ENHANCING CLINICAL CARE THROUGH NURSING INFORMATICS

NIH GUIDE, Volume 23, Number 42, December 2, 1994

PA NUMBER: PA-95-010

P.T. 34; K.W. 0710078, 0785130, 0785035

National Library of Medicine (NLM)

National Institute of Nursing Research (NINR)

PURPOSE

The National Library of Medicine (NLM) and the National Institute of Nursing Research (NINR) invite applications for grants to support research in nursing informatics. Of particular interest is investigation that addresses improvements in the delivery of clinical nursing care through the use of information systems. The intent of this announcement is to generate research that will examine systems to manage and process data, information and knowledge with the goal of facilitating appropriate and effective clinical care. Although NLM's existing program in medical informatics addresses the application of informatics to health care broadly defined, this announcement has the specific purpose of calling the attention of those interested in informatics research to the set of issues of particular concern and importance to the nursing profession.

HEALTHY PEOPLE 2000

The Public Health Service (PHS) is committed to achieving the health promotion and disease prevention objectives of "Healthy People 2000," a PHS-led national activity for setting priority areas. The research solicited in this announcement cross cuts all the priority areas delineated by "Health People 2000" and relates directly to the priority area of Surveillance and Data Systems.

Potential applicants may obtain a copy of "Healthy People 2000" (Full Report: Stock No. 017-001-00474-0) or "Healthy People 2000" (Summary Report: Stock No. 017-001-00473-1) through the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325 (telephone 202-783-3238).

ELIGIBILITY REQUIREMENTS

Applications may be submitted by domestic and foreign, for-profit or non-profit, public and private organizations such as universities, colleges, hospitals, laboratories, units of State and local governments, and eligible agencies of the Federal government. Topics studied by foreign applications must have direct relevance to U.S. populations.

Applications from minority individuals and women are encouraged. Foreign institutions are not eligible for the First Independent Research Support and Transition (FIRST) award (R29).

MECHANISM OF SUPPORT

The mechanisms of support will be the National Institutes of Health research project grant (R01) and FIRST award (R29). Responsibility for the planning, direction, and execution of the proposed project will be solely that of the applicant. Though the length of individual studies will vary, support will be provided for a period of up to five years, based on availability of funds and sufficient scientific progress.

Applicants must plan for five years of support for the R29 award. Costs of individual projects will vary. Direct Costs for R29 awards are capped at $100,000 in any one year and $350,000 across all years.

The average direct cost of a RO1 award in FY 1993 was $186,000.

RESEARCH OBJECTIVES

This initiative builds directly on the work of a panel of scientific experts on nursing informatics convened as part of the development of the National Nursing Research Agenda. The work of this panel was published in a 1993 report entitled, "Nursing Informatics: Enhancing Patient Care". This report is available from NINR; see INQUIRIES section.

The goal of this PA is to encourage proposals of innovative research that focus on the use of nursing information systems to strengthen the quality of clinical care. The term nursing informatics combines the scientific areas related to computers, information and nursing. Nursing informatics assists in the management and processing of nursing data, information, and knowledge to support clinical practice and the provision of nursing care.

Well designed studies are needed to develop, expand, or test a variety of nursing informatic areas. These include, but are not limited to nursing clinical data, processes and outcomes of care, and clinical decision making. Some examples of possible topics are:

Examine methods to integrate existing terminologies representing nursing concepts, patient problems and nursing interventions into larger and broader based systems.
Test the reliability and validity of clinical language for nursing related assessments, diagnoses, interventions and outcomes.
Determine the validity of existing data sets of clinical terms with emphasis on the continuum of care.
Explore processes to link clinical conditions, nursing interventions and treatments with measures of clinical end points.
Ascertain the effectiveness of existing information strategies that support the decision process by nurses in clinical practice.
Examine information systems designed to improve quality of care by defining optimal sequencing and timing of interventions, detailing expected outcomes and determining resource use such as data bases supporting clinical pathways or care mapping focusing on particular patient cohorts frequently requiring concentrated nursing care, e.g., CVAs, multiple traumas, or patients who may make frequent transitions across health care settings such as children or older adults.
Analyze the relationship of patient assessment, processes of diagnostic development and clinical inference, and choice of related treatments and intervention alternatives.
Explore the processes of clinical decision making, the extent and influence of participation of patients and their family members in decision making.

STUDY POPULATIONS

INCLUSION OF WOMEN AND MINORITIES IN RESEARCH INVOLVING
HUMAN SUBJECTS

It is the policy of the NIH that women and members of minority groups and their subpopulations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless clear and compelling rationale and justification is provided that inclusion is inappropriate with respect to the health of the subjects or the purpose of the research. This new policy results from the NIH Revitalization Act of 1993 (Section 492B of Public Law 103-43) and supersedes and strengthens the previous policies (Concerning the Inclusion of Women in Study Populations) which have been in effect since 1990. The new policy contains some new provisions that are substantially different from the 1990 policies.

