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:

Getting less than six hours of sleep a night raises levels of inflammation among women with heart disease, and therefore increases the risk of a heart attack, according to a five-year study led by RWJF Health & Society Scholars alumnus Aric Prather, PhD. The findings did not hold true for men. United Press International and HealthDay are among the outlets to report on the findings.

RWJF Community Health Leader Darleen Reveille, RN, spoke to The Record about new community gardens in Garfield, New Jersey, and a program that will give 7th-graders and their families hands-on gardening experience as a way to learn healthy eating habits. “We’re trying to raise awareness in a fun way,” she said. “By creating these activities, you’re engaging the community, not just lecturing them on what they should do.”

“Nurses are particularly at risk for becoming overwhelmed and depleted,” RWJF Executive Nurse Fellows alumna Cynda Hylton Rushton, PhD, RN, FAAN, told the Washington Post about “compassion fatigue ” She said: “When the clinician suffers, so does the patient,” which is why many hospitals are using creative arts to help nurses manage stress and re-energize. Fierce Healthcare also picked up the story.

A study led by RWJF Physician Faculty Scholars alumnus Deverick J. Anderson, MD, MPH, finds that small community hospitals have higher rates of ventilator-associated pneumonia than larger hospitals, even though they use ventilators less frequently. The researchers hypothesize the disparity could result from limited familiarity with the equipment and the on-staff availability of fewer respiratory therapists and other specialty workers, News Medical and Fierce Healthcare report.

Amal Trivedi, MD, MPH, is an alumnus of the Robert Wood Johnson Foundation/U.S. Department of Veterans Affairs Physician Faculty Scholars program. He is an assistant professor of health services, policy and practice at Brown University and a hospitalist at the Providence VA Medical Center. His co-author, Danya Qato, PharmD, MPH, is a pharmacist and doctoral candidate in health services research at Brown University. They recently published a study that finds older patients are routinely prescribed potentially harmful drugs, particularly in the South.

Human Capital Blog: Why did you decide to look at this particular topic? And why are some drugs considered high-risk for elderly patients?

Danya Qato and Amal Trivedi: Adverse drug events are an important public health problem. For the elderly, such events are often precipitated by use of potentially inappropriate or high-risk medications. Over the past several decades, clinicians and researchers have sought to identify medications that should be used with caution in the elderly. These high-risk medications should be avoided among people 65 years of age or older because the associated adverse effects outweigh potential benefits or because safer alternatives are available. Elderly patients are susceptible to these medications because they have more chronic illness, greater frailty, and an altered ability to metabolize drugs. The Centers for Medicare and Medicaid Services now require all Medicare Advantage plans to report on the use of high-risk medications among their enrollees.

We undertook this study because successful efforts to reduce high-risk medication use in the elderly require knowledge of how prescribing of these agents varies geographically and the factors that predict their use. Half of persons aged 65 and older use three or more prescription medications a day. Therefore, potentially inappropriate use of medications in the elderly has important implications for health care spending and quality.

This is part of the June 2013 issue of Sharing Nursing's Knowledge.

Heart Failure Patients Benefit from Adequate, Stable Nurse Staffing

A new study suggests that rural hospitals may be better able to ensure high-quality care for heart failure patients if they have lower nursing turnover and better practice environments.

With funding from the Robert Wood Johnson Foundation's Interdisciplinary Nursing Quality Research Initiative (INQRI), a team of researchers led by Robin Newhouse, PhD, RN, NEA-BC, FAAN, and Laura Morlock, PhD, tested a quality collaborative intervention in 23 rural hospitals in the eastern United States. The intervention included in-person meetings, an evidence-based toolkit, and monthly group teleconference calls between site coordinators and the team conducting the study. One group of hospitals used the intervention for six months while the other did not. Then the second group also began using the intervention.

Researchers used four metrics to assess how thoroughly the hospitals implemented the program: whether the hospitals provided smoking cessation counseling, provided adequate instructions to patients being discharged, assessed how well patients' hearts pumped, and made sure the patients received medication to help blood vessels relax. The researchers found that while there was no significant difference in implementation of the four core measures as a result of the intervention, the hospitals with lower nurse turnover and better practice environments implemented more of the measures.

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:

RWJF this week launched the Future of Nursing Scholars program, a $20-million initiative to support some of the country’s best and brightest nurses as they pursue PhDs. The program will provide scholarships, stipends, mentoring, leadership development, and dedicated post-doctoral research support, the Philadelphia Business Journal reports. John Lumpkin, MD, MPH, RWJF senior vice president and director of the Health Care Group, said: “The PhD-prepared nurses the Future of Nursing Scholars program supports will help identify solutions to the country’s most pressing health problems, and educate thousands of nurses over the course of their careers.” Read more about the program.

