INQRI Advisor to Lead Study on Nurses’ Impact

A new survey of more than 250,000 registered nurses (RNs) will help to generate evidence about how nurses impact the outcomes of their patients, according to a Nurse.com article. INQRI Research Manager and National Advisory Committee Member Linda Aiken will lead the survey of RNs and Nurse Practitioners holding active licenses in California, Florida, New Jersey, and Pennsylvania.
 
Aiken is the director of the University of Pennsylvania, School of Nursing’s Center for Health Outcomes and Policy Research (CHOPR). The National Institute of Nursing Research provided a $2.9 million grant to CHOPR for the survey, which is titled Panel Study of Effects of Changes in Nursing on Patient Outcomes. RWJF, the National Council of State Boards of Nursing, the Hillman Foundation, and the Boettner Center also provided funding.

“Our study will examine organizational-level changes over time in nurse inputs in education, staffing, skill mix, and work environment between 1999, 2006 and 2015,” Aiken said in a statement on CHOPR’s website. “The great strength of this project is that in creating a panel of organizational observations, we can see where change has occurred and why.”

States Benefit from Increased Autonomy for Nurses

States that allow Advanced Practice Registered Nurses (APRNs) to practice independently saw an improvement in health outcomes for patients and decreases in costs to Medicare and Medicaid, according to a study by researchers at the Missouri University Sinclair School of Nursing, Nurse.com reports.

The study, “Impact of Nurse Practitioners on Health Outcomes of Medicare and Medicaid Patients,” was published in the November-December issue of Nursing Outlook. Researchers analyzed previous studies with data on Medicare and Medicaid patients and found that states with full practice of nurse practitioners have lower hospitalization rates in all of the groups examined.

An INQRI-funded study, "Scope-Of-Practice Laws For Nurse Practitioners Limit Cost Savings That Can Be Achieved In Retail Clinics,” found similar cost savings at retail clinics in states where nurses had more independence. The study, co-led by Joanne Spetz and Stephen Parente, found that visits to nurse-managed retail clinics were associated with lower costs, and the costs were even lower when Nurse Practitioners (NPs) practiced independently. The researchers concluded that eliminating restrictions on NPs’ scope of practice could have a large impact on the cost savings that can be achieved by retail clinics.

Increased RN Staffing Hours Are Correlated with Higher Quality Patient Care

An INQRI-funded study on the impact of nursing staffing on hospital performance revealed that increasing the number of registered nurse (RN) hours per patient day increased the quality of patient care. The study looked in particular at patients who were being treated for acute myocardial infarction, pneumonia or heart failure.)  For all three conditions, increasing the number of RN hours increased the quality of care. This did not hold true for increasing the number of licensed practical nurse (LPN) or nursing assistant (NA) hours.

The study's authors -- Gestur Davidson, Ira Moscovice and Kathy Belk -- posited that RNs are involved in and directly affect procedures, practices and processes that directly influence patient outcomes. This was the first study into how nurse staffing affects hospital performance on quality metrics used in the Premier Hospital Quality Demonstration project. It is reviewed in a new research brief on the Robert Wood Johnson Foundation website.

Nurses Save Patients Time and Hospital Money

The local CW affiliate for the Dallas Fort-Worth area, KDAF-TV, detailed how a group of nurses tasked with obtaining detailed history for patients has helped improve care and patient satisfaction. The team of five full-time nurses, better known as DART (discharge, admission, resource, transport), also play a crucial role in the discharge process, ensuring patients understand the medications and instructions given to them by hospital physicians.

To read more about the DART team, click here.

Significant Rise in Ohio Nurses Seeking 4-year Degrees

In response to growing demands by hospital systems and ambulatory practices, more Ohio registered nurses are enrolling in bachelors of science programs to enhance their skill-set and improve their desirability in the touch job market. Many of these nurses are seeking to obtain their BSN as part of their job requirements, which require nurses without a bachelors degree to obtain one within five years of employment. These efforts support one of the recommendations made by the Institute of Medicine (IOM) report, "The Future of Nursing: Leading Change, Advancing Health" which seeks to improve the number of registered nurses with BSNs to 80% by 2020.

To read more about Ohio's efforts to improve its nursing workforce, click here.

To read more blogposts relating to the IOM's "Future of Nursing" report, click here.

RN Labor Supply Bubble: What Does it Mean for Rural Health Care?

