Category Archives: Nurses

Mar 31 2014
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Developing New Partners: The Future of Nursing Scholars Program

Susan B. Hassmiller, PhD, RN, FAAN, is co-director of the Future of Nursing Scholars Program and senior adviser for nursing for the Robert Wood Johnson Foundation (RWJF). The Future of Nursing Scholars program’s call for proposals will close on April 15. It is open to schools of nursing with research-focused PhD programs. The schools that receive awards will select the scholars to support.

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I started my nursing career at a community college. It was a terrific experience that left me as prepared as I could be for my beginning staff nurse role. I quickly discovered that I wanted and needed to know more, however, so I returned to school. Over the next several years, I earned a PhD in nursing administration and health policy. It was difficult but incredibly rewarding and has led to a career I could never have imagined when I started out, including serving as a faculty member at the University of Nebraska and George Mason University. That experience has made me want to “pay it forward”—to pay homage to the nurses who mentored and encouraged me on my journey.

Serving as co-director of the Future of Nursing Scholars program is part of my personal mission to help other nurses who want to follow the same path. It also is a big part of RWJF’s extraordinary, long-term support for the nursing profession, which advances the Foundation’s mission to improve health and health care, and build a culture of health in this country.   

Supporting nurses seeking PhD degrees is tremendously important. Because nurses have vast experience working directly with patients and families, we are positioned to help make care safer, more accessible, and higher quality. In particular, PhD-prepared nurse scientists and researchers are in a unique position to identify solutions that make a real difference to patients and families. But, as the Institute of Medicine (IOM) noted in its landmark report, The Future of Nursing: Leading Change, Advancing Health, the country will need many more PhD-prepared nurses in coming years.

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Mar 27 2014
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One in Five Health Care Facilities Falling Short on Hand Sanitizer

In a time of progress against hospital-acquired infections, a new nurse-led study offers a reminder of the work that remains to be done. The study finds that approximately one in five U.S. health care facilities fails to place alcohol-based hand sanitizer at every point of care, missing an opportunity to prevent the spread of infectious diseases.

A research team jointly led by Laurie Conway, RN, MS, CIC, a PhD student at the Columbia University School of Nursing, and Benedetta Allegranzi, MD, of the World Health Organization (WHO), surveyed compliance with WHO hand-hygiene guidelines at 168 facilities in 42 states and Puerto Rico. Just over 77 percent reported that alcohol-based sanitizer was continuously available at every point of care. They also found that only about half of the hospitals, ambulatory care, and long-term care facilities had allocated funds for hand-hygiene training.

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Mar 27 2014
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RWJF Scholars in the News: Cultural barriers to care, medical conspiracies, parenting, 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 Talking Points Memo opinion piece, Harold Amos Medical Faculty Development Program alumna Paloma Toledo, MD, MPH, writes that while the Affordable Care Act holds the promise of greatly increasing access to care, language and cultural barriers could still stand between Hispanic Americans and quality care. Toledo’s research into why greater numbers of Hispanic women decline epidurals during childbirth revealed that many made the choice due to unfounded worries that it would leave them with chronic back pain or paralysis, or that it would harm their babies. “As physicians, we should ensure that patients understand their pain management choices,” she writes.

More than one in three patients with bloodstream infections receives incorrect antibiotic therapy in community hospitals, according to research conducted by Deverick J. Anderson, MD, an RWJF Physician Faculty Scholars alumnus. Anderson says “it’s a challenge to identify bloodstream infections and treat them quickly and appropriately, but this study shows that there is room for improvement,” reports MedPage Today. Infection Control Today, FierceHealthcare, and HealthDay News also covered Anderson’s findings.

People’s health and wellness can be linked to their zip codes as much as to their genetic codes, according to an essay in Social Science and Medicine co-authored by Helena Hansen, MD, PhD. As a result, Hansen argues, physicians should be trained to understand and identify the social factors that can make their patients sick, HealthLeaders Media reports. Hansen is an RWJF Health & Society Scholars alumna.

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Mar 25 2014
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Sharing Nursing’s Knowledge: The March 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 March issue.

