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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 32 Research Studies DisplayedWomack DM, Miech EJ, Fox NJ
Coincidence analysis: a novel approach to modeling nurses' workplace experience.
This study’s objective was to identify combinations of workplace conditions that uniquely differentiate high, medium, and low registered nurse (RN) ratings of appropriateness of patient assignment during daytime intensive care unit (ICU) work shifts. The RN members of the study team hypothesized a set of 55 workplace conditions having potential difference makers to define high, medium, and low perception of patient assignment appropriateness. An analysis of 64 cases (25 high, 24 medium, and 15 low) produced three models, one for each level of the outcome. The high appropriateness model was the simplest with two paths: 1) an absence of overtime and before-noon patient discharge or transfer; and 2) an absence of overtime and RN assignment to a single ICU patient.
AHRQ-funded; HS026370.
Citation: Womack DM, Miech EJ, Fox NJ .
Coincidence analysis: a novel approach to modeling nurses' workplace experience.
Appl Clin Inform 2022 Aug;13(4):794-802. doi: 10.1055/s-0042-1756368..
Keywords: Provider: Nurse, Workflow
Choi KR, Hughesdon K, Britton L
Interpersonal trauma in the lives of nurses and perceptions of nursing work.
This study’s purpose was to explore associations between trauma experiences among nurses and nursing perceptions of risk for involuntary job loss and standing in society. This observational study used 2001 data from the Nurses’ Health Study which surveyed 53,323 female nurses. The outcome looked at were nurses’ perceptions of their risk for involuntary job loss and their social standing in the US and within their own community. The majority of nurses surveyed reported high rates of emotional trauma, in childhood and adulthood with lower rates of physical and sexual trauma. Emotional trauma was associated with perception of higher risk for involuntary job loss, but also higher perception of societal standing.
AHRQ-funded; HS026407.
Citation: Choi KR, Hughesdon K, Britton L .
Interpersonal trauma in the lives of nurses and perceptions of nursing work.
West J Nurs Res 2022 Aug;44(8):734-42. doi: 10.1177/01939459211015894..
Keywords: Provider: Nurse, Domestic Violence
Merkow RP, Chung JW, Slota JM
Correlation of the US News and World Report-calculated nurse staffing index with actual hospital-reported nurse staffing.
This study’s objective was to understand how the Nurse Staffing Index (NSI) used in the US News and World Report “Best Hospitals” rankings correlates to actual nurse staffing levels. Nurse staffing data was obtained from publicly available data in the states of Illinois, California, and New Jersey. No other states had publicly accessible data. Hospital characteristics were obtained from the 2016 American Hospital Association (AHA) survey. The NSI was calculated using AHA data and is defined as the number of FTE RNs per adjusted patient day. Hospital characteristics were assessed using Hospital Compare data. Higher actual hospital-reported nurse staffing in Illinois and New Jersey was paradoxically associated with lower nurse staffing when measured by the NSI. California hospital-reported staffing intensity was weakly correctly with the NSI and RN nursing hours per patient day was not correlated with any of the 9 structural measures of hospital quality, while NSI was positively correlated with 3 of the 9 measures, particularly hospital volume status. None of the 11 outcome measures the authors assessed were associated with RN nursing hours per patient day or the NSI in either Illinois or California. All 12 patient experience measures were significantly and positively correlated with RN nursing hours in Illinois. However, none of the patient experience measures were significantly associated with the NSI in Illinois. The authors concluded that the NSI may not measure actual nurse staffing as intended.
AHRQ-funded; HS024516; HS026385.
Citation: Merkow RP, Chung JW, Slota JM .
Correlation of the US News and World Report-calculated nurse staffing index with actual hospital-reported nurse staffing.
J Nurs Care Qual 2022 Jul-Sep;37(3):195-98. doi: 10.1097/ncq.0000000000000619..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Provider: Nurse, Workforce
Yu A, Jordan SR, Gilmartin H
"Our hands are tied until your doctor gets here": nursing perspectives on inter-hospital transfers.