Patients who are involved in their care spend more time in the hospital and increase the cost of their hospital stays, compared to patients who delegate medical decisions to their doctors, according to a study led by David Meltzer, MD, PhD. Meltzer is an alumnus of the RWJF Generalist Physician Faculty Scholars program, and recipient of an RWJF Investigator Award in Health Policy Research. Among the outlets to report on the findings: HealthDay, Time Magazine’s Healthland blog, United Press International, and Modern Healthcare.

A study led by RWJF Nurse Faculty Scholar Jodi Ford, PhD, RN, finds that having lived in a poor neighborhood as a teen—even if the teen’s family wasn’t poor—increases the risk of having chlamydia in young adulthood by 25 percent, compared to teenagers living in wealthier settings, Science Daily reports.

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:

Smoking and not having a job are the two factors most strongly associated with higher death rates among the country’s least educated white women, according to a study led by RWJF Health & Society Scholar Jennifer Karas Montez, PhD, published today in The Journal of Health and Social Behavior. The study found that the odds of dying for the least educated women were 66 percent greater than for their more highly educated peers between 2002 and 2006, the New York Times reports. Read more about Montez’s research.

Many consumers significantly underestimate the calorie counts of fast food meals, according to a study led by Health & Society Scholars alumnus Jason Block, MD, MPH. One-fourth of study participants underestimated the calories in the meals they ordered by at least 500 calories, USA Today reports, with teens underestimating the most. Among other outlets to report on the findings: United Press International, CBS News, and MedPage Today. Read more about the study.

A survey from Yale and George Mason universities finds that 70 percent of American adults say global warming should be a priority for the nation’s leaders, the Los Angeles Times reports, and an even greater percentage say developing sources of clean energy should be a priority. The survey was co-authored by RWJF Investigator Awards in Health Policy Research recipient Edward W. Maibach, PhD, MPH, who directs the Center for Climate Change Communication at George Mason University.

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:

The New Jersey Nursing Initiative (NJNI), a project of RWJF and the New Jersey Chamber of Commerce Foundation, has graduated its first cohort of doctorally prepared nurses, NJ Spotlight reports. The new graduates are on track to become nursing professors, to help address New Jersey’s staggering 10.5 percent nurse faculty vacancy rate. Read more about the New Jersey Nursing Scholars who graduate this month.

In an op-ed for the Daily Journal, New Jersey Nursing Scholar Marlin Gross, MSN, APN, NP-C, writes, “I’m able to combine my love of nursing practice and education because NJNI put me on a fast track to a master’s degree in nursing… I also benefited from the program’s professional and personal development activities and its many mentoring and networking opportunities. But most importantly, NJNI helped me re-imagine my future. I now see myself as an emerging nurse leader and plan to enroll in a doctorate program in the fall to realize that vision.” Robert P. Wise, FACHE, a member of NJNI’s Leadership Council, also wrote about NJNI in an op-ed for The Times of Trenton.

Insight Into Diversity reports on the Dental Pipeline National Learning Institute, an RWJF-funded project led by the American Dental Education Association and the University of the Pacific Arthur A. Dugoni School of Dentistry. It is funding dental schools to create new recruitment projects that will help increase the number of underrepresented students at their institutions. Read a post on the RWJF Human Capital Blog by National Learning Institute Director Paul Glassman.

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:

RWJF Clinical Scholar Alan Teo, MD, MS, is the lead author of a study that finds the quality of a person’s social relationships influences the person's risk of major depression, regardless of how frequently their social interactions take place. “The magnitude of these results is similar to the well-established relationship between biological risk factors and cardiovascular disease,” Teo told Health Canal. “What that means is that if we can teach people how to improve the quality of their relationships, we may be able to prevent or reduce the devastating effects of clinical depression.”

RWJF recently announced the selection of 30 primary care practices as exemplary models of workforce innovation. The practices will serve as the basis for a new project: The Primary Care Team: Learning from Effective Ambulatory Practices (LEAP). Among them is CareSouth Carolina, the Hartsville Messenger reports. Learn more about the LEAP project and the practices selected for the program.

Low-income Oregonians who received access to Medicaid over the past two years used more health care services, and had higher rates of diabetes detection and management, lower rates of depression, and reduced financial strain than those without access to Medicaid, according to a study co-authored by RWJF Investigator Award in Health Policy Research recipient Amy N. Finkelstein, PhD, MPhil. The study found no significant effect, however, on the diagnosis or treatment rates of hypertension or high cholesterol levels.  Among the outlets to report on the findings: Forbes, the New York Times, the Washington Post Wonk blog, Health Day, and the Boston Globe Health Stew blog. Read more about Finkelstein’s research on the Oregon Medicaid system.

