Category Archives: Nursing

Sep 30 2014
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Sharing Nursing’s Knowledge: The September 2014 Issue

Have you signed up to receive Sharing Nursing’s Knowledge? The monthly Robert Wood Johnson Foundation (RWJF) e-newsletter will keep you up to date on the work of the Foundation’s nursing programs, and the latest news, research and trends relating to academic progression, leadership and other essential nursing issues. Following are some of the stories in the September issue.

Advocates Work to Recruit Latinos to Nursing
Latinos comprised only 3 percent of the nation’s nursing workforce in 2013, according to a survey by the National Council of State Boards of Nursing and the National Forum of State Workforce Centers, and 17 percent of the nation’s population, according to the U.S. Census Bureau. More Latino nurses can help narrow health disparities, experts say. “Having a culturally competent nurse really makes a difference in terms of compliance and patient outcomes,” said Elias Provencio-Vasquez, PhD, RN, FAAN, FAANP, an RWJF Executive Nurse Fellows program alumnus. “Patients really respond when they have a provider who understands their culture.”

New Careers in Nursing Program Helps Minnesota College Expand and Diversify While Improving Care in Rural Communities
Since its 2008 launch, the RWJF New Careers in Nursing program (NCIN) has kept a tight focus on attracting a diverse group of “second-career” students to nursing. Along the way, NCIN has had a profound effect on many of the institutions themselves. One such school, the College of St. Scholastica (CSS), saw its overall program change and grow substantially, in great measure because of its participation. NCIN has supported scholarships to 40 CSS accelerated-degree nursing students over the last seven years.

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Sep 25 2014
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RWJF Scholars in the News: Unintended consequences of shorter ER wait times, Ebola response, vaccinations and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

Policies aimed at shortening emergency departments waiting times may have unintended consequences, including unnecessary admission of patients who might be better off being discharged, RWJF Physician Faculty Scholars alumna Renee Hsia, MD, MSc, tells Health Day. Hsia published two research letters in JAMA Internal Medicine on emergency wait times at urban and rural hospitals. RWJF Clinical Scholar alumnus Jeremiah Schuur, MD, MHS, author of an accompanying editorial, seconds Hsia’s concerns. “Medicare started advertising waiting times at ERs about a year ago. And that will be a strong incentive for hospitals to work on and improve their waiting times...[h]owever, some of the hospitals with longer waiting times, like teaching hospitals, care for the most complex patients who often don’t have access to regular care. And these places are, by nature and necessity, going to have longer waiting times,” he warned. The article was republished by U.S. News & World Report and Health.com, among other outlets.

CBS Detroit interviews Howard Markel, MD, PhD, FAAP, recipient of an RWJF Investigator Award in Health Policy Research, for a story on President Obama’s decision to send American troops and medical and logistical support to Africa to stop Ebola from spreading. “It is a humanitarian gesture,” Markel said. “I applaud the president for doing it. Do I wish as a physician and an epidemiologist it was done earlier? Yes, of course.” Markel says he does not expect the virus to spread to the United States. He is also quoted in the New Republic and Politico.

In an op-ed for the New York Times, Jason Karlawish, MD, explores the balance between risk-avoidance and enjoying life as we age. Noting that 3.6 percent of the population is 80 or older, he writes that as Americans age, “life is heavily prescribed not only with the behaviors we should avoid, but the medications we ought to take.” Aging in the 21st century is all about risk reduction, but “[w]e desire not simply to pursue life, but happiness” and “medicine is important, but it’s not the only means to this happiness,” Karlawish writes. National investment in communities and services that improve the quality of our aging may be one answer, he adds. Karlawish is a recipient of an RWJF Investigator Award in Health Policy Research.

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Sep 23 2014
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Are Simulators as Effective for Nursing Students as Actual Clinical Experience?

In the last 15 years, the availability of high-fidelity simulation has slowly begun to transform the clinical education of the nation’s nursing students. Schools that once relied on the combination of classroom education and hands-on experience in a clinical environment began to mix in time in a simulation lab, where nursing students could work with highly sophisticated mannequins able to display a range of symptoms and react in real-time to treatment.

Such simulation labs offer many advantages to nurse educators, including the ability to replicate a range of patient situations, thus allowing students to practice specific nursing skills without having to practice their budding skills on actual patients.

But how effective are simulators at training the next generation of nurses? That’s a question that the National Council of State Boards of Nursing (NCSBN) has a particular interest in answering, because the state boards it represents are asked with increasing frequency to permit nursing schools to replace on-the-ground clinical time with simulation.