Over the past year, many studies have predicted that a temporary employment bubble is approaching for Registered Nurses in many urban areas. In response to one of the more recent articles discussing this trend, authored by Staiger, Auerbach, & Buerhaus and appearing in the April edition of the New England Journal of Medicine, the Online Journal of Rural Nursing and Health Care's editor, Pamela Stewart Fahs, DSN, RN, brought up the important question as to how this trend will effect rural nursing. Dr. Fahs discussed how the upcoming labor supply bubble may actually improve rural nursing by making these health care facilities more competitive with their urban counterparts. By having a tougher job market, new nurse graduates may be more willing to relocate than they have been in the past.

To read Dr. Fahs' editorial, click here.

To read more blogposts relating to nursing workforce issues, click here.

Webinar: The Supply of Registered Nurses – Are We in an Employment Bubble?

We are pleased to share with all of you an upcoming webinar hosted by our colleagues at Versant Holdings, LLC focused on the supply of registered nurses (RNs). You may remember Charles F. Krozek, MN, RN, FAAN, Managing Partner of Versant Holdings, LLC, led a webinar hosted by the INQRI program addressing the (IOM) report The Future of Nursing: Leading Change, Advancing Health's third recommendation at the end of Feburary of this year, which you can view a video of here. Versant Holdings, LLC upcoming webinar will feature Peter I. Buerhaus, PhD, RN, FAAN, an expert in nurse and physician workforces in the United States.

We encourage all of you to participate in this free webinar.

Click here to register for the webinar.

Upcoming Webinar on May 17, 1-2pm EST: Lifelong Learning: Creating Partnerships to Build a Culture for Professional Growth

The INQRI program is pleased to announce the fifth webinar in our series focused on the IOM report, 'The Future of Nursing: Leading Change, Advancing Health."    

This session will focus on the sixth recommendation made in the IOM report, which focuses on ensuring that nurses engage in lifelong learning. Accrediting bodies, schools of nursing, health care organizations, and continuing competency educators from multiple health professions should collaborate to ensure that nurses and nursing students and faculty continue their education and engage in lifelong learning to gain the competencies needed to provide care for diverse populations across the lifespan.

 

Lifelong Learning: Creating Partnerships to Build a Culture for Professional Growth  

Presented by:

Teresa Wehrwein PhD, RN, Associate Dean for Academic and Clinical Affairs Michigan State University College of Nursing    

Kathleen Kessler, MSN, RN, Director of Professional Partnerships Michigan State University College of Nursing    

Thursday, May 17, 2012  1pm - 2pm ET 

Click here to register.

The programs we will be discussing are: "Nursing for Life: RN Career Transition Program" and "Leading Toward Tomorrow: Creating a Community of Nurse Leaders" in Michigan.

Webinar Objectives:

1.   Discuss lifelong learning and strategies to engage nurses.

2.   Describe specific programs developed to support career development for practicing nurses.

3.   Explore how utilizing partnerships can leverage lifelong learning program development.

Recognizing and Thanking Our Committed Nurses - A Letter From Rep. Eddie Bernice Johnson

Yesterday, The Huffington Post, featured an Op-Ed by Representative Eddie Bernice Johnson, ranking member on the House Committee on Science, Space and Technology. Rep. Johnson discussed her past experience as a registered nurse, while also highlighting the great importance that the nursing workforce contributes to the health of the United States.
Click here to read the full Op-Ed.

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). 

No Jobs for 43% of Newly Licensed Nurses Responding to California Statewide Survey

A recent survey conducted by the California Institute for Nursing & Health Care (CINHC) has found that forty-three percent of nurses who obtained their RN license within 18 months. With conflicting reports stating that there is a nursing shortage in the United States, this latest poll is rather troubling for new nursing graduates attempting to break into the field. The CINHC survey found that 92% of nurses polled cited that their lack of experience was the primary reason they were unable to obtain a job. This is a rather complex issue with new nursing graduates unable to obtain a job due to lack of experience, and unable to gain experience due to the lack of entry level positions.

Click here to read the full press release.

Minimum Nurse Staffing Level Legislation Introduced In Minnesota

Last week, Renee Passal, of local ABC affiliate WDIO, reported that the Minnesota House and Senate has introduced legislation aiming to establish minimum nurse staffing levels at hospitals. The article also features a video snippet further detailing the proposed bills.

Click here to read the article and watch the video.

Click here to read other blogposts relating to nurse staffing.

Important Opportunities And Challenges Posed For Registered Nurses And APRNs In The Creation And Implementation Of ACOs

On March 27th, The Nursing Alliance for Quality Care and the American Academy of Nurse Practitioners will be hosting a symposium on nursing leadership in Accountable Care Organizations (ACOs). The symposium will be focused on opportunities and strategies for registered nurses and advanced practiced registered nurses working next to and within ACOs. The event, which will be held in Washington D.C., features Dr. Kavita Patel, Barbara Safriet, Joyce Dubow and Nancy O'Rourke as speakers.

