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.

Improving the Lives of Fragile Newborns: What Does Nursing Have to Offer?

Issue Brief
Eileen Lake, PhD, RN
Apr. 25, 2016

This Issue Brief summarizes evidence of nursing’s effects on NICU outcomes and recommends policies to bolster and support nursing practice in NICUs. Adequate staffing and a supportive work environment are associated with better outcomes for very low birth weight infants.

Unmet Nursing Care Linked to Rehospitalizations Among Older Black AMI Patients: A Cross-Sectional Study of US Hospitals

Apr. 22, 2016

Margo Brooks-Carthon, Karen Lasater, Jessica Rearden, Sara Holland, Douglas Sloane 

In Medical Care, Margo Brooks-Carthon and colleagues, including Karen Lasater, investigate the differences in the relationship between nursing care left undone and acute myocardial infarction readmissions among older black patients compared with older white patients. Brooks-Carthon and colleagues used multiple datasets, including 2006 to 2007 administrative discharge data, a survey of registered nurses, and the American Hospital Association Annual Survey to estimate the association between care left undone, 30-day readmission, and the impact of race on this interaction. The sample...

Magnet® Hospital Recognition Linked to Lower Central Line-Associated Bloodstream Infection Rates

Apr. 19, 2016

Hilary Barnes, Jessica Rearden, Matthew McHugh

In Research in Nursing and Health, Hilary Barnes and colleagues, including Matthew McHugh, investigate the relationship between Magnet status and hospital central line-associated bloodstream infection (CLASBI) rates. In 2014, the Centers for Medicare and Medicaid Services (CMS) began to penalize hospitals for poor performance with respect to selected hospital-acquired conditions, including CLABSI. Magnet hospitals are recognized for their high quality of care and their supportive work environment for nurses. Barnes and colleagues find that Magnet hospital status was associated...

Educating Health Professionals on Social Determinants of Health

Apr. 6, 2016

Health professionals are ill-prepared to address social factors that contribute to poor health, because these factors often lie beyond the scope of medical education. But just as addressing social determinants of health (SDH) involves stretching beyond traditional medical practices, educating health professionals involves stretching beyond traditional medical education.

Nurse staffing and the work environment linked to readmissions among older adults following elective total hip and knee replacement

Mar. 14, 2016

Karen Lasater, Matthew McHugh

In the International Journal for Quality in Health Care, Karen Lasater and Matthew McHugh examine the effect of nurse staffing and the work environment on 10- and 30-day unplanned readmissions for Medicare patients following elective total hip and knee replacement. The authors conducted a cross-sectional secondary data analysis using patient administrative data, nurse survey data, and hospital organizational data from acute care hospitals in California, Florida, New Jersey and Pennsylvania. Nurse survey responses were aggregated to construct hospital measures of nurse staffing and...

Nurse Staffing in Neonatal Intensive Care Units in the United States

Mar. 4, 2016

Jeannette Rogowski, Douglas Staiger, Thelma Patrick, Jeffrey Horbar, Michael Kenny, Eileen Lake
 

In Research in Nursing & Health, Jeannette Rogowski and colleagues, including Eileen Lake, provide the first report of national data on nurse-to-patient ratios in the neonatal intensive care unit (NICU) by infant acuity level.  Data were collected in two sequential studies in 104 NICUs. The study finds most NICU infants were low-acuity, and that 12% of infants were high-acuity.  The average nurse cared for two infants, but the nurse-to-infant ratio ranged from 1 nurse to 3 infants for low acuity, to almost 1-to-1 ratio for the highest acuity.  The study found that infant...

Better Nurse Staffing and Nurse Work Environments Associated With Increased Survival of In-Hospital Cardiac Arrest Patients

Feb. 17, 2016

Matthew McHugh, Monica Rochman, Douglas Sloane, Robert Berg, Mary Mancini, Vinay Nadkarni, Raina Merchant, Linda Aiken

In Medical Care, Matthew McHugh and colleagues, including Linda Aiken and Raina Merchant, explore the association between nurse staffing, nurse work environments, and survival rates for in-hospital cardiac arrest (IHCA). Nurses are likely the first responders to IHCA, thus playing a critical role in improving outcomes from these events. Using data from the American Heart Association, the University of Pennsylvania Multi-State Nursing Care and Patient Safety survey, and the American Hospital Association annual survey, the authors modeled the association of nursing features –...

Patient satisfaction and non-UK educated nurses: a cross-sectional observational study of English National Health Service Hospitals

Jan. 29, 2016

Hayley Germack, Peter Griffiths, Douglas Sloane, Anne Marie Rafferty, Jane Ball, Linda Aiken

In BMJ Open, Hayley Germack and colleagues, including Linda Aiken, examine the association between patient satisfaction with nursing care in National Health Service (NHS) hospitals in England and the proportion of non-UK educated nurses providing care. The authors used data from the 2010 NHS Adult Inpatient Survey merged with data from nurse and hospital administrator surveys. They found a significant association between the percentage of non-UK educated nurses providing bedside care and patient satisfaction; hospitals with higher percentages of non-UK educated nurses had lower...

Comparison of the Value of Nursing Work Environments in Hospitals Across Different Levels of Patient Risk

Research Brief
Jan. 20, 2016

In this study, LDI Senior Fellow Jeffrey Silber and colleagues at the Children’s Hospital of Philadelphia and the University of Pennsylvania look at how better nurse working environments influence the “value” of care, which is defined as the quality of care relative to the cost of providing it. Past studies of nurse work environments have looked at their impact on either quality or cost, but not on both. This study asks whether selecting hospitals based solely on excellent nursing environments identifies a set of hospitals that display better outcomes and value, a question most relevant to a patient seeking advice on where to go for care.

Advancing LGBTQ Health – Hot topics on the national stage

Dec. 9, 2015

Although Section 1557 of the ACA may not be well known to the public, it took center stage at the recent Gay and Lesbian Medical Association (GLMA) annual conference in Portland, Oregon. The conference educates practitioners and students about the unique health needs of lesbian, gay, bisexual, transgender and queer (LBGTQ) individuals and families, and reports on the latest research on LGBTQ health. Here are some of the latest research and policy developments emerging from the conference.

Section 1557 of the ACA

How Nursing Affects Medicare’s Outcome-based Hospital Payments

Data Brief
Nov. 12, 2015

Improving value is one of the central aims of recent and ongoing health care reform. In our last LDI/INQRI Brief, we reviewed the evidence of the role of nurses in increasing the value of health care. In this companion brief, we dig deeper into the three reimbursement strategies that Medicare uses to align hospital financial incentives with quality of care, and we calculate the potential effects of nursing-sensitive quality indicators on hospital payments.

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