Abstract
Submission August 2020 for publication December 2020
The first MNRS research grant was initiated in 1994 in collaboration with the Midwest Alliance in Nursing (MAIN) (Herschberger et al., 2017). MAIN provided management services for the organization at that time. In 1995, a second research grant was initiated with assistance from Glaxo, Inc., a pharmaceutical company. The following year, to reflect a company merger, it became known as the Glaxo Wellcome/MNRS Research Grant. By 1996, a third grant called the MNRS Research Award was initiated. Over the years, the names of the MNRS grants have changed, with each having distinct criteria for eligibility. The number of grants has also varied, depending on the availability of funding, ranging from five to ten grants a year from 2001 to 2020.
Dr Ann Marie McCarthy, PhD, RN, PNP, FNASN, FAAN, Associate Dean for Research, University of Iowa College of Nursing, has been a member of MNRS since 1994, the dawn of the initiation of the grant awards. At that time, she was a new assistant professor and, as she describes, “The senior faculty were all pretty adamant: in the Midwest we support nursing science through MNRS.” She took that wise advice to heart, and by 1998 she was the third recipient of the Glaxo Wellcome/MNRS Research Grant. She has remained a member of the MNRS pediatric RIG for over 25 years, and she has served on the Scholarship Committee for MNRS, on the Board of Directors from 2011 to 2015, and as a trustee on the MNRS Foundation Board since 2017. Over the years, she has received numerous honors from MNRS including Pediatric Section, Senior Researcher Award, 2004; Pain and Symptom Management Section, Advancing the Science of Nursing Research Award, 2010; Distinguished Contribution to Research Award, 2015; and Research thru Academic-Clinical Partnerships Research Interest Group, Outstanding Partnership Award, Shared with Sharon Tucker, 2017.
Dr McCarthy’s research area of interest is children with chronic health conditions, with two lines of research: cognitive-behavioral interventions for pain management in children and children with chronic conditions in the school setting. Her research in childhood pain has been funded for over 25 years by NIH, the Mayday Foundation, and internal grants. She is currently a dual PI as the expert in pediatric pain for a T32 Training grant titled “Pain and Associated Symptoms: Nurse Research Training”. An international expert in childhood pain with over 110 published manuscripts and chapters, in September 2018, she delivered the distinguished NINR Directors Lecture titled “Distraction in Action: Helping Children Cope with Painful Procedures”.
In the interview given here, Dr McCarthy shares her career trajectory and her research related to children with chronic conditions in the school setting, first funded by the Glaxo Wellcome/MNRS Research Grant.
1. What Led You to Your Interest in Pediatrics and an Academic Research Career?
I have always been a “peds person.” My undergraduate degree is from Simmons College in Boston. I spent two years working in pediatrics at Mass General Hospital, and then I got my MSN at Boston College in Maternal Child Nursing and as a pediatric nurse practitioner (PNP). As a PNP I worked in a neighborhood clinic in Boston and in neurology at Boston Children’s Hospital. I taught in the graduate programs at Boston College and the University of Washington. When we moved to Iowa City for my husband’s fellowship, I decided to get my PhD in Educational Psychology and Pediatric Psychology from the University of Iowa (the College of Nursing did not have a PhD program at the time). After completing a postdoctoral fellowship in pediatric psychology at the University of Iowa Hospitals and Clinics, I became a licensed psychologist. I initially planned to continue as a practicing psychologist, but Dr Marty Craft Rosenberg (professor emeritus, University of Iowa, College of Nursing) convinced me to join the College of Nursing. (I think she said, “Once a nurse always a nurse,”)