In pursuit of an answer, NCSBN conducted a full-scale study, tracking 666 nursing students for two academic years, beginning in Fall 2011, and then for six months longer as they began their work in the nursing profession. During their nursing school experience, one-quarter of the students had traditional clinical experiences with no simulation, another quarter had 25 percent of their clinical hours replaced by simulation, and the remaining half had 50 percent of their clinical hours replaced by simulation. At various points during their training and subsequent work as nurses, all study participants were assessed for clinical competency and nursing knowledge.

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Sep 18 2014
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RWJF Scholars in the News: Antibiotic overuse, sexual assault nurse examiners, diaper banks, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

RWJF Investigator Award in Health Policy Research recipient Anthony So, MD, MPA, co-authors a piece in the News & Observer (Raleigh, North Carolina) about the need to reduce the overuse of antibiotics, in both humans and animals. Overuse accelerates the development of antibiotic-resistant bacteria. The Centers for Disease Control and Prevention estimates that half of human antibiotic use and much animal antibiotic use is unnecessary, the article says. So calls for public policies that create incentives for farmers to decrease use of antibiotics and that limit antibiotic use in animals to disease treatment, rather than growth-promotion or as a substitute for hygiene and infection-control.

In Chicago, most children with asthma or food allergies do not have a health management form on file at school, leaving their schools without information they might need in emergencies, according to a study by RWJF Physician Faculty Scholars alumna Ruchi Gupta, MD, MPH that was covered by Reuters Health. Researchers analyzed 2012-13 school year data on more than 400,000 Chicago schoolchildren, including 18,287 with asthma and 4,250 with a food allergy. Only a quarter of the asthmatic students and half of those with a food allergy had a health management plan on file. The study was also covered by The Chicago Tribune, Fox News, The Baltimore Sun, and Red Orbit, among other outlets.

RWJF Nurse Faculty Scholars alumna Angela Frederick Amar, PhD, RN, FAAN, publishes an op-ed on Talking Points Memo about the report from the White House Task Force to Protect Students from Sexual Assault, Not Alone. Amar notes that effective response to campus sexual assault should include medical care for survivors, and that Sexual Assault Nurse Examiners (SANEs) are trained to tend to the medical and emotional needs of survivors and collect forensic evidence. In other institutions with high rates of sexual violence, such as the military, SANEs are considered an essential part of treatment for victims of sexual violence, Amar writes.

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Sep 16 2014
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Inaugural Cohort of 16 Future of Nursing Scholars Announced

The new Future of Nursing Scholars program has announced its first cohort of 16 nurse scholars who are receiving scholarships and other support as they pursue PhDs in nursing. The students were selected by schools of nursing that have received grants to provide those scholarships.

Each Future of Nursing Scholar will receive financial support, mentoring and leadership development over the three years of her or his PhD program. They are in the initial stages of selecting the topics for their doctoral research, which range from infection control in the elderly population to the impact of stigma on people with mental illness to the quality of life of children with implanted defibrillators.

In addition to the Robert Wood Johnson Foundation, United Health Foundation, Independence Blue Cross Foundation, Cedars-Sinai Medical Center and the Rhode Island Foundation are supporting the Future of Nursing Scholars grants to schools of nursing this year. The program is located at the University of Pennsylvania School of Nursing.

Read more about the first cohort of Future of Nursing Scholars.

Schools of nursing with research-focused PhD programs can apply to join the program here.

Sep 16 2014
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Sep 11 2014
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Recent Research About Nursing, September 2014

This is part of the September 2014 issue of Sharing Nursing’s Knowledge.

Lower Hospitalization Rates Linked to Broader NP Scope of Practice

New research correlating state-by-state hospitalization rates with state policies on nurse practitioner (NP) scope of practice offers a revealing conclusion: Medicare and Medicaid patients are less likely to require hospitalization in states that allow NPs a broader scope of practice.

A team of researchers from the University of Missouri Sinclair School of Nursing examined hospitalization data from a range of sources that sorted data by state, and then compared it with American Association of Nurse Practitioners data on state laws and regulations governing NP scope of practice. They found “a significant relationship between full practice of NPs and decreased hospitalization rates of Medicare and Medicaid beneficiaries in the United States and improved health outcomes of states.”

The researchers caution that the data do not prove a causal relationship between scope of practice and hospitalization rates, but write, “Our findings support the increasing call of facilitating Advanced Practice Registered Nurses [APRNs] to fulfill their full scope of practice in providing access and care to patients without direct or indirect supervision from physicians. The outcomes support the Institute of Medicine recommendation that APRNs practice to their full scope of practice including functioning as primary care providers.”

The study was published online by Nursing Outlook on August 4, 2014.

Read an abstract of the study or a news article on it in McKnight’s.

