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Recent Research Publications and Funding
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December 6, 2012 6:00AM
Objective: To determine the association between the use of agency-employed supplemental registered nurses (SRNs) to staff hospitals and patient mortality and failure to rescue (FTR).
Data Sources: Primary survey data from 40,356 registered nurses in 665 hospitals in four states in 2006 were linked with American Hospital Association and inpatient mortality data from state agencies for approximately 1.3 million patients.
Study Design: Logistic regression models were used to examine the association between SRN use and 30-day in-hospital mortality and FTR, controlling for patient and hospital characteristics, nurse staffing, the proportion of nurses with bachelor's degrees, and quality of the work environment.
Principal Findings: Before controlling for multiple nurse characteristics of hospitals, higher proportions of agency-employed SRNs in hospitals appeared to be associated with higher mortality (OR = 1.06) and FTR (OR = 1.05). Hospitals with higher proportions of SRNs have poorer work environments, however, and the significant relationships between SRNs and mortality outcomes were rendered insignificant when work environments were taken into account.
Conclusions: Higher use of SRNs does not appear to have deleterious consequences for patient mortality and may alleviate nurse staffing problems that could produce higher mortality.
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December 1, 2012 6:00AM
Ying Xue, DNSc, RN compares qualifications and characteristics of supplemental nurses and permanent nurses during 1984 - 2008 in an article published by Health Affairs.
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December 1, 2012 6:00AM
Use of supplemental RNs (SRNs) is common practice among US hospitals to fill gaps in nurse staffing. The objective of this study was to examine the relationship between use of SRNs and patient outcomes. Multilevel modeling was performed to analyze hospital administrative data from 19 hospital units in a large tertiary medical center for the years 2003 to 2006. Patient outcomes included in-hospital mortality, medication errors, falls, pressure ulcers, and patient satisfaction with nurses. Use of SRNs ranged from 0% to 30.4% of total RN hours per unit quarter. Among 188 of the 304 unit quarters in which SRNs were used, the average SRN use was 9.8% in non-ICUs and 6.4% in ICUs. All observed effects of SRN use on patient outcomes were nonsignificant. Use of SRNs was substantial and varied widely by unit. No evidence was found that links SRN use to either adverse or positive patient outcomes.
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The effects of guided imagery on sleep and inflammatory response in cardiac surgery: a pilot randomized controlled trial| November 28, 2012 6:00AM
The goal of this preliminary investigation was to lay the groundwork to test the applicability of using guided imagery as a sleep-promoting intervention immediately following cardiac surgery.
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November 26, 2012 6:00AM
The purpose of this study was to describe the physical and social environment of sleep self-management in postpartum socioeconomically disadvantaged women.
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November 12, 2012 6:00AM
Self-management (SM) behaviors reduce disease burden from advancing diabetic kidney disease. From a parent study about patients' transition experience to SM, this study report presents coping resources that support SM and barriers from two focus group interviews (n = 6). Ethnographic analysis identified two patterns: (a) mental health self-management characterized by coping, and (b) relational self-management characterized by social support. Practice implications include focused assessment of perceived social support and social network, dating advisement, and workplace management. Future study considerations include inquiry about diabetes and dating relationships and workplace resources for SM support.
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Practice pattern and professional issues of nurse practitioners in mechanical circulatory support programs in the United States: a survey report| November 10, 2012 6:00AM
The purpose of this research is to describe the pattern and professional issues confronted by nurse practitioners in the rapidly evolving and expanding mechanical circulatory support programs in the United States.
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November 9, 2012 6:00AM
We conducted a descriptive study of the correlates of refusal and acceptance of human papillomavirus (HPV) vaccination by rural parents of preadolescent and adolescent children. We hypothesized that the correlates of parents who allow their children aged 9 to 13 years to get the HPV vaccine and those of parents who do not allow vaccination would differ significantly.
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Health-Related Quality of Life of African American Breast Cancer Survivors Compared with Healthy African American Women| November 5, 2012 6:00AM
The purpose of this study was to compare health-related quality of life of African American female breast cancer survivors with that of African American women with no history of breast cancer (control group).
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November 5, 2012 6:00AM
PURPOSE: To identify predictors of human papillomavirus (HPV) vaccination among rural African American families.
DESIGN: Cross-sectional descriptive study in schools in three rural counties in southeastern United States. The sample consisted of African American parents or caregivers with children 9 to 13 years of age who attended elementary or middle school in 2010-2011.
METHODS: Using an anonymous, 26-item survey, we collected descriptive data during parent-teacher events from African American parents with children in elementary or middle school. The main outcome was measured as a response of "yes" to the statement "I have or will vaccinate my child with the HPV vaccine." In addition, composite scores of knowledge and positive attitudes and beliefs were compared. No interventions were conducted.
FINDINGS: We identified predictors of HPV vaccination and found that religious affiliation had a correlation with vaccinating or planning to vaccinate a child.
CONCLUSIONS: Results indicate a need for further research on the role of local culture, including religion and faith, in rural African Americans' decisions about giving their children the HPV vaccination.
CLINICAL RELEVANCE: This study emphasizes the importance of understanding rural African American parents' knowledge, attitudes, and spiritual beliefs when designing health education programs and public health interventions to increase HPV vaccination uptake among African American boys and girls living in rural areas.