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University of Maryland School of Nursing Professor Leads Study on Effectiveness of Heart Failure Treatment in Rural Hospitals

May 1, 2013

Baltimore, Md. – According to the Centers for Disease Control and Prevention, heart failure affects approximately 5.7 million Americans. Ensuring that heart failure patients receive optimal care can be difficult, especially in rural settings. To that end, Professor Robin Newhouse, PhD, RN, NEA-BC, FAAN, chair of the Department of Organizational Systems and Adult Health at the University of Maryland School of Nursing, in collaboration with Laura Morlock, PhD, professor and associate chair for Health Management Programs, Department of Health Policy and Management at Johns Hopkins Bloomberg School of Public Health, led a new study that examined the effectiveness of heart failure treatment in rural hospitals.

While it is thought that residents in rural settings are not as likely to get the recommended care as residents in urban or suburban settings because they have fewer options, Newhouse’s study refutes this assumption. The study, funded by the Robert Wood Johnson Foundation Interdisciplinary Nursing Quality Research Initiative (INQRI), found that rural hospitals were better equipped to ensure high-quality care if the turnover of nurses was lower and they had better practice environments. 

“The results of this study really speak to the central role nurses play in almost any quality improvement effort,” Newhouse said. “Appropriate practice environments and keeping turnover low are important factors in hospitals’ ability to implement quality initiatives and adopt best practices.”

Researchers concluded that rural hospitals with lower nurse turnover are more likely to implement all four measures that are central to optimal care for heart failure patients. Metrics examined were: providing smoking cessation counseling, providing adequate instructions to patients being discharged from the hospital, assessing how well the heart pumps, and making sure the patient receives medication to help blood vessels relax. However, researchers found that there was no significant difference in implementation of the four core measures as a result of the quality collaborative intervention, but hospitals with lower nurse turnover and better practice environments implemented more of the measures.

Twenty-three rural hospitals in the eastern United States were involved in the study, which included an evidence-based toolkit, in-person meetings, and monthly group teleconference calls between the site coordinators and the study team.

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The University of Maryland School of Nursing, founded in 1889, is one of the oldest and largestnursing schools, and is ranked eleventh nationally. Enrolling nearly 1,700 students in its baccalaureate, master’s, and doctoral programs, the School develops leaders who shape the profession of nursing and impact the health care environment.