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Research from a Nurse’s Point of View

A Kaiser Permanente Northern California nurse brings the bedside perspective to research.

Elizabeth Scruth, RN, PhD, has a unique perspective on nursing. She’s a full-time clinical practice consultant with Kaiser Permanente’s Regional Quality and Regulatory Services, most recently working on an initiative to improve patient outcomes in the Intensive Care Unit. Dr. Scruth also maintains her bedside nursing skills by working part time outside Kaiser Permanente as a critical care transport nurse, and lately she’s been receiving national attention for her work to improve patient care as a nurse researcher.

In January, she was recognized for the publication “Visitation policies and practices in U.S. ICUs,” and was appointed fellow to the College of Critical Care Medicine—an honor given to only about 300 RNs worldwide. Dr. Scruth collaborated on her ICU research with Eugene Cheng, MD, of Kaiser Permanente San Jose, Julie Read, RN, of Kaiser Permanente Fremont, and Vincent Liu, MD, from Kaiser Permanente’s Division of Research. The study was funded by a Kaiser Permanente Community Benefit grant.

Dr. Scruth recently spoke about her work as a nurse researcher.

Tell us about your research into ICU visitation policies.

We surveyed more than 600 hospital ICUs across the country, interviewing nurse managers about visiting hours and visitation policies. The overwhelming majority of ICUs in the study had restrictive policies, very few had 24-hour visitation. We also found that nurses in the ICU were routinely allowing patient families to visit outside the official visiting hours in order to meet family needs. The nurses said they knew it was the right thing to do.

Current research and many professional societies for nursing and medicine recommend open visitation policies. Studies show both patients and their families feel less anxious when families can visit when they want to. Our research points to the need for hospitals to review policies frequently to ensure they’re evidence-based.

Why is it important for nurses to do research?

Because nurses are at the bedside, we have unique insight into how patients and their families experience the hospital. With this perspective, nurses can identify opportunities to improve that experience, and improve patient care and outcomes.

It’s also very important to have multidisciplinary researchers, such as nurses, doctors, and respiratory therapists, doing research together. The team brings a global perspective to caring for a patient, and having that perspective makes the research more meaningful.

Tell us about your current research.

I’m working with Dr. Liu on a study looking at whether electronic ICU patient diaries can help in a patient’s recovery. Many patients who’ve been in the ICU have gaps in memory because of sedation or delirium. We have a Kaiser Permanente Innovation grant to develop an app where families can record what’s happening each day, or if the patient is able, the patient can. This could help patients from feeling anxious and stressed about their hospitalization, and perhaps prevent the post-traumatic stress that some patients develop after an ICU stay. Similar work using paper diaries has been done by a nurse in the United Kingdom, and we’ve been in contact with her.

What advice do you have for nurses interested in research?

There’s a place for all nurses to be involved in research, regardless of their education. If you’re a nurse at Kaiser Permanente who would like to learn more about nursing research in Northern California, you can go to the Northern California Nursing Research page on the Kaiser Permanente Nursing Pathways website. Northern California Nursing Research provides consultation, financial, and technical support for nurses to conduct, publish, and present research findings.