Category Archives: Nurses

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 1 2014
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Quotable Quotes About Nursing, October 2014

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

“I’ve learned over the last couple of years, as my mother came to rely more on nursing assistance at home for daily tasks, that health care is all about what happens between people. It’s the relationship of trust between the patient and family members and a universe of medical professionals. Nowhere is the relationship more vital than between patient and nurse.

Nurses are the front line of care. Doctors parachute into our world and we into theirs, but nurses stay on the ground from crucial moment to moment.”
--Marsha Mercer, independent journalist, They Put the ‘Care’ in Health Care, The (Lynchburg, Va.) News & Advance, Sept. 28, 2014

“Unfortunately, due to the culture of the health care industry, nurses have usually taken a back seat to physicians and administrators when it comes to changing the policies and practices of optimizing care. However, there is a wealth of evidence that points to the vital and increasing leadership role nurses are taking in health care practices around the country.  ... The message to hospital administrators should be clear—if you’re looking to improve the quality of care and reduce costs, try talking to the people working on the front lines every day—talk to a nurse.”
--Rob Szczerba, PhD, MS, CEO of X Tech Ventures, Looking to Transform Healthcare? Ask a Nurse, Forbes, September 23, 2014

“I’ve been a nurse for 25 years and love what I do. But when we are forced to work overtime, it adds unnecessary stress, frustration and fatigue that can impair your ability to function at your best. You can’t think straight when you’ve been working 16 hours.”
--Terri Menichelli, Nurse., State Auditor Will Look into Health Care Overtime Law, The Citizen’s Voice (Wilkes-Barre, Pennsylvania), Sept. 19, 2014 

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Sep 30 2014
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Building the Optimal Primary Care Team

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. Summaries of the first two webinars in the series are available here and here. The third webinar in the series focused on building an effective primary care team. Speakers included leaders from three primary care sites around the country that the LEAP program has deemed exemplars.

LEAP Director Ed Wagner, MD, MPH, began the webinar by framing the question for participants: Patients need multiple forms of contact across a primary care team, he observed. Given that, how does an organization build an effective team? How does an organization go from a collection of employees to a coherent, high-functioning team?

Charles Burger, MD, Medical Director Emeritus at Martin’s Point Health Care in Bangor, Maine, discussed the importance of recruitment and training.

He began by describing the members of Martin’s Point’s teams:  a medical provider, practice administrator, collaborative care nurses, medical assistants, and care team patient service representatives.

The recruiting process is quite rigorous, he explained. “We invite the whole team in reviewing and selecting new team members,” he said. “Really what we are looking for are certain behavioral characteristics.” He said training is similarly rigorous: a six- to eight-week competency-based training period for each new team member, working one-on-one with a trainer and moving steadily through a number of modules. Each new team member moves through each module at his or her own pace, and move on when they demonstrate competence with the material in each module. 

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Sep 30 2014
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Sharing Nursing’s Knowledge: The September 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 September issue.

Advocates Work to Recruit Latinos to Nursing
Latinos comprised only 3 percent of the nation’s nursing workforce in 2013, according to a survey by the National Council of State Boards of Nursing and the National Forum of State Workforce Centers, and 17 percent of the nation’s population, according to the U.S. Census Bureau. More Latino nurses can help narrow health disparities, experts say. “Having a culturally competent nurse really makes a difference in terms of compliance and patient outcomes,” said Elias Provencio-Vasquez, PhD, RN, FAAN, FAANP, an RWJF Executive Nurse Fellows program alumnus. “Patients really respond when they have a provider who understands their culture.”

New Careers in Nursing Program Helps Minnesota College Expand and Diversify While Improving Care in Rural Communities
Since its 2008 launch, the RWJF New Careers in Nursing program (NCIN) has kept a tight focus on attracting a diverse group of “second-career” students to nursing. Along the way, NCIN has had a profound effect on many of the institutions themselves. One such school, the College of St. Scholastica (CSS), saw its overall program change and grow substantially, in great measure because of its participation. NCIN has supported scholarships to 40 CSS accelerated-degree nursing students over the last seven years.

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Sep 25 2014
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RWJF Scholars in the News: Unintended consequences of shorter ER wait times, Ebola response, vaccinations 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:

Policies aimed at shortening emergency departments waiting times may have unintended consequences, including unnecessary admission of patients who might be better off being discharged, RWJF Physician Faculty Scholars alumna Renee Hsia, MD, MSc, tells Health Day. Hsia published two research letters in JAMA Internal Medicine on emergency wait times at urban and rural hospitals. RWJF Clinical Scholar alumnus Jeremiah Schuur, MD, MHS, author of an accompanying editorial, seconds Hsia’s concerns. “Medicare started advertising waiting times at ERs about a year ago. And that will be a strong incentive for hospitals to work on and improve their waiting times...[h]owever, some of the hospitals with longer waiting times, like teaching hospitals, care for the most complex patients who often don’t have access to regular care. And these places are, by nature and necessity, going to have longer waiting times,” he warned. The article was republished by U.S. News & World Report and Health.com, among other outlets.

