAT in the context of PU prevention care practices by re-examining its content validity in this context and exploring focus group perspectives on its accuracy. Use these findings to guide item refinement and/or development of a protocol manual to standardize NCAT use in future clinical trials.

• Comparison of Careful Hand Feeding Techniques for Older Persons with Dementia  
  John A. Hartford Foundation Building Academic Geriatric Nursing Capacity: Claire M. Fagin Fellowship award
  07/2012-06/2014
  Role: Co-Mentor
  

• CONNECT for Better Falls Prevention in VA Community Living Center  
  Veterans Affairs Health Services Research and Development
  EDU 08-417
  08/2009-07/2012
  Role: Co-investigator
  In this longitudinal, randomized, controlled trial using multiple levels of analysis, we will compare the uptake of fall risk factor reduction practices and related patient fall-related outcomes in nursing homes, under two approaches to education: (1) FALLS, which is delivered using content-focused approaches to education including self-instructional modules, an in-house falls program coordinator, academic detailing sessions and audit and feedback and (2) FALLS as described above, plus CONNECT, which is delivered using learner-centered approaches and is intended to increase information exchange among staff of all levels and disciplines, increase direct care nursing providers’ participation in decision-making, and increase cognitive diversity when implementing evidence-based care practices.

• Compassion Fatigue in Adult Daughter Caregivers  
  National Institutes of Health
  1F31-NR012870-01A1
  09/2011-08/2013
  Role: co-PI
  Support for doctoral research for Jennifer R. Day

• Transitional Care for Post-Acute Residents in Nursing Homes  
  John A. Hartford Foundation
  11-223
  07/2011-06/2013
  Role: Co-PI
  

• Regulating Licensed Nursing Practice in Nursing Homes: How RN and LPN Scopes of Practice Are Enacted  
  National Council for State Boards of Nursing
  NCSBN R30010
  10/2010-09/2012
  Role: Co-Investigator
  To describe practice patterns of RNs and LPNs used to implement their scope of practice, to compare these practice patterns between two states, and to develop a facility-level tool to measure these patterns.

• Director of Nursing Leadership and Quality of Nursing Home Care: The Impact of DON Turnover and Practice Patterns on Care Quality Over Time  
  Duke University School of Nursing Postdoctoral Fellowship
  10/2011-02/2013
  Role: Co-Mentor for PI Selina Hunt McKinney
  Title of Project: Project Goal: To describe the relationships between nursing practice environments, DON turnover, and quality of care outcomes over time in NC nursing homes, controlling for contextual and market factors.

• Agency Staffing and Nursing Home Quality  
  Agency for Healthcare Research and Quality (to U. Pittsburgh)
  1R01HS017532-01A1 (subcontract 0006388)
  04/2010-01/2012
  Role: subcontract PI
  Project aims are to: (1) examine association between use of agency staff and quality indicators in nursing homes; (2) determine at what points use of agency staff are most negatively associated with quality indicators; (3) determine whether effect of use of agency staff on quality varies across different categories of caregivers (i.e., RNs, LPNs, and NAs); and (4) examine whether the association between agency use and quality is influenced by the interaction with other staffing factors such as caregiver staffing levels.

• Supplement to Outcomes of Nursing Management Practice in Nursing Homes  
  National Institute of Nursing Research, National Institutes of Health
  3R56NR003178–09SI
  05/2010-01/2011
  Role: PI
  Purpose: To fund four, 2nd-degree Bachelor of Science in Nursing students to enhance or accelerate achievement of parent study aims by assisting in collecting follow-up measures, assessing reliability and validity; assisting in administering the FALLS intervention, and assisting in describing baseline differences in the staff interaction measures between nursing homes across study arms.

• Regulating licensed nursing practice in nursing homes: RN delegation, LPN practice, and care outcomes  
  National Council for State Boards of Nursing
  P19004
  07/2008-09/2010
  Role: Co-investigator
  Project Goal: To measure the relationships between state Nurse Practice Acts codification of RN delegation and LPN practice, and facility-level outcomes of care.

• Outcomes of Nursing Management Practice in Nursing Homes  
  National Institutes of Health/National Institute of Nursing Research
  2R56-NR003178-09
  09/2009-08/2010
  Role: co-PI
  This research will test the benefit of a new staff interaction intervention (CONNECT) over and above falls quality improvement intervention in reducing patient fall rates in nursing homes.

