2013 Research Institute Annual Report

Re b e c ca
D .
C o nsi d i ne
Researc h
Insti tute
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2013
Annual
Report
Why not?
Table of contents
From our founders
From our director
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6
Can a small device do big things?
Can we solve the unsolvable?
8
12
How can we collaborate to define – and measure – quality?
Is there a better way to sustain our sickest patients?
Making an impact
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20
24
Center for Nursing Research
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From our founders
Dear Friends,
There’s one question that parents know all too well: “Why?”
Whether it’s about the color of the sky or the reason for eating broccoli, “why?” expresses the curiosity
of a child.
But for an ill or injured child, trying to find answers can be difficult. Sometimes, we don’t know the
reason behind a disease or illness. That’s why, in 2009, we established the Rebecca D. Considine
Research Institute – to support the work in finding answers to childhood diseases’ toughest questions
while embodying the spirit of discovery and innovation at Akron Children’s Hospital.
The institute channels the curiosity of our physicians, nurses and staff into innovative breakthroughs in
pediatric healthcare. Through their work, we’ve taken our patients’ question to the next level:
“Why not?”
Why not find a better way to feed a critically ill child on a ventilator? Why not investigate new therapies
that could help treat untreatable illnesses? Why not bring the latest advancements in medical
technology to Akron Children’s?
In this report, you’ll learn how we’re working to find answers to these questions, and more, as
investigators take their knowledge from the research bench to the bedside, demonstrating our hospital’s
unfailing commitment to providing exceptional care through pediatric clinical, translational and
outcomes research. Discover the many impressive milestones we reached in 2013, and learn how
research is shaping the way we approach patient care.
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It’s an honor to be a part of the Rebecca D. Considine
Research Institute. We’re thankful for all our investigators
who aren’t satisfied with what “is” and staunchly pursue
what “could be” to improve the lives of infants, children
and teens in our region and beyond.
Sincerely,
Rebecca D. Considine
William H. Considine
President and CEO,
Akron Children’s Hospital
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From our director
Dear Friends,
When Akron Children’s physicians, nurses and staff ask “why?” or “why not?” they frequently search for
answers through research.
In this annual report, we illustrate the notable accomplishments achieved by Akron Children’s Hospital’s
investigators supported by the Rebecca D. Considine Research Institute in 2013. We profile four
investigators seeking to discover new treatments and methods that aim to improve patient care. They
are four of many throughout the Akron Children’s system who share the same zeal to advance pediatric
healthcare and outcomes – asking and finding answers to some of our toughest questions.
Rigorous clinical research begins with a vision. Discovering answers requires determination, tenacity
and teamwork. The Rebecca D. Considine Research Institute provides the infrastructure to support
Akron Children’s investigators.
Having expertise in core research disciplines, our professional staff collaborates with hospital
investigators to overcome the challenges of pediatric clinical research. When investigators in any
discipline ask “why?” research institute specialists join their team to advance the project – be it with
study design, biostatistics, database design and management, medical communications, contracting,
budgeting or grant administration. Our skilled research nurses and study coordinators work directly with
investigators, patients and their families to ensure that Akron Children’s studies are well-managed, safe
and adhere to the high ethical standards our study participants deserve.
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We’re encouraged by the culture of innovation that’s
fostered at Akron Children’s Hospital and inspired by the
contributions made by the children and families who are
willing to participate in our research programs. It’s through
their courage and determination that we’re achieving
our mission: discovering answers to questions that spur
significant progress in improving pediatric healthcare for all.
Sincerely,
Michael Reed, PharmD, FCCP, FCP
Director, Rebecca D. Considine Research Institute
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Can a small device do big things?
New study could revolutionize how to
measure intracranial pressure
Researchers at Akron Children’s Hospital’s Rebecca D. Considine Research Institute have developed a
reputation for seeking advancements in the care of babies, children and teens.
“One of the most important missions of our institution is to provide the highest-quality care,” says Michael
Reed, PharmD, FCCP, FCP, director of the Rebecca D. Considine Research Institute. “We can’t stay at the
forefront of high-quality care without researching new approaches in delivering it to our patients.”
“One of the most important missions
This includes exploring new medical devices that have potential to improve pediatric care and outcomes.
Through its current investigation, the research institute is partnering with Akron Children’s pediatric
intensive care unit (PICU) and division of neurosurgery to test and study a new device that could
revolutionize how to treat, monitor and care for children who have experienced a traumatic brain injury.
highest-quality care. We can’t stay
It’s called the HeadSense HS-1000, and it was developed by Israeli company HeadSense Medical Ltd.
The device offers a non-invasive way to measure intracranial pressure (ICP), which is monitored to
diagnose, manage and provide follow-up care to patients with neurological conditions.
delivering it to our patients.”
of our institution is to provide the
at the forefront of high-quality care
without researching new approaches in
“Monitoring ICP is extremely important for patients who’ve suffered from a traumatic brain injury or
stroke, or underwent brain surgery,” says James Besunder, DO, director of the division of pediatric
critical care and medical director of the PICU. “These patients have better outcomes if we can maintain
their pressure below a certain level.”
