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Journal articles on the topic 'Nurse-sensitive outcomes'

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Author: Grafiati

Published: 10 December 2022

Last updated: 28 January 2023

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1

Haberfelde, Mimi, Diane Bedecarr??, and Martha Buffum. "Nurse-sensitive Patient Outcomes." JONA: The Journal of Nursing Administration 35, no. 6 (June 2005): 293???299. http://dx.doi.org/10.1097/00005110-200506000-00005.

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2

Ingersoll, Gail L., Elaine McIntosh, and Mamie Williams. "Nurse-sensitive outcomes of advanced practice." Journal of Advanced Nursing 32, no. 5 (November 2000): 1272–81. http://dx.doi.org/10.1046/j.1365-2648.2000.01598.x.

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3

de Vos, Rien. "Nurse sensitive outcomes? Een gevoelig onderwerp." Nederlands Tijdschrift voor Evidence Based Practice 12, no. 1 (February 2014): 24. http://dx.doi.org/10.1007/s12468-014-0011-0.

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4

Krau, Stephen D. "Nurse-Sensitive Outcomes: Indicators of Quality Care?" Nursing Clinics of North America 49, no. 1 (March 2014): ix—x. http://dx.doi.org/10.1016/j.cnur.2013.12.002.

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Krau, Stephen D. "Using Nurse-Sensitive Outcomes to Improve Clinical Practice." Critical Care Nursing Clinics of North America 13, no. 4 (December 2001): 487–95. http://dx.doi.org/10.1016/s0899-5885(18)30016-9.

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6

Johnson, Sarah, and Elizabeth Schenk. "A Proposal: Nurse-Sensitive Environmental Indicators." Annual Review of Nursing Research 38, no. 1 (December 23, 2019): 265–74. http://dx.doi.org/10.1891/0739-6686.38.265.

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Healthcare contributes significant pollution to the natural environment. Nurses are obligated by professional commitment, to avoid causing harm in their care processes and decisions, including environmental harm. Nurse awareness of healthcare-generated pollution is growing but nurses may lack an understanding of how nursing contributes specifically to this pollution and what nurses can do within their scope and span to address it. This chapter introduces the concept “Nurse-Sensitive Environmental Indicators” as a proposal to identify, measure, and reduce the unintended harm of nursing practice that contributes to healthcare-generated pollution. It discusses the environmental problem, environmental health, and healthcare. The chapter explains what environmental stewardship has to do with nursing and describes nurse sensitive indicators. As has been the case with other quality outcomes measures, identifying agreed-upon environmental outcomes measures may give the nursing profession tools to measure and then address environmental impacts arising from nursing practice.

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Murphy, A., J. Drennan, N. Brady, and D. Dahy. "Economic Impact Of Nurse Sensitive Outcomes In Irish Hospitals." Value in Health 20, no. 9 (October 2017): A667—A668. http://dx.doi.org/10.1016/j.jval.2017.08.1624.

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8

Twigg, Diane E., Lucy Gelder, and Helen Myers. "The impact of understaffed shifts on nurse-sensitive outcomes." Journal of Advanced Nursing 71, no. 7 (January 9, 2015): 1564–72. http://dx.doi.org/10.1111/jan.12616.

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9

Flaherty, Mary Jean. "The Challenge: The Need for Nurse-Sensitive Patient Outcomes." Clinical Nurse Specialist 14, no. 4 (July 2000): 158. http://dx.doi.org/10.1097/00002800-200007000-00007.

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Driscoll, Andrea, Maria J. Grant, Diane Carroll, Sally Dalton, Christi Deaton, Ian Jones, Daniela Lehwaldt, Gabrielle McKee, Theresa Munyombwe, and Felicity Astin. "The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis." European Journal of Cardiovascular Nursing 17, no. 1 (July 18, 2017): 6–22. http://dx.doi.org/10.1177/1474515117721561.

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Background: Nurses are pivotal in the provision of high quality care in acute hospitals. However, the optimal dosing of the number of nurses caring for patients remains elusive. In light of this, an updated review of the evidence on the effect of nurse staffing levels on patient outcomes is required. Aim: To undertake a systematic review and meta-analysis examining the association between nurse staffing levels and nurse-sensitive patient outcomes in acute specialist units. Methods: Nine electronic databases were searched for English articles published between 2006 and 2017. The primary outcomes were nurse-sensitive patient outcomes. Results: Of 3429 unique articles identified, 35 met the inclusion criteria. All were cross-sectional and the majority utilised large administrative databases. Higher staffing levels were associated with reduced mortality, medication errors, ulcers, restraint use, infections, pneumonia, higher aspirin use and a greater number of patients receiving percutaneous coronary intervention within 90 minutes. A meta-analysis involving 175,755 patients, from six studies, admitted to the intensive care unit and/or cardiac/cardiothoracic units showed that a higher nurse staffing level decreased the risk of inhospital mortality by 14% (0.86, 95% confidence interval 0.79–0.94). However, the meta-analysis also showed high heterogeneity (I2=86%). Conclusion: Nurse-to-patient ratios influence many patient outcomes, most markedly inhospital mortality. More studies need to be conducted on the association of nurse-to-patient ratios with nurse-sensitive patient outcomes to offset the paucity and weaknesses of research in this area. This would provide further evidence for recommendations of optimal nurse-to-patient ratios in acute specialist units.

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Snyder,, Mariah, Cheryl L. Brandt,, and Yueh-Hsia Tseng,. "Measuring Intervention Outcomes: Impact of Nurse Characteristics." International Journal of Human Caring 4, no. 1 (February 2000): 36–42. http://dx.doi.org/10.20467/1091-5710.4.1.36.

