Mobile Apps Empower Nurses to Use Evidence-Based Guidelines, Identify Health Problems

A new nurse-led study concludes that custom mobile health applications can help nurse practitioners use evidence-based guidelines, which would improve their ability to diagnose health issues during exams, MHealthNews reports.

Mobile apps that include clinical decision support tools helped clinicians diagnose chronic health issues, according to the study led by Suzanne Bakken, alumni professor of nursing at Columbia University School of Nursing.

The study, published in the Journal for Nurse Practitioners, examined the diagnosis rates of nearly 400 nurses during more than 34,000 patient exams and found significant diagnostic rate increases:

• Seven times more obese and overweight (33.9% vs. 4.8%)
• Five times more tobacco use (11.9% versus 2.3%)
• 44 times more adult depression (8.8% versus 0.2%)
• Four times more pediatric depression (4.6% versus 1.1%)

“What clinicians need is decision support tools that fit into their workflow and remind them of evidence-based practices,” Bakken said in a statement. "Our app focused specifically on the work that nurse practitioners do to identify health problems, counsel patients and coordinate care plans, resulting in higher diagnosis rates and more opportunities for intervention."

The goal of an INQRI-funded project “Dissemination and Implementation of Evidence-Based Methods to Measure and Improve Pain Outcomes” was to disseminate and implement evidence-based approaches to measure and improve pain care and outcomes in a sample of 100 hospitals across the United States. Two webinars are available detailing the results of the project: Webinar I and Webinar II. The interdisciplinary team was led by Susan Beck and Nancy Dunton.

RN Researching Communication Tool that could Reduce Readmissions

A nurse researcher is exploring whether or not hospital readmissions among elderly patients in assisted living could be reduced through improved communications between medical providers, the Lubbock Avalanche Journal reports.

Alyce Ashcraft, associate dean for research at the Texas Tech University School of Nursing, is conducting a study with a customized Situation, Background, Assessment and Recommendation (SBAR) tool that gathers additional patient information and forces more transparency in nurse-provider communication.

Over a 16 week-period, Ashcraft instructed nurses at a retirement community in Lubbock, Texas, to document all of their consultations with health care providers, including phone and fax communications, on SBAR forms. The intent is to eliminate repeats tests and create more efficient care by recording when nurses contact other providers about a patient’s condition, and the actions taken. The data is still be collected and analyzed.

“I don’t care if you’re here in long-term care, or the hospital or home health, it doesn’t matter,” Ashcraft, told the Journal. “Communicating the right information and getting the residents’, the patients’, the clients’ story right so that decisions can be made that are good for them; [t]hat’s what we hope to do.”

INQRI researchers at Marquette University, led by Marianne Weiss and Olga Yakusheva, studied what hospital-based nurses do to influence outcomes, including readmission rates, after a patient is discharged from a hospital. Specifically, they identified the contributions that nursing staff make to the quality of discharge teaching and the impact of that teaching on patient outcomes, readiness and readmission rates of patients who are discharged home. They 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 post-discharge utilization of readmission and emergency room visits was lower.

More Nursing Schools Focus on Interdisciplinary Care

A number of the nation’s top nursing schools now require students to participate in at least one interprofessional education course or activity, according to a “dashboard” report recently released by the Future of Nursing: Campaign for Action, an initiative of RWJF and AARP.

Experts have been calling for interprofessional education for decades, but more schools are now responding because requirements are being written into health professions accreditation standards, Barbara Brandt tells RWJF’s Sharing Nursing’s Knowledge (SNK) newsletter. Brant is head of the National Center for Interprofessional Practice and Education, a public-private partnership supported by RWJF, the U.S. Health Resources and Services Administration, and other organizations. While there is not yet any comprehensive data quantifying the number of interprofessional activities and courses offered nationwide, Brandt said that there is “no question” the number of schools requiring these types of activities is growing rapidly.

INQRI is credited in the SNK article for helping to foster interdisciplinary research and collaborative practice. The ongoing impact can also be seen in health journals, where the number of articles in 10 of the top health services research journals co-authored by a registered nurse (RN) is increasing dramatically, according to a supplemental dashboard indicator, which shows that articles co-authored by RNs jumped from 80 to 145 from 2010 to 2012.

“For much of history, physicians made the major care decisions,” INQRI Grantee Joanne Spetz said. “We need to start teaching nursing students that they bring a set of skills to the table that are unique and distinct, and add value to the skills provided by other professionals. That will help them develop good, collaborative relationships over time.”

Evidence-Based Practice, Nurse-led Research Key to Patient Outcomes

In a two-part series, Nurse.com provides first-hand feedback from nurses presenting posters at the Oncology Nursing Society national conference, who share guidance for other nurses interested in research practice.

One of the researchers quoted, Nalo Hamilton, a Robert Wood Johnson Foundation Nurse Faculty Scholar, advises nurses to recognize the contributions they can make to research practice and to realize that all research, whether small or large, makes a difference in nursing knowledge and patient care.

“As nurses, we can examine how we can improve our nursing interventions and showcase what we do in our research,” Hamilton tells Nurse.com. “For example, we are great at health care prevention and can demonstrate through our research how, for example, patient education improves medication compliance and patient outcomes.”

All of the nurses interviewed noted that evidence-based practice projects and research in oncology nursing help nurses determine their role in improving patient care and outcomes.

Part I is available here. 
Part II is available here.  

American Nurses Foundation Supports Nursing Research Into Bullying, Loneliness, Walking

Nursing research runs the gamut from investigations into nursing processes that affect patient care to testing whether seniors are better able to age in place if their homes are adapted to meet their needs. No matter, the topic, the body of research conducted by nurses continues to grow exponentially.

The latest issue of The American Nurse highlights the studies of three nurse researchers who have received grants from the American Nurses Foundation (ANF), including RWJF Nurse Faculty Scholar Laurie Theeke.

Theeke's research, funded by ANF and RWJF, involves exploring the emotions associated with loneliness, specifically among older adults living with chronic illness in Appalachia. She has found that older adults who scored high on a loneliness index felt stigma, sadness, anxiety, depression, anger, and fear. Theeke plans to test interventions that target specific components of loneliness. She suggests that further research might address whether people isolate themselves because of functional decline or whether isolation speeds that decline.

Other highlighted research studies explore how novice nurses cope with workplace bullying by nurse colleagues and whether safer walking areas influence health outcomes of low-income residents.

Research Grants Awarded to Study Nurse Residency Programs, Scope of Practice, Primary Care Workforce

The Robert Wood Johnson Foundation and INQRI today announced the recipients of four new grants from the Future of Nursing National Research Agenda. The grants will support research into key issues being addressed by the Future of Nursing: Campaign for Action: nursing education and scope of practice regulations.

A fifth study funded last year, to determine the how emerging models of primary care will affect future primary care workforce needs, is nearing completion.That study was co-funded by the Donaghue Foundation. It's being conducted by David Auerbach of the RAND Corporation.

The other four studies are:

• A team from the University of Pennsylvania will examine the impact of the provision of the Prescription for Pennsylvania law that removed practice barriers for APRNs. The research team will evaluate the development and architecture of the bill, and the success of the provision in expanding access to health care, particularly in medically underserved communities.