The current method used to measure ICP is highly invasive, painful and expensive. It requires
neurosurgeons to drill a hole in a patient’s skull and surgically insert an intraventricular catheter into the
child’s brain, which is then used to measure ICP.
“We wanted to find a new way for physicians to monitor ICP non-invasively,” says Guy Weinberg, CEO of
HeadSense Medical. “We saw an opportunity to equip them with a tool that would enable better patient
management and clinical diagnoses, while reducing the level of discomfort to the patient.”
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Measuring intracranial pressure
HeadSense HS-1000 is designed to monitor ICP acoustically via ear buds placed in the patient’s ears.
A low-frequency acoustic signal is generated for a few seconds in one of the ear buds and picked
up on the opposite side. The acoustic data is then analyzed using signal processing algorithms. In a
matter of seconds, the patient’s ICP level is available. The procedure can be repeated automatically for
continuous monitoring.
“If we’re able to replace the need for a neurosurgeon to insert an invasive device – avoiding the risks
and expenses – it would exponentially impact the way we deliver care,” says Dr. Reed. “However, the
only way to understand its effectiveness is to study it.”
Heading a multi-site study
This summer, Akron Children’s will be leading a multi-site study to test the new device involving three
major pediatric hospitals. The study will be conducted under the oversight of principal investigators
Dr. Reed and Michael Forbes, MD, FAAP, director of clinical research and outcomes analysis in
Akron Children’s PICU, who together designed the study and wrote its protocol. Roger Hudgins, MD,
director of the division of neurosurgery, also contributed to the study design and is a key collaborator
on the team directing it.
“Clinical research plays an important role in the PICU and critical care medicine,” says Dr. Besunder.
“You cannot optimize safe and quality care for children in either setting without including clinical
research as one of your building blocks. That’s why studies like this are vital to our operation.”
In the study, investigators will measure ICP in PICU patients ages 2 to 18, who already have the
standard catheter device in place, via two methods: the HeadSense device and the current standard
process. Simultaneous ICP measurements will be taken, outcomes will be compared and findings will
be reported into a secure database. The research institute will be responsible for pooling the data and
analyzing it on a real-time basis. The study is expected to last 12 to 18 months.
It will mark the first time the product is tested in the U.S., and Dr. Reed notes that it’s a prestigious vote
of confidence that the Israeli manufacturer is working with Akron Children’s.
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“We always look to collaborate with key opinion leaders
and experts who can help us validate the technology we’re
bringing to the market for the first time,” says Weinberg.
“Dr. Reed, his team at the research institute and the other
Akron Children’s investigators are these opinion leaders.
Each is well-known and respected in their respective areas
of expertise.”
Identifying the potential to expand care
Because the insertion of the standard ICP device is so
invasive and can bring complications, there may be
additional patients with trauma who could benefit from
the HeadSense device if the outcomes of the initial
investigations are successful. One potential area is sports
medicine, where Joseph Congeni, MD, director of sports
medicine, will be conducting an investigation to see if the
HeadSense HS-1000 could be used in monitoring patients
who experience concussions.
It’s another reason why studying this device is so
important. If it’s viable, it’s highly likely that it will both
reduce the use of standard measurement methods and
allow doctors to measure ICP in other children where it was
previously unable to be measured.
Find out more about the latest news and achievements
in the Rebecca D. Considine Research Institute. Scan
the code or visit http://bit.ly/1qZKy1C.
“We’re leading the way to continuously improve the care we
provide to sick children,” says Dr. Reed. “If this new device
is viable, we’ll take the care of patients with brain injury to
the next level.”
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Can we solve the unsolvable?
Improving the outlook for mitochondrial diseases
According to the United Mitochondrial Disease Foundation, each year 1,000 to 4,000 children in the
United States are born with a mitochondrial disease. The problem is, there are hundreds of mitochondrial
diseases – some that appear in infancy, others that don’t appear until as late as age 70.
The variable nature of mitochondrial diseases makes them difficult to diagnose and especially
challenging to treat. Researchers like Bruce H. Cohen, MD, FAAN, are working to find adequate
treatments and define outcomes for mitochondrial disease patients across the country.
“In comparison to defining outcomes for mitochondrial diseases, it’s actually easier to define outcomes
for issues like brain tumors,” says Dr. Cohen, director of pediatric neurology at Akron Children’s
NeuroDevelopmental Science Center (NDSC). “For some diseases, we can easily define the life
expectancy – an example being a particular form of a childhood brain tumor with less than a 10
percent survival rate at two years after diagnosis. We don’t have measures like this with mitochondrial
diseases, because they vary in onset, symptom, inactivity and so on.”
Researchers also struggle to overcome another big obstacle – there have been no new mitochondrial
disease medications to study in the last 30 years.
“We’re thrilled with where
we are now, but it’s still not
good enough. That’s the
quality of the human spirit
– to make things better for
those who are suffering
from terrible disorders.”
“Luckily, drug companies have begun pushing to solve the mitochondrial disease conundrum because
other more common diseases like diabetes, Alzheimer’s, Parkinson’s, Lou Gehrig’s Disease – and even
some cancers – have been linked to mitochondrial function,” says Dr. Cohen.
