Category Archives: Workforce issues
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 July issue.
Nurses Lead Innovations in Geriatrics and Gerontology
As the nation becomes older and more diverse, and more people are living with chronic health problems, nurses are developing innovations in geriatric care. They are finding new ways to improve the quality of care for older adults; increase access to highly skilled health care providers with training in geriatrics; narrow disparities that disproportionately affect older minorities; avoid preventable hospital readmissions; and more. Nurse-led innovations are underway across the nation to improve care for older Americans.
Improving Care for the Growing Number of Americans with Dementia
By 2050, 16 million Americans—more than triple the current number—will have Alzheimer’s disease. RWJF Nurse Faculty Scholars are working now to get ahead of the problem. “We’re all well aware of our aging population and how we’re going to see more individuals with Alzheimer’s disease or some other form of dementia,” says alumna Elizabeth Galik, PhD, CRNP, who is researching ways to improve functional and physical activity among older adults with dementia.
The Robert Wood Johnson Foundation’s (RWJF) LEAP National Program is working to create a culture of health by discovering, documenting, and sharing innovations in the primary care workforce. To advance this goal, the program is holding a series of six webinars that highlight best practices. The first webinar addressed the responsibility of health delivery organizations to strengthen community health and the ways primary care providers can address social determinants of health. It featured leaders from four primary care sites around the country that the LEAP program has deemed exemplars.
Bringing Change to a Low-Income Community in Philadelphia
Patricia Gerrity, PhD, RN, associate dean for community programs at Drexel University and director of 11th Street Family Health Services at Drexel University, discussed the origins and work of her clinic, which is a partnership with the Philadelphia Housing Authority (PHA) that began in 1996. In response to a letter between the University and the PHA, Gerrity worked to gain mutual trust with the aim of improving the residents’ health status.
Getting started wasn’t easy, Gerrity noted. To achieve some wins, she assigned a public health nursing faculty member from Drexel to each public housing development. The nurse faculty members asked residents about pressing problems—and then became partners in solving them. For instance, residents said car accidents were an issue, so stop signs were put up. Residents wanted to learn CPR, so training was offered. Residents expressed concerns about dog bites, so they worked with Animal Control to remove stray dogs. “We had to have some short term wins to gain trust,” Gerrity said.
The Robert Wood Johnson Foundation (RWJF) today announced awards to 52 schools of nursing that will comprise the final cohort of its prestigious New Careers in Nursing Scholarship Program (NCIN). In the upcoming academic year, the schools will use these grants to support traditionally underrepresented students who are making a career switch to nursing through an accelerated baccalaureate or master’s degree program. NCIN is a program of RWJF and the American Association of Colleges of Nursing.
Each NCIN Scholar has already earned a bachelor’s degree in another field, and is making a transition to nursing through an accelerated nursing degree program, which prepares students to assume the role of registered nurse in as little as 12-18 months.
In addition to a $10,000 scholarship, NCIN scholars receive other support to help them meet the demands of an accelerated degree program. All NCIN grantee schools maintain leadership and mentoring programs for their scholars, as well as a pre-entry immersion program to help them succeed.
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.
To mark National Minority Health Month, the Human Capital Blog asked several Robert Wood Johnson Foundation (RWJF) scholars to respond to questions about improving health care for all. In this post, Paloma Toledo, MD, MPH, an assistant professor of anesthesiology at Northwestern University, responds to the question, “Minority health is advanced by combating disparities and promoting diversity. How do these two goals overlap?” Toledo is a Harold Amos Medical Faculty Development Program scholar.
Addressing racial and ethnic disparities has been a part of the national public health agenda for decades. The U.S. Department of Health and Human Services establishes national objectives to improve the health of Americans through the Healthy People program. In Healthy People 2000, one goal was to reduce racial and ethnic disparities. A decade later, the goal was revised. Currently, the goal for Healthy People 2020 is to establish health equity, eliminating disparities. Despite these goals, disparities persist, and minorities continue to suffer worse health than non-minority whites. Much work has focused on raising awareness of disparities and improving the quality of care for minority patients; however, increasing the number of minority physicians is equally important in combating health care disparities.
