Nursing

The supply, distribution, certifications, and scope of practice of the 2.8 million RNs (including advanced practice RNs) and 690,000 licensed practical nurses currently in practice.

Expanding Scope of Practice After COVID-19

Feb. 15, 2021

To expand access to health care during the COVID-19 pandemic, many states relaxed or waived regulations that define the scope of health professional practice. This experience highlights the need to ensure that all health care professionals practice to the full extent of their capabilities—an issue that predates and will outlast the pandemic. In a virtual conference on November 20, 2020, Penn LDI and Penn Nursing brought together experts in law, economics, nursing, medicine, and dentistry to discuss current gaps in health professional scope of practice, what we have learned from COVID-19, and how to rethink scope of practice to better meet community and public health needs.

Post-Acute Stays in Skilled Nursing Facilities: Patient Experiences

Feb. 10, 2021

What kind of care do patients expect after they are discharged from a hospital to a skilled nursing facility (SNF)? And how do those expectations align with care they actually receive from physicians and advanced practitioners? We know surprisingly little about the patient care experience in these post-acute settings, even though 1.5 million people in the U.S. are discharged to them each year. One fourth of those people die or are readmitted to the hospital within 30 days.

Pennsylvania Scope of Practice Policy Brief

Jan. 28, 2021

Pennsylvania is one of 28 states that has not expanded the scope of practice in its licensure laws for certified registered nurse practitioners (NPs), who must maintain formal collaborative agreements with physicians to practice. For many years, proposals to update licensure and adapt it to make it more compatible with current models of collaborative care could not overcome legislative logjams. Recognizing an opportunity to break the logjam, the University of Pennsylvania held a virtual workshop on November 20, 2020, bringing together researchers, health professionals, and consumers to chart a new path forward. This policy brief summarizes their recommendations to update scope of practice regulation to better meet the primary care needs of Pennsylvanians.

Nurse Staffing and Outcomes of In-Hospital Cardiac Arrest

Jan. 27, 2021

In-hospital cardiac arrests (IHCAs) are catastrophic and often terminal events. Despite improvements in resuscitation efforts, fewer than 25% of patients who experience an IHCA  survive to discharge. Survival varies significantly across hospitals and by race. Racial disparities in IHCA survival have been linked, in part, to the quality of care during hospitalization.

Evaluation of Hospital Nurse-to-Patient Staffing Ratios and Sepsis Bundles on Patient Outcomes

Dec. 9, 2020

Karen B. Lasater, Douglas M. Sloane, Matthew D. McHugh, Jeannie P. Cimiotti, Kathryn A. Riman, Brendan Martin, Maryann Alexander, Linda H. Aiken

Abstract [from journal]

Background: Despite nurses’ responsibilities in recognition and treatment of sepsis, little evidence documents whether patient-to-nurse staffing ratios are associated with clinical outcomes for patients with sepsis.

Methods: Using linked data sources from 2017 including MEDPAR patient claims, Hospital Compare, American Hospital Association, and a large survey of nurses, we estimate the effect of hospital patient-to-nurse staffing ratios and adherence to the Early Management Bundle for patients with Severe Sepsis/...

Practices To Support Relational Coordination In Care Transitions: Observations From The VA Rural Transitions Nurse Program

Robert Burke, MD, University of Pennsylvania
Nov. 11, 2020

Heather M. Gilmartin, Catherine Battaglia, Theodore Warsavage, Brigid Connelly, Robert E. Burke

Abstract [from journal]

Background: Ensuring safe transitions of care around hospital discharge requires effective relationships and communication between health care teams. Relational coordination (RC) is a process of communicating and relating for the purpose of task integration that predicts desirable outcomes for patients and providers. RC can be measured using a validated survey.

Purpose: The aim of the study was to demonstrate the application of RC practices within the rural Transitions Nurse Program (TNP), a

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Predictors Of Specialty Certification Among Pediatric Hospital Nurses

Linda Aiken honored by Irish Surgeons
Oct. 22, 2020

Karen B. LasaterRebecca R. S. Clark, Margaret A. McCabe, Warren D. Frankenberger, Paula M. Agosto, Kathryn A. RimanLinda H. Aiken

Abstract [from journal]

Aims and objectives: To evaluate differences in hospitals' proportion of specialty certified nurses and to determine whether and to what extent individual nurse characteristics and organizational hospital characteristics are associated with a nurse's likelihood of having specialty certification.

Background: Prior research has shown that patients in hospitals with high proportions of specialty certified nurses have better outcomes including lower mortality and fewer adverse events; yet less is

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Initial Testing of a Web-based Intervention to Reduce Adolescent Driver Inattention: A Randomized Controlled Trial,

Oct. 3, 2020

Catherine C. McDonald, Jamison D. Fargo, Jennifer Swope, Kristina B. Metzger, Marilyn S. Sommers

Abstract [from journal]

Introduction: Motor vehicle crashes are the leading cause of adolescent death. Inattention to the roadway contributes to crash risk. The objective of this study was to deploy an initial study of a web-based intervention (Let's Choose Ourselves) designed to improve adolescent driver attention to the roadway.

Methods: We used a randomized controlled trial design in a sample of adolescent drivers to test if a web-based intervention decreased cell phone engagement in driving simulation at 3 months

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Inside The Black Box Of Improving On Nursing Home Quality Measures

Sep. 28, 2020

Heather Davila, Tetyana P. Shippee, Young Shin Park, Daniel Brauner, Rachel M. Werner, R. Tamara Konetzka

Abstract [from journal]

Nursing Home Compare (NHC) reports quality measures (QMs) for nursing homes (NHs) as part of its 5-star rating system. Most of the QMs are based on facility self-reported data, prompting questions about their validity. To better understand how NHs interact with the QMs, we used qualitative methods, including semistructured interviews with NH personnel (n = 110), NH provider association representatives (n = 23), and observations of organizational processes in 12 NHs in three states. We found that most NHs are working to improve the

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