Ghosts and Goblins and Hospital Admissions (Oh, My)

As we head into Halloween weekend, you might be nervous about rowdy teenagers toilet papering your lawn or worried about running out of candy by 7pm. With the television schedule full of slasher movies and retrospectives on classic horror flicks, you might be scared of things that go bump in the night.

But, INQRI researchers at Midwestern University have uncovered what you should really be nervous about this weekend - the idea of needing to check in to the hospital.

In their INQRI study, Patti Hamilton, Gretchen Gemeinhardt and their team examined the impact of receiving care during "off-peak" times - on nights and weekends. Sixty-four percent of nursing occurs "off-peak" and consumers are (rightfully) concerned about being admitted during those times.

To learn more about their study, please visit the website, Nursing: Open 24/7.

(As for the rest of your weekend, keep that porch light on, make one more run for extra candy and don't watch anything that stars a mad man in a mask.)

Happy Halloween from everyone at INQRI!

Health Wonk Review

This week's "All Hallows Eve" edition of the Health Wonk Review is posted at new Health Dialogue Blog.  Check it out here.

We're pleased to announce that INQRI will host the next edition of Health Wonk Review on Veteran's Day, November 11.  Please click here to submit your entries by 9amET on November 10.

Thank you!

Learn How to Participate in TEDMED

Are you attending (or following via Twitter) the TEDMED conference this week?

Leaders from RWJF's Pioneer Team are in San Diego this week to attend "the world’s preeminent health care innovation conference," TEDMED.  As a sponsor of the event, the Pioneer team has made it possible to get involved in the conference even if you can't be there in person.

Learn how to participate.

If you are attending, please click below to share your thoughts about the event.


About TEDMED:

Created by Marc Hodosh and Richard Saul Wurman, TEDMED celebrates conversations that demonstrate the intersection and connections between all things medical and healthcare related: from personal health to public health, devices to design and Hollywood to the hospital. Together, this encompasses more than twenty percent of our GNP in America while touching everyone's life around the globe.

INQRI's New Grantees Begin Their Grants on November 1

The Robert Wood Johnson Foundation (RWJF) has announced the selection of six interdisciplinary research teams (each of which includes a nurse scholar) from across the country to receive grants from the Foundation's Interdisciplinary Nursing Quality Research Initiative (INQRI).

RWJF created INQRI in order to address gaps in knowledge about nursing's effect on quality of care and to leverage opportunities for research that would identify nurses' contributions to improving patients' health and safety. This is the fifth cohort of INQRI grantees.

Over the past 4 years, INQRI grants have supported research to establish links between nursing and the quality of care delivered to people within and across a variety of healthcare settings. This year's grants will support studies that focus on disseminating and implementing programs that have proven effective.

Each INQRI research team receives an 18-month grant of up to $300,000 to support a project that explores the relationship between nursing and healthcare. INQRI will share the results of this research with policy-makers, hospital administrators and others who make decisions about how nursing resources are distributed to improve quality and patient outcomes.

This year's INQRI grantees are working on a wide range of research projects, from designing a nurse manager development program to increase patient safety, to testing a nursing intervention using a substance abuse screening tool, to implementing a fall prevention program targeted to patient risk factors. All of the projects address creation, implementation and dissemination of plans, protocols, policies and resources, according to RWJF.

The new grantee teams and research projects include:

Michele Balas, PhD, APRN-NP, CCRN, and William Burke, MD
University of Nebraska Medical Center, Omaha, NE
Implementation and Dissemination of an Interdisciplinary Nurse-Led Plan to Manage Delirium in Critically Ill Adults

Susan Beck, PhD, APRN, FAAN, University of Utah
Nancy Dunton, PhD, Kansas University Medical Center
Dissemination and Implementation of Evidence-Based Methods to Measure and Improve Pain Outcomes

Linda Flynn, PhD, Rutgers, The State University of New Jersey
Joel Cantor, ScD, Center for State Health Policy at Rutgers, The State University of New Jersey
Creation of a Nurse Manager Development Program to Increase Patient Safety

