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Research Studies is a compilation of published research articles funded by ´óÏóAPPor authored by ´óÏóAPPresearchers.

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51 to 75 of 121 Research Studies Displayed
Liu J, Larson E, Hessels A
Comparison of measures to predict mortality and length of stay in hospitalized patients.
This study compared performance of five measures in order to predict mortality and length of stay (LOS) in hospitalized adults using claims data; the measures included three comorbidity composite scores, 3 M risk of mortality, and 3 M severity of illness subclasses. Binary logistic and zero-truncated negative binomial regression models were applied to a 2-year retrospective dataset of adult inpatient admissions from a large hospital system in New York City. All five measures demonstrated a good to strong model fit for predicting in-hospital mortality. The authors conclude that these measures can guide nurse managers in assigning nursing care and coordinating patient services, as well as administrators in supporting optimal nursing care more effectively and efficiently.
AHRQ-funded; HS024915.
Citation: Liu J, Larson E, Hessels A . Comparison of measures to predict mortality and length of stay in hospitalized patients. Nurs Res 2019 May/Jun;68(3):200-09. doi: 10.1097/nnr.0000000000000350..
Keywords: Hospitalization, Mortality, Nursing, Patient Safety, Risk
Monsees EA, Tamma PD, Cosgrove SE
´óÏóAPPAuthor: Miller MA
Integrating bedside nurses into antibiotic stewardship: a practical approach.
This study looked into a framework for nurses to integrate antibiotic stewardship (AS) into their clinical work with patients. The practices that nurses can take include improving antibiotic prescribing practices through appropriate obtainment of Cloistridioides difficile tests, appropriate urine culturing practices, optimal antibiotic administration, accurate and detailed documentation of antibiotic allergy histories, and through the prompting of antibiotic time outs. Barriers were also identified to engagement of nurses in AS and offered potential solutions.
AHRQ-authored; AHRQ-funded; 233201500020I.
Citation: Monsees EA, Tamma PD, Cosgrove SE . Integrating bedside nurses into antibiotic stewardship: a practical approach. Infect Control Hosp Epidemiol 2019 May;40(5):579-84. doi: 10.1017/ice.2018.362..
Keywords: Antibiotics, Antimicrobial Stewardship, Guidelines, Healthcare-Associated Infections (HAIs), Medication, Nursing, Patient Safety
Holmes E, Thompson D, Michell D
An inpatient HIV support nurse to promote engagement in outpatient HIV care.
In this paper, the investigators describe an inpatient HIV support nurse to promote engagement in outpatient HIV care. It provides two case reports and a discussion. The investigators indicate that their hospital has employed an RN specializing in HIV care coordination for more than a decade on their dedicated HIV unit and has recently created a position to extend this work to PLWH who have been admitted to the 42 other adult units in their hospital.
AHRQ-funded; R01 HS024079.
Citation: Holmes E, Thompson D, Michell D . An inpatient HIV support nurse to promote engagement in outpatient HIV care. J Assoc Nurses AIDS Care 2019 Mar-Apr;30(2):245-48. doi: 10.1097/jnc.0000000000000017..
Keywords: Human Immunodeficiency Virus (HIV), Patient and Family Engagement, Care Coordination, Nursing, Healthcare Delivery
Manojlovich M, Frankel RM, Harrod M
Formative evaluation of the video reflexive ethnography method, as applied to the physician-nurse dyad.
Poor communication between physicians and nurses continues to contributor to adverse events in the hospital setting. This article evaluates the use of video reflexive ethnography (VRE) as a means of improving communication and improving patient safety, and concludes that video-record communication between physicians and nurses during patient care rounds is feasible and acceptable.
AHRQ-funded; HS024760.
Citation: Manojlovich M, Frankel RM, Harrod M . Formative evaluation of the video reflexive ethnography method, as applied to the physician-nurse dyad. BMJ Qual Saf 2019 Feb;28(2):160-66. doi: 10.1136/bmjqs-2017-007728..
Keywords: Adverse Events, Communication, Hospitals, Nursing, Patient Safety
Jarrin OF, Pouladi FA, Madigan EA
International priorities for home care education, research, practice, and management: qualitative content analysis.