What do mitochondria do?
Almost all cells in the body have mitochondria, which are tiny “power plants” that produce a body’s
essential energy. When patients have a mitochondrial disease, their mitochondria don’t convert enough
food and oxygen into energy. Instead, they make an excess of toxic byproducts.
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Mitochondrial Disease
“Mitochondria are to the cell of the body what a car engine is to the car itself,” says Dr. Cohen.
“An engine generates energy by burning gasoline but also generates heat and a physical banging force,
resulting in the destruction of the engine over time, plus unburned fuel products. Mitochondria are
similar, because the toxic byproducts destroy DNA and rip apart the integrity of the cell.”
Common symptoms of mitochondrial diseases include vision and/or hearing loss, muscle control
issues, movement disorders, seizures, dementia and epilepsy, a slow heart rate and more. One of these
symptoms alone doesn’t mean a patient has mitochondrial disease. Rather, Dr. Cohen sees patients
who’ve experienced an evolution of symptoms over time. Perhaps they have a seizure and then notice
hearing loss, fatigue and other symptoms.
Physicians from across the country refer patients – both children and adults – to see Dr. Cohen.
“A mitochondrial patient’s primary doctor should be either his family doctor or pediatrician, as their
specialty is treating the patient holistically,” says Dr. Cohen. “I want to come alongside the primary
doctor and work with them to prescribe the best course of treatment.”
Small cell components – Large-scale research
Akron Children’s Hospital is one of 18 mitochondrial centers across America researching treatment
options through the North American Mitochondrial Disease Consortium. The consortium referred
Dr. Cohen to the hospital three years ago and partially funds two of his current investigations into
mitochondrial function and dystonia.
“One of the reasons I came to Akron Children’s was because of what Dr. Michael Reed established with
the Rebecca D. Considine Research Institute,” says Dr. Cohen. “He provides the infrastructure to get
the project off the ground and completed.”
Dr. Cohen’s studies revolve around a medication called EPI-743 for children with Leigh Syndrome,
one of the more fatal forms of mitochondrial disease. EPI-743 helps stimulate inactive (or oxidized)
glutathione – an important antioxidant in our bodies that detoxifies harmful substances produced in
mitochondrial diseases.
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Participants receive six months of placebo or EPI-743,
followed by reevaluation and another six months of
monitoring. In total, patients are tracked for a two-year
period using verified scales to define outcome measures.
The research institute’s Hilary Tonni, MSE, BSN, RN, CCRC,
a clinical research nurse, assists Dr. Cohen by enrolling
patients, monitoring their visits and following medication
compliance. Akron Children’s is second in terms of the
number of patients entered into the consortium for study.
The reputation of research
While there is still plenty of work to do, mitochondrial disease
research has come a long way in the last 30 to 40 years.
“We’re thrilled with where we are now, but it’s still not good
enough,” says Dr. Cohen. “That’s the quality of the human
spirit – to make things better for those who are suffering
from terrible disorders.”
The goal is to find one medication or a set of medications
or treatments to improve mitochondrial function and
ultimately alleviate debilitating symptoms. And a continued
partnership with the Rebecca D. Considine Research
Institute helps Dr. Cohen get closer to reaching that goal.
“Our institution is making its best efforts to hire people
who want to do clinical research,” says Dr. Cohen. “Akron
Children’s has delivered on its promise to be the premier
medical center for children in northern Ohio, but we want
to have a more global impact and will continue to push the
envelope through research initiatives.”
Learn more about Dr. Cohen’s work as he investigates
new treatment options for mitochondrial disease. Scan
the code or visit http://bit.ly/1hL1adE.
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How can we collaborate to define – and measure – quality?
Forming consensus guidelines for quality metrics
in neonatal and pediatric critical care transport
Each year, more than 200,000 neonatal and pediatric patients across the U.S. are transported from
one medical facility to another to receive more specialized care. During transport, the care that these
patients receive can impact outcomes – from mortality rates to unplanned events.
While information and performance metrics are readily available about pediatric emergency and critical
care in a hospital setting, there’s remarkably little data on the care provided during patient transfer from
community hospital centers to larger hospitals.
“Critical care transport medicine touches a huge number of patients,” says Michael Bigham, MD, FAAP,
medical director of transport services at Akron Children’s Hospital. “The critical care team at Akron Children’s
transports approximately 2,500 patients annually. And these numbers are growing rapidly.”
Dr. Bigham notes that neonatal and pediatric critical care transport involves much more than picking up
a child at a community location or hospital and taking the child to the regional pediatric hospital.
“Children face different factors than adults, and there are a lot of time-sensitive issues unique to the
younger patient population,” says Dr. Bigham.
Finding a way to consistently measure performance in neonatal and pediatric critical care transport has
been a longtime goal for Dr. Bigham and his colleague, Hamilton Schwartz, MD, medical director of
Cincinnati Children’s Hospital’s pediatric transport program.
