Ruth A. Anderson, PhD, MSN, MA, RN, FAAN

Virginia Stone Professor of Nursing
Director, ADAPT Center for Cognitive/Affective Symptom Science
Phone: 
(919) 668-4599
Office: 
4111 Pearson Building

Dr. Anderson is Virginia Stone Professor of Nursing and a Senior Fellow in the Duke University Center for Aging and Human Development. She is also a Research Development Coordinator in the Office of Research Affairs in the School of Nursing. She earned a BSN from Stockton State College in New Jersey, a Master of Science in Gerontological Nursing and Master of Arts in Social Gerontology from the University of Pennsylvania, and the PhD in nursing with a business minor from The University of Texas at Austin. She has extensive experience teaching graduate courses in managing complex healthcare systems, chronic illness, and outcomes in health care.

Dr. Anderson's scholarship is dedicated to improving management of nursing homes, an area of rapidly growing need. Her research has been interdisciplinary from its inception, and she has collaborated with scholars at Duke and across the country in schools of nursing, business, economics, engineering and medicine. She pioneered the application of complexity theory and management science in nursing in analysis of the institutional environment of the nursing home. Her studies that show the relationships between patient outcomes and organizational structure, interpersonal relationships of staff and families, patterns of staff communication, and employee turnover have given researchers new tools for implementing evidence-based changes in the care delivery practices in long term care facilities.

Academic Program Affiliations

  • PhD in Nursing Program
  • Doctor of Nursing Practice Program

Education

  • PhD - The University of Texas at Austin School of Nursing
  • MA - University of Pennsylvania, Faculty of Arts and Sciences
  • MSN - University of Pennsylvania, School of Nursing
  • BSN - Stockton State College (NJ)

Research Interests

My research program is concerned with understanding and improving nursing management practices and their impact on outcomes, with a particular interest in resident outcomes in nursing homes. I use complexity science, organizational and nursing theory to bring together the constructs of communication and decision processes, relationship and interaction, organizational structures, context, resource allocation and health care outcomes. In my previously NIH/NINR funded study, Outcomes of Nursing Management Practice in Nursing Homes, I worked with a multidisciplinary team to explore relationship patterns and management practices that enable nursing homes to attain high quality resident outcomes in a series of eight comparative case studies, identifying management practices that are distributed through all levels of workers and appear to build capacity for high quality outcomes. From these findings, we developed a new intervention for improving staff interactions and information exchange in long term care settings. In a competing continuation NINR-funded R01, my team and I are now testing this intervention in 16 community nursing homes for its impact on reducing patient falls; our team is also funded by the VA (Colón-Emeric, PI) to test the intervention in four Community Living Centers. I have expertise in both quantitative and qualitative research methods.

Awards and Honors

  • 2012 || Outstanding PhD Faculty Award, Duke University School of Nursing
  • 2011 || Distinguished Contributions to Nursing Science Award, Duke University School of Nursing
  • 2010 || Virginia Stone Professor of Nursing, Duke University School of Nursing
  • 2004 || Science Advisory Board, The Plexus Institute
  • 2003 || Fellow, American Academy of Nursing
  • 2002 || Annual Meeting Best Paper Award (top ten percent of submissions), Academy of Management
  • 2000 || Member, Council for the Advancement of Nursing Science
  • 1997 || Ed and Molly Smith Fellow in Nursing, The University of Texas at Austin, School of Nursing
  • 1997 || Virginia Henderson Fellow, Sigma Theta Tau, International Honor Society of Nursing
  • 1991 || Luci Baines Johnson Fellow in Nursing, The University of Texas at Austin, School of Nursing
  • 1990 || Faculty Research Award, The University of Texas at Austin, School of Nursing
  • 1989 || American Organization of Nurse Executives’ Scholar, The American Nurses’ Foundation
  • 1989 || Luci Baines Johnson Fellow in Nursing, The University of Texas at Austin, School of Nursing
  • 1987 || Member, Academy of Management
  • 1985 || Inducted, Beta Gamma Sigma, National Scholastic Honor Society (Business & Administration)
  • 1985 || Inducted, The Honor Society of Phi Kappa Phi
  • 1981 || Inducted, Sigma Theta Tau, International Honor Society of Nursing

