Nurse Practice Environment Influences in Reducing Disparities In Hospital Outcome

描述（由申请人提供）：本K01指导研究科学家发展奖的目的是准备Margo Brooks Carthon，博士，注册护士，独立的卫生服务研究事业，特别关注差异研究。职业发展计划包括三种方法，以实现候选人的近期和长期职业目标，包括1)完成专门培训，以获得先进的健康成果研究方法和统计技能；2)招募专家指导团队，包括Linda Aiken博士、FAAN博士、注册护士、Herbert Smith博士和David Barton Smith博士。3)开展一项研究，评估护士执业环境对少数族裔患者住院结果的影响，这将导致未来的r系列资助申请。在完成我的博士后研究后，我收到了宾夕法尼亚大学护理学院的教职工作邀请。该研究项目旨在了解护士工作队伍和护士实践环境的特点如何影响住院少数民族患者的结果。本研究将采用横断面观察设计来确定护士工作队伍和实践环境对选定患者结果的影响，以评估哪种护理资源投资可能对少数患者结果最有利。该研究项目的具体目的是：1)检查少数民族和非少数民族患者术后死亡率和抢救失败率的差异，并确定少数民族患者结果的差异在多大程度上可以用潜在的患者特征（如合并症或少数民族就医的医院特征）来解释；2)确定少数民族患者术后预后差异与护士配备、接受过BSN教育的护士比例和护士执业环境质量的关系。预计这项研究的结果将为如何改善健康结果的管理和政策举措提供信息，特别是在为大量少数民族服务的医院。

DESCRIPTION (provided by applicant): The purpose of this K01 Mentored Research Scientist Development Award is to prepare Margo Brooks Carthon, PhD, RN, for an independent health services research career, with a special focus on disparities research. The career development plan entails three approaches to achieve the immediate and long-term career goals of the candidate, including 1) completion of training dedicated to acquiring skills in advanced health outcomes research methods and statistics; 2) enlistment of an expert mentorship team including Dr. Linda Aiken, PhD, FAAN, RN, Dr. Herbert Smith and Dr. David Barton Smith and 3) the conduct of a study to evaluate the influence of nurse practice environments on hospital outcomes of minority patients, that will lead to future R-series grant applications. I have an offer for a faculty position from the University of Pennsylvania School of Nursing upon the completion of my post-doctoral research fellowship. The research project seeks to understand how characteristics of the nurse work force and the nurse practice environment influence outcomes among hospitalized minority patients. This study will employ a cross sectional, observational design to determine the effects of nurse work force and the practice environment on selected patient outcomes in order to assess what types of investments in nursing resources might be most beneficial to minority patient outcomes. The specific aims of the research project are to: 1) examine the difference in post operative mortality and failure to rescue rates among minority and non-minority patients, and determine how much of the differences in minority patient outcomes are explained by underlying patient characteristics such as comorbidites or characteristics of the hospitals where minorities seek care; and 2) determine to what extent differences in minority patient post surgical outcomes are associated with nurse staffing, the proportion of nurses with BSN education, and the quality of the nurse practice environment. It is anticipated that the results of the study will inform managerial and policy initiatives on how to improve health outcomes, particularly in hospitals serving a large proportion of minorities. PUBLIC HEALTH RELEVANCE: This proposal directly addresses the public health concern regarding disparities in health outcomes among hospitalized racial and ethnic minorities. Its results will represent one of the first initiatives to evaluate the influence of nursing care and the practice environment on minority patient outcomes and will provide a preliminary assessment of what kinds of investments in nursing are most beneficial.