Nursing research influences healthcare across the country

Early within the pandemic, nurses often faced uncertainties about the best way to best look after COVID-19 patients. That uncertainty prompted Christine Wendt, MSN, RN, CEN, TCRN, a clinical specialist at Morristown Medical Center in New Jersey, to launch a study to search out her own answers. Wendt desired to help COVID-19 patients delay or avoid mechanical ventilation altogether, because she was seeing too many individuals having difficulty coming off ventilators—and demand for the machines threatened to outpace supply in lots of states. To delay intubation, nurses across the country experimented with prone positions for hypoxic COVID-19 patients who were still conscious and respiratory on their very own. This positioning strategy involved showing them the best way to lie face down and place one arm above their head and the opposite at their side. “We did a literature review, and there was almost no data on proning patients who weren’t on a ventilator,” Wendt said. To investigate whether the strategy helps patients who weren’t intubated, Wendt’s research team reviewed the charts of patients who had COVID-19 and were admitted to the emergency department between March 30, 2020, and April 30, 2020. They found that the approach improved patients’ oxygen saturation, respiratory rate, and heart rate. “It’s a nurse-developed protocol that’s easy to implement,” Wendt said. The next step is to research whether proning patients before intubation results in shorter lengths of stay and higher outcomes. This study is only one example of how nursing research is shaping health care practices and policies across the country.

“It’s incredibly important for nurses to get involved in research because, being on the front lines and caring for patients every day, they can proactively identify areas for improvement,” said researcher Jenna LoGiudice, PhD, nurse midwife, FACNM, assistant professor on the Egan School of Nursing and Health Studies at Fairfield University in Connecticut.

To support nurses curious about using research to enhance patient care, the work environment, or other features of the occupation, hospitals are increasingly hiring nurse researchers or consultants who may help staff design and implement research.

Nursing Research on Burnout Prevention

LoGiudice realized that her expertise in trauma research could possibly be applied to studying the experiences of nurses treating COVID-19 patients in the course of the pandemic. In the spring of 2020, she found only two studies that focused on the subject in China. LoGiudice and her colleague, Susan Bartos, PhD, RN, CCRN, posted a request for participation on the American Association of Critical-Care Nurses website, and inside two weeks, dozens of nurses responded. “It was clear that they needed to be heard and to process what they were going through,” LoGiudice said. Through quantitative and qualitative evaluation, one theme that emerged was the increased stress nurses felt as hospital protocols for patient care modified day by day, in addition to the correct use and allocation of non-public protective equipment. In the study, one intensive care unit nurse at a county hospital said that the staff “literally had no idea how to treat this, [and] every week is a guessing game because new data comes out showing that what we did last week made patients worse.” Participants also shared how patients were depressed and scared, and the way they smiled less when relations weren’t around. Some COVID-19 patients asked nurses in the event that they were going to die. One nurse said that “the worst part was being assured ‘no,’ but not being sure myself,” in response to the article. While these experiences took their toll on the nurses, additionally they described the advantages of working in the course of the pandemic, LoGiudice said.

“They were extremely proud to be nurses and highlighted how nurses have come together during this difficult time,” she said.

LoGiudice hopes the study will validate nurses’ experiences and motivate more hospitals to speculate in staff wellness programs.

Nursing research delves into employment rates

The pandemic has also highlighted the work of nursing researchers who’ve studied the impact of nurse staffing rates. A recent study found wide variation within the variety of patients nurses cared for in New York and Illinois—two states which can be considering nurse staffing laws. Rates ranged from three to 10 patients per nurse, with the very best rates in New York. “Our study found that before the pandemic, half of hospital nurses experienced high levels of burnout,” said study writer Karen Lasater, MD, an assistant professor on the University of Pennsylvania School of Nursing.

Half of respondents gave their hospitals unfavorable safety rankings, and two-thirds would definitely not recommend their hospitals. Nurses were also more prone to be dissatisfied with their jobs and to mean to go away their employers in the event that they worked in hospitals with higher than average staffing levels.

Although improved nurse staffing is related to cost savings if a state law on staffing is passed, the hospitals that need improved nurse staffing probably the most might also be probably the most financially constrained, said Rachel French, BSN, RN, one in every of the study’s authors and an assistant professor on the Center for Health Outcomes and Policy Research on the University of Pennsylvania. “The next step is to find creative solutions, such as grants, to enable better staffing rates for all hospitals,” she said.

Vaccine Beliefs Survey

Nurse researchers are also beginning to explore the best way to look after their communities as hundreds of thousands of individuals face decisions about whether to get vaccinated against COVID-19. Nancy Blake, PhD, RN, FAAN, assistant professor of nursing at UCLA and CNO at Harbor-UCLA Medical Center in Torrance, California, noticed vaccine hesitancy amongst people of color at her hospital, and the vast majority of patients on the medical center were Latinx, Black, or Asian Pacific Islander. To investigate why patients were refusing vaccinations, Blake applied for a DAISY Health Equity Grant, a brand new program offered by the DAISY Foundation, a corporation known for honoring nurses who reveal extraordinary compassion of their work. Blake’s proposal was approved, and later this spring, she’s going to use the grant to check how social determinants of health and other aspects affect vaccine decisions. “There may be an aunt or a grandparent or another relative who makes the decision for the whole family, but those choices may be based on fear,” Blake said. The goal of the study is to develop interventions to reply questions people could have about vaccines. For Blake, studies like this one underscore the powerful impact nurse researchers can have on their communities. “We’ve seen hundreds of people of color die from COVID-19 in our facility, and many of their loved ones have said they haven’t heard about the risks of large gatherings during the pandemic,” Blake said. “We hope to publish and disseminate our findings to improve outcomes for people of color.”