Empowering patients to manage their own symptoms

July 26, 2023
Dr. Teresa Kelechi leaning on a desk near a window.
Dr. Teresa Kelechi, pictured here, was just inducted into the International Nurse Researcher Hall of Fame.

On July 22, Teresa Kelechi, Ph.D., the David and Margaret Clare Endowed Chair and interim dean of the MUSC College of Nursing, was one of only 22 nursing researchers worldwide to be inducted by the Sigma Theta Tau International Honor Society of Nursing into the International Nurse Researcher Hall of Fame. The induction ceremony was held at the honor society’s annual conference, held this year in Abu Dhabi, United Arab Emirates. The new inductees, like the 270 nurse researchers already in the Hall of Fame, were selected because they had achieved significant national and international recognition and improved the profession of nursing and the people it serves through their research.

“I am honored to be joining this group of highly prestigious nurse scientists who have taken their research to the next level and who are improving people's health and quality of life,” said Kelechi.

Kelechi, an internationally recognized expert in wound care, has published more than 100 peer-reviewed articles and been awarded $10 million in government grant funding for her research, including $5 million in the past five years.

But those are not the metrics by which Kelechi measures the impact of her research. For that, she goes back to the advice a mentor once gave her: “It's not always about publish or perish. It's about changing patient care, changing policy or developing a product that improves the lives of the people for whom we provide our care and our research.” Taking that guidance to heart, she has centered her clinical practice and research on improving the lives of geriatric patients.

“It's important to me to empower patients to be the directors of their own health.” 

-- Dr. Teresa Kelechi

She earned a master’s in gerontological nursing from Case Western Reserve University in 1984 and eventually a doctorate in nursing from MUSC and the University of South Carolina in 2001. In her clinical practice at MUSC, she directed the Skin Integrity Clinic from 2001 to 2008, which focused on wound care. She saw firsthand how leg ulcers, which can occur in those with vascular conditions and diabetes, affected people’s quality of life.

“They would always tell me, ‘”Please, please do something for my pain and please do something for my itch,’” said Kelechi. They wanted to feel better and be active in their communities.

As part of her clinical work, Kelechi often traveled to remote areas of the state, where many could not access or afford health care. Some of the patients she visited reused their leg dressings or resorted to home remedies to manage the pain and itch of the ulcers.

“We had patients who would develop their own wound treatments, such as a man who would use cobwebs,” said Kelechi. “Others would use natural things from the woods or use different ingredients to make plasters to manage the symptoms caused by these ulcers.”

Kelechi’s research grew out of a desire to help these patients to manage their symptoms more effectively. She established a now widely recognized and implemented protocol for preventing venous leg ulcers in those with vascular conditions. The protocol reduced leg ulcers 18% more than what was then the standard of care.

Venous leg ulcers form when the leg becomes inflamed, causing the skin to redden and crack. Kelechi led clinical trials showing that a patient could reduce the risk of developing a leg ulcer by self-monitoring the temperature of the leg, and if the temperature was elevated, applying a cooling gel pack to the affected area.

In her clinical research, Kelechi tested various technologies for monitoring skin changes due to inflammation, from expensive skin physiological monitors to various forms of thermometers. She collaborated with bioengineers to create a cooling gel pack and was inducted into the Charleston Chapter of the National Academy of Inventors in 2017 for her efforts.

Always motivated by a desire to help people to manage their own symptoms better, regardless of their socioeconomic backgrounds, she established the efficacy of now inexpensive infrared thermometers for measuring skin temperature. Coupled with widely available cheap cooling packs, implementing the self-monitoring protocol she established is now within everyone’s reach.

“Today people can buy a $10 infrared thermometer and a cheap cooling gel patch and be able to self-manage pretty well,” said Kelechi. “It's important to me to empower patients to be the directors of their own health.”

Kelechi is currently researching the impact that loneliness and social isolation have on these patients’ ability to heal, and she continues to be interested in the ways that wearable technologies can be used to help patients to self-monitor and manage their own symptoms.

“Nurse researchers bring a unique perspective because it's from the lens of the patient, the family and their community.”

-- Dr. Teresa Kelechi

Kelechi’s research has also informed health care policy. “I went to the Hill and spoke to legislators and staffers about the importance of people wearing protective footwear to prevent foot ulcers,” said Kelechi of a trip to D.C.

Thanks to advocacy by Kelechi and others, Congress opted to renew a bill that supported their assertions of the importance of therapeutic footwear.

Kelechi believes that a focus on improving symptom management is the “special sauce” that nurses bring to research.

“As nurses, we have been taking care of patients in a wide variety of venues – at the bedside in the hospital, at home, in nursing homes and in community settings,” she said. “Nurse researchers bring a unique perspective because it's from the lens of the patient, the family and their community and how what they're dealing with affects their day-to-day ability to take care of themselves.”

Kelechi is proud that this unique perspective has made nurse-scientists valued members of interdisciplinary clinical research teams. “Every one of the grant applications coming out of the College of Nursing has a colleague in either another college or a different discipline,” she explained.

She has also worked with the South Carolina Clinical & Translational Research (SCTR) Institute since its inception to improve clinical trial infrastructure and recruitment, particularly among older adults and other underrepresented populations. Her work with SCTR reflects her love of technology and her commitment to disadvantaged communities. She has worked with teams at SCTR and the Biomedical Informatics Center to explore the role of artificial intelligence in identifying people eligible for trials based on their electronic health records. As promising as this new approach is, she doesn’t think it will ever replace the human touch or community engagement when it comes to encouraging clinical trial participation in disadvantaged populations.

“We now recruit from MyChart and people who are patients in the hospital or ambulatory patients,” said Kelechi. “However, there are people who do not have an opportunity to engage in research because they're not in those systems. So my philosophy has always been to get out there in the community and offer people these opportunities.”

Kelechi is also generous in sharing the expertise and insights she has gained in her more than 40-year clinical and research career with the next generation of nurse scientists. As the associate dean for Research and Ph.D. Studies at the MUSC College of Nursing, Kelechi directly supports the engagement of faculty and students at all levels of nursing education in clinical research opportunities and scholarship. Almost half of her publications have been co-authored with mentees, and three of her mentees have gone on to secure career development awards from the National Institutes of Health.

She tries to instill in her mentees the same focus on improving patients’ lives that her mentor passed on to her. In 2017, Kelechi was honored with the Peggy Schachte Mentor Award that recognized her contributions as a mentor to all levels of students and colleagues across disciplines. This is one of the awards of which Kelechi is most proud.

“I think it's taking time with mentees not only to talk about the technical aspects or the grant-writing aspects. You also must challenge them to think about the ‘so what’ question – why the research matters and how it influences patients and patient care,” said Kelechi. “That's hard to teach people unless you can show them what it means and give them examples. I do it from my own research, and they love to see the progression.”