April 9, 2009

UCSF Teams with University of Hawaii to Address Neonatal Nurse Shortage

Cecelia Glennon, RN, MN, NNP, assistant clinical professor in family health care nursing, treats an infant in the UCSF Children’s Hospital Neonatal Intensive Care Unit (NICU).

With preterm births — and the number of premature infants who survive — on the rise in the United States, UCSF has launched a first-of-its-kind neonatal nursing program in collaboration with the University of Hawaii. The NeoRISK Project aims not only to address the current national shortage of highly skilled neonatal nurse practitioners (NNPs) but also to prepare graduates to provide vital support to the highest-risk infants as they leave the carefully controlled environment of the hospital. More than half a million babies — or about one in eight — are born premature in the U.S. every year, an increase of more than a third since the 1980s, according to the Centers for Disease Control (CDC). Premature infants may face lifelong health problems such as intellectual disabilities; cerebral palsy; breathing and respiratory problems; and vision and hearing loss. “Historically, our focus in the field has always been saving (premature) babies and caring for them in hospital settings,” said NeoRISK Project director Christine Kennedy, RN, PhD, UCSF’s Jack and Elaine Koehn Chair in Pediatric Nursing and a professor of family health care nursing. “But now, with the growing population of preterm infants who survive, there’s a whole set of unique health challenges during the transition from the hospital to the community.”

NeoRISK Project participants at UCSF, (from front) Talar Papazian, Ria Bernardo and Mary Petrella, participate in a video conference call with their University of Hawaii counterparts on the first day of class in September 2008.

Those challenges include limited access to quality medical care among families in rural areas, as well as health disparities linked to race, ethnicity and socioeconomic status. The complex geographic, demographic and cultural characteristics of California and Hawaii make those states ideal incubators for a program like NeoRISK, Kennedy said. “Both California and Hawaii have a very diverse premature infant population, and neither meets the Health People 2010 national goal of 5 percent of infants coming from the low birth-weight population,” she said. “We’ve had great advances in medical technology, but not much has been done to really change what happens when babies go home.” NeoRISK kicked off quietly in September with nine students: five based at UCSF’s School of Nursing and four at the University of Hawaii at Manoa (UHM) School of Nursing & Dental Hygiene. The program is being funded by a three-year grant from the Health Resources and Services Administration (HRSA) within the U.S. Department of Health and Human Services. Throughout the two-year course of study, program faculty will make use of the latest technologies — such as streaming online videos —to bridge the geographical divide. The Hawaii-based students will complete most of their clinical application at neonatal intensive care units and various other sites in Hawaii, but they will also complete a portion of their clinical training hours at UCSF-affiliated facilities. All students will receive a UCSF degree upon completing the program. Kathleen Dracup, RN, DNSc, dean of the UCSF School of Nursing, called NeoRISK “an incredibly exciting program” that will help meet the growing demand for NNPs while also addressing the special needs of “fragile infants in underserved communities.” NeoRISK is the first NNP training program to focus on infants at risk for experiencing health disparities, particularly during the transition from hospital to home, said project coordinator Mary Lynch, RN, MPH, a clinical professor and coordinator of the neonatal and pediatric specialty programs at the School of Nursing. The program is also the first graduate program collaboration between the School of Nursing and the University of Hawaii and marks the first opportunity for Hawaii-based students to receive graduate-level NNP training from UCSF while caring for sick infants in Hawaii, said Lynch, who serves as liaison between the two universities. In addition to Lynch and Kennedy, other key players in the NeoRISK Project include Associate Clinical Professor Annette Carley, RN, the lead NNP faculty at UCSF; Assistant Professor Dana Ing, the lead NNP faculty at UHM; and Vicki Niederhauser, DrPH,, the project director at UHM. Photo by Susan Merrell

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