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Increased attention is being placed on measuring outcomes from specific interventions. Within nursing, nurse-sensitive patient outcomes are being used to measure outcomes of interventions. Less attention has been given to the impact that characteristics of the caregiver, such as caring behaviors, may have on outcomes. Identification of caring behaviors, challenges encountered in measuring the impact of nurse characteristics on outcomes, and implications for research and practice are presented.

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Krapohl, Greta, Milisa Manojlovich, Richard Redman, and Lingling Zhang. "Nursing Specialty Certification and Nursing-Sensitive Patient Outcomes in the Intensive Care Unit." American Journal of Critical Care 19, no. 6 (November 1, 2010): 490–98. http://dx.doi.org/10.4037/ajcc2010406.

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Background To the public and to individual nurses, certification usually means expert, high-quality, competent nursing care. Little research, however, has yielded results that support, or refute, any differences in clinical practice between certified and noncertified nurses. Objectives To determine whether the proportion of certified nurses on a unit is associated with the rate of nurse-sensitive patient outcomes. Methods A nonexperimental, correlational, descriptive design was used to anonymously survey 866 nurses working in 25 intensive care units in Southeast Michigan. The Conditions for Work Effectiveness Questionnaire-II was used to measure workplace empowerment, and an additional question was asked about certification status. Outcome data were simultaneously collected on 3 nurse-sensitive patient outcomes: (1) rate of central line catheter-associated blood stream infection, (2) rate of ventilator-associated pneumonia, and (3) prevalence of pressure ulcers. Data were aggregated and analyzed at the unit level. Results No significant relationship was found between the proportion of certified nurses on a unit and patients’ outcomes. The association between nurses’ perception of overall work-place empowerment and certification, however, was positive and statistically significant (r=.397, P=.05). Conclusions Although a link between certification and nurse-sensitive outcomes was not established, the association between workplace empowerment and the proportion of certified nurses on a unit underscores the importance of organizational factors in the promotion of nursing certification.

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Furukawa, Michael F., T. S. Raghu, and Benjamin B. M. Shao. "Electronic Medical Records, Nurse Staffing, and Nurse-Sensitive Patient Outcomes: Evidence from California Hospitals, 1998-2007." Health Services Research 45, no. 4 (April 9, 2010): 941–62. http://dx.doi.org/10.1111/j.1475-6773.2010.01110.x.

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Shepherd, Mary, and Nina Hawthorne. "Charting the course for American Nurses Credentialing Center–Approved perioperative nurse-sensitive indicators." Journal of Nursing Education and Practice 8, no. 5 (December 20, 2017): 63. http://dx.doi.org/10.5430/jnep.v8n5p63.

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The current health care environment, with increasing public awareness of and attention to patient safety, mandates the delivery of exceptional quality care. To meet the health care requisites of the perioperative patient population, clinical nurses have identified the need for nurse-sensitive clinical indicators for this setting. We describe the strategies used to identify, obtain American Nurses Credentialing Center approval for, and integrate nurse-sensitive indicators into the perioperative setting to advance a Magnet culture. Prior to this, nurse-sensitive indicators for the perioperative setting that enabled nurses to monitor and improve patient care outcomes, in accordance with the standards of a Magnet-recognized hospital, had not been formally established. A review of the literature yielded a list of potential metrics, which included normothermia, patient falls with harm, and retained surgical items. Methodology and data collection processes for these metrics were established, facilitating quarterly Nursing Dashboards and collaboration among nurses to improve patient outcomes. This groundbreaking initiative enables nurses to routinely evaluate whether the structures and processes of care effectively yield quality outcomes. This foundational work has broader implications for nursing practice, because these quality metrics can easily be translated into perioperative settings in other health care organizations.

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Haun, Courtney N., Zachary B. Mahafza, Chassidy L. Cook, and Geoffrey A. Silvera. "A Study Examining the Influence of Proximity to Nurse Education Resources on Quality of Care Outcomes in Nursing Homes." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 1, 2018): 004695801878769. http://dx.doi.org/10.1177/0046958018787694.

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This examination seeks to determine the influence of proximal density to nurse education resources (nursing schools) on nursing home care quality outcomes in Alabama. Motivated by the social network theory, which highlights the influence of relational closeness on shared resources and values, we hypothesize that nursing homes that have higher levels of nursing education resources within a close proximity will exhibit significantly higher nursing home quality outcomes. As proximal density to nurse education resources increases, the opportunity for nursing homes to build closer, stronger ties increase, leading to higher quality outcomes. We examine this hypothesis via ordered logistic regressions of proximal density measures developed through geographic information systems (GIS) software, nurse education resource data from Johnson & Johnson’s Campaign for Nursing’s Future (n = 37), and nursing home quality outcome data from Centers for Medicare and Medicaid Services’s (CMS) Nursing Home Compare from 2016 (n = 226). The results find that increases in proximal density to nurse education resources have a negative and significant association with nursing home quality outcomes in Alabama. Additional sensitivity analysis, which examines the degree to which the nature of this relationship is sensitive to health care facilities’ location in high-density areas, is offered and confirms principal findings. Because nursing programs generally have stronger ties with hospitals, the findings suggest that the nursing homes in areas with higher nurse education resources may actually face greater competition for nurses.

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16

Idemoto, Bette K., and Denise M. Kresevic. "Emerging Nurse-Sensitive Outcomes and Evidence-Based Practice in Postoperative Cardiac Patients." Critical Care Nursing Clinics of North America 19, no. 4 (December 2007): 371–84. http://dx.doi.org/10.1016/j.ccell.2007.07.005.

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17

Connor, Jean, Lauren Hartwell, Jennifer Baird, Benjamin Cerrato, Araz Chiloyan, Courtney Porter, and Patricia Hickey. "Nurse-Sensitive Quality Metrics to Benchmark in Pediatric Cardiovascular Care." American Journal of Critical Care 29, no. 6 (November 1, 2020): 468–78. http://dx.doi.org/10.4037/ajcc2020884.