The purpose of this study was to articulate an international vision for the future of home care education, research, practice, and management shared by experienced home care nurses working in leadership roles. Four major themes emerged, in this qualitative study, reflecting international priorities for the future of home care education, research, practice, and management: 1) Build the evidence base for home care; 2) Design better systems of care; 3) Develop leaders at all levels; and 4) Address payment and policy issues.
AHRQ-funded; HS022406.
Citation: Jarrin OF, Pouladi FA, Madigan EA . International priorities for home care education, research, practice, and management: qualitative content analysis. Nurse Educ Today 2019 Feb;73:83-87. doi: 10.1016/j.nedt.2018.11.020..
Keywords: Education: Continuing Medical Education, Healthcare Delivery, Home Healthcare, Nursing, Provider
Kutney-Lee A, Sloane DM, Bowles KH
Electronic health record adoption and nurse reports of usability and quality of care: the role of work environment.
This study assessed the role of electronic health record (EHR) adoption and work environment for nurses. If the EHR system has positive usability ratings it impacts quality of care. Over 12,000 nurses in 353 hospitals were surveyed.
AHRQ-funded; HS023805.
Citation: Kutney-Lee A, Sloane DM, Bowles KH . Electronic health record adoption and nurse reports of usability and quality of care: the role of work environment. Appl Clin Inform 2019 Jan;10(1):129-39. doi: 10.1055/s-0039-1678551..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Nursing, Provider: Nurse, Quality of Care
de Cordova PB, Steck MBW, Vermeesch A
Health policy engagement among graduate nursing students in the United States.
This study researched the availability and requirements for graduate nursing students to take a dedicated health policy course. American Association of College of Nursing (AACN) member institution students were polled and over 75% reported taking a health policy course. There was an equal distribution between master’s and doctoral students.
AHRQ-funded; HS024339.
Citation: de Cordova PB, Steck MBW, Vermeesch A . Health policy engagement among graduate nursing students in the United States. Nurs Forum 2019 Jan;54(1):38-44. doi: 10.1111/nuf.12295..
Keywords: Education: Continuing Medical Education, Nursing, Policy, Provider: Nurse
Yang Y, Bass EJ, Bowles KH
Impact of home care admission nurses' goals on electronic health record documentation strategies at the point of care.
The article reports on a study designed to investigate documentation strategies used by home care nurses with respect to entering electronic data during admission as well as the effect of nursing goals on the process. This was done to characterize admission nurses' practices at the point of care and to establish a basis for design recommendations for electronic health records (EHRs). Five nurses in rural Pennsylvania home care agencies were observed during the admission process. The results of the study lead the authors to recommend that EHR design and training should support the manner in which home care nurses document patient encounters.
AHRQ-funded; HS024537.
Citation: Yang Y, Bass EJ, Bowles KH . Impact of home care admission nurses' goals on electronic health record documentation strategies at the point of care. Comput Inform Nurs 2019 Jan;37(1):39-46. doi: 10.1097/cin.0000000000000468..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Home Healthcare, Nursing
Ricciardi R, Shofer M
´óÏóAPPAuthor: Ricciardi R, Shofer M
Nurses and patients: Natural partners to advance patient safety.
In this ´óÏóAPP commentary, the authors discuss the nurse-patient partnership and its potential for enhancing communication and improving patient safety practices.
AHRQ-authored.
Citation: Ricciardi R, Shofer M . Nurses and patients: Natural partners to advance patient safety. J Nurs Care Qual 2019 Jan/Mar;34(1):1-3. doi: 10.1097/ncq.0000000000000377..
Keywords: Nursing, Provider: Nurse, Patient Safety
Dowding D, Merrill JA, Barron Y
Usability evaluation of a dashboard for home care nurses.
Usability tests were conducted on a creation of a dashboard prototype for home care nurses for their patients’ electronic health records (EHRs). The prototype was created by first observing and interviewing several nurses; getting feedback on paper versions of the dashboard; and then a usability evaluation of the electronic prototype. The dashboard was positively evaluated.
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill JA, Barron Y . Usability evaluation of a dashboard for home care nurses. Comput Inform Nurs 2019 Jan;37(1):11-19. doi: 10.1097/cin.0000000000000484..
Keywords: Health Information Technology (HIT), Home Healthcare, Nursing, Provider
Rosen MA, Dietz AS, Lee N
Sensor-based measurement of critical care nursing workload: Unobtrusive measures of nursing activity complement traditional task and patient level indicators of workload to predict perceived exertion.
