University of Pennsylvania

Expanding Access to Health Care by Removing APRN Practice Barriers: Lessons from Pennsylvania University of Pennsylvania

The Institute of Medicine’s groundbreaking report, The Future of Nursing: Leading Change, Advancing Health, recommends removing scope of practice barriers so that advanced practice registered nurses are be able to practice to the full extent of their education and training. This research project will examine the impact of the provision of the Prescription for Pennsylvania law that removed practice barriers for APRNs.

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Scope of practice (R1)
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Nurse Staffing and NICU Infection Rates

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There are substantial shortfalls in nurse staffing in U.S. neonatal intensive care units (NICUs) relative to national guidelines. These are associated with higher rates of nosocomial infections among infants with very low birth weights. This study examines the adequacy of NICU nurse staffing in the U.S. using national guidelines and analyze its association with infant outcomes.

Challenges and directions for nursing in the pay-for-performance movement

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Pay-for-performance (P4P) drives improvements in the quality of care by aligning desired outcomes and care processes with reimbursement. Nursing care is central to preventing poor outcomes and ensuring optimal results in many different sectors of the health care system. This article attempts to trace the challenges and opportunities for the practice of nursing; the administration of nursing services; and the role of nursing in health policy as presented by P4P. The authors suggest four ways that health care providers can prepare for P4P. These include:

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Dr. Sean Clarke
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Dr. Joanne Disch

Acuity-adjusted Staffing, Nurse Practice Environments and NICU Outcomes

An INQRI-funded effort spearheaded by a team at the University of Pennsylvania and the University of Medicine and Dentistry of New Jersey, led by Eileen Lake and Jeannette Rogowski, has demonstrated the importance of nurse staffing and the professional practice environment in preventing infection among tiny babies in neonatal intensive care units (NICUs). Care for these babies is typically among the most expensive care provided in a hospital, costing anywhere from $50,000 to $70,000 for each patient.

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Scope of practice (R1)
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Academic progression (R4)
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Translation of a Transitional Care Nursing Intervention for People with Serious Mental Illness

The transition from a psychiatric hospitalization back into the community is a vulnerable period for individuals with serious mental illness. Cycling in and out of psychiatric hospitals and emergency services is harmful to this population and depletes scarce public resources. The Transitional Care Model for Persons with Serious Mental Illness (TCM-SMI) proposes to break this cycle by providing 90 days of intensive hospital-to-home services. This project is designed to translate the TCM intervention to meet the complex needs of SMI clients in public managed care.

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Interprofessional collaboration (R2)
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Validating NQF Nursing-Sensitive Performance Measures

Led by Sean Clarke, an INQRI team at the University of Pennsylvania conducted a study to understand how a number of the National Quality Forum's nursing sensitive measures track with each other. Do nurse staffing and practice environment measures for hospitals predict the quality of care patients receive? And do quality of care measures link with endpoints like inpatient mortality?

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Interprofessional collaboration (R2)
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Dr. Sean Clarke
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Dr. Doug Sloane

Dr. Eileen Lake

Dr. Eileen Lake

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Dr. Sean Clarke

Dr. Sean Clarke

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