Supplies of N95 face masks, surgical face masks, and face shields at US hospitals are under the microscope in the latest research project led by nurse scientist Kelly Aldrich, DNP, MS, RN-BC, FHIMSS, associate professor of nursing informatics at Vanderbilt University Nursing School.
The DNP and her team are receiving CDC funding to the tune of $80,000 to support their analysis of daily hospital personal protective equipment (PPE) on-hand inventories to measure trends, patterns, or statistically significant changes in PPE supply in the nation’s nearly 7,000 U.S. hospitals. The project is designed to support the CDC’s National Personal Protective Technology Laboratory, which was established under the aegis of the National Institute for Occupational Safety and Health (NIOSH) in 2001 and invested with the mission of preventing disease, injury, and death for the millions of American workers who rely on personal protective technology (PPT).
“In analyzing the data with advanced analytics, we will be able to find patterns that were not seen before. I think because of that, it will have a true impact on supply chain management for the country.”
Aldrich is being supported by a Vanderbilt team that includes four second-year data science students under the supervision of Jesse Spencer-Smith, chief data scientist of the Data Science Institute, and Dana Zhang, professor of computer science and electrical engineering, to leverage artificial intelligence and data modeling for this large-scale analysis and reporting effort.
Nurse scientist Kelly Aldrich, DNP, MS, RN-BC, FHIMSS.
“We’re conducting data analysis on a medical organization’s average consumption rates to figure out if they have enough PPE and other essential items to provide for their teams,” Aldrich said. “In analyzing the data with advanced analytics, we will be able to find patterns that were not seen before. I think because of that, it will have a true impact on supply chain management for the country.”
“By [enlisting the aid of] the Data Science Institute to support this important work, Dr. Aldrich has deepened and extended the research while providing a meaningful opportunity for our team to put their expertise to use,” said Jesse Spencer-Smith, chief data scientist for the Data Science Institute. “Our faculty and graduate students formed a team that is enabling this analysis to go from simple data points to insights that can shape the country’s future responses to health care events.”
Study aims to increase transparency and efficiency of PPE supply distribution
The necessity of this effort was brought to light by pandemic-related lack of access to PPE due to supply shortages or prohibitive costs. In the early stages of the pandemic, the World Health Organization called on industry and governments to boost PPE manufacturing with a warning of “severe and mounting disruption to the global supply of personal protective equipment—caused by rising demand, panic buying, hoarding and misuse.”
The WHO was right. Months into the pandemic, PPE shortages among hospitals, nursing homes and medical practices across the U.S. put health care providers and patients at heightened risk of exposure to COVID-19. Two goals of Aldrich’s project are to bring transparency to PPE supply across the country and to eliminate the common problem of one hospital having a PPE surplus while neighboring hospitals scramble.
The project is a follow-up to a 2020 project Aldrich led with the Center for Medical Interoperability, a national nonprofit working to integrate health care technologies for information exchange, and the National Personal Protective Technology Laboratory, part of the National Institute for Occupational Safety and Health. The TOGETHER for PPE project phase connected 78 hospitals in nine federal Health and Human Services’ regions. Thousands of real-time data points allowed for predictive modeling and other data analysis which helped hospitals and the CDC examine exactly what PPE they had on hand, which enabled hospitals to plan and develop solutions that kept caregivers and hospital patients safe. A paper on the project phase entitled Lessons Learned from the Development and Demonstration of a PPE Inventory Monitoring System for US Hospitals was published in the journal Health Security on Nov. 9.
Aldrich’s trans-institutional project will restart and amplify the TOGETHER for PPE effort. The data collected by Aldrich’s team in 2021 will focus on N95 face masks, surgical face masks, and face shields.
“Collaboration with the Data Science Institute in data modeling and data analysis with predictive and artificial intelligence models are of high priority,” said Aldrich, also the director of Vanderbilt’s new Nursing Informatics Innovation Lab within the Vanderbilt School of Nursing and the chief clinical transformation officer for the Center for Medical Interoperability. “This collaboration is a terrific example of bringing researchers together with diverse areas of expertise and distinct backgrounds to discover new information. We are excited about the progress to date.”
