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Biomedical subjects

Robin P Newhouse

Publications and source records attributed to Robin P Newhouse.

8 recordsLinked to original sources
PubMed2006

The slippery slope: differentiating between quality improvement and research.

As hospitals strive to create strong work environments for nurses, many use the core requirements for Magnet designation to enhance and build new programs in research and evidence-based practice into patient care and operational processes. The problem is the use of quality improvement projects in these efforts as evidence of a healthy "research" program. This confusion can lead to 3 major consequences: (1) poorly designed and interpreted studies; (2) lack of consideration of subject rights; and (3) Institutional Review Board or other regulatory sanctions for noncompliance with federal, state, and local law and institutional policies. The purpose of this article is to differentiate between research and quality improvement, explore the potential risks of confusing quality improvement with research, and suggest criteria by which to determine the difference.

Evidence-Based Medicine↗
PubMed2005

Perioperative nurses and patient outcomes--mortality, complications, and length of stay.

THE PURPOSE OF THE STUDY described in this article was to identify the relationship between RN staffing factors in the OR and surgical patient outcomes. THE STUDY ADDRESSED two main questions: whether the level of RN staffing in the OR is related to postoperative complications, mortality, and length of stay (LOS) and whether certification, RN agency use, 24-hour staffing, and the performance of multidisciplinary code drills are related to complications, mortality, and LOS. ACCORDING TO THIS STUDY, selected organizational factors in ORs had a significant influence on patient outcomes.

Aged↗
PubMed2003

Is there a relationship between service integration and differentiation and patient outcomes?

OBJECTIVE: To examine the level of service integration within Maryland hospitals and service differentiation across the hospital system or network and its affect on heart failure patient clinical and economic outcomes. DATA SOURCES/STUDY SETTING: Maryland Health Services Cost Review Commission Inpatient Data for 1997 and 1998 were used for secondary data analysis. STUDY DESIGN: Retrospective cross sectional. Independent variables were the level of service integration and differentiation created from the 1998 American Hospital Association Annual Survey based on the work of Bazzoli et al. The primary dependent variables were readmission, in-hospital mortality, length of stay and costs. DATA COLLECTION/EXTRACTION METHODS: Patients discharged from Maryland hospitals with a diagnosis that grouped to DRG 127 (heart failure) were extracted. Multivariate linear and logistic models clustered by hospital were used to analyse results at the patient level. PRINCIPAL FINDINGS: A higher likelihood of readmission was found as the level of Community Differentiation increased. Although costs were higher as Total Differentiation increased in 1998, these results were not validated by 1997 data. No significant relationship was found between integration of services and outcomes. CONCLUSIONS: Similar outcomes were achieved regardless of the level of service integration or differentiation. Community hospitals produce similar patient outcomes at the same cost for this diagnosis.

Journal Article↗
PubMedDate not supplied

Evaluating an innovative program to improve new nurse graduate socialization into the acute healthcare setting.

PROBLEM: New nurse graduates experience a stressful role transition into healthcare organizations, with 30% leaving their first job within 1 year and 57% leaving by 2 years of employment. AIM: This study tests whether an internship program, Social and Professional Reality Integration for Nurse Graduates (SPRING), improves new nurse graduate retention, sense of belonging, organizational commitment, and anticipated turnover. DESIGN: Quasi-experimental, posttest only, control group design. METHOD: New nurse graduates hired by an academic institution that completed SPRING were compared with baseline nurse graduates who did not complete SPRING, using the Organizational Commitment Questionnaire, Modified Hagerty-Patusky Sense of Belonging Instrument, and Anticipated Turnover Scale. Retention was also examined. RESULTS: Anticipated Turnover was higher for baseline nurses than for 6-month SPRING nurses. Six-month SPRING nurses have lower antecedent sense of belonging than baseline or 12-month SPRING nurses. One-year retention is higher for SPRING new graduates than for non-SPRING new graduates. CONCLUSION: Internship programs for nurse graduates must support the socialization of nurses and their transition into the professional role as well as teach the skills and knowledge needed for competence. This study supports the value of a comprehensive program for new nurse graduates in improving nurse retention and decreasing new nurse graduate intent to leave the organization at 6 months.

Acute Disease↗
PubMedDate not supplied

Exploring nursing issues in rural hospitals.

OBJECTIVE: To explore the impact of legislative, strategic, and organizational changes on nursing in rural hospitals since 1995. BACKGROUND: Rural hospitals have faced decreasing financial margins. This economic pressure is due to multiple reasons, and is a major issue for nurse executives. Nurse executives are responsible for assuring quality of nursing care. Nursing care affects patient outcomes. The impact of legislative, economic, and strategy decisions on nursing in rural hospitals is unknown. METHODS: A focus group was conducted with 11 nurse executives from rural hospitals who attended the American Organization of Nurse Executives Annual Meeting held on April 20, 2004. RESULTS: Themes from the content analysis were grouped into 3 major categories: external environmental (physical isolation, patient population, services needed, legislation), internal organizational (patient acuity, volume, services, technology, financial margin and strategy, staffing, leadership, culture, and resources), and nursing infrastructure (staffing, salary, registered nurse-physician conflict, continuity of care, competency, culture, politics and leadership). CONCLUSIONS: Nurse executives in rural hospitals face distinctive issues and challenges. Further study of the impact of policy and strategy decisions on rural nursing is needed.

Focus Groups↗