“There’s a void of scientific expertise and understanding about how we can optimize this particular
branch of care,” says Dr. Bigham. “This led Dr. Schwartz and I to begin brainstorming a way that allows
consistent measurement of performance for pediatric neonatal and critical care transport teams. If we
aren’t engaged in the investigations that help us make these stair-step discoveries and improvements
over time in the care we deliver, then we’ll never achieve anything new.”
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“If we aren’t engaged in the
investigations that help us
make these stair-step discoveries
and improvements over time in the
care we deliver, then we’ll never
achieve anything new.”
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Neonatal and pediatric critical care transport
Their efforts led to the formation of the Ohio Pediatric/Neonatal Transport Quality
Collaborative in 2011. Comprised of transport services representatives from Akron
Children’s Hospital, Cincinnati Children’s Hospital, Cleveland Clinic, Dayton’s Children’s
Hospital, Nationwide Children’s Hospital, and Rainbow Babies and Children’s Hospital,
the collaborative set out to develop guidelines for neonatal and pediatric transport quality
metrics that could be used throughout Ohio.
“By comparing how everyone is doing – using the exact same definitions and the
exact same language – we can define the appropriate transport success rates and
performance metrics,” says Dr. Bigham.
Creating metrics, establishing consensus
In June 2011, representatives from each hospital – including physicians, nurses,
respiratory therapists, EMTs and nurse practitioners – gathered in Columbus, Ohio, for a
three-day conference. Together, they aimed to achieve consensus on quality metrics that
may create best practices and educational priorities in the hospitals’ training programs.
“The first phase in our work was brought to reality through funding from the Rebecca D.
Considine Research Institute, Cincinnati Children’s Hospital and the goodwill of the other
participating collaborative members,” says Dr. Bigham.
Employing a consensus methodology known as Nominal Group Technique (NGT), the group
considered 257 metrics using four information sources: 1) the published scientific literature
(which was gathered for the collaborative by an evidence and measures expert); 2) existing
metrics; 3) published standards; and 4) conceptually important metrics. Their goal was
to define 18 to 24 quality metrics that could be grouped by the Institute of Medicine’s six
domains of quality: effectiveness, efficiency, safety, family/patient centeredness, timeliness
and equity.
Through the guidance of an NGT facilitator, the group reviewed, contemplated and
discussed the presented data in a round-robin fashion.
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“As we examined each metric, we encouraged the team to vet it through the National
Quality Forum’s criteria for assessing quality measurements,” says Dr. Bigham. “We
needed to filter each one by asking: Is it important? Is it scientifically acceptable? Is it
usable? Is it feasible?”
Dr. Bigham notes that they also used the Donabedian model, which frames quality across
three categories – structure, process and outcomes.
“While outcomes are important, this model focuses instead on ensuring that people have
the right tools and are putting the right processes in place to achieve the right outcomes,”
says Dr. Bigham.
At the end of the session, the 19 participants “tore down” hundreds of possibilities to 23
quality metrics that they deemed most important in neonatal and pediatric critical
care transport, including intubation success rate, family presence during transport,
unplanned neonatal hypothermia and intravenous infiltration.
“Now we had the metrics defined,” says Dr. Bigham. “Our next step was to begin tracking them.”
Looking forward
Since 2011, the outcome of the collaborative’s conference has been presented in abstract
form and published in multiple critical care transport and pediatric critical care venues,
including the esteemed journal Pediatric Critical Care Medicine. Each hospital has
been tracking the agreed-upon metrics, including new collaborative member Kentucky
Children’s Hospital.
“We’re very excited in how our Ohio project is taking shape,” says Dr. Bigham. “We’re now
working together to determine goals for each metric and investigate best practices. It’s
essential that we create a structure around those best practices, as they’ll eventually be
disseminated to the rest of the collaborative.”
In 2012, Dr. Bigham and Dr. Schwartz had the opportunity
to broaden the scope of the process and achieve national
quality metrics when they hosted a quality summit at the
National Conference & Exhibition of the American Academy of
Pediatrics’ (AAP) Section on Transport Medicine.
“With the 125 participants, we aimed to identify the most
important transport metrics using another consensus
methodology called Delphi,” says Dr. Bigham. “Using the same
long list of candidate metrics that we used in the Ohio study,
we narrowed it to a more refined list of 12 metrics that they
agreed were the most important nationally. The participants
are beginning to track that data, as well.”
Dr. Bigham notes that there’s a lot of enthusiasm in the
pediatric and adult transport industry around this methodology,
and he’s led a Quality Summit mirroring the AAP’s project,
which was sponsored by the Air Medical Physicians
Association. Collectively, the quality projects have resulted
in the development of the Ground and Air Medical Quality
Transport (GAMUT) database, which currently serves as the
central location for data collection. Dr. Bigham hopes to
gain extramural funding to optimize the database and fund
the many quality improvement opportunities that will be
identified through the centralized quality measurement and
benchmarking at the GAMUT database.
“This year, our largest goal is to gain large-scale funding to
support the infrastructure for tracking the neonatal, pediatric
and adult metrics,” says Dr. Bigham.