The purpose of this study was to characterize the experiences of inpatient floor-level bedside nurses caring for inter-hospital transfer (IHT) patients and to identify care coordination challenges and solutions. Results from this study are mapped to AHRQ’s Care Coordination Measurement Framework domains of communication, assessing needs and goals, and negotiating accountability. Findings showed that three key themes characterized nurses' experiences with IHT related to these domains: challenges with information exchange and team communication during IHT, environmental and information preparation needed to anticipate transfers, and determining responsibility and care plans after the IHT patient has arrived at the accepting facility.
AHRQ-funded; HS023331.
Citation: Yu A, Jordan SR, Gilmartin H .
"Our hands are tied until your doctor gets here": nursing perspectives on inter-hospital transfers.
J Gen Intern Med 2022 May;37(7):1729-36. doi: 10.1007/s11606-021-07276-5..
Keywords: Transitions of Care, Hospitals, Provider: Nurse
Cimiotti JP, Becker ER, Li Y
Association of registered nurse staffing with mortality risk of Medicare beneficiaries hospitalized with sepsis.
The purpose of this cross-sectional study was to determine if registered nurse workload was related with mortality in Medicare beneficiaries admitted to an acute care hospital with sepsis. The researchers evaluated the records of Medicare beneficiaries ages 65 to 99 years with a primary diagnosis of sepsis that was present on admission to 1 of 1958 nonfederal, general acute care hospitals that had data on CMS SEP-1 scores and registered nurse workload. Researchers utilized 2018 data from the American Hospital Association Annual Survey, CMS Hospital Compare, and Medicare claims. The patient outcome of interest was mortality within 60 days of admission. The study found that 702,140 Medicare beneficiaries with a mean age of 78.2 years, 51% of whom were women, had a diagnosis of sepsis. In a multivariable regression model, each additional registered nurse hour per patient day (HPPD) was associated with a 3% decrease in the odds of 60-day mortality. The researchers concluded that hospitals which provide more registered nurse hours of care could possibly decrease the likelihood of mortality in Medicare beneficiaries with sepsis.
AHRQ-funded; HS026232.
Citation: Cimiotti JP, Becker ER, Li Y .
Association of registered nurse staffing with mortality risk of Medicare beneficiaries hospitalized with sepsis.
JAMA Health Forum 2022 May;3(5):e221173. doi: 10.1001/jamahealthforum.2022.1173..
Keywords: Sepsis, Mortality, Provider: Nurse, Nursing, Workforce
Jeffery AD
Data science for nurses.
This “Practice Matters” article discusses how nurses can apply data science methods to improve nurses’ insight into care delivery. Data science in nursing is defined and the data science process is described in five steps: capture, maintain, process, analyze, and communicate. A table is included which highlights several recently published studies that leveraged data science methods in nursing-relevant projects. The article ends with a call to action.
AHRQ-funded; HS026395.
Citation: Jeffery AD .
Data science for nurses.
Am Nurse 2022 May; 17(5)..
Keywords: Provider: Nurse, Electronic Health Records (EHRs), Health Information Technology (HIT)
Dierkes AM, Aiken LH, Sloane DM
Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis.
The timely and effective administration of sepsis treatment may improve sepsis outcomes, and those improvements may provide evidence of the need for mandated reporting of adherence to sepsis care protocol. The purpose of the study was to better understand the association between patient-to-nurse staffing ratios, sepsis protocol compliance, and patient outcomes. The researchers conducted a cross-sectional study utilizing linked data from 537 hospitals from across California, Florida, Illinois, Pennsylvania, New Jersey, and New York (representing 252,699 Medicare inpatients with sepsis present on admission), nurse and hospital surveys, and Centers for Medicare and Medicaid Services Hospital Compare and the corresponding MedPAR patient claims. The study found that every additional patient per nurse was associated with greater odds of mortality, readmission, ICU admission, and greater risk of relative duration of stay. Every 10% increase in compliance of sepsis protocol was only associated with a shorter duration of stay. The study concluded that improvements in nurse staffing and the nurse-to-patient ratios had a greater impact on sepsis infection outcomes than compliance with protocols.
