ISSN:0002-0443    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objectives:The study identifies patient profile variables that explain variation in resource utilization and outcomes for home healthcare.Background:The healthcare reform and the demand for quality patient care have increased the need to identify key patient characteristics that can predict the use of resources and outcomes; however, home healthcare industry currently lacks adequate information collection to reflect these needs. This study explored both the resource use and care outcomes for nursing administrators in monitoring quality, resource distribution, and reimbursement policy decision making.Method:The conceptual framework is based on Donabedian's quality care elements (structure, process, and outcome) and Nursing Minimum Data Set. This is a retrospective descriptive study design in which 244 patient records and data were obtained from a home healthcare agency located in Washington, DC.A series of stepwise and discriminant analyses was conducted for data analysis.Results:The findings indicated that the total number of nursing diagnoses and two specific nursing diagnoses (alteration in mobility and knowledge deficit in IV therapy) were strong predictors of overall resource use. Prognosis proved to be the strongest predictor of discharge outcomes.Conclusions/implications:The results indicated that data related to nursing diagnoses and nursing interventions can provide valuable information in predicting resource use. Prognosis made by nursing judgment was also sensitive in predicting patient outcomes. These critical data elements should be included in describing home health patient characteristics and related resource utilization and care outcomes.

ISSN:0002-0443    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

Objectives:The purpose of this study was to measure the impact of a change initiative using the strategies of inpatient bed consolidation and patient population reaggregation on staff, patient, and financial outcomes.Background:Bed consolidation and patient population reaggregation are extensively used strategies in the hospital industry. However, the state of science as it relates to these two strategies is limited, with no studies measuring the effect of bed consolidation, patient reaggregation, or both in isolation of multiple other concurrent care model changes.Methods:An exploratory, single case, longitudinal field study design with embedded levels of analysis was used for the study. The impact associated with the reaggregation and consolidation of the acute inpatient system of care was evaluated at the organization, the acute inpatient nursing unit, and the individual nursing staff member levels. This article reports the outcomes found at both the nursing unit level and the staff member level on three general medicine nursing units. Baseline nursing unit-level data are reported from fiscal year 1994-1995 and the first half of fiscal year 1995-1996 (July 1995 through December 1995); data from January 1996 through June 1996 reflect the planning phase of the project. Outcomes related to the change process are reported from the time period January 1996 through June 1997. Staff perceptions of multiple variables were measured at five different data points over a 2-year period. Both quantitative and qualitative data were collected.Results:Unit-level cost and hours per patient day (HPPD) increased during or immediately after the merger of major patient populations on two of the study units; no significant variation was found in medication errors or patient falls. The quantitative and qualitative data analysis of the nursing staff member surveys revealed a nursing staff that was dissatisfied with many aspects of their job, worried about job security, had low morale, and had many concerns about the quality of care provided to patients.Conclusions:This study suggests that consolidation and reaggregation strategies may cause an increase in costs and HPPDs, at least on a short-term basis. Also, these strategies may have a significant effect on the morale and job satisfaction of unit-level nursing. In light of these findings, on-going testing of the efficacy of consolidation and patient reaggregation strategies in improving quality and cost outcomes is essential.

ISSN:0002-0443    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

After 2 years of experience with a basic computerized system for documenting care, the nursing leaders in an inner city hospital undertook a redesign process to create an effective and efficient system for documentation that also provided data for monitoring care processes, patient outcomes, and staff performance. The basic system was a source of frustration and dissatisfaction for nurses, physicians, and managers. The redesigned system has exceeded the expectations of staff and physicians and delighted managers. Managers can now access the clinical data collected by the staff to create meaningful reports describing the patient population, identifying patients needs, monitoring staff compliance with care standards, and tracking improvements in care processes.

ISSN:0002-0443    

出版商:OVID    

年代:2000

数据来源: OVID

摘要:

As complex healthcare systems are created, professional nurses in these systems must address the integration of nursing practice. To facilitate the transition to a more common system-wide approach to professional practice, leaders at one health system began by conducting an assessment of their current reality of nursing practice. The authors describe the assessment process, including the staff survey questionnaire and recommendations to strengthen nursing practice and make the transition to a more common system-wide approach to professional practice.

ISSN:0002-0443    

出版商:OVID    

年代:2000

数据来源: OVID

ISSN:0002-0443    

出版商:OVID    

年代:2000

数据来源: OVID