• Staffing Characteristics of Nursing Homes and Quality  
  University of Pittsburgh subcontract
  04/2008-03/2009
  Role: Subcontract PI
  Project aims: to examine the associations between staffing levels, turnover, stability, and use of agency staff and quality, not only for licensed practical nurses (LPNs), and registered nurses (RNs), but also for nurse aides (NAs).

• Manualizing an Intervention to Improve Quality of Care in Nursing Homes  
  DUSON Small Grant
  04/2008-04/2009
  Role: PI
  Project aims: This project goal is to develop and test the CONNECT intervention manual.

• Center of Excellence in Geriatric Nursing Education  
  The Duke Endowment
  01/2008-12/2010
  Role: Co-Director of Center
  Project goals: Pathways to Sustained Careers in Academic Geriatric Nursing -- The goal of this geriatric nursing initiative is to increase the number and quality of geriatric nursing faculty available to educate future generations of nurses that understand and provide effective geriatric nursing care. The aims are to: (1) Expand opportunities for careers in academic geriatric-nursing by partnering with associate-degree and baccalaureate-nursing programs; (2) Create and evaluate new models that increase the number of geriatric nursing clinical instructors by partnering with diverse health systems to equip expert practicing clinicians with knowledge and skills needed to become clinical instructors in geriatric-nursing; and (3) Expand a virtual community that connects geriatric nursing faculty in diverse locations, enhances faculty access to state-of-the-art geriatric nurse training resources, and provides ongoing academic mentoring and support.

• Translating Nursing Systems Science into Practice in LTC: The PALS Intervention  
  University of Iowa GNIRC/Hartford Center
  07/2007-06/2007
  Role: Co-PI
  Project Goal: To develop a culturally relevant, feasible and acceptable methodology for translating systems-level empirical findings into practice which will serve as the basis for an intervention amenable to testing in a randomized-controlled trial design.

• Staffing Characteristics of Nursing Homes and Quality  
  University of Pittsburgh subcontract
  0003617-112512-1
  04/2007-03/2009
  Role: Subcontract PI
  Project aims are to: (1) examine the association between use of agency staff and quality indicators in nursing homes; (2) determine at what points use of agency staff are most negatively associated with quality indicators; (3) determine whether the effect of use of agency staff on quality varies across the different categories of caregivers (i.e., RNs, LPNs, and NAs); and (4) examine whether the association between agency use and quality is influenced by the interaction with other staffing factors such as caregiver staffing levels.

• Staffing Characteristics of Nursing Homes and Quality  
  Agency for Healthcare Research and Quality, National Institutes of Health
  R01 HS16808
  04/2007-03/2008
  Role: Subcontract PI
  Project aims: to examine the associations between staffing levels, turnover, stability, and use of agency staff and quality, not only for licensed practical nurses (LPNs), and registered nurses (RNs), but also for nurse aides (NAs).

• The Influence of Staff Turnover on Quality  
  University of Pittsburgh subcontract
  111533-1
  07/2006-12/2007
  Role: Subcontract PI
  Project aim: to examine whether turnover of caregivers (RNs, LPNs, and NAs) influence quality of care.

• Outcomes of Nursing Management Practice in Nursing Homes  
  National Institutes of Health
  2R01-NR03178-04A2
  05/2002-01/2008
  Role: PI
  Project goals: To describe and explain how relationship patterns and nursing management practices lead to behaviors that result in high quality or poor quality outcomes in nursing homes. Specific aims are to: 1) describe relationship patterns; 2) explore staff’s and managers’ understanding of relationship patterns and nursing management practices in use; 3) compare relationship patterns and nursing management practices between homes with high-quality and poor-quality resident outcomes; and 4) develop a model of the relationship patterns and nursing management practices that foster better outcomes.

• Trajectories in Aging & Care in Nursing Science - Pilot Feasibility Studies Core  
  National Institutes of Health / National Institute of Nursing Research
  2P20-NR007795-04
  07/2004-06/2007
  Role: Director, Pilot/Feasibility Studies Core
  

  Project goals: Establish the Trajectories of Aging and Care (TRAC) Center to enhance the capacity for nurse investigators to examine patterns of health, illness, and care among the elderly over time and across diverse settings, including home and institution.