AHRQ-funded; HS026232.
Citation: Dierkes AM, Aiken LH, Sloane DM .
Hospital nurse staffing and sepsis protocol compliance and outcomes among patients with sepsis in the USA: a multistate cross-sectional analysis.
BMJ Open 2022 Mar 22;12(3):e056802. doi: 10.1136/bmjopen-2021-056802..
Keywords: Sepsis, Hospitals, Provider: Nurse, Workforce
Tzeng HM, Raji MA, Chou LN
Impact of state nurse practitioner regulations on potentially inappropriate medication prescribing between physicians and nurse practitioners: a national study in the United States.
The American Geriatrics Society regularly updates the Beers Criteria for Potentially Inappropriate Medication (PIM) to improve prescribing safety. This study assessed the impact of nurse practitioner (NP) practices on PIM prescribing across states in the United States and compared the change in PIM prescribing rates between 2016 and 2018. The investigators found that the PIM prescription rate was lower in states with full NP practice and lower among NPs than among physicians; these rates for both physicians and NPs decreased from 2016 to 2018.
AHRQ-funded; HS020642.
Citation: Tzeng HM, Raji MA, Chou LN .
Impact of state nurse practitioner regulations on potentially inappropriate medication prescribing between physicians and nurse practitioners: a national study in the United States.
J Nurs Care Qual 2022 Jan-Mar;37(1):6-13. doi: 10.1097/ncq.0000000000000595..
Keywords: Medication, Medication: Safety, Provider: Nurse, Adverse Drug Events (ADE), Adverse Events, Policy
Gaughan AA, Walker DM, Sova LN
Improving provisioning of an inpatient portal: perspectives from nursing staff.
This study’s aim was to identify and describe practices important for provisioning an inpatient portal from the perspectives of nursing staff and provide insight to enable hospitals to address challenges related to provisioning workflow for the inpatient portal accessible on a tablet. Qualitative interviews were conducted at 26 inpatient units in six hospitals within The Ohio State University Wexner Medical Center (OSUWMC) with 210 nursing staff members following the introduction of tablets providing access to an inpatient portal, MyChart Bedside (MCB). Provisioning rates were divided into tertiles to create three levels of provisioning performance. Higher-performing units showed three critical strategies that contributed to MCB tablet provisioning success: (1) establishing a feasible process for MCB provisioning; (2) having persistent unit-level MCB tablet champions; and (3) having unit managers actively promote MCB tablets.
AHRQ-funded; HS024767; HS024091; HS024379.
Citation: Gaughan AA, Walker DM, Sova LN .
Improving provisioning of an inpatient portal: perspectives from nursing staff.
Appl Clin Inform 2022 Mar;13(2):355-62. doi: 10.1055/s-0042-1743561..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Provider: Nurse
Cohen B, Sanabria E, Liu J
Predicting healthcare-associated infections, length of stay, and mortality with the nursing intensity of care index.
The purpose of this study was to develop, validate, and utilize a simulation model to predict healthcare-associated infections (HAIs), length of stay (LOS), and patient mortality, as well as evaluate whether the variation in incidence of HAIs was dependent upon the adequacy of unit staffing levels. The researchers analyzed data from all patients discharged from four different types of New York City hospitals within a single healthcare network between 2012-2016 (N=562,435). The researchers developed a simulation model to estimate the daily probability rates of 5 different HAIs, length of stay, and mortality, and modeled staffing adequacy based on nursing care supply (as indicated by total nurse staffing) and nursing care demand (indicated using the Nursing Intensity of Care Index.) The study results indicated that the model predictions were within 95% confidence intervals of the actual outcomes. The authors reported that the incidence of HAI was the highest when total nurse staffing (supply) was lowest and nursing care intensity (demand) was highest.
AHRQ-funded; HS024915.
Citation: Cohen B, Sanabria E, Liu J .
