Oct 9 2014
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Hospitals Must Recruit Nurses to Their Leadership Boards

This week marks the 4th anniversary of the Institute of Medicine’s future of nursing report. David L. Knowlton is president and CEO of the New Jersey Health Care Quality Institute.

David Knowlton

Nurses truly run the front lines of hospitals. Their leadership oversees every hospital quality initiative essential to improving care—from reducing hospital-acquired infections, to cutting unnecessary readmissions, to preventing patient falls.

Poor scores in these quality measures now result in government penalties that can hit hospitals hard.

And as health care evolves and hospitals stretch beyond their own walls, nurses are leading the programs that bring health care into communities. They are critical to the success of health reform as more Americans obtain health insurance and seek primary care.

So tell me something? Why is the highest level of hospital leadership in our nation nearly devoid of nurses?

Surveys find the number of nurses with voting positions on hospital boards is about 4 to 6 percent — an unfathomable statistic for anyone who understands, even a little, how hospitals work.

We need the leadership of nurses on every hospital board.

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Oct 9 2014
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RWJF Scholars in the News: The nurse faculty shortage, teaching empathy, a link between overtime and diabetes, 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:

ABC News explores the nation’s nursing workforce shortage, focusing specifically on the faculty shortage at nursing schools. “Suddenly, we turned around and realized we’re not attracting enough nurses to go into teaching,” said Kimberly Glassman, PhD, RN, chief nursing officer at NYU Langone Medical Center. “The fear is we will have to shrink the number of nurses we can prepare for the future at a time when we need to prepare more.” Glassman is an RWJF Executive Nurse Fellow. The article was republished by Yahoo News and ABC News Radio.

RWJF Health & Society Scholars program alumnus Allison Aiello, PhD, MS, is interviewed for an NBC News story on Enterovirus D-68. She recommends that parents consider getting flu shots for their children, noting that preventing children from getting the flu should help make Enterovirus less complicated to diagnose and treat. The video is available here.

RWJF Harold Amos Medical Faculty Development Program scholar Paloma Toledo, MD, co-authors a Huffington Post blog entry on the need for medical schools to teach students to be empathetic. Over the course of their training, they become less empathetic, as opposed to more empathetic, and the reasons for this are unclear,” Toledo writes, recommending lectures on active listening and communication skills, among other measures. 

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Oct 8 2014
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Proud to be ‘The Nurse on the Board’!

This week marks the 4th anniversary of the Institute of Medicine’s future of nursing report. Fran Roberts, PhD, RN, FAAN, is owner and executive leader of the Fran Roberts Group, a consulting and contracting practice providing expertise on health care leadership, higher education, governance, regulation and patient safety. The Kate Aurelius Visiting Professor for the University of Arizona College of Medicine–Phoenix, Roberts serves on the boards of directors of several health care organizations, including the Presbyterian Central New Mexico Health System. She is an alumna of the Robert Wood Johnson Foundation (RWJF) Executive News Fellows program.

Fran Roberts

“Leadership from nurses is needed at every level and across all settings.” That’s what the Institute of Medicine’s (IOM) Future of Nursing panel wrote in its 2011 report—a message I’ve taken to heart. Here’s why the IOM was exactly right.

I’ve served (and still serve) on several health-related boards, in most cases as the only nurse in a group dominated by physicians, local business leaders, and administrators. My experience on the Presbyterian Central New Mexico Healthcare Services board, which I now chair, is both representative and instructive. I joined the board about eight years ago, recruited by one of my colleagues in the RWJF Executive Nurse Fellows program, Kathy Davis, RN, the senior vice president and chief nursing officer at Presbyterian.

It was an honor to be asked, doubly so because I live and work out of state. But Presbyterian had concluded that it needed a nurse with executive experience on its board, so I got the call.

I started my first term on the board determined not to pigeon-hole myself as “the nurse on the board.” I didn’t want my fellow board members to think I had tunnel vision, unable to see beyond the need to advocate for nurses. That’s not to say I didn’t intend to advocate for nurses when that was called for, but I didn’t want to be limited to that, either in my colleagues’ estimation or in reality.

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Oct 7 2014
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A Business Community Board Role Broadens a Nurse Leader’s Horizons

This week marks the 4th anniversary of the Institute of Medicine’s future of nursing report. Sandra McDermott, DNP, RN, NEA-BC, is an assistant professor of nursing and the director of health and service related professions at Tarleton State University in Fort Worth, Texas. A member of the Texas Team Action Coalition, which recently launched the Nurses On Board training program, she is a newly appointed member of the board of directors for the Fort Worth Chamber of Commerce South Area Council.

