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Research Highlights

About NINR Research Highlights

NINR-supported researchers explore and address some of the most important challenges affecting the health of the American people. NINR Research Highlights feature research accomplishments from the community of NINR-supported scientists across the U.S.

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Evidence that Reducing Patient-to-Nurse Staffing Ratios Can Save Lives and Money

Having more nurses can increase patient safety and improve quality of care, yet hospitals often differ in the number of nurses they have per patient. A recent study, funded in part by NINR, examined variation in patient-to-nurse staffing in NY hospitals and its association with adverse outcomes (i.e., mortality and avoidable costs). Findings revealed that nurse staffing varied considerably across hospitals ranging from having 4.3 to 10.5 patients per nurse. Importantly, each additional patient per nurse increased the likelihood of death, length of hospital stays, and chances of being readmitted to the hospital within 30 days. The authors concluded that improving hospital nurse staffing would likely save thousands of lives per year, and that the associated cost would be offset by savings achieved by reducing hospital readmissions and length of hospital stays. This study provides important information for administrators and policymakers to consider when determining ways to improve healthcare.

Lasater KB, Aiken LH, Sloane DM, French R, Anusiewicz CV, Martin B, Reneau K, Alexander M, McHugh MD. Is hospital nurse staffing legislation in the public's interest? An observational study in New York State. Med Care. 2021 May 1;59(5):444-450. PMID: 33655903

Return to Work After Serious Injury Associated with Better Mental Health Outcomes in Black Men

Researchers explored the association between return to work and mental health outcomes in Black men living and recovering from serious traumatic injuries in Philadelphia. The study, funded in part by NINR, found that men who did not return to work after a serious traumatic injury had almost three times the odds of poor mental health when compared to men who did return to work. The study also found that younger age, lack of insurance or public insurance, and higher lifetime experience of racism were independently associated with both return to work and screening positive for depression or post-traumatic stress disorder. Programs to optimize recovery after injury in Black men should include consideration of key structural factors such as employment, financial stability, and the impact of racism-related exposures.

Palumbo AJ, Richmond TS, Webster J, Koilor C, Jacoby SF. The relationship between work and mental health outcomes in Black men after serious injury. Injury. 2021 Apr;52(4):750-756. doi: 10.1016/j.injury.2021.02.021. Epub 2021 Feb 14. PMID: 33627251

Perceived Discrimination and Elevated BMI Increase Symptoms of Depression in African American Mothers

The lack of economic and social resources, combined with other environmental stressors, such as discrimination, can heighten the risk for depression and cardiovascular disease, especially among racial and ethnic minority populations. However, the association between symptoms of depression and cardiovascular disease (CVD) risks, such as elevated body mass index (BMI), is uncertain for African American mothers. A recent study, supported in part by NINR, examined the relationships among multiple social determinants of health (e.g., income, education, and discrimination), cardiovascular risk (BMI and smoking), and depressive symptoms in a sample of young African American mothers. The findings suggest that perceived discrimination and elevated BMI are associated with higher reported symptoms of depression among young, socioeconomically disadvantaged African American mothers. This study suggests that CVD prevention should include screening for depression and perceptions of discrimination, as well as creating a treatment plan to address any positive findings.

Millender E, Barile JP, R Bagneris J, Harris RM, De Faria L, Wong FY, Crusto CA, Taylor JY. Associations between social determinants of health, perceived discrimination, and body mass index on symptoms of depression among young African American mothers. Arch Psychiatr Nurs. 2021 Feb;35(1):94-101. doi: 10.1016/j.apnu.2020.09.014. Epub 2020 Nov 25. PMID: 33593522

Recurrence of Severe Maternal Morbidity in Second Pregnancy

Severe maternal morbidity (SMM) has increased in the United States by 45% in the last decade. While the recurrence of several adverse pregnancy outcomes from one pregnancy to the next has been established, the recurrence risk of SMM is unknown. An NINR-funded population-based study used linked vital statistics and hospital discharge records from California from 1997-2012 to determine whether women who have SMM in a first pregnancy are at increased risk of SMM in their second pregnancy. Findings indicate an approximate sixfold increased risk compared to women who did not have SMM in their first pregnancy. Given the study’s findings, health care providers may want to consider extra reproductive life planning discussions and very attentive inter-conception and prenatal care for women who experienced SMM at the time of their first birth.

Bane S, Wall-Wieler E, Lyndon A, Carmichael SL. Recurrence of severe maternal morbidity: A population-based cohort analysis of California women. Paediatr Perinat Epidemiol. 2021 Mar;35(2):155-161. doi: 10.1111/ppe.12714. Epub 2020 Nov 6. PMID: 33155710

New Adaptive Technology Breaks Down Communication Barriers

Barriers to effective patient-provider communication can lead to significantly poorer medical outcomes, lower patient satisfaction with care, and increased staff stress. For example, some patients are unable to use a hospital’s nurse call system due to hearing loss, mechanical ventilation, a motor– speech impairment, or a language barrier. With the support of Small Business Innovation Research funding from NINR, Iowa Adaptive Technologies (business name Voxello®) developed the noddle® switch and noddle-chat™ tablets to address communication barriers and to provide hospitals with a relatively simple system that can be rapidly deployed in acute-care settings. The noddle uses patented gesture-detecting algorithms to identify a patient’s smallest intentional gesture, such as a tongue click, head nod, or finger tap, to activate a hospital’s nurse call system. The noddle-chat communication tablet generates a synthesized voice allowing patients to communicate with others and actively engage in their care. After commercialization, Voxello’s technology has been used with adult and pediatric patients at 15 medical centers across the U.S.

Hurtig RR, Alper RM, Bryant KNT, Davidson KR, Bilskemper C. Improving patient safety and patient–provider communication. Perspect ASHA Spec Interest Groups. 2019 Oct; 4(5): 1017–1027. PMID: 34113718

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