Predicting healthcare-associated infections, length of stay, and mortality with the nursing intensity of care index.
Infect Control Hosp Epidemiol 2022 Mar;43(3):298-305. doi: 10.1017/ice.2021.114..
Keywords: Healthcare-Associated Infections (HAIs), Provider: Nurse, Inpatient Care, Mortality
Crist K, Lafferty M, Umberfield E
Which factors promote shared understanding between physicians and nurses in inpatient oncology care settings?: A qualitative exploration.
This qualitative secondary analysis was conducted to identify factors that contribute to shared understanding between physicians and nurses from video-recorded conversations that occurred between them during inpatient rounds on oncology units. Four factors emerged as contributors to shared understanding: engagement, clarification, confirmation, and resolution. These factors occurred in sequence with engagement occurring first and resolution occurring last, as the closure of a communication exchange. A greater awareness of body language and positioning at the start of a communication exchange may increase the effectiveness of nurse-physician communication.
AHRQ-funded; HS022305.
Citation: Crist K, Lafferty M, Umberfield E .
Which factors promote shared understanding between physicians and nurses in inpatient oncology care settings?: A qualitative exploration.
Cancer Nurs 2022 Mar-Apr;45(2):E338-E44. doi: 10.1097/ncc.0000000000000959..
Keywords: Communication, Provider: Physician, Provider: Nurse
Gray NA, Kamal AH, Hanson LC
Clinician perspectives guiding approach to comprehensiveness of palliative care assessment.
This paper discusses the results of a two-part web-based survey of palliative care clinicians from five academic groups in the United States. The objective was to describe clinicians’ assessment practices and factors influencing their approach to quality palliative care in contrast to the National Consensus Project guidelines for palliative care. Nineteen out of 25 invited clinicians completed the survey, including physicians, nurse practitioners, and physician assistants. The majority (62%) reported that their usual practice was to tailor the focus of the consultation, mainly due to time limitations and workload, followed by beliefs that comprehensive assessment was unnecessary, and absence of the full interdisciplinary team. Most participants cited reason for consult as factors influencing a tailored approach. Physical symptoms were the most commonly assessed factor (81%), with spiritual and cultural factors least commonly (24% and 19%, respectively) listed. Although most clinicians reported usually tailoring their consultations, mean importance scores for almost all assessment elements were high (mean of 7.1 on a 0-9 importance scale).
AHRQ-funded; HS022763.
Citation: Gray NA, Kamal AH, Hanson LC .
Clinician perspectives guiding approach to comprehensiveness of palliative care assessment.
J Palliat Med 2022 Feb;25(2):307-11. doi: 10.1089/jpm.2021.0391..
Keywords: Palliative Care, Provider: Nurse
Smith LB
The effect of nurse practitioner scope of practice laws on primary care delivery.
Nurse practitioners (NPs) are an increasingly integral part of the primary care workforce. NPs' authority to practice without physician oversight is regulated by state-level scope of practice (SOP) restrictions. To the extent that SOP restrictions prevent NPs from practicing to their full abilities and capacity, they could create inefficiencies and restrict access to health care. The purpose of this paper was to explore what occurs at primary care practices when states ease their scope of practice (SOP) laws. The researcher utilized a novel dataset of claims and electronic health records to quantify the effects of easing SOP laws in 3 areas: 1. Nurse Practitioners' autonomy in their everyday jobs; 2. Total workload and the allocation of patients between physicians and NPs; and 3. The delivery of low-value services at primary care practices. The study found no evidence that easing SOP laws impacts neither the volume or allocation of patients to NPs, nor the delivery of low-value services.
AHRQ-funded; HS026659.
Citation: Smith LB .
The effect of nurse practitioner scope of practice laws on primary care delivery.
Health Econ 2022 Jan; 31(1):21-41. doi: 10.1002/hec.4438..
Keywords: Primary Care, Healthcare Delivery, Policy, Provider: Clinician, Provider: Nurse
O'Leary KJ, Manojlovich M, Johnson JK
A multisite study of interprofessional teamwork and collaboration on general medical services.