Nancy Hanrahan, PhD, RN, University of Pennsylvania
Phyllis Solomon, PhD, University of Pennsylvania
Translation of a Transitional Care Nursing Intervention for People with Serious Mental Illness

Robin Newhouse, PhD, MS, MGA, University of Maryland, Baltimore
Bonnie Spring, PhD, ABPP, Northwestern University
Nurse-Led Intervention to Improve Screening and Treatment for Substance Abuse: An RCT of Hospitals

Maria Titler, PhD, RN, FAAN, University of Michigan School of Nursing
Paul Conlon, PharmD, JD, Trinity Health
Implementation of a Risk Specific Fall Prevention Bundle to Reduce Falls in Hospitals

To learn more, visit http://www.inqri.org/.

Guest Blogger: INQRI Grantee Robin Newhouse

I commend the Initiative on the Future of Nursing committee on their tremendously important and timely report. I was especially pleased to read their second recommendation: “Expand opportunities for nurses to lead and diffuse collaborative improvement efforts.” The committee suggests that funders collaborate to advance research on care models that will enable nurses to contribute to the improved quality of health care by offering nurses the chance to lead collaborative efforts with clinicians from other disciplines.

In my own research, I have seen the importance of nurse-led interventions to make positive change. In 2007, my colleagues and I were awarded a grant from RWJF’s Interdisciplinary Nursing Quality Research Initiative (INQRI) program to conduct our project, “Rural Hospital Quality Collaborative on Evidence-Based Nursing.”

Recent estimates indicate that people with chronic conditions receive 55% of the recommended care with only 68% of patients with heart disease receiving the appropriate treatment. Our interdisciplinary research team evaluated the effects of a rural hospital collaborative established to facilitate translation of evidence on heart failure (HF) patient care. Specifically, we examined nursing characteristics that are associated with improvements in HF patient care. Results indicate that the collaborative enhanced networking, increased evidence-based tool use, and fostered multidisciplinary teams. Nurses in better practice environments use more evidence based interventions. A quality collaborative is an effective mechanism to enable rural hospital nurses to fully engage in improving quality of heart failure care.

As a researcher, I know that it is important to have a wide distribution of successfully proven interventions in order to affect greater change. I was honored to be selected as a member of INQRI’s latest cohort of grantees, all of whom will focus on translation of programs of proven effectiveness to more settings and more general applications. This November, my team and I will launch our project, “Nurse-Led Intervention to Improve Screening and Treatment for Substance Abuse: An RCT of Hospitals.” An alarming one in four hospital admissions are related to substance abuse. Because of the prevalence, health risks to society and strong evidence of effectiveness and efficacy, this study will test implementation of a nursing intervention using substance use Screening, Brief Intervention, and Referral to Treatment (SBIRT) in an acute hospital setting. SBIRT is a comprehensive, integrated, approach to the delivery of early intervention and treatment services for persons at risk or with substance use disorders. Results of the study will move us toward learning how to implement sustainable evidence-based behavioral practices that have significant effects on quality of care outcomes.

By contributing to the evidence-base with proven nurse-led interventions, my team and I hope to provide the type of support that the Future of Nursing committee needs to illustrate the vital role that nurses can play as leaders on health care teams.

The committee notes that “nurses must see policy as something they can shape.” I am happy to report that I am one nurse that sees policy in just that way.


Robin Newhouse, PhD, RN, NEA, BC, CNOR is the Assistant Dean for the Doctor of Nursing Practice Program at the University of Maryland School of Nursing.

RWJF's Voices of Quality

Each month, the Robert Wood Johnson Foundation releases "The Quality Report," an e-newsletter which provides a monthly report from their Quality/Equality program area. One of the highlights each month is the "Voices of Quality" segment - an opportunity to hear from a health care provider about what works.