Sandra McDermott

I have been in my university director position for about six months now, and I knew that before I started teaching classes this fall, I had an opportunity to really get involved in the Fort Worth community. I wanted to get my name out there, because when I do that, I am getting my school’s name out there, too. I started attending Chamber events and enjoyed them, and I realized that the South Area Council is the one that encompasses the hospital district, which is where I want to have a lot of my connections.

If my role is to draw nursing students and build awareness for our nursing programs, then clearly, focusing on the hospital district makes a lot of sense. I had made a strong connection with a South Area Council board member, so I lobbied the Chamber to join the board, and they ultimately added a new spot and appointed me to it, which was very humbling. They did not have a university represented on the Council, and they saw value in having a nurse and an educator join them.

The main campus for my school is about 90 miles away. Everyone knows about our presence there, where there are around 8,600 students. But in Fort Worth, we have around 1,600 students, and the nursing programs are relatively new and very small. I knew I needed to be out in the community as we build up our programs, and what better way to do it than to be at multiple Chamber functions? And as a board member, I knew I could influence a lot more people. In the hospital district, I can go in as not only a nurse and an educator, but a Chamber leader as well. That is a great platform to advocate for my school programs and for wellness and health care as community priorities.

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Oct 6 2014
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Celebrating Four Years of Nurses Leading Change to Advance Health

Susan B. Hassmiller, PhD, RN, FAAN, directs the Future of Nursing: Campaign for Action, which is implementing recommendations from that report. Hassmiller also is senior adviser for nursing for the Robert Wood Johnson Foundation.

Susan Hassmiller

This week marks the fourth anniversary of The Future of Nursing: Leading Change, Advancing Health, the landmark Institute of Medicine (IOM) report that galvanized the nursing field and partners to participate in health system transformation. Nurses nationwide are heeding the report’s call to prepare for leadership roles at the national, state and community levels. Why?  Simply put, nurses coordinate and provide care across every setting, and they can represent the voices of patients, their families and communities. Nurses are the reality check on committees and in boardrooms.

The Future of Nursing: Campaign for Action, a national initiative led by the Robert Wood Johnson Foundation (RWJF) and AARP to implement recommendations from the future of nursing report, is promoting nursing leadership—and I’m thrilled by our progress.

To date, Action Coalitions report that 268 nurses have been appointed to boards. Virginia has implemented an innovative program to recognize outstanding nurse leaders under age 40, and several other states including Arkansas, Nebraska and Tennessee are offering similar programs. New Jersey has set a goal of placing a nurse leader on every hospital board. Texas has partnered with the Texas Healthcare Trustees to provide its nurses with governance and leadership education to prepare them for board leadership. Even better, other states are fostering nursing leadership by adopting these best practices.

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Oct 3 2014
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Meeting the Needs of Children in Partnership with Nurses and Nurse Practitioners

Sunny G. Hallowell, PhD, APRN, is a postdoctoral fellow, and Danielle Altares Sarik, MSN, APRN, a predoctoral fellow, at the Robert Wood Johnson Foundation-funded Center for Health Outcomes and Policy Research at the School of Nursing at the University of Pennsylvania. Hallowell is also a Leonard Davis Institute Fellow. Both are pediatric nurse practitioners serving on the executive board of the National Association of Pediatric Nurse Practitioners, Pennsylvania Delaware Valley Chapter. Monday, October 6, is National Child Health Day.

Sunny G. Hallowell Sunny G. Hallowell

Many Americans may not know that children born in the United States are less likely to survive to their fifth birthday than children born in other high-income peer countries. The United States falls at the bottom of the Commonwealth Fund’s recently released “Mirror, Mirror” report, ranking last out of 11 countries for infant mortality.  

As children hold the greatest potential to achieve good health, high infant and child mortality may be particularly surprising.  Early lifestyle and health care decisions can set children on a trajectory that determines their health for a lifetime.  

Danielle Altares Sarik Danielle Altares Sarik

As a country, we can do more to ensure the health of our youngest and most vulnerable population. Using nurses and nurse practitioners (NP) to the highest level of their education and training is one strategy. Robust use of nurses and NPs can offer solutions to improve infant and child survival rates through prenatal, postnatal and early childhood health surveillance. 

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Oct 3 2014
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Recent Research About Nursing, October 2014

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

Study: California’s Mandatory Nurse-Patient Ratio Law Reduces Work-Related Injuries

A 2004 California law mandating specific nurse-to-patient staffing standards in acute care hospitals has significantly reduced job-related injuries and illnesses for nurses, according to a study published online by the International Archives of Occupational and Environmental Health.

A team of researchers from the Schools of Medicine and Nursing at the University of California, Davis used data from the U.S. Bureau of Labor Statistics to compare illness and injury rates in California and other states before and after the law’s implementation. The data documented a downward trend nationwide, but also found that California’s workplace injury and illness rate declined even faster than the national rate.