The purpose of this study was to establish the validity of sensor-based measures of work processes for predicting perceived mental and physical exertion of critical care nurses. Environmental sensors worn by staff in a surgical intensive care unit captured work process data. Nurses rated their mental and physical exertion for each four-hour block, and recorded patient and staffing-level workload factors. Analysis of this data yielded highly predictive models of critical care nursing workload to generate insights into workflow and work design. The researchers conclude that sensor-based measures are a viable complement to traditional task demand measures of workload.
AHRQ-funded; HS023553.
Citation: Rosen MA, Dietz AS, Lee N . Sensor-based measurement of critical care nursing workload: Unobtrusive measures of nursing activity complement traditional task and patient level indicators of workload to predict perceived exertion. PLoS One 2018 Oct 12;13(10):e0204819. doi: 10.1371/journal.pone.0204819..
Keywords: Critical Care, Nursing, Provider: Nurse, Patient Safety, Workflow
Law AC, Stevens JP, Hohmann S
Patient outcomes after the introduction of statewide ICU nurse staffing regulations.
The objective of this study was to assess whether Massachusetts legislation directed at ICU nurse staffing was associated with improvements in patient outcomes. The investigators found that state regulation of patient-to-nurse staffing with the aid of patient complexity scores in intensive care was not associated with either increased nurse staffing or changes in patient outcomes.
AHRQ-funded; HS024288.
Citation: Law AC, Stevens JP, Hohmann S . Patient outcomes after the introduction of statewide ICU nurse staffing regulations. Crit Care Med 2018 Sep 4;46(10):1563-69. doi: 10.1097/ccm.0000000000003286..
Keywords: Intensive Care Unit (ICU), Policy, Nursing, Outcomes, Patient Safety
Auger KA, Simmons JM, Tubbs-Cooley HL
Postdischarge Nurse Home Visits and Reuse: the Hospital to Home Outcomes (H2O) Trial.
In this study, the investigators evaluated the effects of a pediatric transition intervention, specifically a single nurse home visit, on postdischarge outcomes in a randomized controlled trial. The investigators concluded that children randomly assigned to the intervention had higher rates of 30-day postdischarge unplanned health care reuse. They also noted that parents in the intervention group recalled more clinical warning signs 2 weeks after discharge.
AHRQ-funded; HS024735.
Citation: Auger KA, Simmons JM, Tubbs-Cooley HL . Postdischarge Nurse Home Visits and Reuse: the Hospital to Home Outcomes (H2O) Trial. Pediatrics 2018 Jul;142(1). doi: 10.1542/peds.2017-3919..
Keywords: Children/Adolescents, Home Healthcare, Hospital Discharge, Nursing, Transitions of Care
Al Danaf J, Chang BH, Shaear M
Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool.
This paper reported on rounding interventions employed at high performing hospitals, and provided three case studies on how proactive nurse rounding was successfully implemented to improve patient-centredness. The investigators concluded that proactive rounding interventions are a feasible approach to help surface and address hospitalized patients' needs in a timely manner.
AHRQ-funded; HS021921.
Citation: Al Danaf J, Chang BH, Shaear M . Surfacing and addressing hospitalized patients' needs: proactive nurse rounding as a tool. J Nurs Manag 2018 Jul;26(5):540-47. doi: 10.1111/jonm.12580..
Keywords: Consumer Assessment of Healthcare Providers and Systems (CAHPS), Hospitalization, Hospitals, Inpatient Care, Nursing, Patient-Centered Healthcare, Patient Experience, Quality Improvement
Bayramzadeh S, Joseph A, San D
The impact of operating room layout on circulating nurse's work patterns and flow disruptions: a behavioral mapping study.
The purpose of this study was to assess how the adjacencies of functionally different areas within operating rooms (ORs) can influence the circulating nurse's (CN) workflow patterns and disruptions. The investigators video recorded and thematically coded a convenience sample of 25 surgeries for CN's activities, locations, and flow disruptions. The investigators suggest that optimum adjacencies should be considered while designing ORs such that they are more efficient and safer.
AHRQ-funded; HS024380.
Citation: Bayramzadeh S, Joseph A, San D . The impact of operating room layout on circulating nurse's work patterns and flow disruptions: a behavioral mapping study. HERD 2018 Jul;11(3):124-38. doi: 10.1177/1937586717751124..
