A study recently published in JAMA Pediatrics concludes that the health of critically ill newborns is endangered by insufficient nurse staffing. The study, conducted by grantees of the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative (INQRI), finds that very few neonatal intensive care units provide sufficient numbers of nurses to meet guidelines set by the American Academy of Pediatrics, and that the most vulnerable babies are also the most understaffed.
Eileen T. Lake, PhD, RN, FAAN, nursing professor and associate director of the Center for Health Outcomes and Policy Research at the School of Nursing at the University of Pennsylvania, and Jeannette A. Rogowski, PhD, professor in health economics at the School of Public Health at the University of Medicine and Dentistry of New Jersey, led the research team.
Their study on the effect of nurse staffing on newborn care was one of 40 such studies funded by INQRI over the last seven years; all explore the link between nursing care and patient outcomes. When INQRI first started in 2005, there was little evidence linking the two and little knowledge about what nurses do to ensure that care is safe, beneficial, patient-centered, timely, and equitable. RWJF launched INQRI to support interdisciplinary research on these issues and ensure that the evidence generated would be rigorous.
Most observers say it has been highly successful.
The current issue of the journal Medical Care includes a special supplement examining how INQRI has helped improve the rigor of research methodology, built a solid base of evidence linking nursing care and patient outcomes, and increased interdisciplinary research and practice.
“We hope that this series of articles will provide other researchers with the information and insights they need to build on INQRI’s work,” said INQRI Co-Director Mark Pauly, PhD, Bendheim Professor and professor of health care management and business economics and public policy at the Wharton School at the University of Pennsylvania. “Not only have we contributed to the set of research measures, but we have also identified where more research needs to be done, the nature of that research, and barriers that need to be addressed to further enhance our knowledge about nursing’s impact on quality of care.”
The special supplement includes six articles reviewing INQRI research and discussing the implications of that research on: advances in research into nursing’s contribution to quality; measurement of quality; interdisciplinary collaboration; implementation methodology; dissemination and translation of findings; and the business case for nursing. It also provides recommendations to improve research and areas to address in the future.
“It’s safe to say that INQRI has accomplished more than we ever hoped,” said INQRI Co-Director Mary Naylor, PhD, FAAN, RN, Marian S. Ware Professor in Gerontology at the University of Pennsylvania School of Nursing. “The program was established to address the gaps in knowledge about the relationship between nursing and health care quality through interdisciplinary research, raising the bar and bringing important, diverse perspectives to the studies. We have done those things, but we have also identified successful strategies for and challenges associated with implementation, measurement, and dissemination. I believe we have contributed not only to health care and nursing but to increasing the methodological rigor and the quality of health care research.”
Each article was written by a team of INQRI researchers, and examines two or more INQRI studies.
A blog carnival on the INQRI website that began on March 25 includes posts from INQRI researchers, program directors, and National Advisory Committee members discussing and expanding on the Medical Care supplement.