Last year was a nightmare for nearly everyone in health care. But for school nurses, 2021 has been worse.
Since school doors opened this fall, school nurses have been working nonstop on COVID-19 contact tracing and quarantines. In most places, they’ve had to abandon many of their regular duties and add brutal weekend and evening hours to their schedules.
Janis Hogan, a 22-year veteran of school nursing (and 2018-19 School Nurse of the Year by the Maine Association of School Nurses), is among them. Her job at Camden Hills Regional High School in Rockport, Maine, has been reduced to COVID-19 contact tracing all day every day, she told Stateline.
Missing are the one-on-one interactions with kids that she said are invaluable to their physical and mental well-being and academic achievement—and the most rewarding part of her job.
The Biden administration promised in May that help for school nurses was on the way. As part of a $7.6 billion fund created under the American Rescue Plan Act to reinforce the public health workforce, $500 million was set aside to bolster school-based health services.
But a severe nationwide shortage of registered nurses and the unrelenting need for nurses in hospitals overrun with COVID-19 cases mean that much of the new federal money likely will be spent on support for school nurses such as training, scholarships, administrative staff and other contract services—not on fresh troops.
“The goal of the federal relief money was to invest in ways that would address the immediate and long-term impact of the pandemic on kids in schools and to help schools maintain a safe and healthy environment,” said Linda Mendonça, president of the National Association of School Nurses.
Fresh Recruits Unlikely in a Combined Nursing Shortage/National Labor Shortage
Hiring more school nurses as soon as possible would be everybody’s preference, Mendonça said, but that’s going to be challenging. Registered nurses working in hospitals and other medical settings can make $10,000 to $20,000 more than school nurses, and they are in even greater demand now because of the delta surge.
Hogan had hoped her state’s share would be used to hire another nurse at her high school. That would have allowed her and a partner to address COVID-19 as a team, while still conducting annual vision and hearing screenings, flu shot drives, and other services for students.
Instead, Maine’s public health agency plans to spend the new money on a telehealth contract and school-based health assistants with minimal health care training to fill in for school nurses while they’re busy juggling COVID-19 cases, said Emily Poland, Maine’s top school nurse official and president of the National Association of State School Nurse Consultants.
States applied to the federal Centers for Disease Control and Prevention for their share of the American Rescue Plan in September, and the money will flow to states this year and next.
In their applications, Poland said, some states said they plan to use the funding for school nurse scholarships and mentoring programs to develop a stronger workforce.
Other states are slated to use the money on support personnel for existing school nurses, such as state and regional experts to advise school nurses on managing chronic diseases, deciphering new CDC guidance, and addressing emerging health issues that affect school-age children.
To free up more of existing school nurses’ time so they can work with students one-on-one and help schools develop better nutrition and exercise programs, some states plan to use the new federal money to reduce administrative chores such as billing Medicaid and Medicare for certain services.
[foogallery id=”61453″]
“State health officials would be very enthusiastic about having more nurses in schools,” said Dr. Marcus Plescia, chief medical officer of the Association of State and Territorial Health Officials. “I understand there’s a nursing shortage, but some nurses may be attracted to school nursing programs. The pace is different, and they wouldn’t be dealing as much with sick patients.”
With a stronger bench of nurses in schools, Plescia said, they could get more involved in preventive care and wellness programs. They also could contribute more to public health by acting as eyes and ears on the health of the local population, since many illnesses first start to show up in schools, he said.
Diminishing Workforce
The roster of school nurses charged with protecting the health and well-being of the nation’s more than 50 million K-12 students and their teachers was already meager before the pandemic.
In the past year, retirements and resignations tied to burnout thinned their ranks even further, Mendonça said.
Fewer than 40% of the nation’s public schools have a full-time nurse.
The American Academy of Pediatrics and the school nurses association recommend having at least one registered nurse in every school.
