Author Interviews, Brigham & Women's - Harvard, Nursing, Occupational Health / 07.01.2015

Eva Schernhammer, MD, DrPH Associate Professor of Medicine Brigham and Women's Hospital and Harvard Medical School Associate Professor of Epidemiology Harvard School of Public Health Channing Division of Network MedicineMedicalResearch.com Interview with: Eva Schernhammer, MD, DrPH Associate Professor of Medicine Brigham and Women's Hospital and Harvard Medical School Associate Professor of Epidemiology Harvard School of Public Health Channing Division of Network Medicine Medical Research: What is the background for this study? What are the main findings? Prof. Schernhammer: The study is an observational cohort study of over 70,000 registered nurses from within the US who reported the total number of years they had worked rotating night work and were followed for several decades. We examined overall mortality in these women, and observed significantly higher overall mortality, as well as higher mortality from cardiovascular disease in women with several years of rotating night shift work, compared to nurses who had never worked night shifts. There was also some suggestion for modest and non-significant increases in mortality from a few cancers. The study is unique due to its size, the fact that all participants were nurses (eliminating potential biases arising from differing occupational exposures), the long follow-up, and the possibility to take into account most known risk factors for chronic diseases that we currently know of (all of this information has been collected regularly and repeatedly). 
Author Interviews, Cost of Health Care, Geriatrics, Nursing / 11.12.2014

Karen Dorman Marek, PhD, MBA, RN, FAAN Bernita 'B' Steffl Professor of Geriatric Nursing Arizona State University College of Nursing & Health Innovation Phoenix, AZ 85004-0696MedicalResearch.com Interview with: Karen Dorman Marek, PhD, MBA, RN, FAAN Bernita 'B' Steffl Professor of Geriatric Nursing Arizona State University College of Nursing & Health Innovation Phoenix, AZ 85004-0696 Medical Research: What is the background for this study? What are the main findings? Response: For many older adults, self-management of chronic illness is an overwhelming task, especially for those with mild cognitive impairment or complex medication regimens. The purpose of this study was to evaluate cost outcomes of a home-based program that included both nurse care coordination and technology to support self-management of chronic illness, with as an emphasis on medications in frail older adults. A total of 414 older adults, identified as having difficulty self-managing their medications, were recruited at discharge from three Medicare-certified home health care agencies in a large Midwestern urban area. A prospective, randomized, controlled, three-arm, longitudinal design was used. A team consisting of both Advanced Practice Nurses (APNs) and Registered Nurses (RNs) coordinated care to two groups: home-based nurse care coordination (NCC) plus mediplanner group and NCC plus the MD.2 medication-dispensing machine group. Major findings were:
  • Total Medicare costs were $447 per month lower in the NCC + mediplanner group (p=0.11) when compared to the control group.
  • For participants in the study at least 3 months, total Medicare costs were $491 lower per month in the NCC + mediplanner group (p=0.06) compared to the control group.
  • The cost of the NCC intervention was $151 per month, yielding a net savings of $296 per month or $3552 per year for the NCC + mediplanner group.
  • Participants who received the nurse care coordination intervention scored significantly better than the control group in depression (p < 0.001), functional status (p < 0.001), cognition (p < 0.001), and quality of life (p < 0.001) than participants in the control group.
Author Interviews, Nursing / 22.09.2014

Dr. Peter Griffiths PhD, RN Centre for Innovation and Leadership in Health Sciences University of Southampton, Southampton, UK MedicalResearch.com Interview with: Dr. Peter Griffiths PhD, RN Centre for Innovation and Leadership in Health Sciences University of Southampton, Southampton, UK Medical Research: What are the main findings of the study? Dr. Griffiths: This study found that hospital nurses who are working on a 2 shift system, where care is provided by nurses working long shifts of 12-13 hours, report lower quality and safety of care than nurses who work a traditional three shift system where nurses typically work shifts of 8 hours. We also found that nurses who were working overtime reported lower quality and safety of care. We found that these shifts are common in some European countries – most notably Poland, Ireland and England.
Author Interviews, Nursing, Outcomes & Safety / 26.08.2014

dr_susan_millerMedicalResearch.com Interview with: Susan Miller, PhD Professor of Health Services, Practice and Policy (Research) at the Center for Gerontology and Health Care Research The Warren Alpert Medical School of Brown University Medical Research: What are the main findings of the study? Prof. Miller:  Upon introduction of culture change, the nursing homes that implemented culture change most extensively produced statistically significant improvements in the percent of residents on bladder training programs, the percent of residents who required restraints, the proportion of residents with feeding tubes, and the percent with pressure ulcers. They also showed a nearly significant reduction in resident hospitalizations. No quality indicator became significantly worse. Among homes that implemented less culture change, the only significant improvement occurred in the number of Medicare/Medicaid health-related and quality of life survey deficiencies. Urinary tract infections and hospitalizations got slightly worse.
Author Interviews, Health Care Systems, Lancet, Nursing, University of Pennsylvania / 04.03.2014

Professor Linda H Aiken PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology Director of the Center for Health Outcomes and Policy Research Center for Health Outcomes and Policy Research University of Pennsylvania School of NursingMedicalResearch.com Interview with: Professor Linda H Aiken PhD, FAAN, FRCN, RN Claire M. Fagin Leadership Professor in Nursing, Professor of Sociology Director of the Center for Health Outcomes and Policy Research Center for Health Outcomes and Policy Research University of Pennsylvania School of Nursing MedicalResearch.com: Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. Against that backdrop, can you start by letting us know the background of the study?  Prof. Aiken: European Surgical Outcomes Study in 28 countries showed higher than necessary deaths after surgery. A comparable study in the US showed that despite the nation spending hundreds of millions of dollars on improving patient safety, there were no improvements in adverse outcomes after surgery in US hospitals between 2000 and 2009.  Clearly it is time to consider new solutions to improving hospital care for surgical patients, who make up a large proportion of all hospital admissions.  Our study was designed to determine whether there are risks for patients of reducing hospital nurse staffing, and what, if any, are the benefits to patients of moving to a more educated nurse workforce.
Author Interviews, General Medicine, Nursing / 03.12.2013

Dr. Lianne Jeffs 
PhD Nurse and researcher at St. Michael's Hospital University of TorontoMedicalResearch.com Interview with: Dr. Lianne Jeffs 
PhD Nurse and researcher at St. Michael's Hospital University of Toronto MedicalResearch.com: What are the main findings of the study? Dr. Jeffs: The main findings of the study include: 1. Patients described the bedside nursing handover as engaging, personal and informative.  The bedside nursing handover created a a space to connect with their nurses in a more personal manner (e.g., provided an introduction between patient and nurse at the beginning of the shift) 2. Patients found the experience increased their engagement in their own care, and kept them informed about their health status and care plan. It also gave the patient an opportunity to identify important needs to the nurse (e.g., daily activities) 3. Not all patients wanted to participate in the bedside nursing handover. This was typically exemplified by long-term-stay patients.