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Background Associations between the quality of nursing care and patient outcomes have been demonstrated globally. However, translation and application of this evidence to robust measurement in pediatric specialty nursing care has been limited. Objectives To test the feasibility and performance of nurse-sensitive measures in pediatric cardiovascular programs. Methods Ten nurse-sensitive measures targeting nursing workforce, care process, and patient outcomes were implemented, and measurement data were collected for 6 months across 9 children’s hospitals in the Consortium of Congenital Cardiac Care–Measurement of Nursing Practice (C4-MNP). Participating sites evaluated the feasibility of collecting data and the usability of the data. Results Variations in nursing workforce characteristics were reported across sites, including proportion of registered nurses with 0 to 2 years of experience, nursing education, and nursing certification. Clinical measurement data on weight gain in infants who have undergone cardiac surgery, unplanned transfer to the cardiac intensive care unit, and pain management highlighted opportunities for improvement in care processes. Overall, each measure received a score of 75% or greater in feasibility and usability. Conclusions Collaborative evaluation of measurement performance, feasibility, and usability provided important information for continued refinement of the measures, development of systems to support data collection, and selection of benchmarks across C4-MNP. Results supported the development of target benchmarks for C4-MNP sites to compare performance, share best practices for improving the quality of pediatric cardiovascular nursing care, and inform nurse staffing models.

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18

Cox, Ruth Alyce. "Implementing Nurse Sensitive Outcomes into Care Planning at a Long-Term Care Facility." Journal of Nursing Care Quality 12, no. 5 (June 1998): 41–51. http://dx.doi.org/10.1097/00001786-199806000-00008.

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19

Furukawa, Michael F., T. S. Raghu, and Benjamin B. M. Shao. "Electronic Medical Records, Nurse Staffing, and Nurse-Sensitive Patient Outcomes: Evidence From the National Database of Nursing Quality Indicators." Medical Care Research and Review 68, no. 3 (November 11, 2010): 311–31. http://dx.doi.org/10.1177/1077558710384877.

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20

Speroni, Karen Gabel, Kirsten Wisner, Amy Stafford, Fiona Haines, Majeda A. AL-Ruzzieh, Cynthia Walters, and Chakra Budhathoki. "Effect of Shared Governance on Nurse-Sensitive Indicator and Satisfaction Outcomes: An International Comparison." JONA: The Journal of Nursing Administration 51, no. 5 (May 2021): 287–96. http://dx.doi.org/10.1097/nna.0000000000001014.

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21

Veldhuizen, J. D., T. B. Hafsteinsdóttir, M. C. Mikkers, N. Bleijenberg, and M. J. Schuurmans. "Evidence-based interventions and nurse-sensitive outcomes in district nursing care: A systematic review." International Journal of Nursing Studies Advances 3 (November 2021): 100053. http://dx.doi.org/10.1016/j.ijnsa.2021.100053.

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22

Kim, Min Young. "Effects of Oncology Clinical Nurse Specialists' Interventions on Nursing-Sensitive Outcomes in South Korea." Clinical Journal of Oncology Nursing 15, no. 5 (September 27, 2011): E66—E74. http://dx.doi.org/10.1188/11.onf.e66-e74.

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23

Clarke, Sean P. "Understanding and improving nurse-sensitive outcomes in acute care practice: State of the science." Australasian Emergency Nursing Journal 10, no. 4 (November 2007): 216–17. http://dx.doi.org/10.1016/j.aenj.2007.09.078.

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24

Hahtela, Nina, Eija Paavilainen, Brendan McCormack, Paul Slater, Mika Helminen, and Tarja Suominen. "Influence of workplace culture on nursing-sensitive nurse outcomes in municipal primary health care." Journal of Nursing Management 23, no. 7 (May 21, 2014): 931–39. http://dx.doi.org/10.1111/jonm.12237.

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Kim, Chul-Gyu, and Ji-Soo Kim. "The association between nurse staffing levels and paediatric nursing-sensitive outcomes in tertiary hospitals." Journal of Nursing Management 26, no. 8 (August 22, 2018): 1002–14. http://dx.doi.org/10.1111/jonm.12627.

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Cisler-Cahill, Lorna. "A Protocol for the Use of Amorphous Hydrogel to Support Wound Healing in Neonatal Patients: An Adjunct to Nursing Skin Care." Neonatal Network 25, no. 4 (July 2006): 267–73. http://dx.doi.org/10.1891/0730-0832.25.4.267.

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The care registered nurses offer makes a critical difference in the quality and cost-effectiveness of patient outcomes. The prevention and treatment of alterations in skin integrity remain primary nurse-sensitive quality indicators. Although wound prevention is a primary goal for nurses, iatrogenic wounds do occur. Neonatal patients are at greater risk for alterations in skin integrity because of the fragile nature of their skin. When skin breakdown occurs, nurses must have knowledge of effective treatment alternatives. The purpose of this article is to describe the use of a collaborative practice protocol to introduce and document patient outcomes with the use of amorphous hydrogel as a treatment modality for iatrogenic neonatal wounds. All hospitals collect data on the quality of patient care, and it has been known for some time that registered nurses can make a critical difference in the quality of patient care and the effectiveness of patient outcomes. The American Nurses Association has identified ten specific quality measures that are impacted by nursing care. Referred to as nurse-sensitive quality indicators, these measures include the maintenance of skin integrity.1

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Kilpatrick, Kelley, Eric Nguemeleu Tchouaket, Maud-Christine Chouinard, Isabelle Savard, Naima Bouabdillah, Julie Houle, Geneviève St-Louis, Mira Jabbour, and Renee Atallah. "Identifying indicators sensitive to primary healthcare nurse practitioner practice: a review of systematic reviews protocol." BMJ Open 11, no. 1 (January 2021): e043213. http://dx.doi.org/10.1136/bmjopen-2020-043213.

