Bold Voices - May 2012 - (Page 11)

PRACTICE ALERT CERTIFICATION Low-Cost Changes to Nurses’ Work Environment Benefit Patients In the absence of staffing increases, low-cost improvements to nurses’ work environments can improve the quality of patient care, a recent study notes. “Work Environment Factors Other Than Staffing Associated With Nurses’ Ratings of Patient Care Quality,” in Health Care Management Review, Nov. 2, 2011, says hospitals can positively impact nurses’ ratings of patient care by focusing on areas such as work group cohesion and nurse-physician relations. Significantly, costly and complex changes such as earning Magnet recognition produce a similar outcome in ratings to low-cost changes that include implementation of team-building programs. In light of The Joint Commission’s December 2011 Sentinel Event Alert on the impact of healthcare workers’ fatigue on patient outcomes, hospitals need to address nurses’ physical and mental well-being more effectively. Just as risk mitigation for fatigue is critical, so too are healthy work environments (HWEs). “Health care managers need to think about how they can best redesign RNs’ work environments to promote AACN Resources for a Healthy Work Environment AACN advocates for a healthy work environment where nurses can make their optimal contribution to the care of patients and families. The link between healthy work environments and patient safety, nurse retention and recruitment has been confirmed repeatedly. The ingredients for success — skilled communication, true collaboration, effective decision making, appropriate staffing, meaningful recognition and authentic leadership — are laid out in “AACN Standards for Establishing and Sustaining Healthy Work Environments” at Access a free team assessment tool at high quality patient care,” study author Christine Kovner, professor at the College of Nursing, New York University, says in a related article. The study, based on a mail-in survey of 1,439 RNs across the U.S., recognizes the nursing shortage and financial constraints hospitals face but seeks correlation between nurses’ ratings of their work environment and the quality of patient care. Overall, 69.5 percent of respondents say patients are “very likely” to receive high-quality care, and 28.4 percent say it is “somewhat likely.” Areas with a high correlation between HWEs and quality of care include physical environment (4.99 times more likely to produce a “very likely” rating), work group cohesion (1.69), Magnet status (1.69), nursedoctor relations (1.40), procedural justice (1.34) and job satisfaction (1.26), the study adds. Study Examines Response to Therapy Among Patients With Asthma bout one-half of patients with mild-to-moderate asthma are unlikely to respond to anti-inflammatory therapy because they have persistently noneosinophilic disease, according to the results of a study published online in American Journal of Respiratory and Critical Care Medicine. “A Large Subgroup of Mild-to-Moderate Asthma Is Persistently Noneosinophilic,” which involved 995 patients with asthma who were not using an inhaled corticosteroid, found that 22 percent had persistent eosinophilia. The intermittent eosinophilic subgroup (47 percent of participants) was characterized by lower average eosinophil percentages, which often fell below the 2 percent cutoff for eosinophilia in repeated sputum analyses. In contrast, the median value for sputum eosinophils in the persistently noneosinophilic asthma group was consistently closer to 0 percent than the 2 percent cutoff, notes a related article in Medscape Medical News. These results have important implications for future asthma research, according to senior study author John Fahy, professor of medicine and director of cardiovascular research at the Airway Clinical Research Center, University of California, San Francisco. “In clinical studies, the eosinophil phenotype of patients should be characterized to better understand treatment responses and disease mechanisms,” Fahy says in the article. “In addition,” he notes, “appropriate in vitro and animal models for the study of the mechanisms of noneosinophilic airway disease need to be developed.” A AACN BOLD VOICES MAY 2012 11

Table of Contents for the Digital Edition of Bold Voices - May 2012

Front/Digital Edition Viewing Guide
Another Angle
AACN Boards and Contact Information
Your NTI Checklist
AACN, Case Western Reserve University Announce Innovative DNP, PhD Collaboration
Patients at End of ICU Rounds Receive Less Face Time
Medical Panel Members Have Conflicts of Interest
Adverse Events Unreported
Penn Nursing Study: Nurse Burnout a Worldwide Problem
Low-Cost Changes to Nurses' Work Environment Also Benefit Patients
Hospital Workers Reluctant to Report Medical Errors
Flame of Excellence Awards
Circle of Excellence Awards
UTI Prevention Lower Priority Than Other HAIs
Children at Higher Risk for Infection in Intensive Care
Cameras, Feedback: Effective Tools to Enforce Hand Washing
In Our Journals
More Coronary Events Associated With Dabigatran
Certification Capsules
Publishing-related Events at NTI
Stay Connected at NTI
From the President

Bold Voices - May 2012