Posted January 2012 The Cost of PainPain is generally under-treated in the U.S., but low-income and minority patients are even less likely to receive guideline-recommended pain treatment in virtually all healthcare settings in the U.S., according to the authors of a new paper from the University of Pennsylvania School of Nursing, even though minority patients often suffer more severe pain and physical impairments than non-minority patients and are more likely to perform potentially harmful physical work.
In “Pain Medicine, the Official Journal of the American Academy of Pain Medicine,” the reviewers recommended:
Posted January 2012 Better Together - The RN and the EHR With the prodding of new federal legislation, electronic health records (EHRs) are rapidly becoming part of the daily practice of hospital nurses – the frontline providers of care. In the first large study of its kind, researchers at the University of Pennsylvania School of Nursing determined that nurses working with EHRs consistently reported more improvements to nursing care and better health outcomes for patients than nurses working in hospitals without this technology.
A study of more than 16,000 nurses working at 316 hospitals in four states indicates that “implementation of an EHR may result in improved and more efficient nursing care, better ca...
Posted February 2012 The Mobile Health RemedyOral rehydration therapy (ORT) to prevent dehydration during diarrheal episodes is one of the most effective and affordable interventions to reduce child mortality and morbidity. Yet ORT has yet to be widely adopted in underdeveloped nations. In a pilot study, Alison Buttenheim, PhD, MBA, of the University of Pennsylvania School of Nursing, is investigating whether mobile health (mHealth) technologies can encourage more widespread use of ORT. Her work is supported by Penn's Global Health Partnership program.
"The expansion of cell phone ownership around the world has created an unprecendented oppo...
Posted March 2012 Big Breakthrough for the Tiniest HeartsA novel feeding device developed at the University of Pennsylvania School of Nursing may decrease the risk of failure to thrive (FTT), which currently affects half of all newborns with congenital heart defects even after their surgical lesions are corrected. Professor and nurse practitioner Barbara Medoff-Cooper, PhD, CRNP, of Penn Nursing invented a device that analyzes an infant’s ability to organize feeding by sucking, swallowing, and breathing effectively. This device, developed in collaboration with Penn Engineering, allows healthcare professionals to assess infants at risk for dysfunctional feeding and poor weight gain as often seen in both premature in...
Posted March 2012 Food Stamps and Farmers' MarketsCurrent food stamp programs at urban farmers’ markets attempting to bring fresh produce to economically stressed city dwellers are so complicated for the shopper and expensive for the farmer that fewer people are taking advantage of the federal program designed to help them, according to research at the University of Pennsylvania School of Nursing.
Record numbers of Americans are receiving Supplemental Nutrition Assistance Program (SNAP) benefits, as food stamps are now known, and many SNAP participants live in neighborhoods with little or no access to healthy food. A study conducted at the Clark Park Farmers’ Market in Philadelphia, Pa., found that making it easier for vendors to collect SNAP payments with electronic point-of-sale systems increased fresh produce sales to SNAP recipients by 38 percent. However, the costs associated with ...
Posted April 2012 The Secret to Preventing AsthmaFor the student athlete with asthma, spring and summer pose particular dangers. The most significant danger is the all-too-frequent lack of access to a life-saving asthma inhaler, explains Maureen George, PhD, RN, of the University of Pennsylvania School of Nursing. Federal law permits students to carry their asthma inhalers with them, yet many schools do not because of safety concerns. “Managing asthma is especially challenging for student athletes because many coaches do not feel comfortable assuming responsibility for administering asthma medications, nor are they trained to do so,” explains Dr. George. “School rules keep epinephrine pens and inhalers off the playing field a...
Posted April 2012 Cancer and Clinical TrialsIn one of the first studies of its kind, University of Pennsylvania School of Nursing researchers have identified what cancer patients consider the “benefits and burdens” of participating in clinical research trials. From their findings, the researchers developed a model of the five elements of decision-making (physical, psychological, economic, familial, and social) that patients with cancer use to determine whether to participate or remain in a clinical trial.