Health care may have some of the nation’s most promising career opportunities. But it also promises a lot of stress to go along with those jobs, according to a survey from CareerBuilder and its health-care-focused website.
Health care workers topped the list of most stressed workers in the United States, with 69 percent reporting that they feel stress in their current jobs. Next are workers in professional and business services, retail, financial services, information technology, leisure and hospitality, and manufacturing. Health care also had the highest percentage (17) of workers reporting that they are “highly stressed.”
“Stress is part of the environment in many health care settings, but high levels sustained over a long period of time can be a major detriment to employee health and ultimately stand in the way of providing quality care to patients,” CareerBuilder Healthcare President Jason Lovelace said in a news release.
Federal health care workforce and research programs will receive modest funding boosts in this fiscal year under a new omnibus spending bill cleared in January by Congress, according to a summary released by the American Association of Colleges of Nursing (AACN). The programs affect nursing and other health professions.
Under the Consolidated Appropriations Act of 2014, signed into law on Jan. 17, two health care workforce agencies are slated for increases in fiscal year 2014.
The Health Resources and Services Administration will receive $6.3 billion, an 8 percent increase over the last fiscal year, and the Bureau of Health Professions will get $469.2 million, a 7 percent increase, according to AACN. Nursing workforce development programs under Title VIII of the Public Health Service Act will get $223.8 million in fiscal year 2014, a 3 percent increase.
Taura Barr, PhD, RN, is an assistant professor at the West Virginia University School of Nursing. Timothy Landers, PhD, RN, CNP, is an assistant professor at The Ohio State University College of Nursing. Both are Robert Wood Johnson Foundation Nurse Faculty Scholars. This post is part of the “Health Care in 2014” series.
This is the time of year when people consider how they are doing with their new year’s resolutions. The three most common resolutions are lose weight, improve finances, and exercise more. Two out of three of those resolutions involve health.
Sadly, most of these resolutions will fail.
While we rate our physical, emotional, and spiritual health as a top priority, in practice we often fall short. This seems to be especially true for us as health care providers and our health care system.
Jane Kirschling, PhD, RN, FAAN, is president of the American Association of Colleges of Nursing and an alumna of the Robert Wood Johnson Foundation Executive Nurse Fellows program. This post is part of the “Health Care in 2014” series, in which health leaders, as well as Robert Wood Johnson Foundation scholars, grantees, and alumni, share their New Year’s resolutions for our health care system and their priorities for action this year.
2014 marks the 10th anniversary of the landmark study conducted by Linda Aiken, PhD, FAAN, FRCN, RN, and colleagues, which showed a strong connection between nursing education and patient outcomes. Published in the September 2004 issue of the Journal of the American Medical Association (JAMA), the study’s researchers found that patients experienced significantly lower mortality and failure to rescue rates in hospitals with higher proportions of baccalaureate-prepared nurses. In her analysis, Dr. Aiken stated that the study’s results “suggest that employers’ efforts to recruit and retain baccalaureate-prepared nurses in bedside care and their investments in further education for nurses may lead to substantial improvements in the quality of care.”
Efforts to expand the role of nurse practitioners (NPs) to help address the country’s shortage of primary care providers have been bolstered by legislation in several states. But laws expanding scope of practice may not do all they could to relieve the nation’s primary care crisis, according to a new study by researchers at the Columbia University School of Nursing, which suggests that the culture in health care settings can impede full utilization of NPs.
The study, published in the Journal of Professional Nursing, was conducted in Massachusetts, where state health reform increased demand for primary care and legislation recognized NPs as primary care providers. Researchers found that gains made by government can be neutralized by formal and informal practices at health care organizations. For example, the study cited instances where NPs were not allowed to conduct physical assessments or see new patients.
“Organizational policies can often trump governmental policies, keeping the contribution of the nurse practitioner unrecognized and preventing them from making the fullest contribution possible to effective patient care,” lead researcher Lusine Poghosyan, PhD, RN, an assistant professor of nursing at Columbia and a Robert Wood Johnson Foundation Nurse Faculty Scholar, said in a news release.