This multisite study of four mid-sized hospitals measured teamwork climate of nurses, nurse assistants, and physicians working on general medical services. Teamwork climate scores for 380 participants (80 hospitalists, 13 resident physicians, 193 nurses, and 94 nurses) were measured using the Safety Attitudes Questionnaire. Hospitalists had the highest median teamwork climate score and nurses had the lowest, but it was not a statistically significant difference. A higher percentage of hospitalists (63.3%) rated the quality of collaboration with nurses as high or very high, but only 48.7% of nurses rated the collaboration with hospitalists as high or very high. There were significant differences in perceptions of teamwork climate across sites and across professional categories.
AHRQ-funded; HS025649.
Citation: O'Leary KJ, Manojlovich M, Johnson JK .
A multisite study of interprofessional teamwork and collaboration on general medical services.
Jt Comm J Qual Patient Saf 2020 Dec;46(12):667-72. doi: 10.1016/j.jcjq.2020.09.009..
Keywords: Teams, Hospitals, Patient Safety, Provider: Clinician, Provider: Physician, Provider: Nurse, Provider
Smith JG, Rogowski JA, Lake ET
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
Being unable to provide required nursing care to infants could contribute to poorer neonatal nurse job outcomes, which may exacerbate staffing challenges. Little evidence exists about how missed nursing care relates to neonatal nurse job outcomes. The purpose of this study was to determine relationships among missed nursing care, job enjoyment and intention to leave for neonatal nurses.
AHRQ-funded; HS024918.
Citation: Smith JG, Rogowski JA, Lake ET .
Missed care relates to nurse job enjoyment and intention to leave in neonatal intensive care.
J Nurs Manag 2020 Nov;28(8):1940-47. doi: 10.1111/jonm.12943..
Keywords: Newborns/Infants, Neonatal Intensive Care Unit (NICU), Intensive Care Unit (ICU), Provider: Nurse, Provider, Burnout, Nursing
Fraze TK, Briggs ADM, Whitcomb EK
Role of nurse practitioners in caring for patients with complex health needs.
The objective of this study was to estimate trends in the percentage of Medicare beneficiaries cared for by nurse practitioners from 2012 to 2017, to characterize beneficiaries cared for by nurse practitioners in 2017, and to examine how the percentage of beneficiaries cared for by nurse practitioners varies by practice characteristics. Findings showed that nurse practitioners are caring for Medicare beneficiaries with complex needs at rates that match or exceed their physician colleagues. The growing role of nurse practitioners, especially in health care systems, warrants attention as organizations embark on payment and delivery reform.
AHRQ-funded; HS024075.
Citation: Fraze TK, Briggs ADM, Whitcomb EK .
Role of nurse practitioners in caring for patients with complex health needs.
Med Care 2020 Oct;58(10):853-60. doi: 10.1097/mlr.0000000000001364..
Keywords: Provider: Clinician, Provider: Nurse, Provider, Chronic Conditions, Primary Care, Medicare
Isbell LM, Boudreaux ED, Chimowitz H
What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care.
Despite calls to study how healthcare providers' emotions may impact patient safety, little research has addressed this topic. The current study aimed to develop a comprehensive understanding of emergency department (ED) providers' emotional experiences, including what triggers their emotions, the perceived effects of emotions on clinical decision making and patient care, and strategies providers use to manage their emotions to reduce patient safety risks.
AHRQ-funded; HS025752.
Citation: Isbell LM, Boudreaux ED, Chimowitz H .
What do emergency department physicians and nurses feel? A qualitative study of emotions, triggers, regulation strategies, and effects on patient care.
BMJ Qual Saf 2020 Oct;29(10):1-2. doi: 10.1136/bmjqs-2019-010179..
Keywords: Emergency Department, Provider: Nurse, Provider: Physician, Patient Safety
Temkin-Greener H, Cen X, Li Y
Nursing home staff turnover and perceived patient safety culture: results from a national survey.