Watch Dr. Bigham discuss his work in defining
quality transport standards. Scan the code or visit
http://bit.ly/1m7gFi3.
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Is there a better way to sustain our sickest patients?
Defining best practices for delivering enteral nutrition
to critically ill ventilated children
Proper nutrition plays a crucial role in the care and treatment of a critically ill child. It holds the
potential to decrease risks like mortality, hospital-acquired infection and prolonged hospitalization when
that child is admitted to a pediatric intensive care unit (PICU). But does the way in which nutrition is
delivered play a role in outcomes, as well?
That’s the question Ann-Marie Brown, PhD, CPNP-AC/PC, CCRN, FCCM, hopes to answer through her
latest investigation, “Comparison of Two Gastric Feeding Methods in Mechanically Ventilated Critically
Ill Children.”
Brown is the lead nurse practitioner in Akron Children’s Hospital’s PICU and chair of the Advanced
Practice Providers Education Committee. She also is one of the most prolific researchers in the
hospital’s Center for Nursing Research.
“My passion and personal mission is translating research to the bedside,” says Brown. “One of my
greatest interests is understanding the best way to deliver nutrition to our children. We know the
importance of it, but there are barriers. I’m looking to define best practices in the delivery of enteral
nutrition to critically ill ventilated children.”
“What we know is not static,” Brown observes. “Our dedication to research ensures Akron Children’s
will continue to be an organization of excellence in the care of the children entrusted to us.”
Questioning the status quo
In her current investigation, which was her doctoral dissertation topic, Brown takes a hard look at the
strengths and weaknesses of enteral nutrition protocols for patients on ventilators – comparing the
standard practice of continuous delivery with a bolus, or intermittent, feeding regimen.
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“What we know is not static.
Our dedication to research
ensures Akron Children’s will
continue to be an organization
of excellence in the care of the
children entrusted to us.”
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Delivering enteral nutrition
In enteral feeding, the prescribed nutritional requirements are delivered in a fluid to the patient’s
stomach through a nasogastric tube. The greatest risk is aspiration. If that happens, feeding has to
be stopped, at least temporarily, increasing the risk of malnutrition. It is estimated that more than
30 percent of children admitted to PICUs are malnourished and could develop new or worsened
malnutrition, increasing their risk of developing other illnesses, infections or worse.
“Traditionally, it’s been assumed that continuously dripping feedings into patients’ bellies is the best
way to deliver nutrition, because slow and steady makes it less likely for them to be intolerant,” says
Brown. Intermittent feeding, however, may better mimic the way the stomach is designed to be fed.
Simply put, it has the potential to provide better nutrition with fewer complications.
“My primary goal will be to see if there’s a difference in the time it took to achieve the patient’s feeding
goal,” says Brown. “I’ll also examine the number of times they experienced feeding intolerance and
compare the intake amounts that the groups achieve each day compared to their target intake.”
Patients enrolled in Brown’s investigation are between the ages of 1 month to 12 years who are
currently on a ventilator and being fed through a nasogastric tube. They’re placed into either the
continuous or intermittent feeding group, and data is collected for four days on each child.
Brown began the enrollment process in October 2013, and she completed the data collection and
statistical data analysis phases in the spring of 2014. Brown defended her findings for her doctoral
dissertation in June.
Fostering a love of clinical research
Although Brown’s primary research interest is nutrition in critically ill children, she has also conducted
investigations focusing on pediatric rapid response systems and deep vein thrombosis.
But for Brown, it always comes back to nutrition. In her first investigation in 2004, she and her
colleagues noticed a lot of variability in the gastric feeding practices in the PICU. So she worked with
an interdisciplinary team of dietitians, nurses and physicians to develop a nasogastric feeding protocol.
The result of that investigation was better, more consistent feeding practices. It also was when she
discovered her love of clinical research.
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“I knew this was a path I wanted to take, but I definitely
needed to advance my research methodology skill set,” says
Brown. “After the three years it took to complete my original
project, I decided to enroll in the doctoral program.”
Gaining key support
To help fund her current investigation, Brown was
awarded a research grant from The University of Akron’s
Delta Omega Chapter of Sigma Theta Tau International,
an international nursing honor society she has been
a member of since 1985. The Rebecca D. Considine
Research Institute designed and maintains the database
Brown used to collect and store study data.
Following study completion, Brown plans to finish her
dissertation and hopes to publish two or three journal
articles based on her findings. She notes that the backing
she receives from the hospital has been essential to her
ability to perform clinical research.
“While this is uniquely my dissertation project, gathering
the data I need to support it and completing my doctoral
degree in general wouldn’t have been possible without the
enthusiastic support of the hospital, the PICU doctors,
nurse practitioners, dietitians and nurses, as well as the
support of the Rebecca D. Considine Research Institute.”
Discover more about Ann-Marie Brown’s investigations
in nutrition in critically ill infants and children. Scan the
code or visit http://bit.ly/1p9EUym.
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Making an impact
From the number of studies to new collaborations,
2013 marked a year of growth and advancement for
the Rebecca D. Considine Research Institute.
