Jun 24 2014
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Nurse Leader Honored for Public Service Work

Kathy Apple, MS, RN, FAAN, is CEO of the National Council of State Boards of Nursing and an alumna of the Robert Wood Johnson Foundation (RWJF) Executive Nurse Fellows program (2006-2009). She received the Ben Shimberg Public Service Award from the Citizen’s Advocacy Center.

Kathy Apple

Human Capital Blog: Congratulations on receiving the Ben Shimberg Public Service Award from the Citizen’s Advocacy Center! What does the award mean for you and for your work at the National Council of State Boards of Nursing (NCSBN)?

Kathy Apple: It is quite an honor for both NCSBN and myself, as this recognition comes from an independent, objective organization that advocates for the public interest, effectiveness, and accountability of health care licensing bodies. It confirms that NCSBN is on the right track in supporting its members, the nurse licensing boards in the United States.

HCB: The award is named for a man who is considered the “father” of accountability in professional and occupational licensing. How are you carrying out his mission at NCSBN?

Apple: Dr. Shimberg was an expert on competency testing and challenged all licensing boards to ensure competence assessments meet the highest psychometric and ethical standards. He urged licensing boards to continuously examine how to improve testing procedures. Dr. Shimberg challenged licensing boards to improve communication to applicants and consumers, to keep data and accurate records on all board business, and be accountable for their own performance.  He advocated for licensing boards to conduct research in all aspects of regulatory functions. He encouraged collaboration between and among licensing agencies. He challenged all regulators to have and follow their own code of ethics. Dr. Shimberg really was incredibly insightful and visionary regarding the role and work of licensing boards.

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Jun 23 2014
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RWJF Milestones, June 2014

The following are among the many honors received recently by Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, grantees and alumni:

Emery Brown, MD, PhD, an alumnus of the Harold Amos Medical Faculty Development Program has been elected a member of the National Academy of Sciences.

RWJF Investigator Award in Health Policy Research recipient James Perrin, PhD, is the new president of the American Academy of Pediatrics. He took office on January 1, 2014, beginning a one-year term.

The American Association of Colleges of Nursing (AACN) has named Deborah E. Trautman, PhD, RN, as its new chief executive officer, effective June 16. Trautman, an RWJF Health Policy Fellows program alumna, currently serves as executive director of the Center for Health Policy and Healthcare Transformation at Johns Hopkins Hospital.

The American College of Physicians (ACP), the nation’s largest medical specialty organization, has voted Wayne Riley, MD, MPH, MBA, its president-elect. Riley is a former RWJF senior health policy associate.

Kenneth B. Chance, Sr., D.D.S. has been appointed dean of the Case Western Reserve University School of Dental Medicine and will begin his duties on July 1, 2014. He is an alumnus of the RWJF Health Policy Fellows program, and served on its national advisory committee. His is a current member of the national advisory committee of the RWJF Summer Medical and Dental Education Program.

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Jun 20 2014
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The DEU as a Response to the Nurse Faculty Shortage

Janet M. Banks, MSN, RNC, is an instructor and clinical faculty at the University of Portland, a recipient of the Robert Wood Johnson Foundation Evaluating Innovations in Nursing Education grant. She is working on her Doctor of Nursing Practice degree at Case Western Reserve University, with a focus on nursing clinical education.

Janet Banks

It’s no secret that there’s a serious shortage of nursing faculty in the United States. This problem will result in schools of nursing educating too few nurses to meet the growing demand for these health care professionals. One solution to this vexing problem is to increase the number of Dedicated Education Units, or DEUs, to increase faculty capacity.

Chances are good that if you are reading this blog, you know what a DEU is. But, for the sake of being on the same page, it is a collaboration between a nursing unit and an academic institution such as a school of nursing. Often referred to as an academic-service partnership, the school of nursing provides students as well as faculty who are experts in teaching. The nursing unit provides a culture that supports learning, as well as expert nurses to act as teachers.

The students, nurses, and faculty usually work in a ratio of two students to each nurse, with the faculty supporting the nurse as teacher and supporting the student’s professional development.

