March 4, 2016 – Nurse Management

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Anchor lead: Can nurses keep people with many medical problems from coming back to the hospital? Elizabeth Tracey reports

When people with a number of medical problems are discharged from the hospital, they often come back very soon.  Now a new study examined whether putting a nurse in charge of their care can help reduce the number of readmissions, but the results were disappointing.  Trish Davidson, dean of the school of nursing at Johns Hopkins, says this study deserves closer scrutiny.

Davidson: What are the contextual factors that lend support to an intervention?  Some of those factors to consider are the sense of autonomy and independence the nurse feels.  How valued his or her opinion is in the clinical encounter, the quality of the professional practice environment, how nurses are respected, what is the level of interdisciplinarity and communication across health care professionals?  :27

Davidson says previous research has shown the efficacy of nurse coordination, especially with regard to patient satisfaction.  At Johns Hopkins, I’

King: It’s a process that at least potentially lends itself to a cookie cutter approach to patient care or to the assessment of patient care, when in fact, not uncommonly, the care of an individual patient is much more nuanced, because there’s an overlay of multiple medical conditions or multiple psychosocial that somehow, despite all good intentions, encroach on the validity of a particular measure.   :25