Category Archives: Interdisciplinary Nursing Quality Research Initiative

Mar 12 2014
Comments

Recent Research About Nursing, March 2014

This is part of the March 2014 issue of Sharing Nursing’s Knowledge.

Comparing Nurse and Physician Performance on Colonoscopies

A new study finds that colonoscopies performed by nurse and physician endoscopy trainees are comparable in terms of quality and safety.

Researchers in The Netherlands studied 15 endoscopy trainees—seven nurses and eight physicians—at two medical centers over the course of three-and-a-half years. At the beginning of the study, none had experience in endoscopy. All were trained according to the applicable regulations of the Dutch Society of Gastroenterology, performing a minimum of 100 colonoscopies. After completing their training, each performed 135 consecutive colonoscopies under the supervision of a gastroenterologist, with their work evaluated for safety and quality.

The nurse group and the physician group had comparable results on both measures, with the nurse group producing marginally better scores in some areas. Each group detected the same percentage of adenomas (benign polyps), and had the same low rate of complications. The nurses had slightly higher rates of cecal intubation (successfully passing the colonoscope to a key part of the colon), and slightly higher rates of completing the procedure without assistance.

Read More

Mar 6 2014
Comments

RWJF Scholars in the News: Nurse staffing and patient mortality, communicating about vaccines, specialized HIV training for NPs, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

A study led by Linda H. Aiken, PhD, FAAN, FRCN, RN, and covered by CNN.com, finds that hospital nurse-patient ratios and the share of nurses with bachelor’s degrees both have an important impact on patient mortality. Aiken, a research manager supporting the Future of Nursing: Campaign for Action and a member of the RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) National Advisory Committee, found that increasing a hospital nurse’s workload by one patient increased by 7 percent the likelihood of an inpatient death within 30 days of admission. The same research revealed that a 10-percent increase in the number of nurses with bachelor’s degrees at a given hospital reduces the likelihood of a patient death by 7 percent. Aiken’s study has also been covered by the Guardian, Philly.com, and FierceHealthcare, among other outlets.

Public health messages aimed at boosting childhood vaccination rates may be backfiring, according to a new study led by RWJF Scholars in Health Policy Research alumnus Brendan Nyhan, PhD. Campaigns that use studies, facts, and images of ill children increased fears about vaccine side-effects among some parents, NBC News reports. In fact, messaging that debunked myths about links between vaccines and autism actually made parents less inclined to have their children inoculated. Time magazine online also covered the study.

The Johns Hopkins University School of Nursing has developed a new curriculum that provides specialized HIV training to nurse practitioners, with funding from the Health Resources and Services Administration, Medical Xpress reports. “The design of our program starts with the recognition that HIV care cannot be provided in a silo, that it needs to be integrated holistically into primary care," RWJF Nurse Faculty Scholar Jason Farley, PhD, MPH, said in a statement. Farley is the developer of the curriculum.

Read More

Feb 6 2014
Comments

Human Capital News Roundup: Avoiding aneurysms, healthy food, gun safety, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

In a Huffington Post Latino Voices blog, Harold Amos Medical Faculty Development Program alumna Paloma Toledo, MD, discusses obesity among Hispanic Americans and how parents can influence children’s behavior, particularly regarding physical activity. She also flags influences that impede efforts to improve health for Hispanic youth: “In the U.S., food advertising on Spanish-language television is more likely to promote nutritionally-poor food than English-language advertising, hindering Hispanic children.”

During months when low-income individuals have access to Earned Income Tax Credit benefits, they spend more on healthy food, according to a study by RWJF Scholars in Health Policy Research alumna Diane Whitmore Schanzenbach, PhD. The study suggests that people with low incomes also buy more healthy food when their income increases, reports the Wall Street Journal Real Time Economics blog.

Health care professionals could make a vital contribution to educating children about the dangers of gun-related injuries, according to a study by RWFJ Clinical Scholar John Leventhal, PhD. He told Fox News: “Pediatricians and other health care providers can play an important role in preventing these injuries through counseling about firearm safety, including safe storage.”