This month, you can watch a short RWJF Promising Practices video on one hospital's experience improving Race, Ethnicity and Language data collection.

Click here to watch the video.

New Products Available from RWJF's Quality/Equality Portfolio

Catch up on the latest news releases, journal articles, research reports or other publications in the RWJF Quality/Equality program area.

Paper: Closing the Performance Gap in Hospitals?
Annals of Internal Medicine paper examines the effect pay-for-performance measures have on safety net hospitals.
• Read the paper.

Report: Improving Access to Primary Care
Dartmouth Atlas report shows neither higher amounts of primary care, nor routinely seeing a primary care clinician guarantees that a patient will receive recommended care.
• Read the report.

Resource: RWJF Multicultural Newsroom
RWJF’s Multicultural Newsroom provides information for anyone working to improve the health and health care of African-Americans and Latinos in the U.S.
• Take a look and listen.

Brief: How Reform Affects People, Places, Costs
Short reports from Urban Institute researchers look at how health reform may affect consumers, state governments, the economy and health care costs.
• Read the briefs.

Journal: Avoiding Complications While Reducing Costs
Latest issue of Health Services Research shows how payment reform could play a key role in reducing health care costs while improving outcomes.
• Read the report.

Update: PROMETHEUS Payment on the Frontlines of Health Care Payment Reform
A recent update from the RWJF-supported PROMETHEUS Payment model reports on the project’s core concepts, successes and challenges to date.
• Read the brief.

Guest Blogger: INQRI Grantee Susan Letvak

As the Initiative on the Future of Nursing report illustrates, nurses:

• Are the largest component of the health care workforce;
• Spend the most time with patients; and
• Understand care processes across the continuum of care.

Evidence, like the findings generated by the INQRI program, links nurses to high-quality patient care. I commend the committee on their work in understanding the important role of nurses and making such compelling recommendations for ensuring that nurses’ voices are heard and their skills put to the greatest possible use.

 

To that end, it is vitally important that we give nurses the resources they need to be able to deliver the quality of care that our country expects and deserves while also helping to cut costs. The report talks much about developing leadership opportunities and supporting lifelong learning endeavors to allow nurses to continue to grow in their roles. I agree that these efforts are incredibly important. However, my research shows that an even more basic need must be addressed to support these vital caregivers. We have to guarantee that nurses are not only a well-trained workforce, but a healthy one as well.

 

High levels of workplace stress, and the physical nature of nursing, have led nurses to experience high rates of musculoskeletal pain and depression. Our recent Robert Wood Johnson Foundation INQRI study found that almost 3 of 4 hospital employed nurses work with some degree of pain and 18% have depression. Most concerning, these health problems have led to a loss of job productivity and a decrease in quality of care (specifically more medication errors and patients falls and a decrease in self perceived ability to provide quality of care). Focus groups with nurses demonstrated that little is currently being done to address the individual health concerns of the nursing workforce. The current economic downturn is presenting even higher job demands on staff nurses who have health problems and those who are being required to “pick up the slack.”

 

In this era of health reform, patients in the U.S. will be looking more and more to nurses to deliver their care. We have to support nurses to allow them to be at their best when they care for patients. This will ensure that care to be of the highest quality at a reasonable cost.

 

Susan Letvak, PhD, RN, is an Associate Professor in the Community Practice Department at the University of North Carolina – Greensboro’s School of Nursing. She recently completed her INQRI-funded project, “The Effects of Nurse Presenteeism on Quality of Care and Patient Safety.”

Free Webinars from AcademyHealth

This fall, AcademyHealth is pleased to offer a special collection of free webinars on open data initiatives, disparities research, and public health systems and services research. Log in, register, and let the learning begin. It’s a free for fall!

This collection of methods and policy webinars is free to all participants, thanks in part to series sponsors the Kaiser Permanente Institute for Health Policy (Data Innovations Series), the Aetna Foundation (Disparities Research Series) and the Robert Wood Johnson Foundation (PHSR). Separate registration is required for each. To learn more, visit www.academyhealth.org/training.