But with just under 96,000 registered nurses employed in public schools, fewer than 40% of the nation’s public schools have a full-time nurse, according to a 2017 survey from the National Association of School Nurses. (A new survey will be taken this year.)
At least 25% of schools have no nurse and 35% have only a part-time nurse, the survey found.
At the same time, the registered nurses who could fill those positions were in short supply before the pandemic and the deficit has deepened since. More than 500,000 registered nurses are expected to retire by 2022, creating a need for 1.1 million more nurses, according to the American Nurses Association.
“Before COVID, school nurses’ responsibilities were vast,” Mendonça said. “They helped students manage chronic diseases such as asthma and diabetes and detected the early warning signs of kids in crisis.”
But since the pandemic began, the jobs of school nurses have been overtaken to fight the spread of the virus.
“They’re finding this year much more challenging than last year,” Mendonça said. “In 2020, everybody went home. This year, they’re back in school and everyone is stressed, tired and challenged with the ever-changing landscape of this pandemic. The delta variant changed everything.”
Before the American Rescue Plan money became available, some states and localities spent their own funds on contract nurses from local hospitals and other efforts to help school nurses get through the pandemic.
Maine, for example, hired a nurse for every county that school nurses could contact for guidance during the fast-paced changes in COVID-19 protocol last year.
Contact Tracing
At a news conference organized by the local teachers union this month, nurses in the Columbus, Ohio, school system said contact tracing COVID-19 cases was consuming so much of their time that they were unable to safely address all of the other health care needs of the students, according to a report in the Columbus Dispatch.
“When any student shows up with symptoms that could be COVID, there’s a snowball effect of calling parents, giving them information about quarantining, calling for a COVID test, walking the student out to the car—it’s a time-consuming process.
[Then,] “Parents often say, ‘It’s only a cold. Why can’t my kid come back to school?’”
—Janis Hohan, Camden Hills Regional High School in Rockport, Maine
School nurses everywhere are voicing similar concerns and frustrations, said Kate King, school nurse at World Language Middle School in Columbus and president-elect of the National Association of School Nurses.
“COVID-19 cases are falling solely on school nurses, leaving them little time to do all of those other things they do,” she said in an interview with Stateline.
“Of course, we would never leave a student in a crisis,” King said. But screening, chronic disease management, behavioral and mental health care, longer-term wellness planning, and all of the other school nurses’ duties are getting short shrift, she said.
In Maine, Hogan’s high school of 725 students and 150 adult employees has reported only four positive COVID-19 cases since school opened in September. The Maine health department recorded 2,916 cases in all the state’s schools in its latest 30-day report published Oct. 21.
Still, it’s cold and flu season in Maine, and more kids are coming into Hogan’s office with headaches, sore throats, fevers, nausea, stomach aches and coughs. “They could all have COVID-19,” she said. “We don’t know until we test.”
After one student reported COVID-19-like symptoms and tested positive two weeks ago, Hogan said, she and two assistant principals worked for an entire day to track down the kids he was in close contact with.
They had to determine how many classes he was in and whether he rode the bus, played sports or ate in the lunchroom. Initially, they identified 200 close contacts and then used seating charts to determine who sat farther than 6 feet away. They ended up with 95 students in close contact with the student, eliminated those who had been vaccinated, and arrived at 28 students who had to be quarantined outside of school.
“When any student shows up with symptoms that could be COVID,” Hogan explained, “there’s a snowball effect of calling parents, giving them information about quarantining, calling for a COVID test, walking the student out to the car—it’s a time-consuming process.”
On top of that, Hogan said, “Parents often say, ‘It’s only a cold. Why can’t my kid come back to school?’”
This year, online classes aren’t an option for Camden Hills Regional High School students who must quarantine.
Even when a student in quarantine gets a negative COVID-19 test, Hogan said, “I have to tell the parents, ‘Thanks for the negative test, but please keep your kid at home until his symptoms are gone. Even a minor cold that gets spread around the school can result in weeks of contact tracing work.’”