Hospital investigators published
in 70
peer-reviewed
journals
Rebecca D. Considine Research Institute staff
Michael D. Reed, PharmD, FCCP, FCP
Research Institute Director
Kelly Culp, BSN, RN Clinical Research Nurse
Ellen Minnozzi
Regulatory Document Specialist
Aris Eliades, PhD, RN, CNS
Research Institute Associate Director and
Director of Nursing Research
Victoria Drummond
Department Secretary
Tonia Polanski, BSN, RN, CPN
Clinical Research Nurse
Debbie Giebner
Regulatory Document Specialist
Monica Swank, CMA, CCRC
Clinical Research Coordinator
Eloise Lemon, BSN, RN, CCRA, CCRC
Administrative Director Clinical Services
Hilary Tonni, MSE, BSN, RN, CCRC
Clinical Research Nurse
Roseann Marsico, BA
Research Grant Coordinator
William Van Nostran, BS
Medical Communications Specialist
Maryan Mathis, MS, RN-BC, CCRC
Administrative Director, Contracts and Development
Donald Wachsberger, MS
Database Manager
Neil McNinch, MS, RN
Biostatistician
Diane Wolski, BSN, RN
Research Clinical Coordinator
Kristine Allmendinger-Goertz, BA
Research Study Coordinator
Ale’ce Andrew, BS
Research Assistant
Heather Anthony, RN
Clinical Research Nurse
Mira Brown, MS
Biostatistician
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2013 Research Funding – External Grants
Representative sampling of significant grant funding research in selected pediatric specialties.
Division of Clinical Pharmacology
and Toxicology
Acetaminophen
Toxicity
Biomarkers
SPONSORS:
Arkansas Children’s
Hospital Research
Institute, Eunice
Kennedy Shriver
National Institute
of Child Health
and Human
Development (NICHD)
Understudied
U
Drugs for
Children
SPONSORS:
Duke University
Clinical Research
Institute Pediatric
Trials Network,
Eunice Kennedy
Shriver National
Institute of Child
Health and Human
Development (NICHD)
Clindamycin in
Overweight/
Obese Children
SPONSORS:
Duke University
Clinical Research
Institute Pediatric
Trials Network,
Eunice Kennedy
Shriver National
Institute of Child
Health and Human
Development (NICHD)
Akron Children’s Lewis H. Walker, MD,
Cystic Fibrosis Center
Fibrosing
Colonopathy
in Cystic
Fibrosis
SPONSORS:
Seattle Children’s
Research Institute, Cystic
Fibrosis Foundation
Therapeutics Inc.
Akron Children’s Pediatric
Intensive Care Unit (PICU)
Akron Children’s
NeuroDevelopmental Science Center
Seizure
Disorder
Study
SPONSORS:
The Hospital for Sick
Children, Pediatric
Epilepsy Research
Foundation (PERF)
Infection in
Pediatric
Stroke
SPONSORS:
The Regents of the
University of California,
National Institute of
Neurological Disorders
and Stroke (NINDS)
Preventing
Migraines in
Children
SPONSORS:
Pediatric
Septic
Shock
National Institutes of
Health (NIH), Cincinnati
Children’s Hospital
Akron Children’s Vision Center
Sepsis
PRevalence
OUtcomes &
Therapies
(“SPROUT”)
SPONSORS:
National Institutes of
Health (NIH), Cincinnati
Children's Hospital
SPONSOR:
Children’s Hospital of
Philadelphia
Akron Children’s Center for Diabetes
and Endocrinology
SPONSORS:
Topical
Solution to
Treat
Nystagmus
SPONSOR:
The Vision of Children
Type 1
Diabetes
TrialNet
University of South
Florida, National
Institute of Diabetes
and Digestive and
Kidney Diseases
(NIDDK)
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25
eviated titles.
2013Research
Research Funding
Funding –– Akron
Akron Children's
Children's Hospital
2013
Hospital Research
Research Foundation
FoundationAwards
Awards
The Akron Children’s Hospital Research Foundation awarded $131,637 to fund 11 studies.
The Akron Children’s Hospital Research Foundation awarded $131,637 to fund 11 studies.
