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.

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.

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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Supportive Clinical Practice Environments Associated With Patient-Centered Care

Sep. 1, 2020

J. Margo Brooks CarthonHeather Brom, Lusine Poghosyan, Marguerite Daus, Barbara Todd, Linda Aiken

Abstract [from journal]

A lack of organizational supports in clinical settings may prevent nurse practitioners from providing patient centered care. Using a cross sectional survey design, data were collected from NPs in 1,571 practices across four states to investigate clinical practice environments and the extent to which they are associated with NP integration of patient preferences. Three-quarters of NPs reported frequent integration of patient preferences into clinical care. Overall, 371 practices (23.6%) were classified as good practice environments;

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Chronic Hospital Nurse Understaffing Meets COVID-19

Research Brief
Aug. 18, 2020

A study of hospitals in New York and Illinois at the start of the COVID-19 pandemic found that most did not meet benchmark patient-to-nurse staffing ratios for medical-surgical or intensive care units. New York City hospitals had especially low staffing ratios. Understaffed hospitals were associated with less job satisfaction among nurses, unfavorable grades for patient safety and quality of care, and hesitance by nurses and patients to recommend their hospitals. 

Harnessing Implementation Science To Optimize Harm Prevention In Critically Ill Children: A Pilot Study Of Bedside Nurse CLABSI Bundle Performance In The Pediatric Intensive Care Unit

Aug. 17, 2020

Charlotte Z. Woods-Hill, Kelly Papili, Eileen Nelson, Kathryn Lipinski, Judy SheaRinad BeidasMeghan Lane-Fall

Abstract [from journal]

Objectives: Central-line associated bloodstream infection (CLABSI) is associated with increased mortality, morbidity, and cost in hospitalized children. An evidence-based bundle of care can decrease CLABSI, but bundle compliance is imperfect. We explored factors impacting bundle performance in the pediatric intensive care unit (PICU) by bedside nurses.

Methods: Single-center cross sectional electronic survey of PICU bedside nurses in an academic tertiary care center; using the COM-B (

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