UofL News: Please describe some of the health disparities that directly impact the older adult population.��

Harrington: Ageism is a collective result of stereotypes, prejudice and discrimination based solely on age. This is a relevant barrier to health care equity and patient safety. Our mindset of ageism must change. Human life means growing older across the life span without self-exclusion. The burden of preventable disease, mistreatment and inequity in access to and the provision of quality health care impedes opportunities to achieve optimal health. Optimal aging begins in early life and continues across the lifespan.

UofL News: What are some ways to overcome these challenges?��

Harrington: We must take a collaborative all-hands-on-deck approach. There is a strong body of research showing patient outcomes are best when inter-professional teams work together. Our patients are begging for access to high-quality health care.

UofL News: Louisville is home to multiple aging care businesses and city leaders hope we can be innovators for improving quality of life for the growing population of older adults throughout the United States. How do you see your work (both in research and teaching) contributing to this effort?��

Harrington: Ensuring that all our primary care nurse practitioner graduates acquire the knowledge and skill to care for our older adults in the community and long-term care settings is my highest priority as a nursing educator. Disseminating content for student and practicing nurse practitioners on the most complex medical conditions will hopefully help them improve their patients’ outcomes.

I and my medical and computer science and engineering colleagues also are working to change the most confounding social problems affecting older adults with Alzheimer’s disease and their caregivers using artificial intelligence and innovative product design. This exciting research has substantial social and policy implications.

UofL News: As someone with decades of geriatric nursing experience, explain how your research has helped improve the health and well-being of family caregivers of those with��Alzheimer’s disease/Alzheimer’s disease-related dementias (ADRD).��

Harrington: From the 30,000-foot perspective, the gaps are vast in every area of aging. Fifteen million family caregivers of those with ADRD and 12 million ADRD care recipients are potentially impacted by research and innovative practice models adopted by health care professionals. It is difficult to separate research in aging into disease-based categories because they are all interconnected. My defined program of nursing scholarship and creative activity focuses on older adults’ and their caregivers’ health disparities and power inequity in the context of heart failure, Alzheimer’s disease and Alzheimer’s disease related dementias, and ageism.

UofL News: What are some of your significant areas of geriatric research?����Describe for us some of the outcomes.

Harrington: Yes, in the context of the fellowship with the academy, there are several:

• 5 million individuals who reside in long-term care have heart failure. My innovative heart failure evidence-based guideline remains the only nurse-driven practice guideline of its kind since 2006, and has received national and international recognition through citations and inclusion of content. I created the ACE (Assess, Collaborate, Engage) Delirium Superimposed on Dementia practice model to improve how we approach delirium superimposed on dementia that impacts 20 million hospitalized older adults with ADRD yearly. That research recently published in .
• I believe education for quality health care for older adults requires a multi-prong approach that reaches health science students, health science professionals and families in the community. The possibilities for nursing innovation are infinite with inter-professional collaboration and begin with identifying the problems in care provision or care delivery. Redesigning the Medicare Annual Visit process for a 45 office Federally Qualified Health Centers (FQHC), prompted leading an inter-professional team in the development and production of an innovative desktop application for comprehensive geriatric assessment with custom reporting capabilities for FQHCs.
• The outcome of the first population-based study of 1,500 older adults in eastern North Carolina identified family caregivers’ need and desire for the knowledge and skill to be optimal caregivers for those with Alzheimer’s disease. We also realized how unrealistic it is to expect farmers to lose critical daylight hours to seek preventive health care, so we connected them to AgriSafe nursing services who visited them on their farms. The population-based community research led to delivering person-in-context dementia simulation to caregivers as an educational method to improve their understanding of dementia and their family members’ daily challenges and multiple educational workshops in collaboration with area agencies on aging.
• Between 2015 and 2017, I conducted two research studies that successfully eliminated academic silos in inter-professional geriatric education. The outcomes were an innovative and sustained Two-As-One Preceptor Model and the Troika InterProfessional (TIP) Gerontology ����ֱ�� Model impacting over 300 third-year medical, primary care nurse practitioner and physician assistant students. The TIP outcome model was designed for a student team of three primary care professionals who learn and apply gerontology knowledge in a virtual clinic environment. All faculty reported students maintained proficiency in the content over time. These skills impact approximately 8 million older adults these individuals will serve when extrapolated over a 20-year career.