Keywords: Surgery, Workflow, Hospitals, Nursing, Provider: Nurse, Provider, Patient Safety
Sarkhel R, Socha JJ, Mount-Campbell A
HOW nurses identify hospitalized patients on their personal notes: findings from analyzing 'brains' headers with multiple raters.
Many nurses use handwritten notes in order to avoid using electronic health records to access information about patients. At the top of these notes are patient identifiers. By identifying aspects of good and suboptimal headers, the authors began to form a model of how to effectively support identifying patients during assessments and care activities. The primary finding was that nurses use room number as the primary patient identifier in the hospital setting, not the patient's last name.

AHRQ-funded; HS024379.
Citation: Sarkhel R, Socha JJ, Mount-Campbell A . HOW nurses identify hospitalized patients on their personal notes: findings from analyzing 'brains' headers with multiple raters. Proc Int Symp Hum Factors Ergon Healthc 2018 Jun;7(1):205-09. doi: 10.1177/2327857918071045..
Keywords: Electronic Health Records (EHRs), Health Services Research (HSR), Inpatient Care, Nursing
Mistry B, Stewart De Ramirez S, Kelen G
Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment.
This study assessed the accuracy and variability of triage score assignment by emergency department (ED) nurses using the Emergency Severity Index (ESI) in 3 countries. It found that the concordance of nurse-assigned ESI score with reference standard was universally poor and variability was high. Although the ESI is the most popular ED triage tool in the United States and is increasingly used worldwide, its findings point to a need for more reliable ED triage tools.
AHRQ-funded; HS023641.
Citation: Mistry B, Stewart De Ramirez S, Kelen G . Accuracy and reliability of emergency department triage using the emergency severity index: an international multicenter assessment. Ann Emerg Med 2018 May;71(5):581-87.e3. doi: 10.1016/j.annemergmed.2017.09.036.
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Keywords: Shared Decision Making, Emergency Department, Emergency Medical Services (EMS), Health Information Technology (HIT), Nursing
Patterson ES
Workarounds to intended use of health information technology: a narrative review of the human factors engineering literature.
This narrative review sought to integrate and synthesize insights from recent studies of workarounds to the intended use of health information technology (HIT) by health care professionals. It concluded that workarounds were employed to avoid changes to workflow, enable interdisciplinary communication, coordinate activities, and have real-time portable access to summarized and synthesized information.
AHRQ-funded; HS024379.
Citation: Patterson ES . Workarounds to intended use of health information technology: a narrative review of the human factors engineering literature. Hum Factors 2018 May;60(3):281-92. doi: 10.1177/0018720818762546.
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Keywords: Communication, Health Information Technology (HIT), Nursing, Patient Safety
Sockolow PS, Yang Y, Bass EJ
Data visualization of home care admission nurses' decision-making.
This study investigated nurses’ decision making regarding hospital to home care admissions. They conducted a focus group case study with six admitting home health nurses at a rural agency in Pennsylvania and analyzed the data using thematic analysis.
AHRQ-funded; HS024537.
Citation: Sockolow PS, Yang Y, Bass EJ . Data visualization of home care admission nurses' decision-making. AMIA Annu Symp Proc 2018 Apr 16;2017:1597-606..
Keywords: Data, Shared Decision Making, Home Healthcare, Nursing, Transitions of Care
Dudding KM, Gephart SM, Carrington JM
Neonatal nurses experience unintended consequences and risks to patient safety with electronic health records.
The purposes of this study were to describe unintended consequences of use of electronic health records for neonatal nurses and to explore relationships between the phenomena and characteristics of the nurse and the electronic health record. The most frequent unintended consequences of electronic health record use were due to interruptions, followed by a heavier workload due to the electronic health record.
AHRQ-funded; HS022908.
Citation: Dudding KM, Gephart SM, Carrington JM . Neonatal nurses experience unintended consequences and risks to patient safety with electronic health records. Comput Inform Nurs 2018 Apr;36(4):167-76. doi: 10.1097/cin.0000000000000406.
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Keywords: Electronic Health Records (EHRs), Neonatal Intensive Care Unit (NICU), Newborns/Infants, Nursing, Patient Safety
Blaz JW, Doig AK, Cloyes KG
The symbolic functions of nurses' cognitive artifacts on a medical oncology unit.