These findings can help researchers address factors leading to research participation and in ensuring voluntary, informed consent in clinical trials, explained lead author Connie M. Ulrich, PhD, RN, of Penn Nursing. “Clinical research is imperat...
Posted April 2012 No More Business as Usual in Health Education and PracticeThe days of a patient receiving care from a single doctor at a single location have long passed. Healthcare and health information come from numerous sources, facilities, and providers. To maximize the strengths of multiple providers, improve care, and lower costs, healthcare leaders met at the University of Pennsylvania School of Nursing on April 17 to consider steps toward interprofessional education and practice among teams of nurses, doctors, and other health providers.
The symposium, Partners in Education and Practice: Stronger Teams, Better Health, built on calls for interprofessionalism in healthcare in two major commission reports, The Future of Nursing: Leadi...
Posted April 2012 Teen Violence Prevention Keeps It RealBriana and Damon could be the kids up the block. Briana does well in school and wants to follow in her sister’s footsteps to college. Damon works hard at an after-school job in a local barbershop. They hang out with friends and try to stay out of trouble.
But Briana and Damon have a mission. Voiced by Philadelphia teens, they are a pair of digitally animated street-smart characters with a Facebook page aimed at reducing urban youth violence. Working with members of the West Philadelphia community, researchers from the University of Pennsylvania, Drexel University, and the Philadelphia Collaborative Vi...
Posted May 2012 Type 2 Diabetes More Common, More Dangerous in ChildrenAlarming increases of Type 2 diabetes in children are no closer to being managed successfully, according to a study in The New England Journal of Medicine showing common diabetes-control medications failed to work in children.
The study also found that because children develop Type 2 diabetes at younger ages, there is an increased lifetime risk for serious complications such as heart attack and stroke. Terri H. Lipman, PhD, CRNP, of the University of Pennsylvania School of Nursing, was a co-investigator in this multi-center study. Dr. Lipman, the Miriam Stirl Endowed Term Professor of Nutrition and professor of nursing of children, is an expert in pediatric dia...
Posted May 2012 Preventing Maternal and Child MortalityThe statistics on maternal, newborn, and child mortality around the world are staggering: 265,000 maternal deaths, 880,000 stillbirths, 1.2 million neonatal deaths, and 3.2 million infant and child deaths annually, the vast majority occurring in low-income countries.
Many maternal and child deaths are easily preventable, and the United Nations established eight Millennium Development Goals (MDGs) toward this objective and others among the world’s poorest people. The MDGs set ambitious targets to reduce by two-thirds the mortality rate for children under age five between 1990 and 2015, and to reduce the maternal mortality rate by three-quarters during the same pe...
Posted June 2012 Unexpected Hazards of the Affordable Care ActOne of the goals of the Affordable Care Act (ACA) is to reduce the fragmentation of services for patients. The problems of fragmentation are magnified for the six million Americans receiving long-term services. New analysis, led by Mary D. Naylor, PhD, RN, of the University of Pennsylvania School of Nursing, examines the impact on this population of three provisions of the ACA—the Hospital Readmissions Reduction Program, the National Pilot Program on Payment Bundli...
Posted July 2012 Penn Nursing Education Innovation to Produce More Advance Practice Nurses Becomes Part of Affordable Care ActToday, the University of Pennsylvania School of Nursing with their partner, the Hospital of the University of Pennsylvania, became one of five sites nationally to be funded under the Graduate Nurse Demonstration, a national program to educate more advanced practice nurses (APRNs), who are a crucial component to the success of the Affordable Care Act. The research that was instrumental to including the Demonstration in the Affordable Care Act came largely from Penn Nursing researchers.
Increasing the number of advanced practice nurses is an important way to increase the base of primary care providers in the United States. APR...
Posted August 2012 Intentionally Unvaccinated Students Put Others at RiskParents nervous about the safety of vaccinations for their children may be causing a new problem: the comeback of their grandparents’ childhood diseases, reports a new study from the University of Pennsylvania School of Nursing.
