New research shows how nurses can manage patient outcomes

New research shows how nurses can manage patient outcomes

A new Nursing for Health Outcomes and Policy Research (CHOPS) study highlights the critical factors that enable nurses to provide high-quality care or impediments to socially disadvantaged populations. The results, published inJama Network OpenReport key insights to inform hospital strategies to promote high-quality, equitable care.

The study, which analyzed open-text responses from 1,084 Direct Care Hospital nurses at 58 hospitals in New York and Illinois, identified six key themes impacting care:

• Gewinne gegenüber Patienten: Eine systemische Herausforderung, bei der finanzielle Anreize mit gerechter Patientenversorgung falsch ausgerichtet sind.
• Care Continuity und Krankenhaus-Community-Partnerschaften: Die entscheidende Rolle von Sozialarbeitern und Gemeinschaftsressourcen bei der Verbindung von Patienten mit der erforderlichen Unterstützung.
• Unzureichende Personal- und Zeitbeschränkungen: hohe Arbeitsbelastungen und unzureichende Personalstufen als wichtige Hindernisse für die Qualitätsvorsorge.
• Technologie zur Bekämpfung von Sprachbarrieren: Die Bedeutung von Sprachzugangstechnologie und persönliche Dolmetscher für Patienten mit begrenzten Englischkenntnissen.
• Gesundheitsdeterminanten der Patienten: Faktoren wie Gesundheitskompetenz, Familienunterstützung und Patientenvertrauen, die die Versorgung beeinflussen.
• Die Überzeugungen und Hintergründe der einzelnen Krankenschwestern: Wie persönliche Erfahrungen und Vorurteile sowie die Notwendigkeit einer erhöhten kulturellen Kompetenzausbildung und der Vielfalt der Belegschaft die Pflege beeinflussen.

“Our research demonstrates that nurses, as frontline care providers, possess valuable perspectives on the systemic, institutional, community and individual factors that shape quality care"says lead author J. Margo Brooks Carthon, PhD, RN, Faan, the Tyson family chair of Gerontological Research, professor of nursing in the Department of Family and Community Health; director of the Bates Center for the Study of the History of Nursing and associate director of Chops;"Her experiences highlight the urgent need for hospitals to prioritize patient-centered approaches, invest in adequate staffing, strengthen community partnerships, and promote a diverse and culturally competent nursing workforce. By listening and acting on these insights, we can significantly improve health outcomes for all patients, including patients from socially and economically disadvantaged backgrounds. “

The nurses suggested several solutions to improve care, including improving language technology support, strengthening community resources for patients, and promoting tailored cultural competency education. This study complements a recent study by the same team that highlighted the need to improve nursing resources—including staffing and work environments—particularly in hospitals serving vulnerable communities.

Penn Nursing co-authors include K. Jane Muir, PhD, MSHP, RN; Daniela Golinelli, PhD; and Ann Kutney-Lee, PhD, RN; Lee Ang of the University of Pennsylvania mixed methods laboratory; and Kelvin Amenyedor, MD, MPH and Shelli Feder, PhD, APRN, both of Yale University. This research was funded by the National Institute for Nursing Research (RO1NR020471; Koinr021419 to Dr. Muir). The Agency for Healthcare Research and Quality (R01HS028978) and the National Council of State Boards of Nursing provided additional support.

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