  Sub-project (Feasiblity Core) goals: To encourage and support research in gerontological nursing, facilitate effective use of funds for expanding our knowledge of trajectories of aging and care, and prepare new or transitioning nurse scholars for submission of RO1 or equivalent research projects that are innovative and that have strong interdisciplinary collaboration. The TRAC Center will fund three pilot/feasibility studies in the first year and two studies in each of the second and third years of funding.

• Trajectories of Aging and Care in Nursing Science: Feasibility Core  
  National Institutes of Health / National Institute of Nursing Research
  1 P20-NR07795-01
  09/2001-08/2004
  Role: Director, Pilot/Feasibility Studies Core
  Project goals: Establish the Trajectories of Aging and Care (TRAC) Center to enhance the capacity for nurse investigators to examine patterns of health, illness, and care among the elderly over time and across diverse settings, including home and institution.

  Sub-project goals (Anderson, Core Director): To encourage and support research in gerontological nursing, facilitate effective use of funds for expanding our knowledge of trajectories of aging and care, and prepare new or transitioning nurse scholars for submission of RO1 or equivalent research projects that are innovative and that have strong interdisciplinary collaboration. The TRAC Center will fund three pilot/feasibility studies in the first year and two studies in each of the second and third years of funding.

• TRAC Center Pilot: Facility level influences on trajectories of physical function in long-stay nursing home residents  
  National Institutes of Health / National Institute of Nursing Research
  1 P20-NR07795-01
  09/2001-09/2002
  Role: Co-PI
  Project goals: 1) to examine the stability of organizational attributes of management structure, staffing, unit specialization and risk-adjusted quality indicators of care processes (as developed by Zimmerman et al 1995) across a 2-year time period; and 2) to identify subgroups of nursing home residents by disability risk factors of pathology, impairments, and limitations, that experience more rapid decline in ADL performance as a result of facility structure and care processes using multilevel modeling of the linked data.

• Distance Based MSN in Nursing and Healthcare Leadership  
  Health Resources and Service Administration - Division of Nursing
  09/2003-06/2006
  Role: Program Faculty
  Project goals: The purpose of this proposal is to increase access and revise the existing program at the Duke University School of Nursing (DUSON), to address the critical shortage of nursing leaders in rural and underserved areas by preparing advanced practice nurses who practice as nurse executives in health system’s leadership positions.

• Long-Term Care Consortium Scholars-in-Residence Program  
  Scholl Foundation
  10/2001-09/2002
  Role: Scholar-in-Residence
  Project goals: Under the auspices of the School of Nursing’s Long-Term Care Consortium (LTCC), establish (1) a Scholar-in-Residence program, implemented on-site at LTCC facilities demonstrating the utility and benefit of conducting on-site research into topics of mutual interest to LTC providers and university faculty and (2) establish LTCC Fellowships for graduate nursing students specializing in geriatric care.

• Distance-Based Gerontological Nursing Education in Exemplary Long-Term Care Settings  
  Helene Fuld Health Trust
  07/2001-06/2003
  Role: Program evaluator
  Project goals: A two-year project implemented in four long-term care sites in both the eastern and western regions of NC to: (1) establish meaningful clinical collaboration among Duke faculty, LTC administrators, staff, and advanced practice nurses serving as preceptors; (2) adapt the curriculum in the gerontological nursing for distance-based delivery, complementing the core MSN courses already available online; (3) educate gerontological nurse practitioners in evidence-based practice through a web-based curriculum and supervised clinical placements in LTCC facilities; and (4) collaborate with nursing home staff in each facility to develop and implement a clinical care program which addresses a problem identified by the nursing home, and which utilizes an evidence-based practice approach.

• Gerontological Leadership and Outcomes Management Program  
  Teagle Foundation
  07/1999-06/2000
  Role: Co-PI
  Project goals: To develop a innovative approach to preparing nurses for leadership positions in community-based, long term care settings

• Making Sense of Health Information Technology in an Academic Medical Center.  
  Agency for Healthcare Research and Quality
  1R36HS020161-01
  03/2011-02/2012
  Role: Faculty Sponsor for PI Rebecca Kitzmiller
  Project Goal: Explore the role of project teams’ sensemaking during the implementation of new information technology in a tertiary care hospital.