Nurses Need Residency Programs Too, Experts Say
Health care experts, including the Institute of Medicine in its report on the future of nursing, tout nurse residency programs as a solution to high turnover among new graduate nurses. Now, more hospitals are finding that these programs reduce turnover, improve quality, and save money. Success stories include Seton Healthcare Family in Austin, Texas, which launched a residency program to help recent nursing school graduates transition into clinical practice. Now, three out of four new graduate nurses make it to the two-year point, and five or six new nurse graduates apply for each vacant position.

Iowa Nurses Build Affordable, Online Nurse Residency Program
Some smaller health care facilities, especially in rural areas, cannot afford to launch nurse residency programs to help new nurses transition into clinical practice. A nursing task force in Iowa has developed an innovative solution: an online nurse residency program that all health care facilities in the state—and potentially across the country—can use for a modest fee. The task force was organized by the Iowa Action Coalition and supported by an RWJF State Implementation Program grant.

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Mar 20 2014
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Oncologist Shortage Could Put Cancer Care in Critical Condition by 2025

Nearly 450,000 new cancer patients are likely to have difficulty accessing oncology care in just over a decade, according to a report, “The State of Cancer Care in America: 2014,” released this month by the American Society of Clinical Oncology (ASCO).

The report is described by ASCO as the first-ever comprehensive assessment of challenges facing the U.S. cancer care system. It projects that new cancer cases could increase by 42 percent by 2025, but the number of oncologists will likely grow by only 28 percent, creating a deficit of nearly 1,500 physicians.

“We’re facing a collection of challenges, each one of which could keep cancer treatment advances out of reach for some individuals,” ASCO President Clifford A. Hudis, MD, FACP, said in a news release. “Collectively, they are a serious threat to the nation’s cancer care system, which already is straining to keep up with the needs of an aging population.”

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Mar 20 2014
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RWJF Scholars in the News: ADHD medication, reconstruction after mastectomy, care for returning veterans, 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:

NBC News reports on a surge in the number of young adult women taking ADHD medication. An RWJF Investigator Award in Health Policy Research recipient, Stephen Hinshaw, PhD, explains that the rise in diagnoses among women in that age group may be evidence of failure to recognize the problem when the women were children. They may not have manifested symptoms as visibly as their male classmates with ADHD did, turning their distress inward rather than misbehaving in class, for example.

“How people with mental disorders are viewed by treatment providers and the general public can have a significant impact on treatment outcomes and the quality of life of clients,” Jennifer Stuber, PhD, and colleagues write in a study reported by Health Canal. The researchers presented vignettes about people with mental health problems to mental health providers and the general public, and compared their reactions. Providers had more positive attitudes, but some held views about the danger such patients might pose in the workplace that the researchers called “concerning.” Stuber is an RWJF Health & Society Scholars alumna.

More women are having breast reconstruction after mastectomies, USA Today reports. As a result of a 1998 federal law, most group insurance plans that cover mastectomies also cover breast reconstruction. Researchers found that the share of women who received reconstruction after mastectomy rose from 46 percent to 63 percent between 1998 and 2007. Author Reshma Jagsi, MD, DPhil, an RWJF Physician Faculty Scholars alumna, says the law could be contributing to the increase. The study was also covered by 9 News (Denver) and WKYC.com (Cleveland), among other outlets.

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Mar 19 2014
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New Charting Nursing’s Future Brief: Patient Safety Through Workplace Transformation

Ten years ago, a report from the Institute of Medicine (IOM) proposed a transformation of nurses’ workplaces, warning that “The typical work environment of nurses is characterized by many serious threats to patient safety.” The latest issue of the Charting Nursing’s Future policy brief series from the Robert Wood Johnson Foundation (RWJF) focuses on how much has changed in the intervening years, and how much remains to be done.

The new brief identifies a series of initiatives designed by and for nurses that have “spurred the creation of work environments that foster health care quality and patient safety.” Among them:

  • The RWJF-backed Transforming Care at the Bedside (TCAB) initiative, developed in collaboration with the Institute for Healthcare Improvement, which seeks to empower frontline nurses to address quality and safety issues on their units, in contrast with more common, top-down improvement efforts. TCAB is now integrated with Aligning Forces for Quality (AF4Q), RWJF’s signature effort to improve the quality of health care and reduce disparities in targeted communities.