Acute care nurses continue to rely on personally created paper-based tools-their "paper brains"-to support work during a shift, although standardized handoff tools are recommended. This interpretive descriptive study examines the functions these paper brains serve beyond handoff in the medical oncology unit at a cancer specialty hospital.
AHRQ-funded; HS022183.
Citation: Blaz JW, Doig AK, Cloyes KG . The symbolic functions of nurses' cognitive artifacts on a medical oncology unit. West J Nurs Res 2018 Apr;40(4):520-36. doi: 10.1177/0193945916683683.
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Keywords: Nursing, Provider: Nurse, Provider, Workflow
McArdle J, Sorensen A, Fowler CI
Strategies to improve management of shoulder dystocia under the ´óÏóAPPSafety Program for Perinatal Care.
The purpose of this study using TeamSTEPPS was to assess the implementation of safety strategies to improve management of births complicated by shoulder dystocia in labor and delivery units. Results suggested that successful management of shoulder dystocia requires a rapid, standardized, and coordinated response. The Safety Program for Perinatal Care strategies to increase safety of shoulder dystocia management are scalable, replicable, and adaptable to unit needs and circumstances.
AHRQ-funded; 2902010000241.
Citation: McArdle J, Sorensen A, Fowler CI . Strategies to improve management of shoulder dystocia under the ´óÏóAPPSafety Program for Perinatal Care. J Obstet Gynecol Neonatal Nurs 2018 Mar;47(2):191-201. doi: 10.1016/j.jogn.2017.11.014.
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Keywords: Labor and Delivery, Newborns/Infants, Pregnancy, Adverse Events, TeamSTEPPS, Injuries and Wounds, Care Management, Education: Continuing Medical Education, Training, Tools & Toolkits, Patient Safety, Nursing, Communication, Quality of Care
Dowding D, Merrill JA, Onorato N
The impact of home care nurses' numeracy and graph literacy on comprehension of visual display information: implications for dashboard design.
This study explored home care nurses' numeracy and graph literacy and their relationship to comprehension of visualized data. Results suggest that nurses' comprehension of visualized information is influenced by their numeracy, graph literacy, and the display format of the data. Individual differences in numeracy and graph literacy skills need to be taken into account when designing dashboard technology.
AHRQ-funded; HS023855.
Citation: Dowding D, Merrill JA, Onorato N . The impact of home care nurses' numeracy and graph literacy on comprehension of visual display information: implications for dashboard design. J Am Med Inform Assoc 2018 Feb;25(2):175-82. doi: 10.1093/jamia/ocx042.
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Keywords: Shared Decision Making, Health Information Technology (HIT), Health Literacy, Health Information Technology (HIT), Nursing
Hinson JS, Martinez DA, Schmitz PSK
Accuracy of emergency department triage using the Emergency Severity Index and independent predictors of under-triage and over-triage in Brazil: a retrospective cohort analysis.
This study sought to measure the frequency of under- and over-triage of patients by nurses using the Emergency Severity Index (ESI) in Brazil and to identify factors independently associated with each. It concluded that, despite rigorous and ongoing training of ESI users, a large number of patients in this cohort were under- or over-triaged. Advanced age, vital sign derangements, and specific chief complaints were particularly under-appreciated.
AHRQ-funded; HS023641.
Citation: Hinson JS, Martinez DA, Schmitz PSK . Accuracy of emergency department triage using the Emergency Severity Index and independent predictors of under-triage and over-triage in Brazil: a retrospective cohort analysis. Int J Emerg Med 2018 Jan 15;11(1):3. doi: 10.1186/s12245-017-0161-8.
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Keywords: Emergency Department, Emergency Medical Services (EMS), Healthcare Delivery, Nursing
Keenan GM, Lopez KD, Sousa VEC
A shovel-ready solution to fill the nursing data gap in the interdisciplinary clinical picture.
The purpose of this study was to critically evaluate the 2014 American Academy of Nursing (AAN) call-to-action plan for generating interoperable nursing data. The authors of the article present recommendations for revisions to AAN's plan as well as an evidence-based alternative to generating interoperable nursing data in the near term.
AHRQ-funded; HS015054.
Citation: Keenan GM, Lopez KD, Sousa VEC . A shovel-ready solution to fill the nursing data gap in the interdisciplinary clinical picture. Int J Nurs Knowl 2018 Jan;29(1):49-58. doi: 10.1111/2047-3095.12168..
Keywords: Data, Evidence-Based Practice, Nursing

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