ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00602.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract: This article demonstrates how a pilot study can provide useful direction for a research project. In planning a study to improve the use of the Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) program for Medi‐caid‐eligible children, we tested our research methods and interventions (mailed pamphlets, telephone calls, home visits) on a small scale (N= 100) prior to implementing a large‐scale (N>2000) project. The issues and obstacles included obtaining cooperation from many agencies involved in administering the Medicaid program, addressing informed consent, assessing feasibility of methods for random sampling and random assignment, identifying sources of Medicaid data, designing and assessing validity and reliability of research tools, and testing the feasibility of implementing interventions in the field. Our experience may be particularly helpful for public health nurses who plan to investigate approaches to improve the use of services in federally mandated health programs where cooperation from federal, state, and local agencies is req

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00603.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractFollowing the nursing theorists' tradition of using an interdisciplinary approach to community health model building, the concepts of the life span perspective on human development were applied to the practice of community health nursing. As with the perception of individual development from this perspective, communities are viewed as evolving over time, with changes occurring across levels of influence‐ human, societal, historical, and cultural. These levels are interdependent, and factors from any one or more can affect the growth and functioning of the community. Implied in this interdependence is the ability not only to intervene in a community's development, but to go beyond this and recognize that a community has a degree of control over its own development. To be accurate and thorough in working with communities, the community health nurse who takes a life span perspective must be cognizant of the fact that communities do exist in a continual, multilevel, interactive manner that develops through time. Demonstrating the practical use of this perspective, a model for the assessment phase of the nursing process as applied to community study was developed. A pilot study was performed using this model, and initial results suggest that taking a life span perspective toward community health is both valid and practical, and warrants further scholarly investigatio

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00604.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractAdolescents share many developmental similarities with toddlers. When an adolescent becomes a mother, the parent‐toddler relationship is affected by the level of development of both individuals. It may be nurturing and satisfying, or it may be conflicted and frustrating for both. By comparing the developmental similarities the two share, the nurse is provided with a framework for assessing and working with these clients.SUMMARYAdolescent parents share many developmental similarities with their toddlers. The adolescent mother, who is usually the primary caretaker, is at risk for conflict with her child as the two pass through similar developmental stages. Issues of independence, limit testing, cognitive changes, and mobility surface for both individuals and may increase the potential for parent‐child conflict.Nurses are in an excellent position to assess these families for conflict and intervene appropriately. A continuing relationship with these families enables nurses to be a resource and assist adolescent assuming a successful parenting role.Specific strategies such as providing adolescents with a chance to role‐play difficult parent‐child interactions, providing them with concrete suggestions and demonstrations for handling toddler behavior, and planning respite care are helpful. The goal of such individualized care is the healthy growth and development of both young parents and young c

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00605.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

Abstract: Traditionally, home health agencies have been passive in seeking out referrals for patient care. Competition and a tighter economy, however, are altering the way they view themselves. Although physicians continue to be the gatekeepers to home health care, agencies must begin to promote themselves to physicians by using effective marketing techniques. Techniques that use a personal approach have been beneficial to the central Massachusetts agencies studied. It is necessary to expand beyond this method, however, and develop the philosophy of collaborative practice with physicians in the delivery of home care.

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00606.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractCost‐containment strategies initiated in the early 1980s caused a major shift in site of care delivery for persons needing nursing care. Where once the majority of clients were cared for in the acute‐care setting until they were self‐sufficient, now most are discharged to the home environment still requiring acute‐care nursing interventions as well as community health nursing skills. This rapid shift in practice sites has placed severe strain on community health nursing agencies. Not only are more nurses required to fill the increased demand for services, but the demand comes at a time when we are experiencing a severe nursing shortage. This has forced many agencies to hire acute care nurses who have little or no community health nursing experience. These nurses come to community health nursing expecting to use the same set of skills and knowledge base used in their acute‐care practice; however, the skill levels and concepts required for community health nursing are quite different from the acute care setting. Educational preparation has not kept pace with this shift in practice. Consequently, many nurses are not adequately prepared to enter community health nursing. Preparation must include theoretical and experiential components that focus on assessment skills (of the community and individual), decision making, case management, health systems management, teaching, and leadership. Collaborative efforts between community health organizations and educational institutions would seem to be one solution that would ensure adequately prepared nurses for community health nursing. The establishment and maintenance of strong staff‐development programs within community health nursing agencies are al

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00607.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThe whole‐blood hemoglobinometer is an anemia‐screening tool commonly used in public health nursing practice. This study evaluated the reliability and validity of the instrument. Test‐retest, intertester, and intertest reliability were all shown to be strong. Sensitivity was 1.0, specificity ranged from 0.8571 to 0.9024, positive predictive value ranged from 0.6428 to 0.7453, and negative predictive value was 1.0. A small but statistically significant difference in hemoglobinometer versus Coulter readings was found, resulting in a 10% false positive

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00608.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractThis case study documents analysis and planning in a contemporary public health nursing organization using resource dependence organizational theory. Several internal and external factors affect the organization and its relationships with its resources. We attempted to use knowledge of the environment‐organization relationship in several ways. Three examples from inside and outside the county system demonstrate opportunities for nursing to decrease the organization's traditional resource dependence and expand its base of funding and influence. Application of this theory can assist other organizations to adapt and survive in this era of diminishing health care resource

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00609.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

摘要:

AbstractDiminishing financial resources and increasing demands for health care precipitated one public health district to review its framework of delivery of care for effective and efficient use of personnel and facilities. Categorical funding patterns had promoted a framework that functioned along specialized programmatic lines in which were identified inequities in funding and staffing, and use of services by clients. In addition, to the often inefficient use of staff and fragmentation of patient care were the associated consequences of overcrowded clinics, long waiting lists for appointments, and chronic understaffing of some clinics. The concept of cross‐training in core services was initiated in one health center in October 1985. It was based on the belief that the best of generalized and specialized approaches to health care delivery in this district could be merged, and that all nursing staff should be proficient in certain basic functions. Results indicate improved efficiency in clinic management and flow, leading to reduced costs per patient encounter, increased demands for service that were met with existing staff, and reduced patient waiting tim

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00610.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY

ISSN:0737-1209    

DOI:10.1111/j.1525-1446.1990.tb00611.x

出版商:Blackwell Publishing Ltd    

年代:1990

数据来源: WILEY