Shared Resource: Treatment Fidelity

At the INQRI annual meeting, Cohort 3 researcher Barbara Resnick offered to share a presentation she has given regarding treatment fidelity. Click on her slide to view the slides as a PDF.

Examining the Impact of Nursing Structures and Processes on Medication Errors

Drs. Linda Flynn and Dong Suh present findings on their INQRI project: "Examining the Impact of Nursing Structures and Processes on Medication Errors" at the 4th Annual INQRI Meeting.





Project Description: The Institute of Medicine noted that a hospital patient on average is subject to at least one medication error per day, making medication errors the most common cause of preventable adverse events. This interdisciplinary study has been designed to disentangle the effects of nursing structures and care processes on non-intercepted medication errors in acute care hospitals. The economic impact of non-intercepted medication errors will be determined to explore the business case for evidence-based recommendations.

Nursing Care Quality in Acute Care Hospitals: New Linkages to Patient Outcomes

Dr. Arlyss Anderson Rothman and Dr. R. Adams Dudley present their INQRI project: "Nursing Care Quality in Acute Care Hospitals: New Linkages to Patient Outcomes" at the 4th Annual INQRI meeting.





Project Description: Increased public reporting of hospital performance and the emergence of hospital pay-for-performance initiatives provide new impetus to defining and maximizing all aspects of hospital care. This interdisciplinary team has examined whether increases in nurse staffing and skill mix improve hospital performance on a subset of JCAHO core measures, enhance patient perceptions of nursing performance, and improve overall nursing performance as measured by composite indicators that capture patients' perceptions of care and other selected outcomes of care such as complication rates.

The Nurse as Leader in Delivering Care

This panel presentation was delivered by members of INQRI's third cohort of grantees at the 4th Annual INQRI Meeting. Facilitated by NAC Member Shelley White-Means.

Part 1 features Dr. Barbara Resnick, presenting on the study "The Res-Care-AL Intervention Study."



Part 2 features Dr. Doug Wholey, presenting on the study "Multidisciplinary Organization and Outcomes for Chronic Heart Failure Patients in the VA."



Part 3 features Dr. Kathleen Stevens, presenting on the study "Small Troubles, Adaptive Responses [STAR]: Fostering a Quality Culture in Nursing."



Part 4 features Dr. Cynthia Corbett, presenting on the study "Empowering Home Care Nurses to Efficiently Resolve Medication Discrepancies."

Nursing-Pharmacy Collaboration on Medication Reconciliation: A Novel Approach to Information Management

In the first part of this presentation, Drs. Bob Feroli and Linda Costa present the outline and background on the study "Nursing-Pharmacy Collaboration on Medication Reconciliation: A Novel Approach to Information Management." Introduced by INQRI National Advisory Committee member Jose Pagan.



In Part 2, Dr. Costa provides the findings.



Project Description: Deficits in communication across the continuum of care in regards to medication use can place patients at serious risk for harm. This interdisciplinary team has examined how to economically support direct care providers in medication reconciliation in order to facilitate safe transition to and from hospital and community. The team evaluated the effectiveness of a nurse-pharmacist clinical information coordination team in improving drug information management on admission and discharge, quantified potential harm due to reconciliation failures, and determined cost-benefit related to averted harm.

Interdisciplinary Collaboration Reduces Cost

A new Johns Hopkins study has found that teams of nurses and physicians that provide proactive, evidence-based care for patients with chronic conditions reduce health care spending. The researchers found 24% fewer hospital days, 37% fewer nursing home days and 15% fewer emergency department visits in 500 patients enrolled in the Guided Care program. They estimate that this equals an average savings of $1,364 per patient. For more information on the study, click here.

Last month, during INQRI's 4th Annual Meeting, our co-director Mark Pauly (a healthcare economist) explained the importance of our program's focus on interdisciplinary collaboration.

Quality of Pediatric Nursing Care from the Children's Perspective

Part 1: Dr. Nancy Ryan-Wenger (Nationwide Children's Hospital) presents the study, "Quality of Pediatric Nursing Care from the Children's Perspective" at INQRI's 4th Annual Meeting.



Part 2: Dr. Bill Gardner (Nationwide Children's Hospital) presents findings and the researchers answer questions. Moderated by INQRI National Advisory Committee member Randall Krakauer, MD.



Project Description: This interdisciplinary research team identified hospitalized children's perceptions of the linkages between the quality of nursing care and outcomes. This study identified the nursing care processes and outcomes that matter most to children during their hospitalization, and estimated the extent to which disparities exist in the quality of their care and outcomes.