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IntroductionPrimary healthcare nurse practitioners (PHCNPs) practice in a wide range of clinical settings and with diverse patient populations. Several systematic reviews have examined outcomes of PHCNP roles. However, there is a lack of consistency in the definitions used for the PHCNP role across the reviews. The identification of indicators sensitive to PHCNP practice from the perspective of patients, providers and the healthcare system will allow researchers, clinicians and decision-makers to understand how these providers contribute to outcomes of care.Methods and analysisA review of systematic reviews is proposed to describe the current state of knowledge about indicators sensitive to PHCNP practice using recognised role definitions. Outcomes of interest include any outcome indicator measuring the effectiveness of PHCNPs. We will limit our search to 2010 onwards to capture the most up-to-date trends. The following electronic databases will be searched: Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library Database of Systematic Reviews and Controlled Trials Register, Database of Abstracts of Reviews of Effects, EMBASE, Global Health, Health Economics Evaluation Database, Health Evidence, HealthStar, Health Systems Evidence, Joanna Briggs Institute, Medline, PDQ-Evidence, PubMed and Web of Science. The search strategies will be reviewed by an academic librarian. Reference lists of all relevant publications will be reviewed. Grey literature will be searched from 2010 onwards, and will include: CADTH Information Services, CADTH’s Grey Matters tool, OpenGrey, Organisation for Economic Co-operation and Development, ProQuest Dissertation and Theses and WHO. The PROSPERO International Prospective Register of Systematic Reviews will be searched to identify registered review protocols. The review protocol was developed using Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A narrative synthesis will be used to summarise study findings.Ethics and disseminationNo ethical approval is required for the study. The data used in the study will be abstracted from published systematic reviews. Dissemination strategies will include peer-reviewed publication, conference presentations and presentations to key stakeholders.PROSPERO registration numberCRD42020198182.

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Peate, Ian. "Men's health inequalities: a local, national and global issue." Practice Nursing 31, no. 2 (February 2, 2020): 76–79. http://dx.doi.org/10.12968/pnur.2020.31.2.76.

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In many key areas, men's health outcomes are worse than women's. Ian Peate discusses the reasons for these health inequalities and how the practice nurse can help to erradicate them In many key areas, men's health outcomes are worse than women's. In the UK, there has been no strategic response to men's health needs at a national or local level. The chief causes for these differences in health outcomes are associated with men's risk taking behaviours, such as alcohol use, diet, and smoking, non-communicable diseases, and under-use of health services. When there are ‘gender-sensitive’ health interventions that have been aimed specifically at men, these have been shown to improve men's outcomes. Taking seriously the unique needs of men in policy development, implementation and evaluation, including further expansion of nurse-led initiatives, has the potential to make a difference to men's health.

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Dietermann, Karina, Vera Winter, Udo Schneider, and Jonas Schreyögg. "The impact of nurse staffing levels on nursing-sensitive patient outcomes: a multilevel regression approach." European Journal of Health Economics 22, no. 5 (April 19, 2021): 833–46. http://dx.doi.org/10.1007/s10198-021-01292-2.

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AbstractThe goal of this study is to provide empirical evidence of the impact of nurse staffing levels on seven nursing-sensitive patient outcomes (NSPOs) at the hospital unit level. Combining a very large set of claims data from a German health insurer with mandatory quality reports published by every hospital in Germany, our data set comprises approximately 3.2 million hospital stays in more than 900 hospitals over a period of 5 years. Accounting for the grouping structure of our data (i.e., patients grouped in unit types), we estimate cross-sectional, two-level generalized linear mixed models (GLMMs) with inpatient cases at level 1 and units types (e.g., internal medicine, geriatrics) at level 2. Our regressions yield 32 significant results in the expected direction. We find that differentiating between unit types using a multilevel regression approach and including postdischarge NSPOs adds important insights to our understanding of the relationship between nurse staffing levels and NSPOs. Extending our main model by categorizing inpatient cases according to their clinical complexity, we are able to rule out hidden effects beyond the level of unit types.

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Stalpers, Dewi, Brigitte J. M. de Brouwer, Marian J. Kaljouw, and Marieke J. Schuurmans. "Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of literature." International Journal of Nursing Studies 52, no. 4 (April 2015): 817–35. http://dx.doi.org/10.1016/j.ijnurstu.2015.01.005.

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Vercruysse, Lieke, Veerle Duprez, Dimitri Beeckman, Ann Van Hecke, Eddy Deproost, and Sofie Verhaeghe. "Nurse-sensitive patient outcomes in de geestelijke gezondheidszorg: het perspectief van de patiënt." Verpleegkunde 35, no. 4 (December 2020): 7–15. http://dx.doi.org/10.24078/vpg.2020.12.126258.

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32

Berney, Barbara, and Jack Needleman. "Impact of Nursing Overtime on Nurse-Sensitive Patient Outcomes in New York Hospitals, 1995-2000." Policy, Politics, & Nursing Practice 7, no. 2 (May 2006): 87–100. http://dx.doi.org/10.1177/1527154406291132.

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Kelly, A., G. McKee, Y. van Eijk-Hustings, M. Ndosi, D. O'Sullivan, V. Menzies, S. Carter, P. Richards, and P. Minnock. "AB1213-HPR Nurse Sensitive Outcomes in Patients with Rheumatoid Arthritis (RA) – a Systematic Literature Review." Annals of the Rheumatic Diseases 74, Suppl 2 (June 2015): 1340.2–1340. http://dx.doi.org/10.1136/annrheumdis-2015-eular.4837.

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Pierce, Susan F. "Nurse-Sensitive Health Care Outcomes in Acute Care Settings: An Integrative Analysis of the Literature." Journal of Nursing Care Quality 11, no. 4 (April 1997): 60–72. http://dx.doi.org/10.1097/00001786-199704000-00009.