For National Nurses Week, the Human Capital Blog is highlighting some of the pioneering research covered on www.rwjf.org/nursing in the last few years. The nurse scientists who conducted this research are supported by the Robert Wood Johnson Foundation (RWJF) through its nursing programs. The following are examples of the many nurses who have made groundbreaking discoveries in health care quality and innovation.

RWJF Nurse Faculty Scholars program alumna Maren Coffman, PhD, RN (2009-2011) is working to improve health literacy among Latinas with diabetes, a disease that affects Latinos more often than non-Hispanic Whites, so they can better manage their disease. Lack of access to health care for people with diabetes can be devastating, as high blood sugar can lead to vein damage, vision loss, kidney disease, amputation, stroke, and heart disease. Read about Coffman’s project.

RWJF Executive Nurse Fellows program alumna Keela Herr, PhD, RN, FAAN, (2007-2010) is exploring ways to ensure research she and others conducted is put into practice, so fewer seniors will suffer from untreated pain. Even though research is providing new information about how best to manage pain among older patients, many health providers have yet to put that information into practice. Read more about her work.

Maja Djukic, PhD, RN, an RWJF Nurse Faculty Scholar (2012-2014) and a researcher with the RWJF-supported RN Work Project, is seeking ways to improve patient care by improving nurses’ work environments. Studies have shown that the ratio of nurses to patients affects patient care, but hospitals aren’t always able to hire more nurses to increase ratios. Djukic found that hospital administrators can make a number of other workplace changes that will improve the environment for nurses and, at the same time, improve nurses’ ratings of quality patient care. Read about the study.

This is part of the May 2013 issue of Sharing Nursing's Knowledge.

Hospitals that have achieved "Magnet" recognition have lower mortality rates, according to new research led by Matthew D. McHugh, PhD, JD, MPH, RN, of the University of Pennsylvania School of Nursing, with support from the Robert Wood Johnson Foundation (RWJF).

McHugh and colleagues examined patient, nurse, and hospital data for 56 hospitals designated as Magnets by the American Nurses Credentialing Center, along with comparable data from 508 non-Magnet hospitals. They found that "Magnet hospitals had significantly better work environments and higher proportions of nurses with bachelor’s degrees and specialty certification," and that "patients treated in Magnet hospitals had 14 percent lower odds of mortality and 12 percent lower odds of failure-to-rescue." They concluded that "lower mortality we find in Magnet hospitals is largely attributable to measured nursing characteristics but there is a mortality advantage above and beyond what we could measure. Magnet recognition identifies existing quality and stimulates further positive organizational behavior that improves patient outcomes."

About 8 percent of hospitals in the United States have achieved Magnet designation. They are recognized for quality patient care, nursing excellence, and innovations in professional nursing practice.

The study was published in the May issue of Medical Care, a journal of the American Public Health Association. McHugh is an RWJF Nurse Faculty Scholar.

Learn more about the RWJF Nurse Faculty Scholars program.
Read the study.
Read a FierceHealthcare story about the study.

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:

CBS Evening News profiled RWJF Community Health Leader Roseanna Means, MD, who founded the nonprofit Women of Means in 1988 to provide free medical care to homeless women in the Boston area. Today, 16 volunteer doctors and staff nurses provide care at the city’s shelters to women with unique sensitivities and needs. Read a post Means wrote about her nonprofit for the RWJF Human Capital Blog.

A study led by RWJF Clinical Scholars alumnus Matthew M. Davis, MD, MAPP, finds more than 40 percent of American parents give over-the-counter cough and cold medicines to children under age 4, despite product label warnings to the contrary. Health Day and the Examiner report on the findings.

Helena Hansen, MD, PhD, an alumna of the RWJF Health & Society Scholars program, is the lead author of an analysis that concludes social determinants—rather than changes in the environment or flawed diagnostic criteria—help explain the dramatic rise in the number of Americans diagnosed with mental disorders in recent years. Health Canal and MedPage Today report on the findings.

Forty-seven percent of children with cancer who receive part of their treatment at home have been exposed to at least one medication error, according to a study led by RWJF Physician Faculty Scholars alumna Kathleen E. Walsh, MD, MSc. Those errors had the potential to harm 36 per 100 patients, and actually did cause injury to four per 100, MedPage Today reports.