2. What Influenced You to Pursue Research in Children with Chronic Conditions in the School Setting?
When I started in the College of Nursing, I had students with clinical placements in schools for their community experiences. I did some research on children with chronic conditions and school issues. This was around the time that pharmacists started to interact with patients and providers more, and a colleague from the College of Pharmacy, Dr Michael Kelly, asked if his PharmD students could partner with my BSN students in the schools. The PharmD students were consultants; they met a couple of times with the school nurse and the nursing student they were working with, observed medication storage and administration, and then did a project that the school nurse requested. At the end of the semester, Dr Kelly and I had the students present their projects and talk about their experiences as a group. One comment was how the school nurses, who covered multiple schools, stored their medications in a range of containers like fishing tackle boxes with the students’ names and the times the school secretary was to give students their medications. They also commented on how parents often brought medications to school in a range of containers, including baggies. I thought, “How clever,” and Dr Kelly thought, “How unsafe!” This began our collaboration on medication management in schools. We decided our first project would be a national survey of school nurses on medication management. To support the research, titled “Medication Administration in the School Setting,” we successfully sought $4,000 in funding in 1998 from Glaxo Wellcome/MNRS. In addition, we obtained internal funding from five sources (total $128,113) to support both our research and the joint clinical educational experiences.
3. Please Share with Us the Results of Your Early Work on Children with Chronic Conditions in the School Setting
The results of the funding from MNRS were presented at the 23rd Annual Midwest Nurses Research Conference held in Indianapolis in 1999. Primary results were published in the Journal of School Health, 2000.This survey had an impressive response rate. We sent surveys to 1,000 school nurses randomly selected from the National Association of School Nurses (NASN), and 649 responded. They had a great deal to tell us! When we submitted the paper to the Journal of School Health, it’s one of only two times that I had a paper accepted immediately, with no revisions. I began working with the NASN and Dr Kelly worked with his pharmacy colleagues, and this work contributed to making significant changes in how medications are administered in schools. As a result, there are no more baggies. Nationwide medications are now typically brought to schools and stored in containers from the pharmacy. We disseminated our subsequent work, in collaboration with a colleague from the College of Education and our students, in five additional papers published in nursing and pharmacological journals.
4. Please Share with Us the Work You Have Pursued Related to Children with Chronic Conditions in School Settings in Recent Years
There was a gap in my research on medication administration in schools while I focused on my pain research and some other projects. But around 2014, Dr Kelly and I partnered with Dr Erin Maughan, Director of Research for NASN, to again see where we were with medication administration. We received a grant from Mylan Laboratories for research titled “Medication Administration in the Schools: A National Survey” (2014–2015, $40,000). Findings from that study indicate that to ensure safe medication administration, school systems need to develop policies and procedures that take into consideration the unique aspects of the school environment (delegation of medication administration, documentation in the school record, interruptions, phones, and the multiple roles of school nurses).
Currently I am working with Dr Amany Farag, a junior faculty member at the University of Iowa College of Nursing and MNRS member, to develop a process for increasing safe medication administration in schools using bar code scanning of medication bottles, facial/fingerprint scanning of children, and linking this to the electronic school health record. I am consultant on her new grant titled “Integrate the Two MedBarFace Components into the ICCSD PowerSchool Platform” funded by a pilot grant from the University of Iowa’s Institute for Clinical and Translational Science (2019–2020).
Twenty years ago, Dr McCarthy, an early stage investigator, received a $4,000 MNRS grant. This led to additional funding and eventually to policy changes in school nursing. Now she works alongside her mentees, who continue to carry forth this work. MNRS Foundation funding can have a long-term impact on a nurse scientist’s career. Please consider donating to nursing science research through the MNRS Foundation online giving platform, which allows donors to make one time or monthly gifts. All donors to the MNRS Foundation are recognized annually through the Gemstone Recognition Levels: Pearl Donors (Annual Gifts $100–$249) Emerald Donors (Annual Gifts $250–$499) Topaz Donors (Annual Gifts $500–$999) Sapphire Donors (Annual Gifts $1,000–$2,499) Ruby Donors (Annual Gifts $2,500–$4,999) Diamond Donors (Annual Gifts $5,000 or more)