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Milstein, Ricarda, and Jonas Schreyoegg. "The relationship between nurse staffing levels and nursing-sensitive outcomes in hospitals: Assessing heterogeneity among unit and outcome types." Health Policy 124, no. 10 (October 2020): 1056–63. http://dx.doi.org/10.1016/j.healthpol.2020.07.013.

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Olley, Richard, Ian Edwards, Mark Avery, and Helen Cooper. "Systematic review of the evidence related to mandated nurse staffing ratios in acute hospitals." Australian Health Review 43, no. 3 (2019): 288. http://dx.doi.org/10.1071/ah16252.

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Objective The purpose of this systematic review was to evaluate and summarise available research on nurse staffing methods and relate these to outcomes under three overarching themes of: (1) management of clinical risk, quality and safety; (2) development of a new or innovative staffing methodology; and (3) equity of nursing workload. Methods The PRISMA method was used. Relevant articles were located by searching via the Griffith University Library electronic catalogue, including articles on PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Medline. Only English language publications published between 1 January 2010 and 30 April 2016 focusing on methodologies in acute hospital in-patient units were included in the present review. Results Two of the four staffing methods were found to have evidenced-based articles from empirical studies within the parameters set for inclusion. Of the four staffing methodologies searched, supply and demand returned 10 studies and staffing ratios returned 11. Conclusions There is a need to develop an evidence-based nurse-sensitive outcomes measure upon which staffing for safety, quality and workplace equity, as well as an instrument that reliability and validly projects nurse staffing requirements in a variety of clinical settings. Nurse-sensitive indicators reflect elements of patient care that are directly affected by nursing practice In addition, these measures must take into account patient satisfaction, workload and staffing, clinical risks and other measures of the quality and safety of care and nurses’ work satisfaction. i. What is known about the topic? Nurse staffing is a controversial topic that has significant patient safety, quality of care, human resources and financial implications. In acute care services, nursing accounts for approximately 70% of salaries and wages paid by health services budgets, and evidence as to the efficacy and effectiveness of any staffing methodology is required because it has workforce and industrial relations implications. Although there is significant literature available on the topic, there is a paucity of empirical evidence supporting claims of increased patient safety in the acute hospital setting, but some evidence exists relating to equity of workload for nurses. What does this paper add? This paper provides a contemporary qualitative analysis of empirical evidence using PRISMA methodology to conduct a systematic review of the available literature. It demonstrates a significant research gap to support claims of increased patient safety in the acute hospital setting. The paper calls for greatly improved datasets upon which research can be undertaken to determine any associations between mandated patient to nurse ratios and other staffing methodologies and patient safety and quality of care. What are the implications for practitioners? There is insufficient contemporary research to support staffing methodologies for appropriate staffing, balanced workloads and quality, safe care. Such research would include the establishment of nurse-sensitive patient outcomes measures, and more robust datasets are needed for empirical analysis to produce such evidence.

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Speroni, Karen Gabel, Kirsten Wisner, Melanie Ober, Fiona Haines, Cynthia Walters, and Chakra Budhathoki. "Effect of Shared Governance on Nurse-Sensitive Indicator and Satisfaction Outcomes by Magnet® Recognition Status." JONA: The Journal of Nursing Administration 51, no. 7/8 (July 2021): 379–88. http://dx.doi.org/10.1097/nna.0000000000001033.

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38

Burnes Bolton, Linda, Carolyn E. Aydin, Nancy Donaldson, Diane Storer Brown, Meenu Sandhu, Moshe Fridman, and Harriet Udin Aronow. "Mandated Nurse Staffing Ratios in California: A Comparison of Staffing and Nursing-Sensitive Outcomes Pre- and Postregulation." Policy, Politics, & Nursing Practice 8, no. 4 (November 2007): 238–50. http://dx.doi.org/10.1177/1527154407312737.

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Dowding, D. W., M. Turley, and T. Garrido. "The impact of an electronic health record on nurse sensitive patient outcomes: an interrupted time series analysis." Journal of the American Medical Informatics Association 19, no. 4 (July 1, 2012): 615–20. http://dx.doi.org/10.1136/amiajnl-2011-000504.

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Blegen, Mary A. "Patient Safety in Hospital Acute Care Units." Annual Review of Nursing Research 24, no. 1 (January 2006): 103–25. http://dx.doi.org/10.1891/0739-6686.24.1.103.

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The most visible threats to patient safety associated with nursing care occur on hospital inpatient units. Patient safety research is a new phenomenon, but it builds on the knowledge provided by quality-of-care research done previously. The purpose of this chapter is to describe the current state of the science in the area of nurse staffing and patient safety. The results of research studies published since the last round of reviews (1996-2005) are described by level of analysis, measures of nurse staffing and patient outcomes. Although research linking nurse staffing to the quality of patient care has increased markedly since 1996, the results of recent research projects do not yet provide a thorough and consistent foundation for producing solutions to the crisis in hospital nursing care. The inconsistencies are largely due to differing units of analysis (hospital, patient, care unit), variability in measures of nurse staffing, the variety of quality indicators chosen, the difficulty finding accurate measures of these indicators, and the difficulty creating risk-adjustment strategies for the indicators most sensitive to nursing care. Nursing administration and policy most urgently need research conducted with standardized data collected at the patient care unit level.

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Kim, Chul-Gyu, and Kyun-Seop Bae. "Relationship between nurse staffing level and adult nursing-sensitive outcomes in tertiary hospitals of Korea: Retrospective observational study." International Journal of Nursing Studies 80 (April 2018): 155–64. http://dx.doi.org/10.1016/j.ijnurstu.2018.01.001.