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Jun 19 2014
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RWJF Clinical Scholars Video Podcast: Joshua Sharfstein on Hospital Incentives

One of the challenges of health care reform is to realign financial incentives so that providers and hospitals have economic inducements to keep patients healthy, rather than just treating them when they’re ill.

In the latest Robert Wood Johnson Foundation (RWJF) Clinical Scholars Health Policy Podcast, Maryland Secretary of Health & Mental Hygiene Joshua Sharfstein, MD, discusses a hospital in Hagerstown, Md., that took charge of the local public school health program, hiring school nurses and more “because it’d be an economic winner for them.” The hospital’s economic incentives were such that, “If they did it well, and helped kids with asthma control their asthma so they didn’t need to go to the emergency room, [the hospital] would save money on ER visits,” Sharfstein explains.

Sharfstein is interviewed by Clinical Scholar Loren Robinson, MD. The video podcast is part of a series of RWJF Clinical Scholars Health Policy Podcasts, co-produced with Penn’s Leonard Davis Institute of Health Economics.

The video is republished with permission from the Leonard Davis Institute.

Jun 19 2014
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RWJF Scholars in the News: Debt and health, tax exemption controversy, peer influence on adolescent smokers, 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 the context of the Obama administration’s efforts to ease student loan debt, TIME reports on a study by RWJF Health & Society Scholars program alumna Elizabeth Sweet, PhD, that explores the toll debt takes on the borrower’s physical health. Past studies have focused on mental health issues, TIME writes, but Sweet’s research links debt not just to mental health, but also to high blood pressure and general health problems. Sweet says the problem has long-term implications. “These health issues are a warning for more health problems down the road,” she says, “so we have to think about this as a long-term phenomenon.” Forbes also highlights her research.

A Medscape story about a study that shows a direct correlation between vaccinating health care personnel against influenza and reducing cases of flu in the community quotes Mary Lou Manning, PhD, RN, CPNP, an RWJF Executive Nurse Fellows alumna. “We now actually have evidence indicating that higher health care worker vaccination rates in hospitals are having a community effect; they’re actually resulting in lower rates of influenza in the community. That’s remarkably exciting,” says Manning, who is president-elect of the Association for Professionals in Infection Control and Epidemiology. The article is available here (free login required).

Modern Healthcare reports on federal efforts to address concerns about tax exemption for certain nonprofit hospitals, citing research by Gary Young, JD, PhD, recipient of an RWJF Investigator Award in Health Policy Research. In order to obtain tax-exempt status, the Affordable Care Act requires nonprofit hospitals to track and report the charity care and community benefits they provide. Young found wide variation in the contributions of nonprofit hospitals. “The current standards and approach to tax exemption for hospitals is raising concerns about a lack of accountability for hospitals,” he says, and creating problems because “hospitals don’t really know what’s expected of them.” The Internal Revenue Service has proposed a rule to address the issue. (Free registration is required to view the article.)

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Jun 18 2014
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Quotable Quotes About Nursing, June 2014

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

“A registered professional school nurse is the only person [who] has the education, the training, and the skill level to meet the needs of kids in the schools. It’s all about what the kids need and how can they attend schools, be healthy, and learn. Health and education go together: If a child is not healthy, he can’t learn.”
--Sue Buswell, RN, director, Montana Association of School Nurses, Philadelphia Tragedy Highlights Role of School Nurses, Education Week, June 2, 2014

“I quite frankly don’t understand how a school can function without a school nurse. They really are one of the most cost-effective, unrecognized resources in our country.”
--Anne Sheetz, MPH, RN, NEA-BC, director, school health services, Massachusetts Department of Public Health, School Nurses Save, Not Cost Money, New Study Says, Philadelphia Inquirer, May 29, 2014

“And lest we forget: a heartfelt thanks to all nurses, present and past, who are or have served in the military in any capacity, in some cases losing their lives as they tried to save other lives and heal the wounded. And to their families.”
--Jacob Molyneux, BA, MFA, senior editor and blog editor, American Journal of Nursing, Memorial Day Weekend: Thanks to the Nurses Who Served, May 23, 2014

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Jun 18 2014
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Jun 17 2014
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In the Media: Summer Reading

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

Nurse history buffs have two new titles to choose from this summer reading season.