UofL News: What is the future of geriatric health care?��

Harrington: We currently have approximately 680,000 adults over the age of 65 in Kentucky. The majority of the state’s counties, 81 of 120, are medically underserved. This void is compounded by many primary care physicians who are approaching retirement. Nurse practitioners are critical to the care quality of our older adult population and will remain critical for at least the next 30 years. Enacting legislation to remove the practice barriers and allowing nurse practitioner to practice collaboratively at the full scope of our educations, experience and training is growing more so each year. This is imperative to our ability to impact the wide-range of health disparities our older adults experience.

“I am humbled and honored to be named as a Fellow inductee of the American Academy of Nursing. I consider myself a change agent and enjoy challenges promoting innovative effectual change. I will eagerly lend my experience, passion and time to the Aging Expert Panel to develop policy recommendations that eradicate age-related health disparities, systemic racism, and ageism contributing to poor health equity,” Harrington said.��

The academy is an honorific society that recognizes nursing’s most accomplished leaders in policy, research, practice, administration and academia. Academy Fellows, from nearly 40 countries, hold a wide variety of influential roles in health care. Induction into the Fellowship represents more than recognition of one’s accomplishments within the nursing profession. Fellows contribute their collective expertise to the academy, engaging with health leaders nationally and globally to improve health and achieve health equity by impacting policy through nursing leadership, innovation, and science.������

“Dr. Harrington was recruited to the university because of her expertise in the care of older adults. Recognition with the awarding of fellowship in the academy is one of the highest honors a nurse can receive. It signifies the level of esteem to which she is held by her peers,” said Mary DeLetter, interim dean of the School of Nursing.��

Harrington has 37 years of experience as a nurse leader and has had regional, national and international impact on nursing practice, interprofessional health science and intraprofessional nursing education, and knowledge-generating research. She earned a diploma in nursing in 1982 from Presbyterian Hospital School of Nursing in Charlotte, North Carolina, a BSN from Gardner Webb University in 2002, an MSN with an adult gerontology nurse practitioner concentration from the University of North Carolina Greensboro in 2005, and a Doctor of Nursing Practice degree from Vanderbilt University in 2011.��Harrington earned a PhD in Nursing in 2018 from East Carolina University and completed a Post-Master’s Certificate in Nursing ����ֱ�� at the same institution in 2019.��

Through a competitive, rigorous application process, the ��������𳾲�’s Fellow Selection Committee reviewed a record number of applications, representing a 30% increase from the previous year, to select the 2022 Fellows. Harrington was one of 250 individuals selected to be inducted. The 2022 Fellows represent 35 states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, and 17 countries.����

The 2022 inductees will be recognized for their significant contributions to health and health care at the ��������𳾲�’s annual��, taking place on October 27-29, 2022 in Washington, DC at the Marriott Marquis during the Induction Ceremony on the evening of October 29. Once the newest Fellows are inducted, the academy will be comprised of more than 3,000 leaders who are experts in policy, research, administration, practice, and academia that champion health and wellness, locally and globally.��

Hutti is among 195 nurses worldwide selected for the 2018 class of the����fellows, which recognizes distinguished nurse leaders who work in education, management, practice, policy and research. Hutti and the other inductees will be honored at a ceremony during the ��������𳾲�’s annual policy conference Nov. 1-3 in Washington, D.C.

“Being a fellow will give me an opportunity to be a significant voice for women and their families at the national level,” said Hutti, PhD, WHNP-BC, FAANP. “I am excited to be able to advocate for my patients in such an important forum.”

Hutti, who maintains an independent practice in women’s health, is internationally known for her research on perinatal loss and has received national awards as a nursing educator and researcher. She created the Perinatal Grief Intensity Scale, developed for clinical use to predict intense grief and identify need for professional follow-up after perinatal loss, which includes miscarriage, stillbirth and death of an infant within 28 days after birth.