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Chow, Marilyn, Murielle Beene, Ann O’Brien, Patricia Greim, Tim Cromwell, Donna DuLong, and Diane Bedecarré. "A nursing information model process for interoperability." Journal of the American Medical Informatics Association 22, no. 3 (February 5, 2015): 608–14. http://dx.doi.org/10.1093/jamia/ocu026.

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Abstract The ability to share nursing data across organizations and electronic health records is a key component of improving care coordination and quality outcomes. Currently, substantial organizational and technical barriers limit the ability to share and compare essential patient data that inform nursing care. Nursing leaders at Kaiser Permanente and the U.S. Department of Veterans Affairs collaborated on the development of an evidence-based information model driven by nursing practice to enable data capture, re-use, and sharing between organizations and disparate electronic health records. This article describes a framework with repeatable steps and processes to enable the semantic interoperability of relevant and contextual nursing data. Hospital-acquired pressure ulcer prevention was selected as the prototype nurse-sensitive quality measure to develop and test the model. In a Health 2.0 Developer Challenge program from the Office of the National Coordinator for Health, mobile applications implemented the model to help nurses assess the risk of hospital-acquired pressure ulcers and reduce their severity. The common information model can be applied to other nurse-sensitive measures to enable data standardization supporting patient transitions between care settings, quality reporting, and research.

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Beaulieu, M. C., I. Gaboury, N. Carrier, P. Dobkin, F. Gervais, F. Gendron, P. Roberge, P. Dagenais, S. Roux, and G. Boire. "PARE0016 MINDFULNESS-BASED STRESS REDUCTION TO IMPROVE DEPRESSIVE SYMPTOMS AND RHEUMATOID ARTHRITIS-RELATED CLINICAL OUTCOMES: RESULTS FROM A FEASIBILITY AND ACCEPTABILITY TRIAL." Annals of the Rheumatic Diseases 79, Suppl 1 (June 2020): 1294.2–1294. http://dx.doi.org/10.1136/annrheumdis-2020-eular.6339.

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Background:Despite available highly effective pharmacological treatments, up to 30% of current rheumatoid arthritis (RA) patients remain in quasi-remission, where inflammation is controlled but patients still report unacceptable levels of negative impact of RA (high Patient Global Assessment (PGA) on a 0-10 visual analog scale). PGA levels correlated with depressive symptoms assessed by Center for Epidemiologic Studies- Depression (CES-D) scores. Mindfulness-Based Stress Reduction (MBSR) is relatively inexpensive and reduces both anxiety and depression in several conditions.Objectives:To complete a feasibility and acceptability study paving the way for a randomized controlled trial (RCT) of MBSR to improve depressive symptoms and clinical outcomes in RA patients in quasi-remission.Methods:A standardized 8-week MBSR program in adults with controlled inflammatory disease (stable SJC ≤ 2/66 and normal CRP; stable treatments) but high CES-D scores (2 groups), high CES-D or anxiety scores (1 group), or PGA higher than Physician Evaluation of Disease Activity (EVA) by ≥2 (1 group). Feasibility was documented using process indicators. Outcomes were measured at baseline and 6 months after the end of MBSR. Disease activity scores (SDAI) and questionnaires on depressive symptoms (CES-D), HAQ, sleep (VAS), fatigue and pain (SF-36), anxiety (GAD-7), PGA were collected. Qualitative interviews based on a theoretical framework of acceptability were conducted following the post-MBSR evaluation.Results:We report on the first 21 patients (mean age 59, 91% females) having completed their 6-month follow up evaluation. Factors leading to higher recruitment rates were 1) using pragmatic scores to identify eligible patients (e.g. EVA and PGA), 2) no formal clinical evaluation of mental health and no emphasis on depression in the recruitment material.MBSR had a highly significant positive impact on depressive symptoms (p=0.003) and anxiety (p=0.025) (Figure), and positive impact on quality of sleep and HAQ. No change in SDAI or joint counts was noted.During a qualitative interview of 13 participants, most reported that MBSR helped them control their reactions to daily stressful situations. Perceptions were almost uniformly positive towards MBSR, and most appeared to have integrated some part of it in their daily life. No side effects were reported.Conclusion:Although recruitment was challenging, a MBSR trial in RA patients in quasi-remission was found acceptable and feasible. Positive impacts on mood and on clinical outcomes were observed. Anxiety and depression scores appear the most sensitive to change and are recommended as the primary outcome for an eventual RCT. MBSR added to conventional treatments might help empower RA patients towards self-management.Acknowledgments:Grant support from Canadian Initiative for Outcomes in Rheumatology cAre (CIORA)Disclosure of Interests:Marie-Claude Beaulieu: None declared, Isabelle Gaboury: None declared, Nathalie Carrier: None declared, Patricia Dobkin: None declared, France Gervais: None declared, Françoise Gendron: None declared, Pasquale Roberge: None declared, Pierre Dagenais: None declared, Sophie Roux: None declared, Gilles Boire Grant/research support from: Merck Canada (Registry of biologices, Improvement of comorbidity surveillance)Amgen Canada (CATCH, clinical nurse)Abbvie (CATCH, clinical nurse)Pfizer (CATCH, Registry of biologics, Clinical nurse)Hoffman-LaRoche (CATCH)UCB Canada (CATCH, Clinical nurse)BMS (CATCH, Clinical nurse, Observational Study Protocol IM101664. SEROPOSITIVITY IN A LARGE CANADIAN OBSERVATIONAL COHORT)Janssen (CATCH)Celgene (Clinical nurse)Eli Lilly (Registry of biologics, Clinical nurse), Consultant of: Eli Lilly, Janssen, Novartis, Pfizer, Speakers bureau: Merck, BMS, Pfizer

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Giuliano, Karen K. "Challenging Precedent: Critical Care Nursing and Medical Product Innovation." American Journal of Critical Care 29, no. 4 (July 1, 2020): 253–61. http://dx.doi.org/10.4037/ajcc2020275.

