The intersection of nursing and health services research: An agenda to guide future research

Preparing the health services research workforce

OBJECTIVE

To describe the ways in which investigators are trained for careers in health services research and estimate their number.

DATA SOURCES/STUDY SETTING

Sources describing health services research (HSR) training were consulted and published inventories of HSR training programs were reviewed and 124 training programs were contacted and interviewed to determine the numbers of students and the content of their HSR degree programs.

STUDY DESIGN

Observational study.

DATA COLLECTION

HSR programs listed by AcademyHealth were surveyed and asked for details of enrollments; course content was captured from websites for the remaining programs.

PRINCIPAL FINDINGS

There are over 300 programs that train investigators in health services research in master's and doctoral programs. The number of graduates who become HSRs in any given year is unknown, but approximately 5,000 individuals graduate with skills that would allow them to function in or lead HSR projects and up to 200 fellows are annually trained as potential independent health services researchers.

CONCLUSIONS

The training pipeline for HSR appears to match demand because there are no apparent shortages of skilled workers in the field. There are many forces that are pressuring the field to adapt to technology demands and the increasing need for "translation" of results from research into practice.

Nursing and public policy: a tool for excellence in education, practice, and research

Complex social and health policy issues face our nation and profession, and proactive participation in the public policy arena is a key to excellence in clinical practice, scholarship, and education for nursing. The purpose of this article is to reflect on the value of the nursing profession's public policy involvement. Specifically, a case example of the author's experiences as a nurse-legislator at the state level is provided. Public policy examples and political strategies are included. Being a part of the political arena or "game" is a key to shaping health policy and, in turn, a strategy for excellence in nursing.

A view from health services research and outcomes measurement

Depicted in this presentation is the relationship of the aims of the original articles in this issue--using theory in a substantive way; introducing a strong focus on the organization as a contributor to patient, provider, and system outcomes; accounting for organizational level; and moving the field toward a view of research utilization as an intermediate, not terminal, outcome--to outcomes research in health services generally and in nursing health services research more specifically. The insights and innovations described in this set of articles contribute significantly to the literature on research use in healthcare, specifically including the need to account more fully for organizational structure and hierarchy than has been the case to date in health services outcomes research, as well as a strong intimation that research use is not only an important intervening variable in the causal chain producing outcomes at the patient, provider, and system levels but also a latent or unobservable variable.

Existing population-based health databases: useful resources for nursing research

Important research questions, such as the prevalence of health conditions in specific groups and health disparities, can be addressed through population-based health databases. Government-funded, federal databases can provide nurse researchers with a representative sample for various levels of analyses. Population-based health databases easily accessed from federal government Web sites for analysis are identified and discussed. These databases, such as the National Health Interview Survey and the National Sample Survey of Registered Nurses, were collected through rigorous probability sampling and data collection methods and can be generalized to the population of the study. The benefits and limitations of analyzing the databases as a research approach are summarized, using examples from the recently released National Survey of Children's Health. Findings from population-based studies provide significant information on health-related indicators and contribute to the development of sound recommendations for health care practice and policy, thereby supporting evidence-based practice. Analyses of population-based databases provide additional opportunities for nurse researchers to contribute to health policy and evidence-based practice within a framework of nursing-health services research.