Recent Research About Nursing, December 2013
This is part of the December 2013 issue of Sharing Nursing’s Knowledge.
Americans Favor Increased Access to Nurse Practitioners
A new telephone survey commissioned by the American Association of Nurse Practitioners (AANP) shows strong support for increased access to care provided by nurse practitioners (NPs).
Among the survey's findings:
- A large majority favors removal of requirements that NPs work only under the supervision of physicians. Sixty-two percent of respondents support allowing NPs to prescribe medications and order diagnostic tests without such supervision. Just 17 states and the District of Columbia currently grant NPs full-practice authority, according to AANP.
- An overwhelming majority of Americans back legislation making it easier to choose NPs as their health care providers. Seventy percent of respondents favor legislation to eliminate barriers preventing patients from choosing NPs.
- There is widespread familiarity with NPs. Eighty percent of respondents have either seen an NP or know someone who has. More than half (53 percent) say a family member has seen one.
"These results clearly confirm what we have known anecdotally for years: American health care consumers trust NPs and want greater access to the safe, effective services they provide," AANP Co-President Ken Miller said in a news release.
The telephone survey was conducted by The Mellman Group, a Washington, D.C.-based polling firm. Its margin of error is +/-3.1 percent at the 95-percent level of confidence.
Study Links Nurse Experience and Education to Better Outcomes for Pediatric Patients
Research published in the December issue of the Journal of Nursing Administration finds that nursing education and experience has a significant impact on outcomes for pediatric patients who have undergone heart surgery.
A research team led by Patricia Hickey, PhD, MBA, RN, an assistant professor of pediatrics at Harvard Medical School, gathered organizational assessments from nursing leaders at 38 children's hospitals and then compared those assessments with data on patient outcomes at those hospitals.
The analysis found that the odds of death increased as the institutional percentage of pediatric critical care unit nurses with two years’ clinical experience or less increased. In fact, the odds of mortality were highest when the percentage of RNs with two years’ clinical experience or less was 20 percent or greater. By contrast, the odds of death decreased as the institutional percentage of critical care nurses with 11 years’ clinical experience or more increased.
The authors write that the "findings support other research studies in adult hospitals demonstrating the association of at least a BSN and improved adult patient outcomes including mortality. This is the first known study to extend those findings to pediatric nursing. The formal education associated with obtaining the BSN is imperative for building the practice and science of nursing in the future. Care provided in hospitals will grow more complex, and nurses must engage in critical thinking and complex information management that will require skills in analysis and synthesis such as provided in BSN education programs to meet the increasing acuities of patients and the support needs of their families."
Simulation-Based Training Can Further Interprofessional Cooperation
A new study finds that simulation-based team training can improve medical and nursing students' teamwork skills.
The study, conducted by a group of researchers at the Louisiana State University Health Sciences Center New Orleans, and published online in September by the Journal of the American College of Surgeons, focused on 10 high-fidelity simulation operating room sessions using 18 nursing students, 20 nurse anesthetist students, and 28 medical students. The researchers assessed team-based behavior during the simulations, which involved two standardized two-hour scenarios and a full-scale, computer-operated human patient simulator mannequin, as well as an inanimate torso procedural training model. The first scenario featured a life-threatening intra-abdominal hemorrhage from a stab wound, and the second involved local anesthetic toxicity.
The researchers, led by John T. Paige, MD, FACS, evaluated participants' team-based performance using two Operating Room Teamwork Assessment Scales. Participants' scores for teamwork improved from the first scenario to the second, and the researchers concluded that students' behaviors and attitudes were improved by the training.
The authors write, "Improvements in students' team-based attitudes and skills could lead to an appreciation of the potential of optimal interprofessional team performance.... In fact, given that cultural change is best brought about through changing the assumptions of front-line workers in an organization, a constant influx of health professional students aware of and modeling highly reliable team behaviors (i.e., human factors and their corresponding attitudes) could potentially tilt the OR culture to a more team-centered approach."