Data Innovations Series

The Role of HSR in Stimulating and Supporting Open Data Initiatives & Innovations, Part II
Thursday, November 4
1:00–2:30 p.m. ET
(View a recording of Part I)
Register

Disparities Research Webinar Series: Policy-Related Topics

The Affordable Care Act (Part II): Section 4302 and Implications for Data Collection
Faculty: David Meyers, M.D., Agency for Healthcare Research and Quality; José Escarce, M.D., Ph.D. University of California, Los Angeles/RAND
Thursday, November 18, 2010
1:00–2:30 p.m. ET
Register

Upcoming Events:

American Academy of Nursing's Workforce Commission Demonstrates Ways to Use Technology to Improve Nursing Care

Comment on a Project that Streamlined Routine Tasks and Improved the Amount and Quality of Time that Nurses Can Spend with Patients

Aware that technology offers opportunities to streamline routine nursing tasks and improve the amount and quality of time that nurses can spend with patients, researchers at the American Academy of Nursing's Workforce Commission created Technology Drill Downs in 2004, to identify technological solutions to workflow problems. Some 1,000 nurses participated in the two-day drill downs in 25 acute care hospitals through July 2009. The results:

• Participating nurses say that the features of technology they most desire are integration and interoperability across systems; bedside availability; portability; and hands-free capability, such as voice activation.

• Technologies to improve the practice environment include bedside entry systems that interface with medication, supply and equipment systems and "smart beds" that monitor patients' vital signs.

Robert Wood Johnson Foundation wants to hear your thoughts on this project produced by our grantee the American Academy of Nursing's Workforce Commission. Read the complete Grant Results report detailing their research and share your comments on our Web site. Let us know if your hospital has tried technology solutions to workflow problems with nursing.

• Read the Grant Results report.
• Read a profile of Linda Burnes Bolton, who led the effort.
• Read a profile of one technology drill down project at Seton Hospital in Austin, TX.

(c) RWJF 2010

"Real Health Reform Demands an Expanded Role for Nurses"

Last week, the University of Pennsylvania's School of Nursing hosted leaders from the Robert Wood Johnson Foundation to discuss the new recommendations made by the Initiative on the Future of Nursing's committee.
Click here to read the coordinating blog entry, "Real Health Reform Demands an Expanded Role for Nurses" on the Huffington Post, made by the school's dean, Dr. Afaf Meleis.

Click here to read our recap of last week's event in Philadelphia.

The Pennsylvania Launch

Yesterday's event at the Penn School of Nursing represented the "Pennsylvania Launch" for the Initiative on the Future of Nursing.  Robert Wood Johnson Foundation President and CEO, Risa Lavizzo-Mourey spoke to a packed auditorium, explaining that this report is "not about nursing, it's about filling holes in our health care system."  Dr. Lavizzo-Mourey explained the four overlying messages from the committee's report.  Before turning the podium over to Julie Fairman, the nursing scholar in residence at the Institute of Medicine during the committee's deliberations, the crowd heard from Governor Ed Rendell via video. Governor Rendell commended the committee on their work, highlighting the ties between his own "Prescription for Pennsylvania" and the committee's recommendations... especially those related to expanding scope of practice for nurses.  Dr. Fairman then gave an indepth look at the eight recommendations offered by the committee and shared her experiences working with such an accomplished group.  Finally, she welcomed to the podium George Thibault and Julie Sochalski for a panel discussion on the report.

All in attendance agreed about the tremendous importance of this groundbreaking report... and all agreed that the time is now for nursing to embrace its future.  As Governor Rendell said, "nurses hold the key to accessible and affordable health care in this country." 

