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New AHRQ publications focus on hospital nurse staffing and a research agenda for health and the humanities

The following two reports were published recently by the Agency for Healthcare Research and Quality. Copies are now available from the AHRQ Publications Clearinghouse.

Hospital Nurse Staffing and Quality of Care. Research in Action Issue 14. Stanton, M.A., and Rutherford, M.K. AHRQ Publication No. 04-0029.

This Research in Action summarizes the findings of research funded by AHRQ and others on the relationship of nurse staffing levels to adverse patient outcomes. Hospitals with low nurse staffing levels tend to have higher rates of poor patient outcomes such as pneumonia, shock, cardiac arrest, and urinary tract infections. Avoidable adverse outcomes such as pneumonia can raise treatment costs by up to $28,000. There is a nationwide gap between the number of available positions and the number of registered nurses (RNs) qualified and willing to fill them, as evidenced by an average vacancy rate of 13 percent. Meanwhile new technologies and a declining average length of stay have led to higher acuity patients who require more care while they are in the hospital. Despite this, the skill levels of the nursing staff have declined. Moreover, higher acuity patients and added responsibilities have increased nurse workloads. Higher levels of nurse staffing could have a positive impact on both quality of care and nurse satisfaction, and research shows that hiring more RNs does not decrease profits.

Setting a Research Agenda for Health and the Humanities. Conference Summary Report. Abel, E., Bosk, C.L., Jennings, B., and others. AHRQ Publication No. 04-0003.

In March 2002, the National Endowment for the Humanities and AHRQ convened a conference to explore how expanded interaction between health services researchers and scholars in the humanities might broaden the horizons of health care in America. This report summarizes the recommendations from the conference. The majority of the participants felt that a collaborative research agenda depends on finding ways to introduce and fund truly interdisciplinary rather than multidisciplinary research. Interdisciplinary research—with cooperative analysis and shared understanding that starts from the distinctly different modes of analysis, kinds of evidence, and bodies of explanation employed in scientific research and the humanities—was contrasted with multidisciplinary research, in which people might work on a common project but be independent, guided by the terminology and culture of their own discipline. In addition to the group as a whole, the conference had four specific workgroups: end-of-life issues, family caregivers, patient safety, and access to care. Two overarching conference recommendations were to initiate a "big picture" analysis of health care and to empower a national summit conference or continuing task force to identify and examine major issues.

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