Category Archives: Interdisciplinary Nursing Quality Research Initiative

Jun 30 2014
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Sharing Nursing’s Knowledge: The June 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 related to academic progression, leadership, and other essential nursing issues. Following are some of the stories in the June 2014 issue.

Campaign for Action Is Chalking Up Successes that Will Improve Patient Care
Three years after it launched, the Future of Nursing: Campaign for Action is making steady progress on nurse education, practice, interprofessional collaboration, data collection, and diversity, according to a series of indicators released last month. Led by RWJF and AARP, the Campaign has created Action Coalitions in all 50 states and the District of Columbia that are working to implement recommendations from the Institute of Medicine. “Because of the Campaign, there’s more awareness about the importance of preparing the nursing workforce to address our nation’s most pressing health care challenges: access, quality, and cost,” says RWJF Senior Program Officer Nancy Fishman, MPH.

Pioneering Nurse Scientist Addresses Asthma-Related Disparities
Kamal Eldeirawi
, PhD, RN, a pioneering scientist with expertise in immigrant health, was born in the Gaza Strip in Palestine, where he saw the profound impact of poverty and disadvantage on health in his own community. A career in nursing, the RWJF Nurse Faculty Scholar believed, would allow him to make a difference at both the individual and population-wide levels. Today, Eldeirawi, is researching risk factors that contribute to asthma in Mexican American children living in the United States, and the effects of immigration and acculturation on children’s health.

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May 27 2014
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When It Comes to Cost and Quality of Hospital Care, Nurse Tenure and Teamwork Count

The largest study to examine the relationship between nurse staffing and patient care reveals that patients get the best care when they are treated in hospital units staffed by teams of nurses who have extensive experience in their current jobs. The study, conducted by an interdisciplinary team including Patricia Stone, PhD, RN, FAAN, Centennial Professor of Health Policy at the Columbia University School of Nursing and Ciaran Phibbs, PhD, research economist at the Health Economics Resource Center at the Palo Alto Veterans Administration Health Care System, was funded by the Interdisciplinary Nursing Quality Research Initiative (INQRI).

The research team reviewed more than 900,000 patient admissions over four years (from 2003 through 2006) at hospitals in the Veterans Administration Health Care System. They analyzed nurses’ payroll records and patients’ medical records to see how nurse staffing affected patients’ length of stay. Longer hospital stays tend to be associated with delays and errors in care delivery, so shorter stays indicate better care. Shorter stays also reduce the cost of care.

Researchers found that a one-year increase in the average tenure of registered nurses (RNs) on a hospital unit was associated with a 1.3 percent decrease in the average length of stay.

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May 5 2014
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Sharing Nursing’s Knowledge: The April 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. Following are some of the stories in the April issue.

Consumers Benefit from Expanded APRN Practice, FTC Says
In March, the Federal Trade Commission (FTC)—the government agency that works to protect consumers and prevent anti-competitive business practices—released Policy Perspectives: Competition and the Regulation of Advanced Practice Nurses. It warns that barriers to advanced practice registered nurse (APRN) practice could reduce the kind of free-market competition in the health care industry that benefits consumers. The report also says APRNs play a “critical role” in alleviating shortages of primary care providers.

Building a Community of Nurse Scientists
Ann Cashion, PhD, RN, FAAN, has been hooked on the promise and potential of genetics and genomics in nursing since the first survey of the human genome was completed in 2000. She participated in the inaugural cohort of the Summer Genetics Institute at the National Institute of Nursing Research (NINR), and it changed the trajectory of her career. Now, 14 years later, Cashion is NINR’s newly appointed scientific director. She is also an alumna of the RWJF Executive Nurse Fellows program.

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Mar 12 2014
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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.

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Mar 6 2014
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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.

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Feb 6 2014
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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.”

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Jan 28 2014
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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.  

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Jan 9 2014
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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.

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Dec 5 2013
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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.

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Dec 4 2013
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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.

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