Nurse Practice Environment Influences in Reducing Disparities In Hospital Outcome

描述(由申请者提供)：K01指导研究科学家发展奖的目的是为Margo Brooks Carthon博士，RN，为独立的医疗服务研究生涯做准备，特别关注差异研究。职业发展计划需要三种方法来实现候选人的短期和长期职业目标，包括1)完成致力于获得高级健康结果研究方法和统计方面的技能的培训；2)招募一个由琳达·艾肯博士、博士、FAAN、RN、赫伯特·史密斯博士和大卫·巴顿·史密斯博士组成的专家指导小组；以及3)进行一项研究，以评估护士执业环境对少数族裔患者医院结果的影响，这将导致未来的R系列拨款申请。在我完成博士后研究后，我得到了宾夕法尼亚大学护理学院的教职邀请。这项研究项目试图了解护士队伍的特征和护士执业环境如何影响住院少数民族患者的结局。这项研究将采用横断面观察性设计，以确定护士队伍和执业环境对选定的患者结局的影响，以评估在护理资源方面的哪种类型的投资可能对少数族裔患者的结局最有利。研究项目的具体目的是：1)检查少数族裔和非少数族裔患者术后死亡率和抢救失败率的差异，并确定少数族裔患者预后的差异在多大程度上是由潜在的患者特征解释的，如合并症或少数族裔寻求护理的医院的特点；以及2)确定少数族裔患者手术后预后的差异在多大程度上与护士人员配备、接受过BSN教育的护士比例和护士执业环境的质量有关。预计这项研究的结果将为管理和政策倡议提供关于如何改善健康结果的信息，特别是在为很大比例的少数群体服务的医院。 公共卫生相关性：这项提案直接解决了公众对住院的种族和族裔少数群体在健康结果方面存在差异的关切。它的结果将是评估护理和执业环境对少数族裔患者结局的影响的首批举措之一，并将提供对哪些护理投资最有益的初步评估。

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.