Despite the successes of childhood immunizations, wrote Penn Nursing researcher Alison M. Buttenheim, PhD, MBA, in the American Journal of Public Health, controversy over their safety has resulted in an increasing number of parents refusing to have their children vaccinated and obtaining legally binding personal belief exemptions against vaccinations for their children.
Posted September 2012 Alzheimer's Experts Provide Strategic RoadmapThis week, a strategic roadmap to help to the nation’s health care system cope with the impending public health crisis caused Alzheimer’s disease and related dementia will be published in Alzheimer's & Dementia: The Journal of the Alzheimer's Association. The plan aims to link the latest scientific findings with clinical care and bring together patients, families, scientists, pharmaceutical companies, regulatory agencies, and advocacy organizations behind a common set of prioritized goals. The consensus document is the outcome of a June meeting of leading Alzheimer's researchers, advocates and clinicians, who gathered as part of the ...
Posted September 2012 Getting the Best Healthcare at Lower CostOn the national level, healthcare costs have increased faster than the economy as a whole for most of the past 40 years and health insurance and constitute 18 percent of the country’s gross domestic product. On the personal level, out-of-pocket costs for patients have nearly doubled in the past 10 years.
With statistics like these, something has to change. “Best Care at Lower Cost: The Path to Continuously Learning Healthcare in America,” a new report from the Institute of Medicine (IOM), details ways to bring about more cost-effective quality care by harnessing existing knowledge and technol...
Posted September 2012 You Have to Eat Except When You're Not HungryWhen compared to their normal-weight siblings, overweight and obese children ate 34 percent more calories from snack foods even after eating a meal, reports a University of Pennsylvania School of Nursing researcher in The American Journal of Clinical Nutrition. That can be enough calories, if sustained over time, to continue excess weight gain.
In a study of 47 same-sex sibling pairs, the research showed that, even after eating a meal they enjoyed until they were full, overweight and obese children were more prone to overeating when presented with desirable snack foods than their normal-weight siblings.
Posted October 2012 Nurses' Assessment of Hospital QualityA new study from the University of Pennsylvania School of Nursing affirms a straightforward premise: Nurses are accurate barometers of hospital quality. Perceptions from nurses – the healthcare providers most familiar with the patient experience -- about hospital quality of care closely matches the quality indicated by patient outcomes and other long-standing measurements.
“For a complete picture of hospital performance, data from nurses is essential,” said lead author Matthew D. McHugh, a public health policy expert at Penn Nursing. “Their assessments of quality are built on more...
Posted October 2012 Nursing Workloads Multiply Likelihood of Death among Black Patients over White PatientsOlder black patients are three times more likely than older white patients to suffer poorer outcomes after surgery, including death, when cared for by nurses with higher workloads, reports research from the University of Pennsylvania School of Nursing. The large-scale study showed higher nurse workloads negatively affected older surgical patients generally and that the rate was more significant in older black individuals. When the patient-to-nurse ratio increased above 5:1, the odds of patient death increased by 3 percent per additional patient among whites and by 10 percent per additional patient among blacks.
Lead author J. Margo Brooks Carthon, PhD, RN, and Penn Nursing colleagues studied more than 548,000 patients a...
Posted October 2012 Fewer Patient Deaths after SurgeryPatients treated in magnet hospitals (specially designated for their nursing excellence) had 14 percent lower odds of death than those in non-magnet hospitals in a four-state study of 564 hospitals led by the University of Pennsylvania School of Nursing. The magnet designation, determined by the American Nurses Credentialing Center, recognizes high-quality patient care, high levels of nurse education, and nursing innovation. "Even controlling for differences in nursing, hospital, and patient characteristics, surgical patients fared better in magnet hospitals," said lead author ...
Posted November 2012 Long Shifts Lead to Nurse Burnout and Dissatisfied PatientsExtended work shifts of twelve hours or longer are common and popular among hospital staff nurses, but a new study reports that nurses working longer shifts were more likely to experience burnout, job dissatisfaction, and patients were more dissatisfied with their care.