In California, the researchers estimated that the law resulted in an average decline from 176 to 120 injuries and illnesses per 10,000 registered nurses—a 32-percent reduction. For licensed practical nurses, the rate went from 244 injuries to 161 per 10,000—a 34-percent reduction.

Lead author J. Paul Leigh, PhD, speculated in a news release that having more nurses available to help with repositioning patients in bed could help prevent back and shoulder injuries. Similarly, needle-stick injuries could be less common because nurses now conduct blood draws and other procedures in a less time-pressured manner.

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Oct 2 2014
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In the Media: New Annual Event Honors Federal Nurses

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

Every May, the news media zooms in on nurses during National Nurses Week, held the second week of the month in honor of Florence Nightingale’s birthday.

Now, nurses are getting another turn in the media spotlight—but this time in September.

Or at least that’s the goal of Federal Nurses Week, a new annual event held in recognition of the nation’s 100,000 federally employed nurses. The event, held this year between Sept. 22 and Sept. 28, is sponsored by the American Federation of Government Employees (AFGE). J. David Cox, RN, national president of AFGE, is a nurse and also serves on the national executive board of the AFL-CIO.

During the week, supporters were encouraged to host an event to recognize a federal nurse or nurses and spread the word about the importance of federal nurses through posts to social media sites or letters to the editor of newspapers or other publications. AFGE is also urging Congress to pass a resolution recognizing the federal nurse workforce.

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Oct 2 2014
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RWJF Scholars in the News: Autism and birth order, nurse staffing and underweight infants, long-term care insurance, 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:

There is an increased risk of Autism Spectrum Disorders (ASD) among children born less than one year or more than five years after the birth of their next oldest sibling, Forbes reports. The study, led by RWJF Health & Society Scholars program alumna Keely Cheslack-Postava, PhD, MSPH, analyzed the records of 7,371 children born between 1987 and 2005, using data from the Finnish Prenatal Study of Autism. About a third of the children had been diagnosed with ASD by 2007. Researchers found that the risk of ASD for children born less than 12 months after their prior sibling was 50 percent higher than it was for children born two to five years after their prior sibling. “The theory is that the timing between pregnancies changes the prenatal environment for the developing fetus,” Cheslack-Postava said. 

The health outcomes and quality of care for underweight black infants could greatly improve with more nurses on staff at hospitals with higher concentrations of black patients, according to a study funded by RWJF’s Interdisciplinary Nursing Quality Research Initiative (INQRI). The study, led by Eileen Lake, PhD, RN, FAAN, found that nurse understaffing and practice environments were worse at hospitals with higher concentrations of black patients, contributing to adverse outcomes for very low birthweight babies born in those facilities, reports Health Canal. More information is available on the INQRI Blog. The study was covered by Advance Healthcare Network for Nurses, among other outlets.

Because of a “medical-industrial complex” that provides financial incentives to overuse and fragment health care, patients nearing the end of their lives need an advocate to fight for their interests, Joan Teno, MD, MS, writes in an opinion piece for the New York Times. Teno encourages readers to “find a family member or friend who can advocate for the health care that you want and need. Find someone to ask the hard questions: What is your prognosis? What are the benefits and risks of treatments? Find someone not afraid of white coats.” Teno is an RWJF Investigator Award in Health Policy Research recipient. 

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Oct 1 2014
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New Journal Covers Emerging Field of Health Economics

Deborah Haas-Wilson, PhD, is a visiting professor of public policy at the John F. Kennedy School of Government at Harvard University and a member of the editorial board of the forthcoming American Journal of Health Economics. In 1994, she received a Robert Wood Johnson Foundation (RWJF) Investigator Award in Health Policy Research to study antitrust policy and the transformation of health care markets.

Deborah Haas-Wilson

Human Capital Blog: Congratulations on your appointment to the editorial board of the American Journal of Health Economics. Can you tell us about the journal’s mission?

Deborah Haas-Wilson: I am very pleased to be serving on the editorial board of the American Journal of Health Economics (AJHE), along with many distinguished health economists, including Frank Sloan, PhD, who is the editor-in-chief.

A little about the AJHE: The plan is to publish quarterly with the first issue scheduled for the winter of 2015. The mission of the AJHE is to provide a forum for theoretical and empirical analyses of health care systems and health behaviors.

HCB: What topics will the AJHE cover?          

Haas-Wilson: Topics of particular interest include the impact of the Accountable Care Act, pharmaceutical regulation, the supply of medical devices, the increasing obesity rate, the influence of an aging and more diverse population on health care systems, and competition and competition policy in the markets for hospital services, physician services, pharmaceuticals and health care financing.

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