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Pictured above: Diane Boyle, PhD, RN, FAAN
Are you a nurse manager of an acute care unit?
Are you a hospital nurse executive?
Are you a nurse in acute care hospital or wanting to become one?
If so, then Diane Boyle's research will hold your interest. Boyle is concerned with improving patient outcomes by examining nursing work environments and nursing characteristics. Read to the end of this post for upcoming publications of her work.
Dr. Boyle is the Wyoming Excellence Chair in Nursing and a Professor at the FWWSON. She recently received the 2016 College of Health Sciences Outstanding Researcher Award. For over 25 years, she has been leading improvement of the nursing work environment, nursing workforce, and patient safety through expertise in developing and evaluating standardized, value-driven metrics; and sustained investigation of relationships between nursing and patient outcomes. Her work includes contributions in two major impact areas.
DEVELOPMENT AND EVALUATION OF PERFORMANCE METRICS
Boyle was previously Deputy Director of the National Database of Nursing Quality Indicators® (NDNQI®), where she led development and evaluation of several performance metrics. She spearheaded collaborative initiatives to expand NDNQI metrics to include standardized measures of nursing turnover1-3, the nursing work context4-7, nursing national specialty certification8, and perinatal unit staffing (in collaboration with the American Association of Women’s Health, Obstetric, and Neonatal Nurses). In collaboration with American Nurses Association, she headed evaluation of metrics such as nursing skill mix9 and injury falls10 in order to maintain National Quality Forum (NQF) endorsement as national consensus performance standards. The impact of her work is nearly 2,000 U.S. hospitals receive reports based on standardized data that are actionable at the patient care unit level — identifying where quality improvement plans and nursing workforce improvement plans should be focused.
LINKING THE NURSING WORK ENVIRONMENT AND WORKFORCE CHARACTERISTICS WITH PATIENT OUTCOMES
Boyle has (a) led a collaborative research team in examining the relationship between quality of nurse leadership and nurse – physician (N-P) communication with staff nurses’ job satisfaction, intent to stay, and perceptions of patient outcomes; (b) tested an NIH, National Institute of Nursing Research-funded intervention to improve N-P communication; (c) co-led a team testing an intervention to improve nurse manager leadership and communication; and (d) co-led a team examining the effect of the built-environment on N-P communication. She and her colleagues found that the quality of nursing leadership and N-P communication significantly influences outcomes and that N-P and nurse manager communication can be improved through training11-13. Publications from these studies have been cited over 600 times. Her research team also has established links between the nursing work environment, nursing workforce characteristics, and patient outcomes. For example, they found high unit RN turnover in one calendar quarter was associated with increases in pressure ulcer rates in the subsequent quarter and higher RN hours per patient day were associated with lower pressure ulcer rates14.
More recently, Boyle headed a collaborative team that developed a novel composite quality performance indicator of pressure ulcers and falls15. She also leads a team examining the relationship between nursing specialty certification and patient outcomes. So far her team has found that lower rates of central-line associated bloodstream infections in SICUs were significantly associated with higher rates of CPAN (certified postanesthesia nurse) and CNOR/CRNFA (certified nurse operating room/certified RN first assistant) certified nurses in perioperative units16.
Stay tuned because Boyle and her team just had a paper accepted on the relationship between wound, ostomy, and continence certified nurses and the patient outcomes of hospital acquired pressure ulcers (HAPU) and catheter-associated urinary tract infections (CAUTI)17. They also just finished a study on perioperative certified nurses and surgical site infections, which is process of being written for publication.
Boyle, D.K., & Miller, P.A. (2008). Focus on nursing turnover: A system-centered performance measure. Nursing Management, 39(6), 16-20.
Park, S.H., Gass, S., & Boyle, D.K. (2016). Comparison of reasons for nurse turnover in Magnet® and non-Magnet hospitals. Journal of Nursing Administration, 46, 284-290.
Park, S.H., & Boyle, D.K. (2015). How hospitals view unit-level nurse turnover data collection: Analysis of a hospital survey. Journal of Nursing Administration, 45, 100-106.
Gajewski, B.J., Boyle, D.K., Miller, P., Oberhelman, F., & Dunton, N. (2010). A multilevel confirmatory factor analysis of the Practice Environment Scale (PES): A case study. Nursing Research, 59, 147-153.
Choi, J., & Boyle, D.K. (2014). Differences in nursing practice environment among US acute care unit types: A descriptive study. International Journal of Nursing Studies. 51, 1441-1449.
Taunton, R.L., Bott, M.J., Koehn, M.L., Miller, P., Rindner, E., Pace, K., Elliott, C., Bradley, K.J., Boyle, D., & Dunton, N. (2004). The NDNQI-Adapted Index of Work Satisfaction. Journal of Nursing Measurement 12, 101-122.
Boyle, D.K., Miller, P.A., Gajewski, B.J., Hart, S.E., & Dunton, N. (2006). Unit type differences in RN workgroup job satisfaction. Western Journal of Nursing Research, 28, 622-640.
Miller, P.A., & Boyle, D.K. (2008). Nursing specialty certification: A measure of nursing expertise. Nursing Management, 39(10), 10,12,14-16.
Choi, J., Boyle, D.K., & Dunton, N. (2014). A standardized measure: NDNQI nursing care hours indicator. Western Journal of Nursing Research, 36, 105-116.
Garrard, L., Boyle, D.K., Simon, M., Dunton, N., & Gajewski, B. (2016). Reliability and validity of the NDNQI® injury falls measure. Western Journal of Nursing Research, 38, 111-128.
Boyle, D.K., & Kochinda, C. (2004). Enhancing collaborative communication of nurse and physician leadership in two intensive care units. The Journal of Nursing Administration, 34, 60-70.
Boyle, D.K., Bott, M.J., Hansen, H.E., Woods, C.Q., & Taunton, R.L. (1999). Managers’ leadership and critical care nurses’ intent to stay. American Journal of Critical Care, 8, 361-371.
Taunton, R.L., Boyle, D.K., Woods, C., Hansen, H., & Bott, M. (1997). Managerial leadership and retention of hospital staff nurses. Western Journal of Nursing Research, 19,205-226.
Park, S.H., Boyle, D.K. Bergquist-Beringer, S., Staggs, V., & Dunton, N. (2014). Concurrent and lagged effects of registered nurse turnover and staffing on unit-acquired pressure ulcers. Health Services Research, 49,1205-1224.
Boyle, D.K., Jayawardhana, A., Burman, M.E., Dunton, N., Staggs, S., Bergquist-Beringer, S., & Gajewski, B.J. (2016). A pressure ulcer and fall rate quality composite index for acute care units: A measure development study. International Journal of Nursing Studies, 63, 73-81.
Boyle, D.K., Cramer, E., Potter, C., Gatua, M., & Stobinski, J.X. (2014). The relationship between direct care RN specialty certification and patient outcomes in surgical units. AORN Journal, 100, 511-528.
Boyle, D.K., Bergquist-Beringer, S., & Cramer, E., (accepted for publication). Relationship of wound, ostomy, and continence certified nurses and healthcare-acquired conditions in acute care hospitals. Journal of Wound, Ostomy, and Continence Nursing.
Article posted 10/18/2016/updated 5/16/2017