• Trajectory of Self-Management Activities in Diabetic African American Primary Caregiving Grandparents  
  John A. Hartford Foundation Building Academic Geriatric Nursing Capacity: Claire M. Fagin Fellowship award
  07/2010-07/2012
  Role: Mentor for PI Dana Carthron
  Project Goal: To explore the trajectory of self-management activities and provider support in diabetic African American primary caregiving grandparents (AA-PCGs). The specific aims for this study are: 1) to explore the trajectory of self-management activities of diabetic AA-PCGs; 2) to determine the facilitators and barriers to the performance of diabetes self-management activities in diabetic AA-PCGs; and, 3) to explore how interactions with health care providers, overtime (longitudinally), support, or do not support, improvements in self-management by diabetic AA-PCGs.

• Cascade Iatrogenesis: Postoperative Respiratory Failure in Hospitalized Older Adults  
  John A. Hartford Building Academic Geriatric Nursing Capacity: Claire M. Fagin Fellowship award
  07/2010-07/2012
  Role: Mentor for PI Deirdre Thornlow
  Project Goal: To examine factors associated with the development of adverse events in hospitalized older adults, especially those factors that contribute to cascade iatrogenesis, the serial development of multiple medical complications.

• Interactive Care Teams for Long Term Care Residents with Multi-factorial Syndromes  
  John A. Hartford Foundation
  09/2008-08/2010
  Role: PI
  Supports doctoral research of Mark Toles, 2008-2010 John A. Hartford (BAGNC) Scholar. His research focuses on development of relationships in nursing homes that have the potential to improve nursing home quality. He works with a team of researchers at Duke to study strategies for improving collaboration between nursing home staff. He is exploring nursing home quality in relation to patterns of nursing home resident and staff interactions.

• Effective Team Interactions in the Care of Dependent Elders in Long Term Care  
  John A. Hartford Foundation Building Academic Geriatric Nursing Capacity
  09/2008-08/2010
  Role: Mentor
  Supports doctoral study by Mark Toles at Duke University School of Nursing from September 2008 to August 2010.

• Organizational Sensemaking During the Strategic Change Experienced During an Information Technology Implementation  
  Predoctoral Clinical Research Training Programs of NIH Roadmap for Medical Research (Califf, PI)
  06/2008-10/2008
  Role: Faculty Sponsor for PI Rebecca Kitzmiller
  Project goals: In this short-term CTSA research project, the student will establish baseline measurements for her dissertation project including establishing a baseline for current patient quality care indicators, nursing unit climate, and collecting data on staff/managers’ descriptions of sensemaking (defined as evaluating and making sense of events and information) and relate these to a major organization wide change project.

• Title of Project: Nursing Home Coordination and Dependent Elders’ Perceptions of Quality of Life  
  Predoctoral Clinical Research Training Programs of the NIH Roadmap for Medical Research (Califf, PI).
  06/2008-08/2008
  Role: Faculty Sponsor
  Project goals: To explore the relationship between nursing home team processes and resident quality of life. Supports PhD research of Mark Toles.

• Organizational Safety Survey Reliability and Validity  
  Predoctoral Clinical Research Training Programs of the NIH Roadmap for Medical Research (Califf, PI).
  06/2008-08/2008
  Role: Faculty Sponsor
  Project goals: To pilot two measures of organizational safety culture, the Safety Attitude Questionnaire (SAQ) and the Safety Organization Scale (SOS) and determine the most appropriate instrument for use in student’s dissertation research.

• Organizational sensemaking during the strategic change experienced during an information technology implementation  
  Predoctoral Clinical Research Training Programs of the NIH Roadmap for Medical Research (Califf, PI).
  06/2007-10/2007
  Role: Faculty Sponsor
  Supports PhD research of Rebecca Kitzmiller

• Organizational Variability and Racial Disparities in Hospice Use  
  NIH/NIA, Paul B. Beeson Career Development Award in Aging
  AG-07-001
  06/2007-05/2012
  Role: Advisor
  Supports PhD research of Kimberly Johnson. Resarch will explore hypotheses that racial disparities in hospice use are associated with variability in structure, programs, and policies of individual hospice agencies.

