Health Services Research & Development

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FORUM - Translating research into quality health care for Veterans


In This Issue

Director's Letter

Director's Letter
by David Atkins, MD, MPH, Director, HSR&D

Due to their distinct training, and more extensive contact with patients, nurses are in many ways better equipped than physicians to help lead and examine several of the important changes happening in Veteran care...

Commentary

Role of Nurses in Managing Chronic Disease
By Linda McConnell, MSN, RN, NEA-BC, FACHE, VA Central Office, Washington, DC

Managing Veterans with chronic disease is highly complex and requires the use of evidence-based approaches. We have the responsibility to conduct research and determine best practice as we transform care delivery for Veterans....

Response to Commentary

Practicing to the Full Scope of Licensure Can Improve Access to Care
By Sheila Cox Sullivan, PhD, RN, VHA-CM, VHA Office of Nursing Services, Washington, DC

Allowing nurses to practice to the full extent of their licensure and education will require research to determine the best models for delivery of this care while maintaining patient safety and quality. However, allowing this scope of practice is critical to ensuring access to health care for Veterans and civilians alike...

Research Highlights

VA Nursing: Effectiveness and Entry
By Anne Sales, PhD, RN, Claire Robinson, MPH, and Sonia Duffy, PhD, RN, FAAN, all with HSR&D's Center for Clinical Management Research and QUERI/ONS Partnered Evaluation Initiative, Ann Arbor, Michigan; and Sheila Cox Sullivan, PhD, RN, VHA-CM, and Mary Pat Couig, PhD, MPH, RN, FAAN, both with VHA's Office of Nursing Services

The VA Office of Nursing Services (ONS), along with the Quality Enhancement Research Initiative (QUERI), established a Partnered Evaluation Initiative (PEI) with a team of researchers from the Ann Arbor Center for Clinical Management Research in 2014. The purpose of the PEI is to improve Veteran care by informing the QUERI program and ONS about: 1) the ability of strategic initiatives to maintain, modify, and expand nursing programs; and 2) the implementation of strategic initiatives, including variations in implementation across sites...


Using Bundles to Enhance Care and Improve Patient Outcomes
By Sarah L. Krein, PhD, RN, HSR&D Center for Clinical Management Research, VA Ann Arbor Healthcare System, Ann Arbor, Michigan

Care or practice "bundles," defined as a set of evidence-based practices that when implemented together result in better outcomes, have become a mainstay for improving health care quality and safety since the concept was first introduced by the Institute for Healthcare Improvement...


Effects of Nurse-Managed Protocols in the Outpatient Management of Adults with Chronic Conditions
By John W. Williams Jr, MD, MHS, Durham VA Evidence Synthesis Program, and Cristina Hendrix, DNS, GNP-BC, FAAN, Geriatrics Research, Education, and Clinical Center, Durham VAHCS, Durham, North Carolina

Evidence exists to support the effectiveness of nurse-delivered interventions in the management of Veterans with diabetes. Efforts are also underway to develop and test nurse-managed protocols in cardiology...


Home Telehealth RN Insulin Management Improves Health Outcomes
By Nancy N. Brown, MSN, ARNP, ANP-BC, Barbara E. Carrara MSN, RN, and Freta L. Leddige, MSN, RN, all with Home Telehealth, Mann-Grandstaff VAMC, Spokane, Washington and Sharon A. Watts, DNP, FNP-BC, CDE, Louis Stokes VAMC, Cleveland, Ohio

The need for access to high quality chronic disease management is at an all-time high and stretching limited provider resources. Models that focus on use of the entire clinical team are needed to enhance access while improving coordination of care...