Recent Research About Nursing, March 2014
This is part of the March 2014 issue of Sharing Nursing’s Knowledge.
Comparing Nurse and Physician Performance on Colonoscopies
A new study finds that colonoscopies performed by nurse and physician endoscopy trainees are comparable in terms of quality and safety.
Researchers in The Netherlands studied 15 endoscopy trainees—seven nurses and eight physicians—at two medical centers over the course of three-and-a-half years. At the beginning of the study, none had experience in endoscopy. All were trained according to the applicable regulations of the Dutch Society of Gastroenterology, performing a minimum of 100 colonoscopies. After completing their training, each performed 135 consecutive colonoscopies under the supervision of a gastroenterologist, with their work evaluated for safety and quality.
The nurse group and the physician group had comparable results on both measures, with the nurse group producing marginally better scores in some areas. Each group detected the same percentage of adenomas (benign polyps), and had the same low rate of complications. The nurses had slightly higher rates of cecal intubation (successfully passing the colonoscope to a key part of the colon), and slightly higher rates of completing the procedure without assistance.
“In a supervised setting,” the research team wrote in March 2014 issue of Clinical Gastroenterology and Hepatology, “nurse endoscopists perform colonoscopies according to quality and safety standards that are comparable with those of physician endoscopist[s] and can substantially reduce costs.”
Study Links Nurse Caseload and Educational Attainment to Patient Mortality
A new study from a team of researchers led by Linda Aiken, PhD, FAAN, FRCN, RN, adds to the body of data indicating that nurse-patient ratios and the educational attainment of nursing staff affect the quality of patient care.
Aiken, a member of the Robert Wood Johnson Foundation (RWJF) Interdisciplinary Nursing Quality Research Initiative (INQRI) National Advisory Committee and a research manager supporting the Future of Nursing: Campaign for Action, studied hospital discharge data from more than 422,000 patients, aged 50 and older, who had undergone common procedures in any of 300 hospitals in nine European countries, as well as survey data from more than 26,000 nurses in those same hospitals. Together the data sets provided information about patient mortality, nurse-patient ratios in the relevant hospitals, and the educational attainment of nurses in the hospitals.
Analysis revealed that a one-patient increase in a nurse’s workload increased the likelihood of an in-patient death within 30 days of admission by 7 percent. On the other hand, every 10-percent increase in the number of nurses with bachelor’s degrees was associated with a 7-percent decrease in mortality. The authors write, “These associations imply that patients in hospitals in which 60 percent of nurses had bachelor's degrees and nurses cared for an average of six patients would have almost 30 percent lower mortality than patients in hospitals in which only 30 percent of nurses had bachelor's degrees and nurses cared for an average of eight patients.”
Aiken’s article on her research was published online by The Lancet on February 26, 2014. The study was supported by funding from the National Institutes of Health (NIH).
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