Read More

Jan 28 2014
Comments

Sharing Nursing’s Knowledge: The January 2014 Issue

Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the foundation’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. These are some of the stories in the January issue:

Patients Slowly Gaining Access to Care Provided by Advanced Practice Registered Nurses
In recent years, several states have taken steps to ease restrictions on advanced practice registered nurses (APRNs), indicating that efforts to empower them and improve patient access to care are picking up steam. However, many consumers still lack unfettered access to care provided by APRNs because two-thirds of states do not allow them to practice without physician supervision—and even in states that do, APRNs aren’t always able to practice independently.

Stronger Primary Care System Is Goal of RWJF Scholar
RWJF Executive Nurse Fellow Margaret Flinter, PhD, APRN, has been at the center of three movements: community-oriented primary care, the growth of the community health center movement, and the growth of nurse practitioners as primary care providers. She founded the country’s first formal post-graduate residency training program for new nurse practitioners, and co-directs The Primary Care Team: Learning from Effective Ambulatory Practices, a national project supported by RWJF that is working to help health care organizations develop and accelerate innovations.  

Read More

Jan 9 2014
Comments

Guide to Nursing’s Role in Care Coordination

A new guide, Care Coordination: The Game Changer—How Nursing Is Revolutionizing Quality Care, explores how care coordination is positioned in the context of health reform. It was published by the American Nurses Association (ANA).

Care coordination has long been an integral part of nursing practice, the ANA said in a news release, with registered nurses leading the way in designing and delivering successful team-based care coordination programs that improve patient care and reduce costs. In the book, editor Gerri Lamb, PhD, RN, FAAN, and 23 leaders in care coordination explore topics including:

  • A historical perspective on nursing and quality care;
  • The role of care coordination in quality and safety;
  • Models and tools for improving quality and safety;
  • The role of nurse leaders in advancing care coordination;
  • The care coordinator’s role in reducing avoidable hospital stays;
  • Partnering with patients and families for better outcomes; and
  • Community-based care transitions.

Read More

Dec 5 2013
Comments

Joint Commission Guidelines for Preventing Bloodstream Infections Emphasize Role of Nurses

Guidelines and a toolkit released this week by the Joint Commission highlight the key role nurses play in preventing central line-associated bloodstream infections (CLABSIs). CLABSIs are among the most deadly and costly hospital-associated infections, accounting for 31,000 deaths annually and costing the health system an estimated $9 billion. Studies funded by the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative (INQRI) revealed that nurses can play a key role in preventing these infections.

Patricia Stone, PhD, MPH, RN, FAAN, a principal investigator for an INQRI-funded study on the impact of nurse staffing, skill mix, and experience on quality and costs in long-term care, contributed to the new guidelines.  Stone is the Centennial Professor of Health Policy in Nursing at Columbia University School of Nursing.

Read More

Dec 4 2013
Comments

The Importance of Nursing in Achieving the “Best Care at Lower Cost”

Richard C. Lindrooth, PhD, is an associate professor at the University of Colorado Anschutz Medical Campus. Olga Yakusheva, PhD, is an associate professor of economics at Marquette University. Both are grantees of the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative.

file Richard C. Lindrooth

The Institute of Medicine (IOM) released the findings of its Committee on the Learning Health Care System in America in a report entitled “Best Care at Lower Cost: The Path to Continuously Learning Health Care in America[i] in September, 2012. The report recognized that the complexity of clinical decision-making is rapidly increasing and that clinicians need to continuously update their skills in order to keep up with (1) rapidly expanding diagnostic and treatment options and (2) the increasingly complex and chronic clinical condition of patients.  Given the growing external demands placed on nurses, the IOM reports that a critical determinant of the success of an organization in dealing with these demands is how “a learning health care organization harnesses its internal wisdom—staff expertise, patient feedback, financial data, and other knowledge—to improve its operations.”

file Olga Yakusheva

Nurses in particular are in an excellent position to play a central role in creating a virtuous feedback loop such that it is feasible to continuously adjust and incrementally improve systems in response to rapidly changing external demands.  The report, supported by the results of a growing and increasingly robust body of academic research, stresses the important role of leadership and management in fostering and maintaining an environment within which continuous learning could take hold.