In this study, the investigators examined the association between turnover of registered nurses (RNs) and certified nurse assistants (CNAs) and perceived patient safety culture (PSC) in nursing homes (NHs). The investigators suggest that the effect of turnover on PSC depends on who leaves and to a lesser extent on the organizational characteristics. In NHs, improvements in PSC may depend on the ability to retain a well-trained and skilled nursing staff.
AHRQ-funded; HS024923.
Citation: Temkin-Greener H, Cen X, Li Y .
Nursing home staff turnover and perceived patient safety culture: results from a national survey.
Gerontologist 2020 Sep 15;60(7):1303-11. doi: 10.1093/geront/gnaa015..
Keywords: Nursing Homes, Long-Term Care, Surveys on Patient Safety Culture, Patient Safety, Provider: Nurse, Provider
Bettencourt AP, Vance AJ, Jun J
Maximizing the academic nursing model in the era of COVID-19 and beyond.
This opinion paper revisits the 2016 American Association of Colleges of Nursing (AACN) position statement on academic nursing. In the age of COVID-19, the statement is reimagined as a means to maximize nursing’s contributions to this global health crises. The 2016 position statement discussed the potentials for nursing schools to work within healthcare systems beyond clinic training. Most academic nurses do not also provide clinical care which is limited by structural barriers that inhibit academic nursing transformation. Many academic nurses who also have a clinical practice have had to do so on their own time. This new vision would capitalize on nursing’s strength in population health. The authors urge nursing schools to transform their model of academic nursing.
AHRQ-funded; HS024552.
Citation: Bettencourt AP, Vance AJ, Jun J .
Maximizing the academic nursing model in the era of COVID-19 and beyond.
Nurs Outlook 2020 Sep-Oct;68(5):542-44. doi: 10.1016/j.outlook.2020.04.013..
Keywords: COVID-19, Nursing, Provider: Nurse, Public Health, Education: Academic
Lozada MJ, Raji MA, Goodwin JS
Opioid prescribing by primary care providers: a cross-sectional analysis of nurse practitioner, physician assistant, and physician prescribing patterns.
The purpose of this study was to identify prescription opioid over-prescribers by comparing prescribing patterns of primary care physicians (MDs), nurse practitioners (NPs), and physician assistants (PAs). Participants were a national sample of 2015 Medicare Part D enrollees. Findings showed that most NPs/PAs prescribed opioids in a pattern similar to MDs, but NPs/PAs had more outliers who prescribed high-frequency, high-dose opioids than did MDs. Recommendations included efforts to reduce opioid overprescribing including targeted provider education, risk stratification, and state legislation.
AHRQ-funded; HS020642.
Citation: Lozada MJ, Raji MA, Goodwin JS .
Opioid prescribing by primary care providers: a cross-sectional analysis of nurse practitioner, physician assistant, and physician prescribing patterns.
J Gen Intern Med 2020 Sep;35(9):2584-92. doi: 10.1007/s11606-020-05823-0..
Keywords: Opioids, Medication, Primary Care, Practice Patterns, Medication: Safety, Provider: Nurse, Provider: Physician, Provider: Physician Assistant, Provider
Shechter A, Diaz F, Moise N
Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic.
The mental health toll of COVID-19 on healthcare workers (HCW) is not yet fully described. In this study the authors, using a cross-sectional web survey, characterized distress, coping, and preferences for support among NYC HCWs during the COVID-19 pandemic. They concluded that NYC HCWs, especially nurses and advanced practice providers, were experiencing COVID-19-related psychological distress.
AHRQ-funded; HS024262.
Citation: Shechter A, Diaz F, Moise N .
Psychological distress, coping behaviors, and preferences for support among New York healthcare workers during the COVID-19 pandemic.
Gen Hosp Psychiatry 2020 Sep-Oct;66:1-8. doi: 10.1016/j.genhosppsych.2020.06.007..
