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CHOPR Research Wins Prestigious Awards and Endorsements

Investigators saw a surge of interest as projects into health outcomes and quality of care came to the forefront due to increased scrutiny on the impact of working conditions for nurses.

Paper on the effects of staffing size on nurse and patient outcomes is the 2003 AcademyHealth Article of the Year

Co-authors gather with CHOPR research partners following the AcademyHealth2003 awards ceremony.Co-authors gather with CHOPR research partners following the AcademyHealth2003 awards ceremony.June 2003 | CHOPR Authors rocked the healthcare quality research world in October 2002, when The Journal of the American Medical Association (JAMA) published their landmark paper, “Hospital Nurse Staffing and Patient Mortality, Nurse Burnout, and Job Dissatisfaction”. Their research studied 10,000 nurses in 168 Pennsylvania hospitals, looking for the effects of staffing size on nurse and patient outcomes.

The results of the study showed for each additional patient assigned to a nurse, 30-day patient mortality increased by 7 percent; failure to rescue rates rose by 7 percent; the odds of nurse job dissatisfaction increased by 15 percent, and the odds of nurse burnout increased by 23 percent. Dr. Linda H. Aiken and co-authors, Drs. Sean P, Clarke, Douglas Sloane, Julie Sochalski, and Dr. Jeffrey Silber clearly identified a link between patient load and mortality.

Writing for a JAMA Editorial, “Meeting the Challenge of Nursing and the Nation’s Health”, co-authors, Dr. Edward O’Neil and Dr. Jean Ann Seago said, 

“Aiken et al. have provided an important piece of scholarship that helps us to understand more completely the contributions of more intensive nurse staffing to patient safety, outcomes, and the job satisfaction of nurses.”

Key healthcare organizations endorse Dr. Lake’s Practice Environment Scale of the Nurse Working Index as the standard measure of quality of care

<p><span class="subhead" style="font: 11px/18px Verdana, Arial, Helvetica, sans-serif; color: #095885; text-transform: none; text-indent: 0px; letter-spacing: normal; word-spacing: 0px; white-space: normal; widows: 1; font-size-adjust: none; font-stretch: normal; background-color: #ffffff; -webkit-text-stroke-width: 0px;"><strong>Eileen V Lake, PhD, RN, FAAN<br/> Jessie M. Scott Endowed Term Chair in Nursing and Health Policy, Associate Professor of Sociology, and Associate Director of the Center for Health Outcomes and Policy Research</strong></span></p>June 2002 | The paper, Development of the Practice Environment Scale (PES) of the Nursing Work Index (NWI) in Research in Nursing and Health, introduced a new instrument from two prior instruments: the Nursing Work Index (NWI) by Kramer and Hafner (1989); and, the Revised Nursing Work Index (NWI-R) by Aiken and Patrician (2000).

The National Quality Forum (NQF, 2004) selected the PES-NWI as a national voluntary standard of nursing performance in 2003. It is one of only twelve nursing standards with NQF endorsement out of over 750 currently-endorsed measures. The Joint Commission, 2009); the National Database of Nursing Quality Indicators (NDNQI, 2006); and the American Nurses Credentialing Center (ANCC, 2009) have also endorsed. 

The study’s design allowed Dr. Lake to present an instrument derived empirically from reputational Magnet hospital data and confirmed in a representative sample of hospitals. Today, over 150 studies have utilized PES data to demonstrate that the nurse work environment is a key foundation for health care quality. As Dr. Lake explains, 

“The ultimate goal in these efforts is to create and sustain practice environments that will facilitate professional nursing practice, enhance the quality of patient care, and improve outcomes for both nurses and patients.”