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In this presentation, I will share my unconventional journey, starting from my first job as a critical care staff nurse to my current role as tenure-track faculty at the University of Massachusetts Amherst, where I hold a joint position with the Institute for Applied Life Sciences and the College of Nursing. Throughout this journey, I have had many opportunities to participate in interdisciplinary clinical outcomes research and medical product development as a staff nurse, clinical nurse specialist, and project lead from the clinical, industry, and academic perspectives. While passionate about my central clinical research interests in technology innovation and its responsible use in critical and acute care, the foundation of my approach is dedicated to the values and lessons of my earliest experiences in critical care bedside nursing: supporting and preserving the dignity and humanity of person-centered patient care. Early in my career as a critical care nurse, I realized how vitally important a critical care nursing perspective could be in the design of technology for meeting the critical care needs of patients, nurses, and other professionals who provide this care. As the nation’s largest group of health care professionals, nurses use more products than any other health care professional, and thus nurses have a uniquely practical and care-sensitive perspective on the development and design of medical products. Nurses, especially critical care nurses, are in a unique position to identify and address everyday health care issues, challenge assumptions and the status quo, address unrecognized and unarticulated needs, and ensure that clinical outcomes research serves as the foundation for validating the effectiveness of medical product innovation. My goal is to share lessons learned and to help participants to see the many different ways that critical care nursing knowledge can be used to improve patient care

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Bettencourt, Amanda P., Linda H. Aiken, Douglas Sloane, and Matthew McHugh. "T4 Nursing Matters! Better Nurse Staffing and Work Environments Associated with Lower Burn Patient Mortality." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S3. http://dx.doi.org/10.1093/jbcr/iraa024.003.

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Abstract Introduction The complexity of modern burn care requires an integrated team of clinicians working together to achieve the best possible outcome for each survivor. Nurses are central to many aspects of a burn survivor’s care including physiologic monitoring, fluid resuscitation, pain management, infection prevention, complex wound care, and rehabilitation. Previous research suggests that hospital nursing resources such as staffing, education, and the quality of the work environment relate to overall patient mortality, but the relationship between those resources and burn mortality has not been previously examined. Due to their unique and complex care needs, burn patients are likely highly sensitive to nursing resources. Methods This study examined whether patient-to-nurse ratios, nurse education, and features of the clinical work environment are associated with burn patient in-hospital mortality. A multivariable regression model using a linked, cross-sectional claims database of 14,064 adult (>18 yrs.) burn patients admitted to 653 hospitals was employed. Mortality was risk-adjusted for age, burn size, the presence of mechanical ventilation, co-morbidities, and hospital characteristics such as burn patient volume, technological capabilities, and teaching status. Nursing resources were independently reported by 29,586 bedside nurses working in the study hospitals. The work environment was assessed using the National Quality Forum-endorsed Practice Environment Scale. Nursing resources differ in the high vs. low-volume hospitals, so the final model includes an interaction term for each nursing resource and hospital burn patient volume. Results In the risk-adjusted main-effects model, the patient’s age, burn size, presence of mechanical ventilation, comorbidities, and hospital burn patient volume were all significantly associated with in-hospital mortality. The full model including interaction terms suggests that in high burn patient volume hospitals (>100 patients / yr.) each additional patient added to a nurse’s workload is associated with 30% higher odds of mortality (p< 0.05, 95% CI [1.02, 1.94]), and improvements in the nurse work environment are associated with 28% lower odds of mortality (p< 0.05, 95%CI [0.07, 0.99]). Conclusions Nurse staffing and the nurse work environment significantly relate to burn patient mortality in high-volume burn hospitals where the most complex burn patients often receive care. Applicability of Research to Practice Nursing resources are critical to the survival of the most complex burn patients, and are a significant, yet previously unmeasured variable in the evaluation of burn outcomes. To promote optimal recovery for burn survivors, attention to nurse staffing and the work environment is warranted. Future evaluations of burn patient outcomes should account for hospital nursing resources.

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Rouleau, Geneviève, Marie-Pierre Gagnon, José Côté, Julie Payne-Gagnon, Emilie Hudson, Carl-Ardy Dubois, and Julien Bouix-Picasso. "Effects of E-Learning in a Continuing Education Context on Nursing Care: Systematic Review of Systematic Qualitative, Quantitative, and Mixed-Studies Reviews." Journal of Medical Internet Research 21, no. 10 (October 2, 2019): e15118. http://dx.doi.org/10.2196/15118.

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Background E-learning is rapidly growing as an alternative way of delivering education in nursing. Two contexts regarding the use of e-learning in nursing are discussed in the literature: (1) education among nursing students and (2) nurses’ continuing education within a life-long learning perspective. A systematic review of systematic reviews on e-learning for nursing and health professional students in an academic context has been published previously; however, no such review exists regarding e-learning for registered nurses in a continuing education context. Objective We aimed to systematically summarize the qualitative and quantitative evidence regarding the effects of e-learning on nursing care among nurses in a continuing education context. Methods We conducted a systematic review of systematic qualitative, quantitative, and mixed-studies reviews, searching within four bibliographic databases. The eligibility criteria were formulated using the population, interventions, comparisons, outcomes, and study design (PICOS) format. The included population was registered nurses. E-learning interventions were included and compared with face-to-face and any other e-learning interventions, as well as blended learning. The outcomes of interest were derived from two models: nursing-sensitive indicators from the Nursing Care Performance Framework (eg, teaching and collaboration) and the levels of evaluation from the Kirkpatrick model (ie, reaction, learning, behavior, and results). Results We identified a total of 12,906 records. We retrieved 222 full-text papers for detailed evaluation, from which 22 systematic reviews published between 2008 and 2018 met the eligibility criteria. The effects of e-learning on nursing care were grouped under Kirkpatrick’s levels of evaluation: (1) nurse reactions to e-learning, (2) nurse learning, (3) behavior, and (4) results. Level 2, nurse learning, was divided into three subthemes: knowledge, skills, attitude and self-efficacy. Level 4, results, was divided into patient outcomes and costs. Most of the outcomes were reported in a positive way. For instance, nurses were satisfied with the use of e-learning and they improved their knowledge. The most common topics covered by the e-learning interventions were medication calculation, preparation, and administration. Conclusions The effects of e-learning are mainly reported in terms of nurse reactions, knowledge, and skills (ie, the first two levels of the Kirkpatrick model). The effectiveness of e-learning interventions for nurses in a continuing education context remains unknown regarding how the learning can be transferred to change practice and affect patient outcomes. Further scientific, methodological, theoretical, and practice-based breakthroughs are needed in the fast-growing field of e-learning in nursing education, especially in a life-learning perspective. Trial Registration International Prospective Register of Systematic Reviews (PROSPERO) CRD42016050714; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=50714

