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Nancy Ryan-Wenger, PhD, RN, CPNP, FAAN, Director of Nursing Research and investigator with the Center for Innovation in Pediatric Practice at Nationwide Children’s Hospital in Columbus, Ohio, is one of the lead investigators in the study, which was funded by the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative (INQRI). Her co-lead investigator is William Gardner, PhD, professor of pediatrics, psychology and psychiatry at the Ohio State University College of Medicine. He is also an investigator with the Center for Innovation in Pediatric Practice at Nationwide Children’s Hospital.
The study included 496 children and youth, ages six to 21, who were treated in a free-standing children’s hospital. They were asked two questions about their care: 1) “What do you like most about your nurses and what they do for you, and how does that make you feel?”; 2) “What don’t you like about your nurses and what they do for you, and how does that make you feel?” Their responses were sorted into 18 categories of nurse behaviors, 12 that were regarded as positive (such as “gives me what I need when I need it,” “checks on me often,” “talks and listens to me” and “is nice and friendly to me”). These positive behaviors made the children feel cared about, safe, and happy. Six categories were regarded as negative (such as “wakes me up” or “doesn’t give me what I need when I need it”).
Researchers found that, overall, children felt like their nurses cared about them, regardless of how many behaviors they did or did not like. Nearly two-thirds of the children reported that they did not like it when nurses did things that hurt or were uncomfortable, and they reported that these kinds of negative nurse behaviors made them feel sad, bad, mad, scared or annoyed.
“Children’s experiences in the hospital can influence their attitudes toward health care for the rest of their lives, and their decisions about receiving health care or even a career as a health care provider,” said Ryan-Wenger. “We can help improve those experiences by listening to pediatric patients. We found that children can accurately report their feelings about quality of care and these findings strongly suggest that when children are cared for in hospitals, their perspectives on the care they received should be elicited and considered when evaluating nursing practices and procedures.”
Although, the demographics of the participants limited researchers to comparing responses only of black and white patients, the study revealed that race and gender did not have an impact on their perceptions of nurses’ behavior. Household income did seem to play a role in some cases, however. Children from low-income neighborhoods more often reported that a nurse woke them up (which was identified as a negative nurse behavior), than children from other neighborhoods. Children in neighborhoods with higher incomes were more likely to report that nurses gave them things to do (a positive behavior) than their counterparts from lower income neighborhoods.
The researchers’ recommendations include:
· Providing pediatric patients with systematic opportunities to evaluate the quality of their care during hospitalization and other types of health care visits;
· Holding nurses accountable for timely and appropriate responses to children’s concerns about their care, and for communicating those concerns to other staff; and
· Continuing research to evaluate the link between children’s perspectives on the quality of their care and the outcomes of that care.
INQRI supports interdisciplinary teams of nurse scholars and scholars from other disciplines to address the gaps in knowledge about the relationship between nursing and health care quality. It is helping to advance the recommendations of the Institute of Medicine’s landmark report, The Future of Nursing: Leading Change, Advancing Health, which include fostering interprofessional collaboration and preparing and enabling nurses to lead change. By requiring research teams to include a nurse scholar and at least one scholar from another health care discipline, INQRI not only fosters interprofessional collaboration, the Initiative also ensures that diverse perspectives are brought to bear in research.
The Interdisciplinary Nursing Quality Research Initiative is funded by the Robert Wood Johnson Foundation. To learn more, visit www.inqri.org, or follow on Twitter at @INQRIProgram.
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The Robert Wood Johnson Foundation focuses on the pressing health and health care issues facing our country. As the nation's largest philanthropy devoted exclusively to health and health care, the Foundation works with a diverse group of organizations and individuals to identify solutions and achieve comprehensive, measurable and timely change. For nearly 40 years the Foundation has brought experience, commitment, and a rigorous, balanced approach to the problems that affect the health and health care of those it serves. When it comes to helping Americans lead healthier lives and get the care they need, the Foundation expects to make a difference in your lifetime. For more information, visit www.rwjf.org.
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