Recommendation: Expand Opportunities for Nurses to Lead and Diffuse Collaborative Improvement Efforts

The Initiative on the Future of Nursing (IFN) committee recommends that health care systems and other organizations provide support to nurses to take the lead in developing new interventions and solutions to improve patient care. INQRI fully supports this recommendation and our support is underpinned by our researchers’ findings related to nurse-led quality improvement efforts. For example:

• INQRI researchers at Marquette University have been studying the contributions that hospital-based nurses make to the quality of discharge teaching on patient outcomes, readiness and readmission rates of discharged patients. They have found that when units had more RN hours per patient day, fewer overtime hours and fewer vacancies, the discharge teaching was of higher quality, patients reported greater readiness for hospital discharge, and the number post-discharge readmissions and emergency room visits was lower.

• INQRI researchers at Johns Hopkins are seeing promising results from the first randomized controlled trial of its kind investigating nurses’ role in preventing specific types of infections. Researchers examined the effects of an evidence-based practice intervention for reducing central-line associated blood stream infections among patients in hospital intensive care units. Many ICUs that have embraced this nurse-driven protocol have eliminated bloodstream infections among their patients, and their research is providing insight into how nursing turnover is associated with hospital-acquired infection rates.

• INQRI researchers from the University of Pennsylvania are discovering that having more nurses per baby can make a significant difference for tiny newborns when they are in neonatal intensive care. This study is showing that having more nurses at the bedside produces fewer serious health problems, such as brain hemorrhage, infection, and lung disease.

• An INQRI team from Emory University has developed the first tool of its kind to show what role staff nurses play in coordinating care for hospitalized patients in order to better understand how to improve outcomes. Through this research, the team has identified the care coordination activities that nurses carry out and those activities that are important for better care.

• An INQRI team from Rutgers University is helping to identify the systems and care processes that facilitate nurses’ ability to intercept medication errors and the barriers that hinder nurses in preventing medication errors.