Penn School of Nursing Hosting Panel on the Future of Nursing Report TODAY

Upcoming Event from the NPSF Professional Learning Series

The National Patient Safety Foundation (NPSF) hosts a Professional Learning Series, which offers today’s healthcare professional the convenience of continuing education and peer-to-peer collaboration in an online learning environment. Drawing on the knowledge and expertise of the NPSF, programs offer best practices, cutting-edge perspectives, and unmatched resources to address current and emerging issues in patient safety. Through this online learning series, healthcare professionals can achieve both personal and professional milestones, while also meeting national and organization-specific patient safety goals.

The next event will be held next Thursday, October 21:

Improving Safety and Quality: Lessons from Health Literacy Research

Thursday, October 21, 2010, 2:00 – 3:00pm Eastern

Featured Speaker: David W. Baker, MD MPH, Michael A. Gertz Professor of Medicine, Chief of the Division of General Internal Medicine, Director of the REACH Practice-Based Research Network, Feinberg School of Medicine, Northwestern University

Learn more and register for this webcast!

INQRI Teams Featured in the Future of Nursing Report

As you saw on Monday, Linda Flynn's INQRI project was highlighted in the report from the Initiative on the Future of Nursing committee. We commend Flynn and her team on their wonderful contribution to the evidence base linking nursing to quality.

We also congratulate our two other INQRI teams who were featured in the committee's report:

As the coordination of care was highlighted as "one of the traditional strengths of the nursing profession," we were very pleased to see the inclusion of the work from Gerri Lamb and Francois Sainfort's INQRI project, "Nurse-Sensitive Measurement of Hospital Care Coordination." As the committee noted, their team "developed a Staff Nurse Care Coordination model that features six nurse care coordination activities regularly performed by staff nurses in hospital settings as part of their daily activities—mobilizing, exchanging, checking, organizing, assisting, and backfilling."

• Click here to learn about Gerri Lamb's work as the co-chair of the National Quality Forum's NQF’s Steering Committee on Care Coordination.

We also congratulate researchers at Johns Hopkins University, David Thompson, Jill Marsteller and J. Bryan Sexton for the inclusion of their findings from the INQRI study, "Linking Blood Stream Infection Rates to Intensive Care." As the committee noted, the team "found that substantial reductions in central line associated blood stream infections can be achieved with nurses leading the infection control effort. Hospitals that adopted [the team's] intensive care unit safety program as well as an environment that supported nurse’s involvement in quality improvement efforts reduced or eliminated bloodstream infections."

• Click here to read an article from the Baltimore Sun focused on Maryland hospitals that are joining Peter Pronovost's national effort (which includes the INQRI team members) to reduce infections.

INQRI Team Leaves Lasting Impression

CentraState Medical Center was one of the participating hospitals in a medication error study funded by the INQRI program: “Examining the Impact of Nursing Structures and Processes on Medication Errors.” Based on their findings, Linda Flynn, Dong Suh and team recommended that sites explore ways in which to reduce nurse interruptions while administering medications.

Acting on that recommendation, Jayne Craig, Ph.D., R.N., from CentraState has received funding to implement and test an intervention to reduce nurse interruptions.

In this new undertaking, CentraState Medical Center proposes to demonstrate whether an intervention designed to reduce nurse interruptions that occur at the time of medication administration (in contrast to those that occur during transcription, preparation, etc.) results in fewer medication errors in the community hospital, medical-surgical setting.

The principal investigator of the INQRI study was a guest blogger for us on Monday, discussing her work in regards to the Future of Nursing report published last week. Click here to read her post.

IHI Seminar on Reducing Readmissions

With readmission payment reductions set to take effect in 2012, providers across the care continuum are feeling financial pressure to keep patients from being needlessly readmitted. Therefore, the two-day seminar sponsored by the Institute for Healthcare Improvement (IHI), "Reducing Avoidable Readmissions by Improving Transitions in Care," could not come at a better time.
Presenters will include:

• Peg M. Bradke, RN, MA
• Eric A. Coleman, MD, MPH
• Gail A. Nielsen, BSHCA, FAHRA, RTR
• Pat Rutherford, RN, MS

The event will be held in Washington, D.C. on November 16-17, 2010.  For more information, please click here.

