摘要:

Heart failure (HF) is both highly prevalent and costly to society. Successful self-care is essential to effective HF management. This study sought to develop a method to identify, via medical records (International Classification of Diseases, 9th Revision, Clinical Modification) coding, HF admissions attributable to ineffective self-care. Expert panels completed an iterative series of mailed surveys to generate and validate a list of coded diagnoses that represent HF sequelae modifiable through self-care. Sixteen diagnoses resulted. Chart review at one hospital revealed that these modifiable sequelae were frequently present but not coded. A computerized method of identifying self-care deficits would allow nurses to identify patients in need of patient education.

ISSN:1057-3631    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Three large hospitals in the metropolitan area of Syracuse, New York, implemented a cooperative project to reduce hospital stays and resource utilization without adversely affecting patient outcomes for community acquired pneumonia. The project occurred under the leadership of nurse case managers and nurse managers. It was supported by active physician involvement. The project was implemented over a three-year period. It resulted in reductions of hospital stays through the standardization of patient care for pneumonia throughout the community.

ISSN:1057-3631    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Private-duty, home health care agencies have struggled in assuring compliance with accurate and complete nursing documentation. In this descriptive study, the author reports on an improvement and innovation project in a private-duty, home health care agency aimed at improving nursing documentation, as measured in chart review audits. Initial strategies were directed toward revising the documentation system, with implementation of a flow record, and conducting group nurse education. These efforts had a minimal effect on improving documentation compliance. A major, multifocus strategy was then implemented. The educational component stressed pre- and posttest. The chart audit tool was revised to track individual nurse behaviors. Nurses were mentored when documentation did not meet standards. Lastly, the nurse job description and corresponding performance appraisal document were revised to clarify nurse responsibility and strengthen nurse accountability; progressive discipline was initiated when warranted. Significant and sustained improvement was subsequently realized.

ISSN:1057-3631    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

A vital part of restructuring in hospitals is a continuing effort to find ways to meet the growing demands of caregivers for efficient ways to enter and retrieve patient information. The process of effectively meeting these demands was coordinated through the leadership and efforts of the chief nurse executive and the information manager for nursing at New York Veterans Affairs Medical Center. These efforts resulted in timely support for restructuring, improvement in the development of competency skills among nursing staff, and increase in the use of electronic methods for documentation of patient care. Discussion of the changes implemented include approaches and content of training for computer skills development, a position description for an expanded role of a nurse in the field of informatics, and the facility's structure that fits a patient-centered care model.

ISSN:1057-3631    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Physical restraints have been the standard of practice to manage certain types of patient behavior, such as unstable mobility, wandering, agitation, and interference with medical treatment. However, this intervention is not without serious negative consequences. Patients with neurological disorders or injuries are often at high risk for being restrained. The need to change to a more positive, patient-focused, restraint-free model was the goal of this project. A convenience sample of adult patients who were admitted to a neurological unit were studied. Outcome data that were assessed included (1) staff nurses' perception of restraints, (2) fall rate, (3) fall rate with injury, and (4) tube/line loss rate. Staff perceptions of restraints were assessed by administering the Perception of Restraints use Questionnaire (PRUQ) before and after implementation of the restraint-reduced environment. The results of the outcome data support the change to a more restraint-reduced environment, as indicated by fall rate, fall rate with injury, and tube/line loss. Additionally, nurses' perceptions of restraints, as measured by the PRUQ, indicated a trend toward less emphasis on the use of restraints to control specific unsafe or undesirable patient behaviors.

ISSN:1057-3631    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

In order for a nurse to provide quality care, she or he must know what patients expect from the nurse. Previous research into nurses' insight into patients' expectations of care have been based on idiosyncratic instruments or instruments that measure the perspective of the provider, not the patient. Using the 90 items from the Patient's Perception of Quality Scale-Acute Care Version, an instrument developed from qualitative interviews of patients, 448 patients and 350 nurses from the medical surgical units in seven hospitals ranked the items, patients from their perspective and nurses as they perceived patients would rank them. While the rank order of items was similar across patients and nurses, nurses consistently underestimated the extent to which patients valued most aspects of good nursing care.

ISSN:1057-3631    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

As part of a randomized control trial to improve the delivery of preventive services, the authors studied the effect on clinic nurses in the roles of team leaders or facilitators of multidisciplinary, continuous quality improvement (CQI) teams. Our goal was to learn how these nurses felt about their experience with this project, specifically their satisfaction with process improvement, acquired knowledge and skills, and the impact on their nursing role. Overall, the nurses involved in this study reported significant gains in all three areas. This study suggests that CQI can be a valuable vehicle for improving and expanding the nursing role for clinic nurses.

ISSN:1057-3631    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1057-3631    

出版商:OVID    

年代:1999

数据来源: OVID