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Sep 11 2014
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RWJF Scholars in the News: Mental health and returning service members, children of incarcerated parents, nurse turnover, more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni and grantees. Some recent examples:

When reserve service members return to civilian life, such stresses as marriage and health care problems are more likely to trigger drinking problems than traumatic events that occurred during deployment, according to a study reported by Fox News. When it comes to the “long-term mental health for National Guard members, what matters is what happens after they come home,” said lead author Magdalena Cerdá, PhD, MPH, an RWJF Health & Society Scholars program alumna. “Financial difficulties, re-integrating, difficulties accessing quality health care, all of those seem to matter.” But deployment stress also has an impact. “[T]he more traumatic events they are exposed to during or after combat, the more problems they have in daily life when they come home,” she said. RWJF Investigator Award in Health Policy Research recipient Sandro Galea, MD, MPH, DrPH, co-authored the study. Health Canal also reported on it.

An estimated 17.5 percent of newly licensed RNs leave their first nursing job within the first year, and one in three leave within two years, according to research conducted by RWJF’s RN Work Project. Advance for Nurses quotes co-directors Christine T. Kovner, PhD, RN, FAAN, and Carol Brewer, PhD, RN, FAAN. “One of the biggest problems we face in trying to assess the impact of nurse turnover on our health care system as a whole is that there’s not a single, agreed-upon definition of turnover,” Kovner said. “A high rate of turnover at a hospital, if it's voluntary, could be problematic,” Brewer added, “but if it’s involuntary or if nurses are moving within the hospital to another unit or position, that tells a very different story.” Nurse.com also covered the study.

Having incarcerated parents is associated with significant health problems and behavioral issues, and may be more harmful to children’s health than divorce or the death of a parent, USA Today reports. “These kids are saddled with disadvantages,” said Kristin Turney, PhD, author of the study that reached those conclusions. She is an RWJF Health & Society Scholars program alumna. “They’re not only dealing with parental incarceration, but also mental health issues.” The study found that having a parent in prison was associated with such conditions as attention deficit hyperactivity disorder, learning disabilities, speech or language problems, and developmental delays. Turney’s study was also covered by US News and World Report, Salon, Psych Central, Healthline and Mother Jones, among other outlets. 

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Sep 10 2014
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I Am Who I Am Because of You

Faith Ikarede Atte, RN, MSN, is a Future of Nursing Scholar studying for her PhD at Villanova University, supported by Independence Blue Cross Foundation. The Future of Nursing program is a project of the Robert Wood Johnson Foundation.

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There are things in life so personal and private that when one vocalizes them, there is fear of being judged. It was eleven years ago that I had a personal encounter with myself. It is admittedly odd to look back at the path that I have walked on, now overgrown and distant—yet still so close to my heart.

Eleven years ago is when I lost a sense of who I was in the eyes of society, and I had to look within myself to find my footing. It is during this time that I had arrived from Kenya, full of vigor, light spirited and quick to laughter. I was hungry for knowledge and the sky was the limit.

Little did I know that life was about to teach me a lesson. It became obvious to me that my accent was different. Most immigrants can identify with the situation of being different. The more I spoke, be it in class or in a group of people, the more I felt isolated due to reactions like, “What did you say? Speak up.  Your accent is too thick. I don’t know what you are saying.”

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Sep 9 2014
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Quotable Quotes About Nursing, September 2014

This is part of the September 2014 issue of Sharing Nursing’s Knowledge.

“Changing cultural norms within the nursing profession will require efforts from all parties: from nursing graduates, in treating their colleagues with respect and raising awareness by reporting incidents; from nursing leaders, in leading by example to foster supportive behaviors and promote a healthy work environment; from health care institutions, in setting zero tolerance disciplinary policies and empowering staff to report on issues without fear of retaliation; and from academic institutions, in preparing students with conflict management skills to address situations as they arise.”
--Susan Sanders, DNP, RN, NEA-BC, vice president, Kaplan Nursing, Bullying a Rising Concern for New Nurses, U.S. News & World Report, September 3, 2014

“It is time to stop wringing our hands that there are inadequate MDs wanting to provide primary care service. There is a very synergistic way that medicine and advanced practice nursing can work together, capitalize on the strengths that each discipline brings to the table, and maximize the patient experience and the outcomes. This is a new model.”
--Rosemary Dale, EdD, professor of nursing, University of Vermont, New Health Care Model Tested in BurlingtonBurlington Free Press, August 30, 2014

“The numbers speak for themselves. As the demographics change and more ethnically and racially diverse populations grow, there will definitely continue to be a need for health care providers who mirror these patients.”
--Eva Gomez, MSN, RN-BC, CPN, staff development specialist, Children’s Hospital in Boston, Push to Recruit Black, Latino Nurses, Washington Informer, August 27, 2014

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