Music Eases Anxiety and Need for Sedation, Pain Medication for Patients on Ventilators

A study published online in the Journal of the American Medical Association reveals that listening to music can help soothe critically ill patients who are on ventilators, reducing their anxiety, need for pain medication and sedation. Reearchers conducted the trial with 373 ventilator patients in the ICU and found that those who listened to music for 80 minutes a day reduced their anxiety by nearly 20 points compared with those who did not.

The patients were divided into three groups: those who listened to white noise, those who chose music to listen to and those who received usual care, with neither intervention.  Being able to select the music they listened to also had an impact. Patients who chose their music and listened to it when they wanted to and for as long as they wanted required sedation less often that patients in the control or white noise group.

Most patients in the study had been intubated for respiratory failure or distress and all were alert and able to follow commands.

An INQRI-funded study led by Tracey Yap and Jay Kim found another use for music: reducing the incidence of pressure ulcers. The study used music to cue patients in long-term care facilities to move in order to avoid getting pressure ulcers. The music also cued staff to help to move those patients who couldn't move on their own. Dr. Yap blogged about the study and some unexpected results on the RWJF Human Capital blog for National Nurses Week.

Another INQRI-funded study, led by Michele Balas and William Burke, focused on helping critically ill patients on ventilators stay alert, calm and delirium-free. The researchers tested an intervention that used a nurse-led interprofessional team to implement a bundle of evidence-based practices related to communication, standardized care, and reducing sedation and the amount of time patients spent on a ventilator.

New JAMA Study Underscores Why the Business Case for Nursing Is Problematic

A new study to be published tomorrow in the Journal of the American Medical Association (JAMA) finds that hospitals profit when patients have complications during surgery. According to a report in the Washington Post's Wonkblog, this counter-intuitive finding is a function of the payment structure in our nation's health care system. Hospitals earn money for every procedure done, even if that procedure is necessary to correct an error that occurs during surgery.

It's for just this reason,according to Olga Yakusheva, Douglas Wholey and Kevin Frick, that it has been so difficult to make a business case for investing in nursing care. In their article in the INQRI Medical Care supplement published last month, the INQRI researchers point out that because investments in nursing care improve patient outcomes, they hurt hospitals' bottom line. The authors go on to suggest that the roll out of the Affordable Care Act, which includes penalties for high rates of hospital acquired infections among, will help to address this confounding issue. They, like the authors of the JAMA study, also encourage taking more aggressive steps to make health care payments outcome-based, rather than service-based.

According to the Post blog, the JAMA study found that a hospital's profit margin jumped from $16,936 to $55,953 when there was a surgical complication.

Nursing Excellence Improves Outcome for High-Risk Infants‎

We are pleased to share with you a recently published study in JAMA conducted by INQRI cohort 2 grantees Dr. Eileen Lake, Dr. Jeannette Rogowski and colleagues, which found hospitals designated by the American Nurses Credentialing Center as a "RNE" hospital provide high quality care in three quality measurement areas. These hospitals, who have obtained the "RNE" designation by achieving exemplary practice or leadership in five areas, had significantly better outcomes than hospitals without this designation in rates of hospital infection, severe intraventricular hemorrhage, and death after seven day. Surprisingly, this study found no significant difference in the death rate of low birth weight infants after 28 days of birth between those hospitals with "RNE" designation and those that did not receive this credential.

Click here to read more about this study.

Click here to read the actual study (subscription required).