Akron Children’s
Akron
Children’s
Emergency
Services
Emergency Services
Anatomical
Effect of Early
E
Treatment
Room E
Anatomical
Application
of
A
Effect
of Early
Model: Impact
Tapeofon
Ki
Treatment
Room
Application
AKinesio
on Critical
Ankle
Model:
Impact
Ki AcuteTape
Kinesio
on
Resuscitation
Sprains
on
Critical
Acute
Ankle
Resuscitation
Sprains
INVESTIGATORS:
Leslie Burton, DO
INVESTIGATORS:
Mary Patterson, MD
Leslie Burton, DO
Osama El-Assal, MD
Mary Patterson, MD
Osama
El-Assal, MD
$7,250
$7,250
INVESTIGATORS:
Zaid Khatib, MD
INVESTIGATORS:
Nirali Patel, MD
Zaid Khatib, MD
Michelle Burke, MD
Nirali Patel, MD
Cortney Myer, MD
Michelle Burke, MD
Cortney
Myer, MD
$2,788
Intubation Best
Practices in
Intubation
Best
Specialty
Practices
in
Transport
Specialty
Transport
Objectifying
Pupillary Light
Objectifying
Exam in
Pupillary
Light
Critically
Ill
Exam
in
Children
Critically Ill
Children
INVESTIGATORS:
INVESTIGATORS:
Michael T. Bigham, MD Melissa Walter, MSN, RN,
Amee M. Bigelow, MD CPNP, AC-PC, CPEN
INVESTIGATORS:
INVESTIGATORS:
Michael Forbes, MD
Michael
T. Bigham, MD Melissa Walter, MSN, RN,
$3,300
Amee M. Bigelow, MD CPNP,
AC-PC, CPEN
$6,935
Michael Forbes, MD
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Emotional,
Developmental
Emotional,
and Behavioral
Developmental
Issues
in Rural
and
Behavioral
and
Urban
Issues in Rural
Children
and
Urban
Children
Electronic Screen
Use
in Children
Age
Electronic
Screen
12in– Children
36 Months:
Use
Age
Relationship
to
12
– 36 Months:
Social/Emotional
Relationship to
Skills
Social/Emotional
INVESTIGATOR:
INVESTIGATOR:
INVESTIGATOR:
INVESTIGATOR:
$15,000
$14,776
Diane Langkamp, MD
Diane
Langkamp, MD
$15,000
Akron Children’s Division
Akron
Children’s
Division
of Pediatric
Psychiatry
of Pediatric
Psychiatry
and Psychology
and Psychology
Akron Children’s
Akron Children’s
NeuroDevelopmental
NeuroDevelopmental
Science Center
Science Center
Triple P
Outcomes
Triple P
Study
Outcomes
Study
Child/Parent
Psychosocial
Child/Parent
Functioning
Psychosocial
After
Sport
Functioning
Related
After Head
Sport
Injury Head
Related
Injury
Skills
Sajani Raman, MD
Sajani
Raman, MD
$14,776
INVESTIGATORS:
Elissa Deggelman, PhD
INVESTIGATORS:
Geoffrey Putt, PsyD
Elissa Deggelman, PhD
Geoffrey Putt, PsyD
$10,519
$10,519
INVESTIGATOR:
Roger Hudgins, MD
INVESTIGATOR:
Roger Hudgins, MD
$20,500
$20,500
$2,788
Akron Children’s Pediatric
Intensive
Care Unit
(PICU)
Akron
Children’s
Pediatric
Intensive Care Unit (PICU)
$3,300
Akron Children’s
Akron
Children’s
Developmental-Behavioral
Developmental-Behavioral
Pediatrics
Pediatrics
$6,935
Akron Children’s
Department
of Pediatrics
Akron Children’s
Department of Pediatrics
Oral Health
Perspectives
Among
Refugee
Oral Health
Mothers with
Perspectives
Pre-School
Among
Refugee
Children
Mothers
with
Pre-School
Children
Akron Children’s Division of
Pediatric Pulmonary Medicine
Akron Children’s Division of
and Akron Children’s
Pediatric Pulmonary Medicine
NeuroDevelopmental Science
and Akron
Children’s
Center
NeuroDevelopmental Science
Center
Exercise
Intolerance in
Exercise
Mitochondrial
Intolerance
Myopathy in
Mitochondrial
Patients
Myopathy
Patients
INVESTIGATORS:
INVESTIGATORS:
INVESTIGATORS:
INVESTIGATORS:
Lance A. Jepson, DO
Joel Davidson, MD
Rajeev Bhatia, MD
Bruce Cohen, MD
Lance
A. Jepson, DO
$7,600
Joel Davidson, MD
Rajeev Bhatia, MD
$14,969
Bruce Cohen, MD
$7,600
$14,969
Akron Children’s
Vision Children’s
Center
Akron
Vision Center
New Amblyopia
Treatment in
New Amblyopia
Children
Pilot
Treatment
in
Study
Children Pilot
Study
INVESTIGATORS:
Richard Hertle, MD
Dongsheng Yang, PhD, MD
INVESTIGATORS:
Richard Hertle, MD
$28,000
Dongsheng Yang, PhD, MD
$28,000
eviated titles.
eviated titles.
Learning to innovate
To improve patient care and outcomes, the research institute offers a variety of educational
opportunities that encourage innovation and are creatively tailored to meet the needs of clinician investigators
and others, including college students aspiring to careers in healthcare.
Research
Methodology
Seminar Series
Summer
Pediatric Research
Scholars (SPRS)
2013 Translational
Science Seminar
Series
A series of monthly
classroom sessions
focusing on
statistical research
methods for
investigators with
limited training in
statistics.
In 2013, 11 college
students conducted a
research study during
10 intensive weeks.
Mentored by an
experienced hospital
investigator, students
also benefited from
a variety of formal
and informal learning
opportunities
throughout the
hospital.
Three Akron
Children’s
investigators and
four guest speakers
from academic
institutions spoke at
this lecture series.
Presentations by
outside experts
stimulated
Akron Children’s
investigators to
form collaborative
relationships to
leverage resources
and expertise.