Published courtesy of Stateline, an initiative of The Pew Charitable Trusts.
The Department of Health and Human Services is hoping a $107.2 million-dollar award will help to expand care in rural and underserved communities. The special funds will go out to 310 recipients in 45 states and US territories in an attempt to increase financial and professional support for physicians, faculty, dentists, nurses, and students working in high-need areas.
According to HHS Secretary Alex Azar, “Supporting a strong health workforce is essential to improving health in rural and underserved communities. We’ve seen stark disparities in health and healthcare access contribute to the burden of the COVID-19 pandemic.”
Four nursing education programs will benefit from this award:
The Nurse Faculty Loan Program (NFLP), which provides funds to accredited nursing schools for loans to students in advanced education degree programs who are committed to become nurse faculty.
Scholarships for Disadvantaged Students (SDS), which supports school scholarships for students from disadvantaged backgrounds who are enrolled in a health profession program or nursing program.
The Nurse Anesthetist Traineeship (NAT) Program, designed to increase the number of Certified Registered Nurse Anesthetists (CRNAs), especially those providing care to rural and underserved populations.
The Nurse Education, Practice, Quality and Retention (NEPQR) Interprofessional Collaborative Practice Program (IPCP): Behavioral Health Integration (BHI), which directs funds to develop behavioral health services in nurse-led primary care teams in rural or underserved areas.
The George Washington University School of Nursing has just received the largest philanthropic gift in the school’s history. Through the William and Joanne Conway Transitioning Warriors Nursing Scholars Initiative, $2.5 million in financial aid is being made available to help eligible military veterans working toward a BSN degree. The gift is expected to support more than 65 students over the next five years.
Donors William Conway, co-founder of The Carlyle Group, and his wife Joanne are long-time supporters of nursing education. School of Nursing Dean Pamela Jeffries commented, “The Conways’ commitment to our military veterans is unwavering, and so is ours at the GW School of Nursing. As we celebrate our 10th anniversary, it’s gifts like these that enable us to grow our veteran student population and provide the resources they need to succeed.”
The aid program will be welcomed by veterans. Despite the assistance available through military benefits such as the GI Bill, many vets still find it a challenge to support themselves and their families when they re-enter the civilian world and attempt to pursue a degree. The Conways are happy to offer a helping hand. “The Transitioning Warriors Nursing Scholars Initiative is designed to reward the brave men and women of our armed forces who seek to continue their service to our country as civilian nurses,” Mr. Conway stated. GWU President Thomas LeBlanc responded, “We are grateful to the Conways for enabling this investment when our nation’s nursing workforce and veterans need it most.”
Founded 10 years ago, the George Washington University School of Nursing is currently the sixth ranked school in the US News and World Report assessment of online graduate nursing programs. The gift was presented in May, while the school was celebrating its 10th anniversary.
For further details on this story, visit GWToday at the University website.
1. I just became unemployed and when I submitted my FAFSA back in October, I was told that we didn’t qualify for any need aid assistance. What do I do now?
a. Step One: Go immediately to your college’s financial aid website to see if there are any updates on how to appeal. If there are no updates check to see if any instructions are listed on how to appeal. Some colleges have step-by-step instructions, and some simply do not. Or, call or email the college for advice.
b. Step Two: How to Appeal: Gather all necessary paper documentation that supports your appeal letter. Any type of loss of family income is appealable, as long as you can prove your situation. Even loss of savings can be appealed in addition to unemployment. Make sure to keep a copy of all appeal information and then by certified mail to your college’s financial aid office.
c. Step Three: When to Appeal: Appeal immediately because hundreds, if not thousands of your classmates will be appealing as well. Warning: Do not self-decide if you should appeal. You can’t win if you choose not to appeal, even if you or your family’s income used to be high.
2. How often do appeals get granted?
a. Usually about 30% of the time, but that percentage will be increasing due to the Coronavirus and all its impact.
