Medical Care Supplement Highlights Findings and Recommendations on Nursing Science to Improve Veteran Outcomes
BACKGROUND:
VA continues to face nursing staff shortages. Despite nursing’s central role in Veteran healthcare, research on strengthening the nursing workforce and optimizing nursing practice has remained underdeveloped in VHA. To address this gap, VA Health Systems Research (HSR) and the Office of Nursing Services (ONS) held a Nursing State of the Art (SOTA) Conference in November 2023 that brought together nurses, researchers, operational leaders, and other stakeholders to review current evidence and identify priorities for future research. These priorities include pressure injury prevention and treatment, care coordination models, social drivers of health, nurse staffing and care models, and the nursing work environment. Cross-cutting themes include the need for stronger data infrastructure and expanded support for the VHA nursing workforce. This special issue of Medical Care, supported by HSR and ONS, describes opportunities to support and advance VA’s nursing workforce and practice, and presents a collection of articles that report on novel nursing research and evaluation initiatives. Among the included articles:
- Schlak et al. summarize the Nursing SOTA and the research priority areas that emerged.
- Bay et al. and Arredondo et al. examine nurse turnover, andnurse recruitment and retention, respectively, with a focus on rural healthcare.
- Dick et al. examine the association of direct care nurses with a Bachelor of Science in Nursing or a higher degree and the outcomes of hospitalized Veterans undergoing common surgical procedures.
- Hysong et al. investigate the impact of alternate work schedules on nurses’ well-being.
- Knox et al. assess the extent to which RN staffing and workload have changed following the COVID-19 pandemic, finding that nurses’ workload has increased.
- Vance et al. analyze data from VA’s Workplace Behavioral Risk Assessment to identify which VA workplace settings (e.g., acute care, emergency care) are at highest risk of disruptive behavior.
- Miake-Lye et al. review the evidence on registered nurse transition to practice programs. Such programs can potentially alleviate nurse staffing shortages and support development of the nursing workforce.
- Daus et al. describe an innovative nurse navigator approach to screen for and address the social needs of women Veterans. Findings indicate a strong potential for expanding nurse navigator roles within and outside VHA.
- Brunner et al. identify actionable recommendations for supporting nurses during electronic health record (EHR) transitions based on nurse experiences at healthcare systems that have completed EHR transitions.
IMPLICATIONS:
The Nursing SOTA Conference resulted in the development of a national research agenda that is aligned with VHA priorities, congressional mandates, the VHA Nursing Workforce Strategic Plan, and Veteran care needs. Recommendations from the SOTA Conference were incorporated into VHA’s 2024 Health Systems Research Priorities, led to the creation of the Nursing Data and Research Consortium (NDR Consortium), and are expected to inform future research, policy, and practice.
Advancing Nursing Science in the Veterans Health Administration: Engaging the Nursing Workforce to Improve Veteran Care. Medical Care. January 2026;64(1S).