Click here to find out more information about this upcoming symposium.

Also, don't forget to register for our upcoming national meeting in Washington D.C. on April 26-27. Registration is free and if you are interested, please contact Heather Kelley-Thompson at hkelley@nursing.upenn.edu

Nurses, Care Coordinators Are Gaining Importance in ACOs

Earlier this morning, Jennifer Lubell, of AISHealth.com, detailed the growing importance of nurses in the ACO model of care. These "embedded nurses", or care coordinators, have been found to be an essential part of the ACO framework as they improve patient outcomes by providing a significant communication link between the patient and physician. Insurance companies, including Cigna and Aetna, have touted the care coordinator role as a key contributor to improved patient outcomes.

Click here to read the full article.

Philadelphia Hospital Boosts Use Of Registered Nurses In Bid To Improve care

Yesterday, Stacey Burling, reporting for the Philadelphia Inquirer, detailed how Hahnemann University Hospital plans to utilize more registered nurses (RNs) and reduce the amount of nurse assistants. This decision was spurred by a pilot study conducted in one nursing unit that found that using all registered nurses to care for patients instead of a combination of nurses and nursing assistants led to higher-quality care, and greater patient and nurse satisfaction. The hospital cites changing payment models that emphasize the importance of quality of care as a catalyst for this initiative. The hospital's decision also relates to INQRI studies that have found having higher levels of RN skill mix leads to better patient outcomes.

It should also be noted that the union representing the certified nursing assistants protested outside of the hospital yesterday in response to the new care model announcement?

What are your thoughts on this issue?

Click here to read the full story.

New York State Initiative to Educate The Nursing Workforce: "BSN in 10"

A few weeks ago, we reported on the proposed legislation in the New York State Senate that would require Registered Nurses to obtain a BSN within 10 years of initial employment. Following up on this post, we are sharing another article with you that discussed the significance and challenges associated with this legislation. Christine Loman, of the The Evening Tribune, discussed the importance of nurses with associates degrees obtaining their BSNs and how this will be beneficial to not only the nurses themselves, but the patients they care for. This proposed legislation addresses the fourth recommendation in the IOM's Future of Nursing: Leading Change, Advancing Health report that proposed an increase in the proportion of nurses with a baccalaureate degree to 80 percent by 2020.

Click here to read the article.

Click here to read the blogpost from a couple weeks ago also addressing the "BSN in 10" initiative.

New York Bill Would Require Four Year Registered Nursing Degrees

We hope that everyone had a safe and happy holiday season!

Last week, The Washington Post reported on a new bill being considered by the New York State Senate that will require all registerd nurses to obtain bachelor’s degrees within 10 years in order to keep working in the state. This intiative, “BSN in 10”, is supported by major nursing and health policy organizations across the country. The proposed legislation also directly addresses recommendation #4 made in the IOM's Future of Nursing: Leading Change, Advancing Health report.

Click here to read the article.

Click here to read all blogposts relating to the IOM's report.

Newly Licensed Registered Nurses' Geographic Immobility

The December issue of Health Affairs featured two articles highlighting surprising trends related to the nursing workforce. We have already posted about one of the studies that investigated the growth in the nursing workforce among young adults, which you can access here. The other research article, which we are sharing with you today, discussed the relative immobility of recently licensed Registered Nurses and the issues that may arise from the lack of new RNs unwilling to relocate for employment. The study found that 52.5 percent of newly licensed RNs work within forty miles of where they attended high school, which can potentially affect rural areas that may not have an adequately trained workforce in their local area.

Click here to read the article as it appears in Health Affairs.

National Council of State Boards of Nursing Extends Electronic Licensure Exam to Canada

Last week, the National Council of State Boards of Nursing (NCSBN) announced that the NCLEX-RN® Examination, a RN licensure exam used in foreign countries for the purpose of domestic licensure in the United States, was chosen by ten provincial nurse regulatory bodies in Canada. The adoption of this electronic exam in Canada has the potential to drastically change the nursing workforce in both Canada and the United States, as nurses would technically be licensed to work as a RN in either country. In response, the Canadian Nurses Association (CNA) has expressed disappoint with the choice made by the provincial regulatory bodies as they fear that many qualified Canadian nurses may be lured by the promise of higher paying positions in the United States. Additionally, the CNA fears that licensure content specific to Canada may be excluded from the exam and thus, lower the quality of care in Canadian healthcare facilities.

Click here to read the NCSBN's press release.

Click here to read the CNA's response.