Areas of Expertise

  • Gerontology
  • Nursing and Health Care Leadership
  • Translational Research

Areas of Interest

Care Systems for Chronic Illness

Representative Publications

  • 2014 -- PubMed # : 24655938 Adams, J. A. and Anderson, R. A. and Docherty, S. L. and Tulsky, J. A. and Steinhauser, K. E. and Bailey Jr, D. E. Nursing strategies to support family members of ICU patients at high risk of dying. Heart Lung. March, 2014
  • 2014 -- Hunt, S. R. and Corazzini, K.. and Anderson, R. A. Top nurse management staffing collapse and care quality in nursing homes. Journal of Applied Gerontology. February, 2014 33(1); 51-74
  • 2014 -- PubMed # : 24383890 Toles, M. and Anderson, R. A. and Massing, M. and Naylor, M. D. and Jackson, E. and Peacock-Hinton, S. and Colón-Emeric, C. Restarting the Cycle: Incidence and Predictors of First Acute Care Use After Nursing Home Discharge. J Am Geriatr Soc. January, 2014
  • 2013 -- PubMed # : 23879936 Adams, J. A. and Bailey Jr, D. E. and Anderson, R. A. and Thygeson, M. Finding your way through EOL challenges in the ICU using Adaptive Leadership behaviours: A qualitative descriptive case study. Intensive Crit Care Nurs. December, 2013 29(6); 329-36 PMC3870892
  • 2013 -- PubMed # : 24279686 Colon-Emeric, C. S. and McConnell, E. and Pinheiro, S. O. and Corazzini, K. and Porter, K. and Earp, K. M. and Landerman, L. and Beales, J. and Lipscomb, J. and Hancock, K. and Anderson, R. A. CONNECT for better fall prevention in nursing homes: results from a pilot intervention study. J Am Geriatr Soc. December, 2013 61(12); 2150-9
  • 2013 -- PubMed # : 24297156 Thornlow, D. K. and Oddone, E. and Anderson, R. Cascade Iatrogenesis: A Case-Control Study to Detect Postoperative Respiratory Failure in Hospitalized Older Adults. Res Gerontol Nurs. 1-12
  • 2013 -- PubMed # : 24349771 Anderson, R. A. and Plowman, D. and Corazzini, K. and Hsieh, P. and Su, H. F. and Landerman, L. R. and McDaniel, R. R. Participation in decision making as a property of complex adaptive systems: developing and testing a measure. Nurs Res Pract. November, 2013 2013 706842 PMC3857844
  • 2013 -- PubMed # : 23995465 Corazzini, K. N. and Anderson, R. A. and Mueller, C. and Thorpe, J. M. and McConnell, E. S. Licensed practical nurse scope of practice and quality of nursing home care. Nurs Res. Sept-Oct., 2013 62(5); 315-24
  • 2013 -- PubMed # : 23617442 Falk, H. and Ekman, I. and Anderson, R. and Fu, M. and Granger, B. Older patients' experiences of heart failure-an integrative literature review. J Nurs Scholarsh. September, 2013 45(3); 247-55
  • 2013 -- PubMed # : 23704219 Colón-Emeric, C. S. and Pinheiro, S. O. and Anderson, R. A. and Porter, K. and McConnell, E. and Corazzini, K. and Hancock, K. and Lipscomb, J. and Beales, J. and Simpson, K. M. Connecting the Learners: Improving Uptake of a Nursing Home Educational Program by Focusing on Staff Interactions. Gerontologist. May, 2013

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Grant Funding (Selected)

  • Center for Adaptive Leadership in Cognitive/Affective Symptom Science

    National Institutes of Health
    1P30-NR014139-01
    09/2012 to 06/2017

    The proposed Center of Excellence (P30), “Adaptive Leadership for Cognitive/Affective Symptom Science (ADAPT) at Duke University School of Nursing (DUSON), will promote biobehavioral research to advance symptom science using a new lens — the Adaptive Leadership (AL) framework — to conceptualize and study cognitive/affective symptoms, and/or intervene in ways that promote patients’ and their family caregivers’ adaptive abilities.