Since its inception
in 2006, 88 college
students have
completed the SPRS
program, earning a
stipend toward their
tuition or expenses.
Fellows Medical
Writing Seminars
Three one-hour
medical writing
seminars were
presented to fellows
in collaboration
with the medical
education
department.
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Participating study site for multicenter pediatric
research initiatives
Children’s
Oncology Group
(COG)
The division of pediatric
hematology-oncology is a
distinguished and highly engaged
member of COG, the world’s
largest childhood cancer research
organization. Akron Children’s
patients are continually enrolled in
COG clinical trials. Staff
physicians, nurses, pharmacists
and others also are members of
various COG leadership
committees.
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Cystic Fibrosis
Foundation
Akron Children’s Hospital is one
of 72 therapeutic development
research sites sponsored by the
Cystic Fibrosis Foundation –
making drugs and nutritional
supplements under development
available to patients in our
Lewis H. Walker, MD, Cystic
Fibrosis Center.
Pediatric Trials
Network (PTN)
The research institute participates
in the PTN, a national initiative
providing infrastructure to study
pediatric dosing and the safety of
prescription medications. It’s a
collaboration of the Eunice
Kennedy Shriver National Institute
of Child Health and Human
Development and the Duke Clinical
Research Institute.
Research Pursuits is the institute’s digital newsletter for the pediatric research
community, donors, community leaders, academia, friends and colleagues.
Visit akronchildrens.org/pursuitssignup to subscribe.
2013 Akron Children’s Investigator Videos
Investigating Head Injury
and Concussion Management in Young Athletes
Joseph Congeni, MD,
director of sports medicine
Bullying, Suicidality and
Depression in Psychiatric
Adolescent Inpatients
Sumru Bilge-Johnson, MD,
pediatric psychiatrist
Leadership Behaviors and
Rounding Influence to Safety
Pam Baker, MSN, MBA, RN,
PCNS-BC, associate chief
nursing officer and chief
nursing information officer
Mitochondrial
Disease Research
Bruce H. Cohen, MD, FAAN,
director of pediatric neurology
Home-Based vs.
Center-Based Intervention
Marilyn Espe-Sherwindt, PhD,
director of the Family Child
Learning Center (FCLC)
Using Epigenetics to Study
Bone Tumors in Children
and Adolescents
Steven Kuerbitz, MD, director
of divisional research and stem
cell transplantation
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grants
Center for Nursing Research –
2013 accomplishments
Oral or poster
presentations
at local, regional, national
& international conferences
Directed by Aris Eliades, PhD, RN, CNS, the center creates opportunities to improve family-centered care through
advances in nursing clinical practice, administration and education.
IRB-approved
open studies
as of December 31, 2013
Established a
Nursing
NursingResearch
research
Council
awards and
honors
Ann-Marie Brown, PhD(c),
CPNP-AC/PC, CCRN, FCCM
•Fellow of Critical Care Medicine inductee,
American College of Critical-Care Nurses
•Delta Omega Chapter of Sigma Theta Tau
Research Grant
Nationally
recognized
Jennifer Huth, BSN,as
RN,exemplary
CPN
Nominated Akron Children’s Magnet Nurse of
program
the Year in “New Knowledge,
Innovations &
20,864
Aris Eliades, PhD, RN, CNS
Northeast Ohio Nursing Initiative Legacy Award
In research grants awarded
to Akron Children’s nurses
Improvements” category
Phyllis Mesko, RN, CPN
•First place in research category, International
Conference for PeriAnaesthesia Nurses
•American Society of PeriAnaesthesia Nurses
Novice Research Grant
Shannon Sikorski, RN, MSN,
FNP-BC, CPHON
Selected to attend Nurse Researcher Workshop,
Alex’s Lemonade Stand sponsor
Mellissa Walter, RN, MSN, CPNP, AC-PC
Awarded research grant
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12 master’s degree nursing
students completed
720+ research practicum hours through
the Center for Nursing Research
2 PhD nursing students conducted studies
at Akron Children’s
3 Doctor of Nursing Practice students
conducted studies at Akron Children’s
Meghan Weese, MSN, RN, CPN
Named to Ohio Organization for Nurse Executives
2013 Aspiring Nurse Leader “40 Under 40”
Akron Children’s Hospital’s
Nurse Scholar Program
Akron Children’s Hospital designed the Nurse Scholar Program to further professional growth and development
through a structured educational curriculum offering formal training in the field of pediatric research. Nurse Scholars
then design and conduct a rigorous research study.
2013 – 2014
Nurse Scholars
Nancy Delnay, RN, MSN, CNP
Psychological problems of children with juvenile
rheumatologic disease
Jean Frisone, BSN, RN, CPN
Variability of fever parameters and instructions
to parents
Kari Wahl, BSN, RN
Identifying the source and prevalence
of workplace incivility in a pediatric
nursing workforce
Melissa Walter, RN, MSN, CPNP, AC-PC
Objectifying the pupillary light exam: The role of
an automated pupillometer in critically ill children
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Akron, Ohio 44308-1062