All investigators proposing research involving human subjects should read the "NIH Guidelines For Inclusion Of Women And Minorities As Subjects In Clinical Research," which have been published in the Federal Register of March 28, 1994 (FR 59 14508-14513), and reprinted in the NIH GUIDE FOR GRANTS AND CONTRACTS of March 18, 1994, Volume 23, Number 11.

Investigators may obtain copies from these sources or from the program staff or contact person listed below. Program staff may also provide additional relevant information concerning the policy.

APPLICATION PROCEDURES

Applications are to be submitted on the grant application form PHS 398 (rev. 9/91) and will be accepted at the standard application deadlines as indicated in the application kit. The receipt dates for applications for AIDS-related research are found in the PHS 398 (rev. 9/91) instructions. Application kits are available at most institutional offices of sponsored research and may be obtained from the Office of Grants Information, Division of Research Grants, National Institutes of Health, Westwood Building, Room 449, Bethesda, MD 20892, telephone 301/594-7248. The title and number of this announcement must be typed in Section 2a on the face page of the application.

Applicants for FIRST Award (R29) must include at least three sealed letters of reference attached to the face page of the original application. First Award (R29) applications submitted without the required number of reference letters will be considered incomplete and will be returned without review.

The completed original application and five legible copies must be sent or delivered to:

Division of Research Grants
National Institutes of Health
Westwood Building, Room 240
Bethesda, MD 20892

REVIEW CONSIDERATIONS

Applications received under this announcement will be assigned to an initial review group (IRG) on the basis of established Public Health Service referral guidelines. The IRG will review the applications for scientific and technical merit in accordance with the standard NIH peer review procedures. Applications will receive a second-level review by the appropriate national advisory council. Only applications recommended for further consideration by the Council may be considered for funding.

AWARD CRITERIA

Applications recommended for further consideration will be considered for available funds on the basis of the scientific and technical quality of the proposed project determined by peer review, appropriateness of budget estimates, program needs and balance, policy considerations, and availability of funds.

Written and telephone inquiries are encouraged. The opportunity to clarify any issues or questions from potential applicants is welcome.

To receive a copy of "Nursing Informatics: Enhancing Patient Care," direct your inquiries to:

Office of Information and Legislative Affairs
National Institute of Nursing Research
Building 31, Room 5B13
31 CENTER DR MSC 2178
Bethesda, MD 20892-2178
Telephone: (301) 496-0207

Direct inquiries regarding scientific programmatic issues to:

Dr. Patricia Moritz
Nursing Systems Branch
National Institute of Nursing Research
Bldg. 45, Rm. 3AN-12
45 CENTER DR MSC 6300
Bethesda, MD 20892-6300
Telephone: (301) 594-5966
FAX: (301) 480-8260

Dr. Milton Corn
Acting Associate Director
Division of Extramural Programs
National Library of Medicine
8600 Rockville Pike
Building 38A, Room 5N-505
Bethesda, MD 20894
Telephone: (301) 496-4621
FAX: (301) 402-0421
Email: CORN@NLM.NIH.GOV

Direct inquiries regarding fiscal matters to:

Ms. Sally A. Nichols
Grants Management Officer
National Institute of Nursing Research
Bldg. 45 Rm. 3AN-32
45 CENTER DR MSC 6301
Bethesda, MD 20892-6301
Telephone: (301) 594-6869
FAX: (301) 480-8256

Ms. Ruth E. Bortz
Acting Grants Management Officer
Division of Extramural Programs
National Library of Medicine
8600 Rockville Pike
Bldg. 38A, Room 5N-515
Bethesda, MD 20894
Telephone: (301) 496-4253
FAX: (301) 402-0421
Email: BORTZ@LHC.NLM.NIH.GOV

AUTHORITY AND REGULATIONS

This program is described in the Catalog of Federal Domestic Assistance Nos. 93.879 and 93.361. Awards are made under authorization of the PHS Act, Title III, Part A, Section 301, Title IV, Part A (Public Law 78-410, as amended by Public Law 99-158, 42 USC 241 and 285) and Part D, Subpart 2, Sections 472-476, as amended, Public Law 100-607, and administered under PHS grants policies and Federal Regulations 42 CFR 52 and 45 CFR Part 74. This program is not subject to the intergovernmental review requirements of Executive Order 12372 or Health Systems Agency review.

The Public Health Service (PHS) strongly encourages all grant recipients to provide a smoke-free workplace and promote the non-use of all tobacco products. This is consistent with the PHS mission to protect and advance the physical and mental health of the American people.

NLM HyperDOC / Nursing Informatics Grants / 30 January 1995