Martin Schiavenato,Ph.D., R.N., assistant professor at the University of Rochester School of Nursing, is one of just 15 nurse educators nationwide to receive a prestigious Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (NFS) award.
The three-year $350,000 grant from RWJF will support Schiavenato’s research into how pain is measured in premature babies, a topic he has been interested in since the 1990s when he was a nurse in the neonatal intensive care unit. While his earlier research focused on developing a new, more sophisticated facial scale for detecting and measuring infant pain, his current project focuses on the application of technology to pediatric pain assessment.
Schiavenato has developed a computerized tool that translates behavioral and physiological signs of pain in infants—such as changes in heart rate, facial expressions and hand gestures—into a “real time” display. A glass orb that changes color depending on the signals it receives will provide an immediate indication of infant pain levels. “It’s a great subtle and objective means of conveying information at the bedside that I think could help health care providers assess pain and lead to better treatment,” he said.
Schiavenato is working on the project with faculty and students from the University of Rochester’s Department of Biomedical Engineering. This fall they are going from a lab to a bedside version. He expects to test it in a clinical setting spring 2010.
“The biggest challenge has been determining which signals to use and in what combination,” he said. “It is very difficult to gauge pain in preemies. A baby born at 28 weeks and a baby born at 36 weeks are very different creatures. They don’t send the same signals.”
Initially, Schiavenato has settled on using three key measures: heart-rate variability, which is sensitive to anabolic “flight or fight” response that is triggered by stress; electromyographic (EMG) activity, which measure muscle movement of the mouth; and movement of a flex sensor placed in the palm of a baby’s hand which will bend and send a signal as the hand splays in response to distress. Schiavenato is starting out simply with these measures combining in a complex algorithm and triggering the orb to change to one of three colors: green for fine, yellow for increasing stress, and red for distressed. But the potential for his work is vast. Different combinations of physiological responses will work better for different age babies. More colors may be able to indicate more subtle changes in stress and pain.
“This machine will give a voice to those who cannot articulate their pain. It can be used to alleviate suffering and could have long-term developmental and cognitive health benefits for patients,” said Harriet Kitzman, Ph.D., R.N., F.A.A.N., associate dean of research at the University of Rochester School of Nursing, and one of Schiavenato’s two project mentors. The other is Laurel Carney, Ph.D., a professor of biomedical engineering and neurobiology and anatomy at the University of Rochester.
The goal of the Robert Wood Johnson Foundation Nurse Faculty Scholars program is to develop the next generation of national leaders in academic nursing through career development awards for outstanding junior nursing faculty. The program aims to strengthen the academic productivity and overall excellence of nursing schools by providing mentorship, leadership training, and salary and research support to young faculty.
Despite a rise in applicants, U.S. nursing schools turn away thousands of prospective students from baccalaureate and masters programs because of an acute shortage of faculty and clinical preceptors, training sites, space and funding constraints. Since the stature of nursing schools and the promotion of nursing faculty are dependent on the quality of the nursing faculty’s scholarly and/or research pursuits, the Nurse Faculty Scholars program seeks to strengthen the link between institutional reputation and faculty success by providing career development and other opportunities to junior faculty.
The program is funded by the Robert Wood Johnson Foundation and administered through the Johns Hopkins University School of Nursing. Jacquelyn C. Campbell, Ph.D., R.N., F.A.A.N., Anna D. Wolf chair and professor in the Johns Hopkins University School of Nursing, directs the program. For more information, go to: www.nursefacultyscholars.org.