Her most recent study included development of a free app of the Perinatal Grief Intensity Scale, available to health care providers at����and��.

In 1993, Hutti started the women’s health nurse practitioner program at UofL, the first of its kind in Kentucky, and helped develop the women’s health nurse practitioner scope and standards of practice.

Lisa Carter-Harris, an alumna of the UofL School of Nursing’s Ph.D. and master’s degree programs, also was chosen for the 2018 class of academy fellows. Carter-Harris is a faculty member at Indiana University School of Nursing where she researches improving patient-provider communication and the shared decision making process in cancer screening decisions.

The Academy has named School of Nursing faculty members Whitney Nash, PhD, APRN, and Sara Robertson, DNP, APRN, for establishing and growing the clinic, which serves low-income thoroughbred racing industry workers and their families. The designation recognizes original evidence-based and nurse-designed care models that have shown significant clinical and financial outcomes.

Located a block from Churchill Downs, the clinic is a partnership between the School of Nursing and the that provides comprehensive health care to backside workers, including assistant trainers, grooms and hot walkers.

Most workers the clinic serves migrate from Latin America to work U.S. horse racing circuits. These low-paying jobs typically do not include health benefits. Before the clinic opened in 2005, many of its patients forwent health care or used the emergency room for primary care.

“It is a privilege to be recognized with such a prestigious designation,” said Nash, School of Nursing Associate Dean of Practice and Service and founding director of the clinic. “We are honored to serve one of the most vulnerable populations.”

Funded by uncashed parimutuel tickets at horse racing tracks throughout Kentucky, the clinic decreases health care barriers and has reduced medical costs by providing much of the workers’ health care in one place.

Workers can access the clinic for a $5 copay, which covers the patient visit and lab tests. Services include mental health treatment, physicals and women’s annual exams, care for acute illnesses, and maintenance treatment for chronic conditions such as asthma, diabetes and hypertension.

“The high level of comprehensive care and readily available appointments allow patients to understand and manage their unique health situation,” said Richard Riedel, director of the Kentucky Racing Health & Welfare Fund. “Because satisfaction levels are so high, patients often return for their care.”

Polivka, PhD, RN, Shirley B. Powers Endowed Chair at the UofL School of Nursing, is among 164 nursing leaders worldwide chosen for the 2016 class of academy fellows. She and other inductees will be honored at a ceremony during the annual policy conference Oct. 20-22 in Washington, D.C.

Fellows advance the ��������𳾲�’s mission of transforming health policy and practice by applying collective nursing knowledge. They work with the academy to strengthen the health care delivery system, improve the quality of nursing, and reduce health disparities and inequalities.

Polivka said it was humbling to be recognized for her work in improving environmental and public health.

“Fellows in the academy are a prestigious group of nursing leaders who have and continue to make an impact in nursing and health care,” Polivka said. “I’ve had the privilege of working with a number of amazing colleagues in academia, health care, state and local governments, and professional organizations. I’m indebted to them and to my family for their support, patience and encouragement throughout my career.”

Polivka’s distinguished career in nursing research and academia has spanned more than 30 years. She is leading a $2.4 million study funded by the National Institute on Aging that is comprehensively examining the triggers of asthma in older adults.

Through an $870,000 grant from the National Institute for Occupational Safety and Health, Polivka and researchers from The Ohio State University have developed a virtual simulation system that will train home health care workers on how to mitigate hazards they encounter in clients’ homes.

“Dr. Polivka is most deserving of this recognition,” said Marcia J. Hern, EdD, CNS, RN, UofL School of Nursing dean. “Throughout her career, she has been a consummate scholar and researcher, along with being a mentor to an extensive number of students and faculty at various stages in their careers.”

Polivka joins three other UofL School of Nursing professors who have been inducted as American Academy of Nursing fellows: Vicki Hines-Martin, M. Cynthia Logsdon and Karen Robinson.

The academy is comprised of more than 2,400 nursing leaders, including hospital and government administrators, college deans and researchers from all 50 states and 28 countries.