Category Archives: Nursing
Guidelines and a toolkit released this week by the Joint Commission highlight the key role nurses play in preventing central line-associated bloodstream infections (CLABSIs). CLABSIs are among the most deadly and costly hospital-associated infections, accounting for 31,000 deaths annually and costing the health system an estimated $9 billion. Studies funded by the Robert Wood Johnson Foundation’s Interdisciplinary Nursing Quality Research Initiative (INQRI) revealed that nurses can play a key role in preventing these infections.
Patricia Stone, PhD, MPH, RN, FAAN, a principal investigator for an INQRI-funded study on the impact of nurse staffing, skill mix, and experience on quality and costs in long-term care, contributed to the new guidelines. Stone is the Centennial Professor of Health Policy in Nursing at Columbia University School of Nursing.
Human Capital News Roundup: Light-based defibrillators, the primary care workforce, how women change men, and more.
Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:
A strong primary care system is essential to improving health care in the United States, and front-line clinicians, staff, and leaders need to re-examine traditional roles and responsibilities, Maryjoan Ladden, PhD, RN, FAAN, told Medical Home News. Ladden is senior program officer for RWJF’s Human Capital portfolio. To investigate primary care workforce transformation, RWJF funded The Primary Care Team: Learning from Effective Ambulatory Practices (LEAP), Ladden said. Her full interview is available at: http://medicalhomenews.com/ (subscription required.)
Women with post-traumatic stress disorder (PTSD) gain weight more rapidly and are more likely to be overweight or obese than other women, according to a study co-authored by RWJF Health & Society Scholars alumna Magdalena Cerda, DrPH. The study, featured in Health Canal, is the first to look at the relationship between PTSD and obesity over time.
New tools such as the Omnibus Risk Estimator, which the American Heart Association recommends doctors use instead of cholesterol tests to determine whether to prescribe statins, are developed with little regulatory authority over their design and use, Jason Karlawish, MD, writes in a New York Times op-ed. Karlawish, recipient of an RWJF Investigator Award in Health Policy Research, encourages better oversight and regulations to monitor such tools.
Mirroring national trends, the California State University (CSU) system is turning away qualified nursing school applicants due to faculty shortages, reports the Los Angeles Daily News, and CSU officials fear that the situation will worsen the nurse shortage in a state that already has one of the country’s lowest numbers of nurses per capita.
This fall, CSU Long Beach had a nursing program acceptance rate of 18 percent, having received 450 applications for 82 slots. CSU Northridge had a “very highly qualified” pool of 300 applicants but could only accept 60. CSU Chico had to turn down 86 percent of its fully qualified applicants, while CSU San Marcos turned away nearly 89 percent.
“Let me put it this way, we have over 1,200 pre-nursing students,” Dwight Sweeney, interim chairman of nursing at CSU San Bernardino, told the Daily News. “I can only take about 108 a year. In the fall, we had over 600 applicants for 44 positions. Realistically, we are turning away people with 3.6 and 3.7 GPAs. And I think that story is playing out on CSU campuses everywhere.”
Beverly Malone, PhD, RN, FAAN, is chief executive officer of the National League for Nursing (NLN). She was recently elected to the Institute of Medicine. Last month, the NLN announced the launch of Accelerating to Practice, a new program designed to help new nurses move more seamlessly from education to practice. It is the inaugural program of the NLN's Center for Academic and Clinical Transitions.
Human Capital Blog (HCB): Why is Accelerating to Practice needed?
Beverly Malone: We've always known that there is a difference between how nurse educators view graduates of nursing programs and how nursing directors view graduates. But we never knew how deep the divide was. A recent survey showed that 90 percent of educators thought that nurse graduates were doing just fine, but almost 90 percent of directors felt that nurse graduates did not have the skills that were needed to practice. That kind of a divide is not a small one. It has so much to do with how care is delivered, and the League felt compelled to do something about it.
HCB: What explains the divide?
Malone: We don't talk enough to one another. There are some exemplars out there where educators and administrators are on the same wavelength, and they have worked very hard to ensure that graduates are prepared in a way to move quality patient care forward. But overall, that's not the picture throughout the United States.
Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of RWJF’s nursing programs, and the latest news, research, and trends relating to academic progression, leadership, and other essential nursing issues. These are some of the stories in the November issue:
For decades, experts have called for more team-based care but the movement has gained traction in recent years with more health professions schools incorporating interprofessional education into their coursework. Proponents say this kind of education will prepare students to practice in coordinated, well-functioning health care teams, which in turn will help meet increasing, and increasingly complex, patient needs. Officials in several professions are considering making interprofessional education and training a requirement for accreditation for health professions colleges and universities.