Read More

Nov 25 2013
Comments

Bold Actions Lead to Decisive Change: The Future of Nursing Scholars Program

Heather J. Kelley, MA, is deputy director of the Robert Wood Johnson Foundation’s (RWJF) Future of Nursing Scholars program. Prior to this role, she was the program associate for RWJF’s Interdisciplinary Nursing Quality Research Initiative and a former vice president in a political advertising firm.

file

Three years ago, the Initiative on the Future of Nursing at the Institute of Medicine (IOM) set a revolution in motion with the release of The Future of Nursing: Leading Change, Advancing Health report. Among the bold recommendations offered in the report was the call to double the number of nurses with doctoral degrees by 2020.

RWJF recognizes the valuable contributions that PhD-prepared nurse scientists and researchers make in the lives of patients and families. Their discoveries have the potential to change our health care system. However, as the IOM report suggested, we do not have nearly enough doctorally prepared nurses seeking new solutions to ongoing problems. Currently, less than 1 percent of the nursing workforce has a doctoral degree in nursing or a related field.

Read More

Nov 15 2013
Comments

Promoting Rigorous Interdisciplinary Research and Building an Evidence Base to Inform Health Care Learning, Practice, and Policy

file

By Mary D. Naylor, PhD, RN, FAAN, Marian S. Ware Professor in Gerontology, director of the NewCourtland Center for Transitions and Health at the University of Pennsylvania School of Nursing, and co-director of the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative. This commentary originally appeared on the Institute of Medicine website.

The Institute of Medicine (IOM) established the Roundtable on Value & Science-Driven Health Care to accelerate the advancement and application of science to achieve the best possible health and health care outcomes and value for Americans. The work of the roundtable is predicated on the notion that our health care system must continuously learn from rigorous evidence in order to innovate and improve. To that end, it acknowledges and promotes the importance of identifying best practices in health and health care, developing and testing innovations, and—most importantly— promoting collaborative efforts.

This vision for improving health and health care is shared by the Robert Wood Johnson Foundation, which funds an innovative and unique initiative to improve patient care by examining the role nurses play in improving care quality: the Interdisciplinary Nursing Quality Research Initiative (INQRI). Mark Pauly of the University of Pennsylvania and I have had the great privilege of serving as co-directors of this program since its inception in 2005.

Read More

Oct 31 2013
Comments

Human Capital News Roundup: The cost of disposable diapers, toxins in fish, fast food calories, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

WNYC in New York City broadcast an interview with RWJF Community Health Leader Joanne Goldblum about families reusing disposable diapers due to economic hardship. Goldblum, who is founder and executive director of the National Diaper Bank Network, conducted a study that shows how the practice leads to a range of problems for families living in poverty.

When it comes to digital health and new ways to deliver care, the focus should be on the consumer and improving outcomes, not on the technology, according to experts at a recent Connected Health Symposium in Boston, Massachusetts. Mobile Health News reports that Propeller Health (formerly Asthmapolis) CEO David Van Sickle, PhD, MA, an RWJF Health & Society Scholars alumnus, pressed for greater emphasis on outcomes.  Read more about Van Sickle’s work here and here.

An American Thoracic Society panel of experts, including RWJF Interdisciplinary Nursing Quality Research Initiative (INQRI) grantee Richard Mularski, MD, is calling for better care for those who suffer severe shortness of breath due to advanced lung and heart disease. The Annals of the American Thoracic Society reports that the panel recommends patients and providers develop individualized actions plans to keep episodes from becoming emergencies, Medical Xpress reports.

Read More