In the first study to examine the relationship between nurse shift length and patients’ assessment of care, researchers from the University of Pennsylvania School of Nursing report that nurses working shifts of ten hours or longer were up to two and a half times more likely than nurses working shorter shifts to experience burnout and job dissatisfaction. Furthermore, seven out of ten patient outcomes were significantly and adversely affected by the...
Posted November 2012 Gastric Bypass Surgery: Follow Up as Directed to Lose MoreGastric bypass patients who attended five follow-up office visits in two years as recommended by their surgeons lost nearly twice as much weight (113 lbs. vs. 57 lbs.) as patients who attended only two follow-up visits, according to a University of Pennsylvania School of Nursing study in Obesity Surgery.
The global epidemic of overweight and obese people is estimated to include 1.7 billion individuals, with two-thirds of those living in the U.S. Measurement of body mass index (BMI), a calculation of height and weight, classifies obesity. Patients with severe obesity (a BMI of 40 or higher) are candidates for bariatric surgery when they have at least one co-occurring condition such as Type II diabetes, high blood...
Posted November 2012 Standardizing Pain ManagementBased on the compelling need to provide a “Standardized DoD and VHA Vision and Approach to Pain Management to Optimize the Care for Warriors and their Families,” a 22-member task force commissioned by the Office of The Army Surgeon General generated a comprehensive report to address pain among military service members and Veterans.
This report underscored the importance of a consistent way to measure pain across transitions of care within military and Veterans Administration Healthcare (VHA) systems. The Army Pain Management Task Force developed a new integrated pain rating scale – the Defense and Veterans Pain Rating Scale ...
Posted November 2012 Clinicians and Parents: Working Together During Invasive ProceduresNew research from the University of Pennsylvania School of Nursing reports that parents present during a child’s more invasive procedures reported higher levels of comfort, more procedural understanding and less emotional distress – while clinicians reported parent presence did not affect their technical performance, therapeutic decision-making, or ability to teach.
The study, conducted at Boston’s Children’s Hospital over a four-year period in the cardiovascular and critical care programs (for procedures such as cardiopulmonary resuscitation, chest tube placemen...
Posted December 2012 Second Hand Smoke Linked to Children's Behavior ProblemsIt is a known fact that active maternal smoking during pregnancy has negative effects on child health, such as attention deficit and hyperactivity disorder (ADHD). However, new research suggests that second hand smoke, or environmental tobacco smoke (ETS), may be just as harmful.
In one of the first studies of its kind, researchers from the University of Pennsylvania School of Nursing examined data from 646 mother-child pairs in China, where more than 70 percent of men smoke, and concluded that 25 percent children of whose mothers were exposed to smoke exhibited behavior problems compared to 16 percent of children of unexposed mothers. ...
Posted December 2012 Hiring Extra Temporary Travel Nurses May Save LivesTo reduce the shortage of available staff nurses, hospitals have hired temporary “travel” nurses without fully knowing the effect on patient outcomes. However, a new study has concluded hiring extra nurses may actually save lives.
After examining data from more than 1.3 million patients and 40,000 nurses in more than 600 hospitals, researchers from the University of Pennsylvania School of Nursing have concluded that the use of such supplemental nurses “does not appear to have deleterious consequences for patient mortality.”
“Our study showed these nurses could be lifesavers. Hiring temporary nurses can alleviate shortages that could pro...
Posted December 2012 Lower Readmissions for Hospitals with Good Work EnvironmentNew research from the University of Pennsylvania School of Nursing has found that Medicare patients treated in hospitals with a good work environment for nurses had up to ten percent lower odds of readmission than those treated in hospitals with a poor work environment.
Preventable hospital readmissions are a source of unnecessary costs to Medicare—more than $15 billion annually, and Medicare is now penalizing hospitals with excessive rates of readmissions.
After examining data from more than 200,000 nurses and 412 hospitals in California, Pennsylvania and New Jersey, researchers determined the likelihood of readmission within 30-days among Medicare pa...