 

Click here to learn about INQRI researchers who have uncovered the positive effects that nurses can have on reducing readmission rates.

Guest Blogger: INQRI Grantee Linda Flynn on the IFN Report

I am honored that our study quantifying the predictors of medication errors was cited in the new IOM report as an example of how nurses, when supported by their work environments, improve patient safety and reduce adverse events. I am particularly excited that the nursing leadership in one of the participating hospitals acted upon our study recommendations, and has now received grant funding to implement and test an intervention to reduce nurses’ interruptions during medication administration. This seems to be an example of how well-educated nursing leadership in clinical settings can translate research into value-added practices that keep patients safe.

The new IOM report also recommends that organizational barriers to nursing practice must be reduced or eliminated, and that the leadership skills of nurses must be enhanced. Both of these recommendations are relevant to our research, and help to position it for maximum impact. Studies conducted by our team join the growing body of research indicating that organizational environments that are not supportive of professional nursing practice are not only fairly common in hospitals, nursing homes, home health, and other patient care settings, but that they diminish nurses’ abilities to practice in ways that promote quality and safety. Our current study, funded by INQRI, translates this evidence into practice by implementing a leadership program designed to enhance front line managers’ skills in creating and sustaining nursing practice environments that support the important patient-centered work of nurses.

Linda Flynn, PhD, RN, BC, is the Associate Dean for Graduate Education in the College of Nursing at Rutgers, The State University of New Jersey.  She received funding from the INQRI program for her project, "Examining the Impact of Nursing Structures and Processes on Medication Errors" from 2007-2009.  Recently, she was selected as a member of INQRI's latest cohort of grantees with her new study, "Creation of a Nurse Manager Development Program to Increase Patient Safety."

Recommendation: Ensure that Nurses Engage in Lifelong Learning.

INQRI is gratified that the Initiative on the Future of Nursing (IFN) committee has prioritized the concept of lifelong learning for nurses. We whole-heartedly agree that continuing to educate nurses will contribute greatly to their ability to care for a diverse and aging population.

Because we share the committee’s belief, INQRI made the decision in 2009 to take our webinar series public. Originally designed as tools for our grantees, we realized that it did not further our goals to restrict material to internal audiences only. We launched our first public webinar in February, 2009. Since that time, we have offered two series of webinars: one on medication management and one on research translation. We are investigating ways to package these sessions as an educational tool and we are planning our next series on health reform.

Click here to access webinars from Spring 2009.

Click here to access webinars from Fall 2009.

Click here to access webinars from Spring 2010.

INQRI and IFN Agree: Interdisciplinary Collaboration is Vital

The INQRI program completely agrees with the Initiative on the Future of Nursing (IFN) committee’s assertion that “nurses should be full partners, with physicians and other health professionals, in redesigning health care in the United States.” In fact, the concept of interdisciplinary collaboration is central to INQRI’s mission. Since its inception, INQRI has only funded applicants who would apply diverse perspectives and methodological techniques to answer questions without sacrificing the relevance and insights provided by clinicians. Each of our research teams is led by two co-investigators, one a scholar from nursing and one a scholar from another discipline.

Visit our website to learn more about our teams.

Click here to watch INQRI co-director Mark Pauly discuss the merits of interdisciplinary collaboration.

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.

The Committee's Recommendations

Check out this report brief which provides an overview of the recommendations offered by the Initiative on the Future of Nursing committee. 

The report's key messages:

1. Nurses should practice to the full extent of their education and training.
2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression.
3. Nurses should be full partners, with physicians and other health care professionals, in redesigning health care in the United States.
4. Effective workforce planning and policy making require better data collection and an improved information infrastructure.

You can access the full report here.

Click below to read the eight recommendations.