• Evidence-Based Medicine in the Skilled Nursing Facility  
  National Institutes of Health, National Institute on Aging
  5K23-AG24787-01
  07/2004-05/2009
  Role: Co-Mentor
  Project goals: The purpose of this project is to explore the impact of systems and provider factors on clinical practice guideline implementation in the SNF. Specific aims are to: 1) describe the impact of systems factors (relationship patterns, management practices, and information flow) and provider factors (knowledge, attitudes, and beliefs) on the use of two different clinical practice guidelines in selected SNFs; 2) compare the barriers and facilitators to guideline use between higher and lower-quality SNFs; and 3) develop a model of systems and provider factors that foster clinical practice guideline use.

• Minority Supplement: Outcomes of Nursing Management Practice in Nursing Homes  
  National Institutes of Health / National Institute of Nursing Research
  3R01-NR03178-05S1
  07/2003-01/2007
  Role: PI (with Q. Utley-Smith)
  This grant supports the effort of Dr. Utley-Smith who will be able to support the existing grant, particularly in areas of data analysis and interpretation. The existing grant, in turn, will provide her with a number of meaningful opportunities to advance her own research skills and enhance her potential to develop a significant, independent research program. The minority supplement will provide protected time needed by Dr. Utley-Smith to gain hands-on research experience and lay the foundation for preparing a K01 application and eventually an R01 application for her independent research.

• A Randomized Trial of RN Coordinated Prevention Services  
  TriService Nursing Research Program
  MDA-905-98-Z-0032
  07/1998-08/2002
  Role: Co-PI 11/1998 to 11/2000; PI 12/2000 to 8/31/2002
  Project Goal: The major goals of this project are to: 1) Determine if a Primary Care Nurse Liaison model of health promotion/disease prevention coordination increases quality outcomes significantly over that of usual care for active duty soldiers and 2) Determine the risk factor and chronic disease profile of active duty soldiers.

• Hospital Ownership Conversion  
  Robert Wood Johnson Foundation
  12/1998-11/2001
  Role: Co-PI
  Project goals: To study why hospitals choose to convert and why they change ownership; why they select a particular type of ownership change; whether is a “fair” price paid for the hospital by the acquiring organization; and how conversion affects hospitals’ internal decision making processes.

• Case-Study on Outcomes of Nursing Management Practice in Nursing Homes  
  The University of Texas at Austin, Faculty Development Program, Faculty Research Assignment
  09/1996-05/1997
  Role: PI
  

• Outcomes of Nursing Management Practice in Nursing Homes  
  National Institute of Nursing Research/National Institutes of Health
  1 RO1 NR03178-01A2
  09/1994-06/1998
  Role: PI
  Project goals: To explore the relationship between nursing management practices and contextual factors and examine their independent and joint influences on patient, staff, and financial outcomes in nursing homes. The study used a correlational design to answer the question: Controlling for case mix, to what extent do nursing management practices and contextual factors explain significant variation in patient, staff, and financial outcomes?

• Patient and Provider Perspectives on Outcomes in Home Health Care  
  Biomedical Research Support Grant (BRSG), The University of Texas at Austin, School of Nursing
  03/1993-08/1994
  Role: PI
  

• Creation of a Database for Evaluating Nursing Home Outcomes  
  Biomedical Research Support Grant (BRSG), The University of Texas at Austin, School of Nursing
  01/1993-08/1994
  Role: PI
  

• Influence of Contextual Factors and Decision Making on Nursing Home Performance Outcomes  
  Summer Research Award, funded by University Research Institute, The University of Texas at Austin
  06/1991-08/1991
  Role: PI
  

• Impact of External Environments on Urban Nursing Homes in Texas  
  Policy Research Institute, The University of Texas at Austin
  07/1990-08/1990
  Role: PI
  

• Establishing the Validity and Reliability of the Nursing Participation in Decision Making Instrument and the Environment Turbulence Scale  
  University Research Institute, The University of Texas at Austin
  07/1990-08/1990
  Role: PI
  Support for data entry

• Graduate Joint Degree Program in Nursing and Management  
  Commonwealth Fund
  09/1989-09/1990
  Role: Co-Project Director
  

• Establishing the Validity and Reliability of the Nursing Participation in Decision Making Instrument  
  American Nurses’ Foundation
  10/1989-09/1990
  Role: PI
  

• Establishing the Validity and Reliability of the Nursing Participation in Decision Making Instrument and the Environmental Turbulence Scale  
  BRSG, School of Nursing, University Research Institute, University of Texas at Austin
  07/1989-03/1990
  Role: PI