A team of researchers led by University of California San Francisco (UCSF) nursing professor Mary Blegen, RN, PhD, has launched a two-year study to measure nursing quality in acute inpatient units. UCSF's study is one of nine projects nationwide funded by a grant from the Robert Wood Johnson Foundation through its Interdisciplinary Nursing Quality Research Initiative (INQRI). INQRI seeks to examine the link between nurses' contributions and the safety and quality of patient care.
Blegen is director of the Center for Patient Safety in the UCSF School of Nursing. For the UCSF study, "Examining the Causal Relationship Between the Quality of Nursing Care and Patient Outcomes in Acute Inpatient Units," she and her co-investigators will examine national databases compiled by a consortium of university health systems. They will study benchmarks that measure quality hospital care in terms of outcomes, indicators of how well the patients fare and whether they suffer complications of their care. The researchers will compare these outcomes with data about nurse staffing and nurse education, as well as the acuity of patient care needs.
"Previous research has provided strong evidence that nursing care has an impact on patient safety, preventing errors and unexpected deaths, and influencing the quality of patient care," Blegen said. "Nurses provide round-the-clock surveillance of patients. In hospital units with sufficient staff, nurses can watch hour-by-hour changes in each patient's condition, can identify when something begins to go wrong and communicate that to the rest of the care team."
So far, however, decision-makers do not have clear and consistent data to show which levels of staffing will promote safety depending on patients' needs and the acuity of their conditions, Blegen said.
More than half (54 percent) of all healthcare providers in the United States are nurses, but little rigorous research exists that demonstrates the impact of nurses' care. "The research that the INQRI teams generate will provide that evidence, identifying not only how nurses affect patient care, but also how clinical leaders and policy-makers can support changes that improve the quality of care that nurses are able to provide," said Mary Naylor, PhD, RN, professor at the University of Pennsylvania School of Nursing and co-director of the INQRI program.
Nine teams of nurse scholars and scholars from other disciplines such as informatics, health policy, economics, and medicine -- each received up to $300,000 for their projects, designed to generate, disseminate, and translate research to improve the quality of care provided in hospitals. In addition to UCSF, other INQRI projects include those based at Johns Hopkins University, Emory University, Mayo Clinic, University of Utah, University of Pennsylvania, Massachusetts General Hospital, Massachusetts Hospital Research and Education Association, Inc., and Baruch College in New York.
For the study of quality in acute care units, Blegen's co-principal investigators are Colleen Goode, RN, PhD, chief nursing officer of the University of Colorado Hospital and Thomas Vaughn, PhD, associate professor in health policy and research, School of Public Health, University of Iowa.
Investigators from UCSF are Joanne Spetz, PhD, associate professor in the UCSF School of Nursing and a health economist at the UCSF Center for Workforce Studies, and Catherine Wittenberg, RN, MS, chief nursing officer at UCSF Medical Center.