Linking Processes of Nursing Care and Patient Safety Outcomes: An Analysis of the Cause and Effect of Safe Practice

Part 1: Dr. Richard Lindrooth (University of Colorado) presents the study, "Linking Processes of Nursing Care and Patient Safety Outcomes: An Analysis of the Cause and Effect of Safe Practice" at INQRI's 4th Annual Meeting.



Part 2: Dr. Lindrooth (University of Colorado) presents the findings.



Part 3: Drs. Richard Lindrooth (University of Colorado) and John Welton (Medical University of South Carolina) respond to comments from Leapfrog CEO Dr. Leah Binder and questions from Dr. Nancy Donaldson (CalNOC) after their presentation.




Project Description: This interdisciplinary team has examined how adoption of the National Quality Forum (NQF) safe practices affects nursing sensitive patient safety outcomes. Barriers to adoption of these practices was also explored. This team has taken a step beyond existing literature, testing whether the implementation of safe practices leads to more effective use of nurses, and whether this leads to better performance on patient safety outcomes.

INQRI Meeting: A Recap

We spent an incredibly busy couple of days together in Princeton! INQRI's Fourth Annual Meeting featured tips for using social media, a keynote address entitled "Disruption" by Bob Brook, stirring remarks from RWJF president, Risa Lavizzo-Mourey, project overviews from our new finalists, 2 panels from our Cohort 3 teams, an update on the National Quality Forum's nurse-sensitive measures, an introduction of the Intiative on the Future of Nursing, and of course: the presentation of research findings!

Our 12 Cohort 2 teams are in the final stages of their work and shared their outcomes with us.

“Linking Processes of Nursing Care and Patient Safety Outcomes: An Analysis of the Cause and Effect of Safe Practice”
John Welton and Richard Lindrooth

“Nursing-Pharmacy Collaboration on Medication Reconciliation: A Novel Approach to Information Management”
Linda Costa and Bob Feroli

“Quality and Cost Outcomes of Hospital Supplemental Nurse Staffing”
Ying Xue

“Examining the Impact of Nursing Structures and Processes on Medication Errors”
Linda Flynn and Dong Suh

“Nursing Care Quality in Acute Care Hospitals: New Linkages to Patient Outcomes”
Arlyss Anderson Rothman and Adams Dudley

“Nursing Workforce Impact on Performance Improvement in the CMS/Premier Hospital Quality Incentive Demonstration Project [HQID]”
Presented for the team by Doug Wholey

“Acuity-adjusted Staffing, Nurse Practice Environments and NICU Outcomes”
Eileen Lake and Jeannette Rogowski

“Quality of Pediatric Nursing Care from the Children's Perspective”
Nancy Ryan-Wenger and Bill Gardner

“Rural Hospital Quality Collaborative on Evidence-Based Nursing”
Robin Newhouse and Laura Morlock

“Translating Fall Risk Status into Interventions to Prevent Patient Falls”
Patti Dykes and Stuart Lipsitz

“Impact of System-Centered Factors, and Processes of Nursing Care on Fall Prevalence and Injuries from Falls”
Marita Titler and Leah Shever

“A Quality and Cost Analysis of Nurse Practice Predictors of Readiness for Hospital Discharge and Post-Discharge Outcomes”
Marianne Weiss and Olga Yakusheva

For information on these projects, please visit our website.

Live from the INQRI Meeting

Special thanks to Sue Hassmiller and Linda Burnes Bolton for updating INQRI grantees, National Advisory Committee members and distinguished guests on RWJF's Initiative on the Future of Nursing at the IOM. Sue and Linda provided a wonderful overview of the initiative and answered questions from our researchers during lunch. Thank you, Sue and Linda - we look forward to hearing more!

Susan Hassmiller
Senior Advisor for Nursing

Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine

Linda Burnes Bolton
Vice Chair

Robert Wood Johnson Foundation Initiative on the Future of Nursing at the Institute of Medicine

For more information on the initiative, please check out the website.

Another Way to Follow the INQRI Annual Meeting from Your Desktop

In addition to tweeting with us, you can also watch the meeting live from the Robert Wood Johnson Foundation from your desktop!

For the day long meetings on Wednesday and Thursday, you can view the event in progress via this link. Use password inqrisra so you don’t miss any of the action! The meeting will kick off at 9.30a Wed morning and end around 5.15p. We’ll start up again Thursday morning at 9.30a and conclude around 4p.

Check it out!

Tweet with Us!

Follow us on Twitter!

The INQRI Annual Meeting kicks off tomorrow night in Princeton, NJ. We will be tweeting throughout the program. The hashtag for the event will be #INQRI09. To find the discussion, enter #INQRI09 in the search box in Twitter. To contribute to the conversation, include #INQRI09 in all tweets.