In Nurses and Midwives in Nazi Germany: The“Euthanasia Programs,” Susan C. Benedict, CRNA, PhD, FAAN, professor of nursing and ethics at the University of Texas Health Science Center in Houston, tells the harrowing tale of how ethics in nursing and midwifery were abrogated during the Nazi era. Edited by Benedict and Linda Shields, MD, PhD, BSN, professor of nursing at James Cook University in Australia, the book was published in April.

Another new history book, by author Mary Cronk Farrell, tells a heroic story of nursing during World War II. Released in February and targeted at young readers, Pure Grit: How American World War II Nurses Survived Battle and Prison Camp in the Pacific, tells the inspiring story of American Army and Navy nurses serving in the Philippines who survived three years as prisoners of war.

The bookshelves are also offering a host of new nursing memoirs, including Duty Shoes: A Nurse’s Memoir, by Camille Foshee-Mason, RN; The Last Visit: Reflections of a Hospice Nurse, by Margaret Pecoraro Dodson, RN; and Whose Death Is It, Anyway?: A Hospice Nurse Remembers, by Sharon White, RN, BSN. 

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Jun 17 2014
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Recent Research About Nursing, June 2014

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

Research Compares Nurse and Physician Prescription Practices

A newly published systematic review of more than four decades of research on nurse prescribing finds that in the U.S. states and foreign countries in which nurses are allowed to prescribe, their prescription practices are similar to those of physicians, but their patients report higher satisfaction with their care and are more likely to return for follow-up visits.

The review was conducted by a team of researchers in the Netherlands—one of several countries in which nurses may prescribe. The team screened all studies they could find on the subject dating back to 1974, finally identifying 35 studies that met their criteria, including 13 from the United States, 12 from the United Kingdom, five from the Netherlands, two from Canada, two from Norway, and one from Colombia. The studies’ methods and specific topics varied, but the team conducting the review identified a number of trends in the research. They wrote:

  • “Our findings suggest that nurses prescribe for a wide range of patients and in comparable ways to physicians. Overall, nurses appear to prescribe for just as many patients as physicians do, nurses prescribe comparable numbers of medicines per patient visit and there appear to be few differences between nurses and physicians in the type and dose of medication prescribed and in clinical outcomes.

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Jun 16 2014
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Should There Be Public Access to Data from Clinical Trials?

Michelle Mello, JD, PhD, is a professor of law and public health at the Harvard School of Public Health, and a fellow with the Edmond J. Safra Center for Ethics at Harvard University. She is a recipient of a Robert Wood Johnson Foundation Investigator Award in Health Policy Research.

Michelle Mello

For years, pharmaceutical companies have been lambasted in the media and government prosecutions for concealing information about the safety and efficacy of their products. In one particularly splashy example, GlaxoSmithKline (GSK) agreed to pay $3 billion in 2012 to settle criminal charges that it failed to report safety data concerning its antidepressant drug, Paxil, and its diabetes drug, Avandia, and engaged in unlawful marketing of these products and one other drug. One mechanism proposed for avoiding such problems is to establish a system through which participant-level data from clinical trials, stripped of identifying information about patients, would be available to the public.

A potential benefit of sharing clinical trial data would be that independent scientists could re-analyze data to verify the accuracy of reports prepared by trial sponsors, which might deter sponsors from mischaracterizing or suppressing findings. Data sharing would also allow analysts both within and outside drug companies to pool data from multiple studies, creating a powerful database for exploring new questions that can’t be addressed within any given trial because the sample is too small to support such analyses. 

The potential value of shared data in improving our understanding of the safety and efficacy of drugs, medical devices, and biologics has sparked considerable discussion about how to make data sharing happen. Earlier this year, the European Medicines Agency—the counterpart to the U.S. Food and Drug Administration (FDA) in the European Union—decided to start making data from trials of approved products available in 2014. This begs the question, should the FDA follow suit?

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