Building the Body of Research in the Science of Nursing Care
Happy National Nurses Week! The Robert Wood Johnson Foundation (RWJF) has a proud history of supporting nurses and nurse leadership, so this week, the RWJF Human Capital Blog is featuring posts by nurses, including leaders from some of our nursing programs. This post is by Mary Naylor, PhD, RN, FAAN, director of the RWJF Interdisciplinary Nursing Quality Research Initiative program and the Marian S. Ware Professor in Gerontology at the University of Pennsylvania School of Nursing.
Nurses—the largest group of health professionals in the country—have a tremendous impact on health and health care. But despite the immense size and influence of the nursing workforce, we don’t know enough about how nurses can improve the quality and safety of care and reduce costs.
Nurse scientists have been exploring these questions for decades, but large gaps in knowledge remain. Since it was established in 2005, the Interdisciplinary Nursing Quality Research Initiative (INQRI), funded by RWJF, has worked to address those gaps in our knowledge of nursing care.
Over the last seven years, INQRI grantees—teams of nurse scientists and scholars from other disciplines—have conducted groundbreaking research focused on the ways in which nurses affect the quality of care patients receive and how they improve patient care and outcomes.
The interdisciplinary nature of the project has been key to its success; when scholars from multiple disciplines come together to solve problems in nursing care, they generate solutions that are grounded in rigorous evidence, that take into account diverse perspectives, and that use various methodological techniques. In short, interdisciplinary research leads to more robust findings. And more robust findings are more likely to attract investments in nursing resources, which will, in turn, improve health outcomes while reducing costs.
As program leaders, we don’t just talk the interdisciplinary talk; we walk it too.
Mark Pauly, PhD, a leading health economist, and I, a nurse and health services researcher, direct the program. Mark and I began our work together more than two decades ago to figure out how nurses can help prevent unnecessary, and costly, hospital re-admissions among elderly patients. We are joined by Lori Melichar, PhD, senior program officer at the Foundation. Lori is a labor economist and the third member of INQRI’s leadership team.
Our National Advisory Committee, meanwhile, comprises experts in fields ranging from medicine to health information technology to public health. By involving key stakeholders in the conduct of research from the outset and throughout the initiative’s organizational structure, our intent has been to build strong partnerships with potential end-users of the research findings.
The interprofessional nature of the program is, of course, reflected in our grantees, too. Throughout the course of the initiative, we have sought strong scholarly teams that demonstrated interprofessional involvement from the very start of their planning processes. We also looked for teams that proposed innovative and sound ideas, planned to use scientifically rigorous methods, and had prepared to facilitate the translation of their research findings into practice.
All over the country, our grantees have done just that—and, as a result, have unearthed important answers to key questions about how nurses can improve the delivery of nursing care.
- In Ohio, for example, INQRI researchers found that a key way to improve pediatric nursing care is to talk to the children who receive that care, and not just their parents or caregivers.
- In Minnesota, researchers found that nurse-physician co-leadership improves heart failure patient and staff outcomes by improving team cohesion.
- And in Connecticut, researchers found that a diabetes prevention program provided by visiting nurses improves diet and exercise of low-income adults.
These are but a few of the many important findings uncovered by INQRI grantees over the years. It’s the kind of research we need to transform nursing to achieve better patient care and outcomes.
With INQRI in its final phase, program leaders are continuing to help our grantees get the word out about their findings. We recently concluded a national conference that highlighted six papers that we hope will be published later this year in a special edition of Medical Care. These papers present grantees’ findings as the basis for discussions about the relationship between their research and trends in interdisciplinary collaboration, methodology and implementation science, quality measurement, dissemination and implementation, and the business case for nursing.
We’re also supporting the research initiatives of the Future of Nursing: Campaign for Action, a collaborative effort to implement recommendations of a groundbreaking report on the future of nursing that was released by the Institute of Medicine (IOM) in 2010. Our goal is to focus attention on a common research agenda related to the IOM recommendations and to facilitate and coordinate funding activity across a range of funders of nursing research.
In 2014, when the INQRI program closes its doors, we will have answered some of the key questions about how nurses can improve the quality and safety of care and reduce costs. The initiative itself will cease to exist, but we’re working to ensure that the research it generated—and the mission it promoted—will live on.