3. Could I possibly qualify for any other aid, such as state aid?
a. Yes! Check with your state Higher Education Agency and ask how you can appeal for additional need-based funding. Also ask your financial aid office for guidance.
4. I am a grad nursing student and I received some need-based grant funds. Do I follow the same steps you have just described to appeal for additional assistance?
a. Yes, however, you need to appeal directly to the graduate school of nursing financial aid office, not the undergraduate financial aid office.
5. Will appealing for more financial aid reduce my chances of being admitted to my college of choice?
a. No. Every college is trying their best to address students’ needs. The issue will be the amount of additional funding available. Some colleges have large endowments, and some do not. That’s why it is urgent to appeal now!
6. Since it will take time to have my appeal reviewed, is there any other kind of immediate funds assistance? I don’t want to deal with a lot of red tape.
a. The good news is yes! Colleges and universities have historically had emergency funds available for students, but they are not always well-known, nor well-advertised.
b. Today, several schools have made funds available to give to students in the form of one-time grants as the ongoing pandemic has forced thousands of students to leave their campus and cope with financial hardship.b. Today, several schools have made funds available to give to students in the form of one-time grants as the ongoing pandemic has forced thousands of students to leave their campus and cope with financial hardship.
c. Ask your school if it has an emergency loan or grant fund you can apply for, and how you apply. Best to ask the financial aid office for assistance.
7. Even if I have been awarded my maximum amount of financial aid, I can still apply for emergency funds?
a. Yes. An emergency is an emergency. You need funds now. Just remember that emergency funds are limited, so make that call ASAP. Make sure to specify how much you need and how the Coronavirus adversely impacted you.
8. Since I was told by the college that I had to leave campus due to COVID-19, how do I appeal to get my money back for my room and board that I already paid?
a. Great question. It all depends. Every college is handling this issue differently. Some colleges will give students who paid their bill for the spring semester a prorated credit for room and board to be applied for the fall semester. Other schools will allow students to receive a partial refund for the difference in their prorated housing and dining plans. You have to ask the office of on-campus housing how you can get a refund.
9. What can I say to alert I my college that I am financially in trouble?
a. Appeal for additional fund consideration by saying “I will have to drop out!” The reality is, it costs more to recruit a student than it does to retain a student. And schools are all about saving money and helping students.
10. Can I appeal for additional merit scholarship assistance, not based on financial need (my income) or my family’s income?
a. Yes, you can and should. As we wrote in our book, take ownership of the college funding process, either need-based or merit-based.
b. Best way to appeal for additional merit scholarship funds due the pandemic is to appeal directly to the office that awarded you the merit scholarship. For example, most colleges will award merit scholarships from the admissions office if you are a first time undergrad, as in a freshman. The other office to contact would be the office of your major: English, History, Engineering, etc. Review your merit award letter and determine which office or offices gave you your merit award and appeal directly to the awarding authority.
Ballad Health, a healthcare system serving parts of Tennessee, Virginia, North Carolina, and Kentucky, recently committed $10 million to ensuring their nurses receive well-deserved raises. As the Kingsport Times News reported, this investment will be directly put toward wages for acute care registered nurses, long-term care licensed practicing nurses, and scrub techs, among other roles for direct inpatient care and behavioral health.
Alan Levine, Executive Chairman, President and CEO of Ballad
Health, shared this announcement during National Nurses Week in an email to
Ballad Health team members, noting that this increase will be helping thousands
of employees.
The pay increases will go into effect on June 23 for
existing team members. This investment will also affect starting hourly rates
for new hires.
“Our nurses and those who work with them in the provision of direct patient care are heroes,” Levine added. “Each of us does important work, and that, no doubt, is an important fact. Our amazing nurses would be the first to say they could not do their work without all the people who make a hospital or health care facility operate. And that is part of the humility that makes them great servants. However, it is also true that in an environment where we face a significant national shortage of these critical health care providers, a shortage so significant that the productivity of our nurses and direct bedside caregivers is as high as it has ever been, it is important we appropriately recognize the sacrifice that is being made.”