  • Administrative Core

    National Institutes of Health
    1P30-NR014139-01
    09/2012 to 06/2017
  • Outcomes of Nursing Management Practice in Nursing Homes

    National Institutes of Health
    2R01-NR003178-09A2
    09/2011 to 06/2016
    Role: co-PI

    This research will test the benefit of a new staff interaction intervention (CONNECT) over and above a falls quality improvement intervention in reducing patient fall rates in nursing homes.

  • Family Perceptions of Strategies to Facilitate End-of-Life Decisions

    NIH, National Institute of Nursing Research
    1F31NR013327-01A1
    08/2012 to 07/2014
    Role: Co-Mentor

    Project Goal: Pre-doctoral study to explore how family members respond to nursing strategies to support EOL decision-making.

  • Evaluation of the Nursing Culture Assessment Tool as a basis for improving prevention of pressure ulcers in long-term care

    John A. Hartford Foundation Building Academic Geriatric Nursing Capacity: Claire M. Fagin Fellowship award
    07/2012 to 06/2014
    Role: Co-Mentor

    The purpose of the research is to refine the previously developed Nursing Culture Assessment Tool (NCAT) by administering it to nursing staff in contextually different long-term care settings, to determine the clinical relevance of the NCAT in the context of PU prevention care practices by re-examining its content validity in this context and exploring focus group perspectives on its accuracy. Use these findings to guide item refinement and/or development of a protocol manual to standardize NCAT use in future clinical trials.

  • Comparison of Careful Hand Feeding Techniques for Older Persons with Dementia

    John A. Hartford Foundation Building Academic Geriatric Nursing Capacity: Claire M. Fagin Fellowship award
    07/2012 to 06/2014
    Role: Co-Mentor
  • CONNECT for Better Falls Prevention in VA Community Living Center

    Veterans Affairs Health Services Research and Development
    EDU 08-417
    08/2009 to 07/2012
    Role: Co-investigator

    In this longitudinal, randomized, controlled trial using multiple levels of analysis, we will compare the uptake of fall risk factor reduction practices and related patient fall-related outcomes in nursing homes, under two approaches to education: (1) FALLS, which is delivered using content-focused approaches to education including self-instructional modules, an in-house falls program coordinator, academic detailing sessions and audit and feedback and (2) FALLS as described above, plus CONNECT, which is delivered using learner-centered approaches and is intended to increase information exchange among staff of all levels and disciplines, increase direct care nursing providers’ participation in decision-making, and increase cognitive diversity when implementing evidence-based care practices.

  • Compassion Fatigue in Adult Daughter Caregivers

    National Institutes of Health
    1F31-NR012870-01A1
    09/2011 to 08/2013
    Role: co-PI

    Support for doctoral research for Jennifer R. Day

  • Transitional Care for Post-Acute Residents in Nursing Homes

    John A. Hartford Foundation
    11-223
    07/2011 to 06/2013
    Role: Co-PI
  • Regulating Licensed Nursing Practice in Nursing Homes: How RN and LPN Scopes of Practice Are Enacted

    National Council for State Boards of Nursing
    NCSBN R30010
    10/2010 to 09/2012
    Role: Co-Investigator

    To describe practice patterns of RNs and LPNs used to implement their scope of practice, to compare these practice patterns between two states, and to develop a facility-level tool to measure these patterns.

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