  • Another RWJF-backed project, Quality and Safety Education for Nurses (QSEN), focuses on nursing school faculty, and has helped prepare thousands teaching in graduate and undergraduate programs to integrate quality and safety competencies into nursing school curricula.

  • On the policy side, efforts have been made to further examine and improve the adequacy of nurse staffing. For example, a number of jurisdictions, including California, Illinois, Washington state, and Minnesota, have adopted standards that either require or encourage limits on how many patients a given nurse may be assigned to care for in acute care hospitals. Subsequent research has demonstrated an impact on hospital policies, but evidence of improvements in cost, quality, and safety is mixed so far.

  • A number of institutions, including Vanderbilt University Medical Center in Nashville and The Johns Hopkins Hospital in Baltimore, have taken aim at disruptive behavior and professional discourtesy in the workplace, noting that, given the growing importance of teamwork and collaboration, the consequences of such misbehavior can be “monumental when patients’ lives are at stake.”

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Mar 18 2014
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RWJF Scholar Recognized for Research to Protect Preemies from Hypothermia

Robin Knobel, PhD, RN, is an associate professor at the Duke University School of Nursing and a Robert Wood Johnson Foundation (RWJF) Nurse Faculty Scholar (2010-2013). The University of Carolina at Chapel Hill (UNC-CH) School of Nursing recently recognized her with its Distinguished Alumna award.

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Human Capital Blog: Congratulations on the award! What does it mean for you and for your research?

Robin Knobel: I was truly honored to receive this award from UNC-CH because it recognizes my achievement thus far in my career in my area of research around improving thermal stability with premature infants. I was given great support as a doctoral student at UNC-CH through mentorship in research from faculty who are leaders as nurse scientists. To be recognized by alumni and faculty of the UNC-CH School of Nursing is a tremendous honor.

HCB: You received the award for your research into physiologic processes related to thermoregulation and perfusion in extremely premature infants. Can you explain what this means in lay terms?

Knobel: Yes. Premature infants are born too early to be able to keep themselves warm through the normal methods of heat production. Normally, infants up to one year of age do this through a metabolic production of heat, instead of shivering. Premature infants lack necessary components to accomplish efficient production of heat and consequently can become very cold if exposed to cold air after birth and through stabilization in the neonatal unit. They often experience hypothermic body temperatures during the early weeks after birth, which can lead to instability and possible lasting insults such as brain hemorrhage, infection, or even death. My research is studying the mechanisms around thermal stability in premature infants and ways to prevent bad outcomes from hypothermia.

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Mar 17 2014
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In the Media: Medical Leader Has Epiphany About Nurses

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

It took Arnold S. Relman, MD, one of the nation’s foremost medical thinkers, nine decades and a full-blown medical catastrophe to fully appreciate the value of nurses, according to an essay he penned in the Feb. 6 edition of the New York Review of Books.

Relman, 90, a doctor, a professor emeritus at Harvard Medical School, and a former editor of the New England Journal of Medicine, learned this lesson the hard way: as a patient. Last summer, Relman fell down the stairs and suffered life-threatening injuries—and discovered the critical role nurses play in health and health care during his lengthy recovery.

He shared his late-in-life epiphany in his recent essay: “I had never before understood how much good nursing care contributes to patients’ safety and comfort, especially when they are very sick or disabled,” he wrote. “This is a lesson all physicians and hospital administrators should learn. When nursing is not optimal, patient care is never good.”

Relman’s remarks spawned a surprise reaction from Lawrence K. Altman, MD, who begged the following question in a post on the New York Times Well Blog: “How is it that a leading medical professor like Dr. Relman—who has taught hundreds of young doctors at Boston University, the University of Pennsylvania (where he was chairman of the department of medicine) and Harvard—might not have known about the value of modern-day Florence Nightingales?”

What do you think?  Do medical educators and scholars fully appreciate the contributions nurses make? Register and leave a comment. 

Mar 17 2014
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