Page 249 - Encyclopedia of Nursing Research

216 n HeMODyNAMIc MONITOrING

delivery, nurse staffing, and patient safety The patient protection and Affordable
and quality outcomes (Mick & Mark, 2005). Act, signed into law in 2010, may play a sig-
H Moreover, these researchers may not use nificant role in the focus of health services
health services research language and may research. Under this Act, the patient-centered
not publish in health services research jour- research Institute, a nonprofit corporation,
nals. Some of the gaps identified in the review was formed. In part, the institute’s role will
include the lack of frameworks connecting be to identify research priorities. They must
organizations factors to work processes and take into account the disease incidence, prev-
the need for more sophisticated analytical alence, and burden with a focus on chronic
methodologies (Mick & Mark, 2005). diseases; the gaps in evidence of clinical
In 1999, nurse health services researchers outcomes; the potential new evidence to
began meeting informally at AcademyHealth improve health and quality of care; and the
conferences. They formed the Working Group effect of conditions, treatment, and patient
on Health Services research and Nursing in needs, preferences, and outcomes on national
2001, and in 2003, the group became an inter- expenditures. The Act provides a manda-
est group of AcademyHealth. Their goals are tory funding stream for comparative clini-
to further the knowledge of health services cal effectiveness research and also ensures
research in practice and education through that demographic data on health disparities
interdisciplinary community with interest be collected and made available to research-
in health services research issues impor- ers to help understand health disparities. It
tant to nursing and with the skills needed is yet unclear how the patient protection and
to conduct rigorous health services research Affordable Act will impact health services
(Havens & Brewer 2003). Areas where nurse research. yet, nursing is becoming well posi-
health services researchers can contribute tioned in playing a key role in health services
include access and utilization of health care, research (A report from the coalition for
health behaviors, patient safety and quality Health Services research, 2010).
of care, cost and cost-effectiveness of care,
and organization and care delivery (Jones & Susan Tullai-McGuinness
Mark, 2005).
Health services research does have
unique challenges. Although numerous data
sets are available through state and federal HeMoDynaMiC Monitoring
agencies, they can present multiple problems.
Often there is a lack of published evidence
related to reliability and validity of instru- Hemodynamic monitoring is the use of crit-
ments used to collect data. linking various ical care technology to enhance the clini-
data bases is often challenging, and nurse cal assessment of the patient’s cardiac and
researchers may have difficulty finding stat- pulmonary status and guide appropriate
isticians skilled in multimethod analysis. therapeutic interventions. Hemodynamic
To build capacity, nurse leaders in health monitoring devices such as the pulmo-
services research have identified the need nary artery catheter (pAc), first introduced
for interdisciplinary training, postdoctoral by Dr. Jeremy Swan (Swan et al., 1970), are
opportunities for training in health services commonly used in the intensive care unit.
research, integration of theories from mul- The standard catheter is 7.5F and 110 cm
tiple disciplines in training programs, and long with multiple lumens to monitor var-
exposing nurses to a variety of methods and ious pressures within the heart. It is used
analytical approaches used in health services to assess ventricular function, differentiate
research. shock states, and cardiac and pulmonary