The Time is Now to Fulfill the Promise that Nursing Offers

This morning, committee leaders from RWJF's Initiative on the Future of Nursing, at the IOM are gathering in Washington, D.C. to announce the committee's recommendations regarding the future of nursing in America.  INQRI agrees with the committee that "the United States has the opportunity to transform its health care system, and nurses can and should play a fundamental role in this transformation."

• Click here to watch today's briefing.
• Click here to download the report.
• Click here to read Kaiser Health News's breaking story on the release, "Nurses' Push For Bigger Role Gets Powerful Ally."

"Health Reform Hits Main Street"

Need a quick guide to the Affordable Care Act?  Check out this video, produced by the Kaiser Family Foundation.



This short, animated movie -- featuring the "YouToons" -- explains the problems with the current health care system, the changes that are happening now, and the big changes coming in 2014.

Initiative on the Future of Nursing Committee Unveils Recommendations TOMORROW

Tomorrow, a public briefing will be held to discuss recommendations in the new report by the IOM committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine. The recommendations will serve as the blueprint for expanding access, improving quality, and reducing cost in the American health care system.

Participants will include:

• Donna E. Shalala, Ph.D., FAAN, Committee Chair
• Linda Burnes Bolton, Dr.P.H., R.N., FAAN, Committee Vice Chair
• Harvey V. Fineberg, M.D., Ph.D., President, Institute of Medicine
• Risa Lavizzo-Mourey, M.D., M.B.A., President and CEO, Robert Wood Johnson Foundation

10 a.m. EDT Tuesday, Oct. 5

Register for the video webcast online.

A link to the audio webcast will be posted on www.iom.edu/nursing the morning of Oct. 5.

Since its inception in July 2009, the Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing, at the Institute of Medicine has worked to develop a blueprint for using nurse-led models of innovation to improve the health care system.

The committee, led by former Health and Human Services Secretary and University of Miami President Donna E. Shalala and Vice President and Chief Nursing Officer at Cedars-Sinai Medical Center in Los Angeles Linda Burnes Bolton, organized a number of technical workshops and public forums to discuss key issues that serve as the basis for its recommendations, which will be presented at a public briefing. These address a range of system changes, including innovative ways to improve health care quality and address the health care work force shortage that continues to threaten the availability and quality of care in the United States.

** Follow the briefing live on Twitter at http://twitter.com/FutureofNursing **

New Study Shows Inconsistent Reporting Methods Related to HAIs for Pediatric Patients

A significant cause of in-hospital deaths, bloodstream infections are the most common hospital-acquired infection in pediatric intensive care units.  These infections lead to additional medical costs and added length of stay.  It is very troubling that a new study has found substantial inconsistencies in the methods used to report the number of pediatric patients who develop catheter-associated bloodstream infections.  Conducted by the National Association of Children's Hospitals and Related Institutions Pediatric Intensive Care Unit Focus Group, the study appears in the new issue of the American Journal of Infection Control.

Click here to learn more about the study.

Click here to learn more about how INQRI researchers are working to reduce bloodstream infections.

The Kimberly-Clark Corporation has developed a program to raise awareness about healthcare-aquired infections.  Click here to learn more.

Magazine Names 9 Nurses to Their List list of 100 Most Powerful in Health Care

Modern Healthcare has named nine nurses to their annual list of the 100 most powerful people in health care.  They include Mary Wakefield, Ph.D., R.N., F.A.A.N., head of the Health Resources and Services Administration and an INQRI grantee; Beverly Malone, Ph.D., R.N., F.A.A.N., who is CEO of the National League for Nursing and a member of the national advisory committee for RWJF's Nurse Faculty Scholars program; Linda Aiken, Ph.D., F.A.A.N., F.R.C.N., director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania and a beneficiary of RWJF's Nurse Leaders in the Boardroom program and a member of INQRI's national advisory committee; and Geraldine “Polly” Bednash, Ph.D., R.N., F.A.A.N., who is CEO and executive director of the American Association of Colleges of Nursing and national program director for RWJF's New Careers in Nursing program.

Click here to learn more.