Recent Research About Nursing, April 2013
This is part of the April 2013 issue of Sharing Nursing's Knowledge.
Survey of Nurses: Hospitals’ Patient Safety Programs Lacking
A new survey of hospital nurses in the United States, the United Kingdom, and China finds that nurses lack confidence in their hospitals’ safety programs.
The online survey, conducted by a research firm for the American Nurses Association (ANA) and GE Healthcare, included 500 respondents from the United States and 200 each from the United Kingdom and China. Each country's responses were given equal weight in the final results. Among the findings:
- Ninety-four percent of nurses report that their hospitals have programs in place that promote patient safety, but only 57 percent believe those programs are effective.
- Just 41 percent describe their hospital as “safe.”
- Ninety percent of nurses believe it is important that nurses not be penalized for reporting errors or near misses, but 59 percent agree that nurses often hold back in reporting patient errors in fear of punishment (67 percent in the United States, 62 percent in the United Kingdom, and 49 percent in China). Sixty-two percent agree that nurses often hold back in reporting near misses for the same reason (69 percent in the United States, 65 percent in the United Kingdom, and 54 percent in China).
- Thirty-three percent of nurses said that "poor communication among nurses at handoff" has increased the risk of patient safety incidents in their hospitals in the past 12 months. Thirty-one percent said "poor communication with doctors" has also increased the risk of patient safety incidents.
“It’s no surprise that communication is a challenge for nurses today, given heavy patient loads, and the time that they are able to spend on patient care is constantly decreasing,” Cheryl Peterson, MSN, RN, the ANA's director of nursing practice and policy, said in a news release. “Where we can help is increasing the quality of communication, and arming nurses and front-line staff with the information they need to effectively communicate on behalf of the patient.”
For Asthma Patients, Nurse-Led and Physician-Led Care Deemed Comparable
A new and comprehensive review of studies dating back more than a decade finds "no difference between nurse-led care and physician-led care" for asthma patients.
A research team from the Netherlands conducted an exhaustive search for studies comparing nurse- and physician-led care for asthma, dating back to 2000, and then examined in detail the five studies that met their criteria for rigor and subject matter. Four of those five studies focused on patients with asthma deemed to be controlled; one looked at patients with uncontrolled asthma. In all, the studies included 588 adults and children. The researchers wrote:
The number of asthma exacerbations (flare-ups) and the level of asthma severity did not differ at the end of the study period between the intervention [nurse-led care] and the control [physician-led care] group. Only one study reported information about the costs associated with both kinds of care and there was no significant difference between them. There was also no difference in quality of life. We found no difference between nurse-led care and physician-led care. Based on the relatively small number of studies in this review, nurse-led care may be appropriate in patients with well-controlled asthma. More studies in varied settings and among people with varying levels of asthma control are needed with data on adverse events and healthcare costs.
The review was published online on February 28, 2013, in the Cochrane Library.