The Center for Nursing Research & Innovation  

Completed Projects Overview

1. Impact of Unit Level Nurse Workload on Patient Safety - R01 (website)  

Study Purpose -
To understand whether more sensitive measures of staffing and workload have an impact on patient safety when variance in these factors exceeds a unit-specific margin of safety. This study will break new ground in tracing daily staffing in approximately 100 medical surgical patient care units over a two (2) month period.

Study Aims -
To examine associations between the structure of staffing and patient safety and outcome indicators such as falls, pressure ulcers, restraint prevalence and significant clinical events.
To examine the effect of a new nurse workload indicator (patient turnover) and nurse staffing.

Read the final report for this grant.

2. The UCSF Venous Access Patient Safety Interdisciplinary Education Project (website)

Study Aims

• Develop/Present a 1 unit Venous Access Device Patient Safety interdisciplinary, web-based, academic graduate course;
• Translate the academic course into a CE version for practicing clinicians;
• Evaluate the content, processes and impact of instructional processes on clinician learning and patient safety;
• Disseminate findings and courseware.

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3. CALNOC Partners for Quality TRIP to Reduce Hospital Falls (website)  

The CalNOC Partners TRIP to Reduce Patient Falls Project built on the infrastructure of the California Nursing Outcomes Coalition (CalNOC) Database Project, a joint venture of ANA\California & the Association of California Nurse Leaders (ACNL).

Study Aims -
The primary aim of the CalNOC Partners for Quality TRIP To Reduce Patient Falls Project, a four-year quality improvement demonstration Project, is to use evidence from the reported literature and the California Nursing Outcomes Coalition statewide repository to reduce the incidence of patient falls and severity of fall-related injury in California Hospitals. The Project builds on the established infrastructure and capacity of the California Nursing Outcomes Coalition (CalNOC). CalNOC engages California acute care hospitals in voluntarily reporting standardized nurse staffing, patient falls, and fall-related injuries, as well as other quality indicators, in a collaborative repository development and benchmarking Project using American Nurses Association's quality indicators.

2008   Donaldson NE, Rutledge DN, Geiser K. The Role of the Coach in Advancing Research Translation. In: Henricksen K, Battles JB, Keyes MA, Grady ML, eds. Advances in Patient Safety: New Directions and Alternative Approaches. Vol 1. Washington, D.C.: AHRQ; 2008:285-302.

Read the final report for this grant.

4. Moore Foundation Nursing Initiative - CalNOC Baseline Outcomes Measurement Project

The Center for Nursing Research and Innovation and CALNOC was fortunate to receive funding from the Gordon and Betty Moore Foundation from 2004-2007. During that time, CALNOC expanded to include almost 40 of the acute care hospitals in the 5 Bay Area Counties, enhanced the CALNOC website to improve data submittal and site specific reporting, and supported the testing of new nursing sensitive indicators. Because of the investment in new nursing sensitive indicators CALNOC was able to test 3 nursing measures: Pain Management and Assessment, Catheter Associated Blood Stream Infections in Peripherally Inserted Central Lines (CABSI-PICC), and Medication Administration Accuracy. In July 2006 CALNOC launched the CABSI-PICC and Medication Administration Accuracy. The Center continues to work with the Foundation to provide an annual report regarding Bay Area hospital engagement in CALNOC.

Study Aims -
The University of California San Francisco School of Nursing Center for Nursing Research and Innovation partnered with the Gordon and Betty Moore Foundation in late 2003. The Gordon and Betty Moore Foundation announced their intention to invest in the profession of nursing and safe patient care practices. The Foundation committed $110M over 10 years to address the shortage of nurses and improvement in nursing–related patient care quality in 5 Bay Area Counties, including Marin, San Francisco, Alameda, San Mateo and Santa Clara counties. The UCSF Center for Nursing Research and Innovation, has been conducting research and demonstration projects examine and improving nursing practice safety, quality and outcomes since 1999. Leveraging the existing resources and expertise of the Center, the partnership with the Gordon and Betty Moore Foundation expedited expansion of a key project with the California Nursing Outcomes Coalition Project (CalNOC). CalNOC methods, measures and infrastructure were tapped and expanded to provide the acute care clinical evaluation of GBMF initiatives planned for the 50 acute care hospitals in the target five Bay Area counties.

The Betty Moore CalNOC Nurse-Related Outcomes Project Year One goals, supported by $1.4 Million in grant funds, focused on expansion of CalNOC infrastructure and data capture methods; integrated its advisory and governance stakeholder involvement in the development of new indicators; engaged national experts in the development and pilot testing of new nursing quality/safety indicators and conducted baseline evaluation analyses. It was expected that the outcomes of the Year One Project would serve as the basis for ongoing evaluation of the impacts of emerging GBMF Nursing Initiative activities and interventions. Mary Foley, RN, MS, FAAN served as Project Director for this project.

5. Robert Wood Johnson Foundation Rapid Response Team Evaluation Project (website)

The Robert Wood Johnson Foundation launched an ambitious initiative that provides support to nine health care systems/associations to establish learning networks to assist and accelerate the efforts of their member hospitals to implement and evaluate the impact of rapid response team interventions with the aim of improving patient outcomes and the work environment of nurses. The literature suggests that rapid response teams mobilize clinical expert responders to manage emergent changes in patient condition which are potentially life threatening and may be related to clinician or system errors and omissions.

In Press Donaldson, NE, S E, Shapiro, et al. (2009 (In Press)). "Leading successful rapid response teams, A multisite implementation evaluation." JONA 39(4).

Read the final report for this grant.