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.

Improved Availability and Quality of Care with Epilepsy Nurse Practitioners

Jun. 19, 2017

Chloe E. Hill, Bethany Thomas, Kimberly Sansalone, Kathryn A. Davis, Judy A. Shea, Brian Litt, and Nabila Dahodwala

In Neurology, Chloe Hill and colleagues, including Judy Shea and Nabila Dahodwala, investigate the quality of care delivered by nurse practitioner (NP)–physician teams developed to serve patients with epilepsy, and improve their appointment availability.  The authors observed a cohort of patients with epilepsy who were cared for by either an NP-physician team or a physician only. These care models were compared with regard to adherence to the 2014 American Academy of Neurology epilepsy quality measures. The authors also looked at seizure frequency, presentations to the Emergency...

Missed Nursing Care in Pediatrics

Jun. 19, 2017

Eileen T. Lake, Pamela B. de Cordova, Sharon Barton, Shweta Singh, Paula D. Agosto, Beth Ely, Kathryn E. Roberts, Linda H. Aiken

In Hospital Pediatrics, Eileen Lake and colleagues, including Shweta Singh and Linda Aiken, examine patterns of missed nursing care in inpatient pediatric settings to determine whether it is associated with unfavorable work environments and high nurse workloads. The authors used registered nurse data from over 200 pediatric hospitals. The data shows that nurses reported missed care on their last shift for twelve nursing activities due to time constraints. More than half of pediatric nurses missed care on their previous shift, and missed care was more prevalent in poor work...

How Patients Experience the Trauma Bay

Jun. 16, 2017

After a shooting, a stabbing, a car crash, or a fall, emergency services rush an injured patient to the emergency room. They bypass the waiting room and come directly to a specialized area called the trauma bay, where a team of clinicians performs a fast, intense, full-body exam and initiates treatment for injury. Trauma providers have organized this protocol, known as trauma resuscitation, to identify and treat life-threatening injuries as quickly as possible. Or at least that’s how we see it.

Discriminative Accuracy of Physician and Nurse Predictions for Survival and Functional Outcomes 6 Months After an ICU Admission

May. 22, 2017

Michael E. Detsky, Michael O. Harhay, Dominique F. Bayard, Aaron M. Delman, Anna E. Buehler, Saida A. Kent, Isabella V. Ciuffetelli, Elizabeth Cooney, Nicole B. Gabler, Sarah J. Ratcliffe, Mark E. Mikkelsen, Scott D. Halpern 

In JAMA, Michael Detsky and colleagues, including Michael Harhay and Scott Halpern, examine the accuracy of intensive care unit (ICU) physician and nurses’ predictions about patients’ survival and functional outcomes. Clinician predictions about a patient's chance of survival have been shown to influence decision-making for critically ill patients, yet little is known regarding their accuracy. The study was conducted in five ICUs in three hospitals in Philadelphia, and enrolled patients who spent at least three days in the ICU and required mechanical ventilation, vasopressors, or...

PA House on Verge of Historic Vote for Nurse Practitioners

Sep. 8, 2016

Sometimes you have to look back to see the path forward. As the Pennsylvania House of Representatives considers legislation to modernize Pennsylvania’s antiquated regulations for nurse practitioners, we might learn something by reviewing the history of the Rendell Administration’s similar battle to expand scope of practice nearly 10 years ago. And if history is a predictor, there is reason to be optimistic.

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