CBS Detroit interviews Howard Markel, MD, PhD, FAAP, recipient of an RWJF Investigator Award in Health Policy Research, for a story on President Obama’s decision to send American troops and medical and logistical support to Africa to stop Ebola from spreading. “It is a humanitarian gesture,” Markel said. “I applaud the president for doing it. Do I wish as a physician and an epidemiologist it was done earlier? Yes, of course.” Markel says he does not expect the virus to spread to the United States. He is also quoted in the New Republic and Politico.

In an op-ed for the New York Times, Jason Karlawish, MD, explores the balance between risk-avoidance and enjoying life as we age. Noting that 3.6 percent of the population is 80 or older, he writes that as Americans age, “life is heavily prescribed not only with the behaviors we should avoid, but the medications we ought to take.” Aging in the 21st century is all about risk reduction, but “[w]e desire not simply to pursue life, but happiness” and “medicine is important, but it’s not the only means to this happiness,” Karlawish writes. National investment in communities and services that improve the quality of our aging may be one answer, he adds. Karlawish is a recipient of an RWJF Investigator Award in Health Policy Research.

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Sep 23 2014
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Are Simulators as Effective for Nursing Students as Actual Clinical Experience?

In the last 15 years, the availability of high-fidelity simulation has slowly begun to transform the clinical education of the nation’s nursing students. Schools that once relied on the combination of classroom education and hands-on experience in a clinical environment began to mix in time in a simulation lab, where nursing students could work with highly sophisticated mannequins able to display a range of symptoms and react in real-time to treatment.

Such simulation labs offer many advantages to nurse educators, including the ability to replicate a range of patient situations, thus allowing students to practice specific nursing skills without having to practice their budding skills on actual patients.

But how effective are simulators at training the next generation of nurses? That’s a question that the National Council of State Boards of Nursing (NCSBN) has a particular interest in answering, because the state boards it represents are asked with increasing frequency to permit nursing schools to replace on-the-ground clinical time with simulation.

In pursuit of an answer, NCSBN conducted a full-scale study, tracking 666 nursing students for two academic years, beginning in Fall 2011, and then for six months longer as they began their work in the nursing profession. During their nursing school experience, one-quarter of the students had traditional clinical experiences with no simulation, another quarter had 25 percent of their clinical hours replaced by simulation, and the remaining half had 50 percent of their clinical hours replaced by simulation. At various points during their training and subsequent work as nurses, all study participants were assessed for clinical competency and nursing knowledge.

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Sep 18 2014
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RWJF Scholars in the News: Antibiotic overuse, sexual assault nurse examiners, diaper banks, 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:

RWJF Investigator Award in Health Policy Research recipient Anthony So, MD, MPA, co-authors a piece in the News & Observer (Raleigh, North Carolina) about the need to reduce the overuse of antibiotics, in both humans and animals. Overuse accelerates the development of antibiotic-resistant bacteria. The Centers for Disease Control and Prevention estimates that half of human antibiotic use and much animal antibiotic use is unnecessary, the article says. So calls for public policies that create incentives for farmers to decrease use of antibiotics and that limit antibiotic use in animals to disease treatment, rather than growth-promotion or as a substitute for hygiene and infection-control.

In Chicago, most children with asthma or food allergies do not have a health management form on file at school, leaving their schools without information they might need in emergencies, according to a study by RWJF Physician Faculty Scholars alumna Ruchi Gupta, MD, MPH that was covered by Reuters Health. Researchers analyzed 2012-13 school year data on more than 400,000 Chicago schoolchildren, including 18,287 with asthma and 4,250 with a food allergy. Only a quarter of the asthmatic students and half of those with a food allergy had a health management plan on file. The study was also covered by The Chicago Tribune, Fox News, The Baltimore Sun, and Red Orbit, among other outlets.

RWJF Nurse Faculty Scholars alumna Angela Frederick Amar, PhD, RN, FAAN, publishes an op-ed on Talking Points Memo about the report from the White House Task Force to Protect Students from Sexual Assault, Not Alone. Amar notes that effective response to campus sexual assault should include medical care for survivors, and that Sexual Assault Nurse Examiners (SANEs) are trained to tend to the medical and emotional needs of survivors and collect forensic evidence. In other institutions with high rates of sexual violence, such as the military, SANEs are considered an essential part of treatment for victims of sexual violence, Amar writes.

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Sep 16 2014
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Inaugural Cohort of 16 Future of Nursing Scholars Announced

The new Future of Nursing Scholars program has announced its first cohort of 16 nurse scholars who are receiving scholarships and other support as they pursue PhDs in nursing. The students were selected by schools of nursing that have received grants to provide those scholarships.

Each Future of Nursing Scholar will receive financial support, mentoring and leadership development over the three years of her or his PhD program. They are in the initial stages of selecting the topics for their doctoral research, which range from infection control in the elderly population to the impact of stigma on people with mental illness to the quality of life of children with implanted defibrillators.

In addition to the Robert Wood Johnson Foundation, United Health Foundation, Independence Blue Cross Foundation, Cedars-Sinai Medical Center and the Rhode Island Foundation are supporting the Future of Nursing Scholars grants to schools of nursing this year. The program is located at the University of Pennsylvania School of Nursing.

Read more about the first cohort of Future of Nursing Scholars.

Schools of nursing with research-focused PhD programs can apply to join the program here.