Heather J. Kelley, MA, is deputy director of the Robert Wood Johnson Foundation’s (RWJF) Future of Nursing Scholars program. Prior to this role, she was the program associate for RWJF’s Interdisciplinary Nursing Quality Research Initiative and a former vice president in a political advertising firm.
Three years ago, the Initiative on the Future of Nursing at the Institute of Medicine (IOM) set a revolution in motion with the release of The Future of Nursing: Leading Change, Advancing Health report. Among the bold recommendations offered in the report was the call to double the number of nurses with doctoral degrees by 2020.
RWJF recognizes the valuable contributions that PhD-prepared nurse scientists and researchers make in the lives of patients and families. Their discoveries have the potential to change our health care system. However, as the IOM report suggested, we do not have nearly enough doctorally prepared nurses seeking new solutions to ongoing problems. Currently, less than 1 percent of the nursing workforce has a doctoral degree in nursing or a related field.
Foreign-educated and foreign-born health professionals play a vital role in providing patient care in this country, but strategic shifts such as changes in immigration laws may be needed to stabilize the nation’s health workforce, according to a new RAND Corporation study.
The two groups fill important gaps, particularly among primary care physicians, nurses in hospital settings, and other areas with worker shortages, according to findings published in the November issue of Health Affairs.
However, continuing to rely on foreign-educated and foreign-born health workers may reduce incentives for the nation to address problems such as the inadequate supply of primary care physicians. This, in turn, could lead to a less-stable U.S. health care workforce, researchers said.
This is part of the November 2013 issue of Sharing Nursing's Knowledge.
MTV executives are attempting to mollify nurses and nursing allies who are outraged over a salacious new “reality” television show about a group of young travel nurses in California.
The show, “Scrubbing In” amplifies tawdry aspects of the personal lives of a handful of young nurses and minimizes the important, life-saving work they do, critics say.
The show disrespects “the most respected profession,” said Karen Daley, PhD, RN, FAAN, president of the American Nurses Association.
MTV officials responded with a recent announcement that they would take a number of steps to address the outrage, according to The Truth About Nursing, an advocacy organization that works to improve media portrayals of nurses.
Actions include re-editing some episodes to put a greater emphasis on clinical nursing skills; posting online material to educate visitors about the real reality of nursing education and practice; and airing the show at a less prominent time, potentially slashing viewership.
After the show began airing in October, some nursing organizations called for its cancellation, while others called for a more far-reaching boycott of the channel and its sponsors.
Researchers at Loyola University Medical Center have conducted the first study of moral distress among nurses in an intensive care unit for burn patients, starting to address “a significant gap” in knowledge about responding to the painful feelings that arise in situations where people can’t act according to their ethical ideals, due to barriers such as lack of time and supervisory support, and policy and legal constraints.
Moral distress has been studied in various populations of health care providers, including neonatal ICU nurses, pediatric ICU nurses, genetic professionals, surgical residents, and medical residents. The Loyola study, published in the September/October issue of the Journal of Burn Care & Research, points out that the impact of moral distress on nurses during the provision of care, particularly in critical care settings, is well documented and can result in a wide variety of reactions, including depression, anxiety, emotional withdrawal, frustration, anger, and a variety of physical symptoms.
This is part of the November 2013 issue of Sharing Nursing's Knowledge.
“Being the best is not measured by the number of accolades, positions that you hold, or amount of wealth you accumulate. When you have reached a point on your leadership journey where you can be of assistance and influence a larger sphere of individuals, organizations and society, then you are on the path to being the best.”
-- Linda Burnes Bolton, DrPH, RN, FAAN, chief nursing officer, Cedars-Sinai Medical Center in Los Angeles and trustee, Robert Wood Johnson Foundation, Accelerate Your Career in Nursing: A Guide to Professional Advancement and Recognition, 2013
“I worked closely with a nurse practitioner. We co-managed very complicated patients over many years. This colleague knew when someone needed to be seen to avoid an emergency room visit, to adjust an essential medication or just for reassurance. We trusted each other’s opinion and respected our own unique abilities. Being part of a team increased quality, reduced cost, and definitely improved the experience of our patients. I am sure many of my physician colleagues around the state have had similar experiences … The Green Mountain Care Board‘s inclusion of a highly qualified nurse is another indication of our commitment to respecting the abilities of all health care providers and fostering innovation.”
-- Allan Ramsay, MD, Green Mountain Care Board, Nursing in the Era of Vermont Health Care Reform, VTDigger.org, October 29, 2013