Keywords: COVID-19, Stress, Provider: Clinician, Provider: Physician, Provider: Nurse, Provider: Health Personnel, Behavioral Health
Shuman CJ, Costa DK
Stepping in, stepping up, and stepping out: competencies for intensive care unit nursing leaders during disasters, emergencies, and outbreaks.
In this paper, the authors discuss competencies for intensive care unit nursing leaders during disasters, emergencies, and outbreaks. They draw on the recent example of COVID-19s substantially burdened intensive care units and nursing staff. Informed by extant literature, American Organization of Nurse Leaders--identified competencies, and expert opinion, the authors suggest 3 areas of focused skill development to ensure leaders, especially leaders in ICU settings, are prepared for future crises.
AHRQ-funded; HS024552.
Citation: Shuman CJ, Costa DK .
Stepping in, stepping up, and stepping out: competencies for intensive care unit nursing leaders during disasters, emergencies, and outbreaks.
Am J Crit Care 2020 Sep 1;29(5):403-06. doi: 10.4037/ajcc2020421..
Keywords: Critical Care, Provider: Nurse, Nursing, COVID-19, Emergency Preparedness
Womack DM, Hribar MR, Steege LM
Registered nurse strain detection using ambient data: an exploratory study of underutilized operational data streams in the hospital workplace.
Registered nurses (RNs) regularly adapt their work to ever-changing situations but routine adaptation transforms into RN strain when service demand exceeds staff capacity and patients are at risk of missed or delayed care. The purpose of this study was to assess the utility of ambient workplace data, defined as time-stamped transaction records and log file data produced by non-electronic health record care delivery tools (e.g., nurse call systems, communication devices), as an information channel for automated sensing of RN strain.
AHRQ-funded; HS026370.
Citation: Womack DM, Hribar MR, Steege LM .
Registered nurse strain detection using ambient data: an exploratory study of underutilized operational data streams in the hospital workplace.
Appl Clin Inform 2020 Aug;11(4):598-605. doi: 10.1055/s-0040-1715829..
Keywords: Provider: Nurse, Provider, Health Information Technology (HIT), Workforce, Burnout
Lafferty M, Fauer A, Wright N
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
The purpose of this study was to examine the causes and consequences of chemotherapy treatment delays and possible solutions to improve quality of care. The authors identified four primary themes from the analysis that affect delays. They suggest future investigations to examine nurses' communication practices in the context of timely chemotherapy administration since communication and documentation technologies within healthcare settings continuously evolve.
AHRQ-funded; HS024914.
Citation: Lafferty M, Fauer A, Wright N .
Causes and consequences of chemotherapy delays in ambulatory oncology practices: a multisite qualitative study.
Oncol Nurs Forum 2020 Jul 1;47(4):417-27. doi: 10.1188/20.Onf.417-427..
Keywords: Treatments, Cancer, Ambulatory Care and Surgery, Quality of Care, Clinician-Patient Communication, Communication, Provider: Nurse, Provider, Nursing, Chronic Conditions
Tubbs-Cooley HL, Riddle SW, Gold JM
Paediatric clinical and social concerns identified by home visit nurses in the immediate postdischarge period.
The purpose of this study was to describe paediatric postdischarge concerns manifesting in the first 96 hr after hospital discharge. The investigators analysed home visit records of 651 children (age <18) hospitalized at a large Midwestern children's hospital in 2015 and 2016 who were enrolled in the trial. Registered nurses documented concerns in structured fields and free-text notes in visit records. Descriptive statistics were used to summarize visit documentation. Free-text visit notes were reviewed and exemplars illustrative of quantitative findings were selected.
AHRQ-funded; HS024735.
Citation: Tubbs-Cooley HL, Riddle SW, Gold JM .
Paediatric clinical and social concerns identified by home visit nurses in the immediate postdischarge period.
J Adv Nurs 2020 Jun;76(6):1394-403. doi: 10.1111/jan.14341..
Keywords: Children/Adolescents, Home Healthcare, Hospital Discharge, Provider: Nurse, Provider