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Hemingway, Kristy D., and Megan Fernandez. "609 Development and Implementation of the Burn Nurse Mentor Role." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S148. http://dx.doi.org/10.1093/jbcr/iraa024.235.

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Abstract Introduction Training and preparation of nurses in the burn unit is a long and costly process. Attrition of seasoned staff and a shortage of qualified preceptors places added pressure on experienced preceptors. Additionally, attrition of established preceptors leaves the crucial job of preparing new nurses to novice preceptors who are less experienced or inadequately prepared. High rates of burnout and turnover have been shown to negatively affect patient care outcomes and can lead to further increased staff turnover. Quality of environment and adequate job preparation are evidence-based strategies to increase new nurse retention. Our Burn Center’s Step Down unit was averaging a staff turnover rate of 14%, and 60% of the nursing team had less than one year of experience. We determined the need to create a mentorship role in order to increase staff retention and satisfaction, with the potential to improve patient outcomes. Methods The goals of the Burn Nurse Mentor role are to encourage and develop the competency of the nursing staff on the Burn Step Down unit. In planning for the role, an additional full time position was drafted and justified prior to creation. The job requirements included having a BSN, a minimum of 2 years ICU experience with the burn population, classified as a clinical nurse III or higher on the clinical ladder, and functioning as a preceptor. The role was designed to be at the elbow support for new nurses who are either being precepted or newly off of orientation. This support for the nursing staff would help offload preceptor burden and encourage development of critical thinking skills. Additionally, the Burn Nurse Mentor would assess and intervene when educational, practice, or process gaps arise on the unit. The goals of the position are to encourage and develop the competency of the nursing staff on the Burn Step Down unit. Results The anecdotal response to the Burn Nurse Mentor role from nursing staff has been generally positive. As this was an entirely new role for the Burn Center, periodic clarification of scope and responsibilities was needed to ensure staff comfort and familiarity with the role. Initial qualitative and quantitative data regarding quality outcomes and staff retention have trended upward as well. Conclusions The Burn Nurse Mentor is a newly designed and implemented role for our Burn Center. As such, there is a limited amount of data and research available. Future analysis of the impact of this role will include formal staff feedback at the one year mark and nursing-sensitive and patient quality indicators. Applicability of Research to Practice Using the information presented in this project, other Burn Centers can analyze the need for a mentor on their unit and use it to develop a mentor on their own unit.

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Potempa, Kathleen, Susan Butterworth, Marna Flaherty-Robb, Margaret Calarco, Deanna Marriott, Bidisha Ghosh, Amanda Gabarda, et al. "The Impact of Nurse Health-Coaching Strategies on Cognitive—Behavioral Outcomes in Older Adults." International Journal of Environmental Research and Public Health 20, no. 1 (December 27, 2022): 416. http://dx.doi.org/10.3390/ijerph20010416.

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The practice of nurse health coaching (NHC) draws from the art and science of nursing, behavioral sciences, and evidence-based health-coaching methods. This secondary analysis of the audio-recorded natural language of participants during NHC sessions of our recent 8-week RCT evaluates improvement over time in cognitive–behavioral outcomes: change talk, resiliency, self-efficacy/independent agency, insight and pattern recognition, and building towards sustainability. We developed a measurement tool for coding, Indicators of Health Behavior Change (IHBC), that was designed to allow trained health-coach experts to assess the presence and frequency of the indicators in the natural language content of participants. We used a two-step method for randomly selecting the 20 min audio-recorded session that was analyzed at each time point. Fifty-six participants had high-quality audio recordings of the NHC sessions. Twelve participants were placed in the social determinants of health (SDH) group based on the following: low income (<USD 20,000/year), early-onset hypertension, and social disadvantages. Our analyses significantly improved change talk and the other four factors over time. Our factor analyses indicated two distinct factors at each measurement point of the study, demonstrating the stability of the outcome measures over time. Our newly developed measurement tool, IHBC, proved stable in structure over time and sensitive to change. This NHC program shows promise in improving cognitive–behavioral indicators associated with health behavior change in both non-SDH and SDH individuals.

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Twigg, Diane E., Yvonne Kutzer, Elisabeth Jacob, and Karla Seaman. "A quantitative systematic review of the association between nurse skill mix and nursing‐sensitive patient outcomes in the acute care setting." Journal of Advanced Nursing 75, no. 12 (October 3, 2019): 3404–23. http://dx.doi.org/10.1111/jan.14194.

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Stalpers, Dewi, Maartje L. G. De Vos, Dimitri Van Der Linden, Marian J. Kaljouw, and Marieke J. Schuurmans. "Barriers and carriers: a multicenter survey of nurses’ barriers and facilitators to monitoring of nurse-sensitive outcomes in intensive care units." Nursing Open 4, no. 3 (May 27, 2017): 149–56. http://dx.doi.org/10.1002/nop2.85.

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