Outcomes management for nursing practice (Outcome Manag Nurs Pract )

Description

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  • Other titles
    Outcomes management for nursing practice
  • ISSN
    1093-1783
  • OCLC
    36569178
  • Material type
    Periodical
  • Document type
    Journal / Magazine / Newspaper

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Elderly patients (n = 121) with hip fracture were followed to determine if: (1) outcomes measured 12 months post-fracture differed significantly from pre-fracture measures, and (2) patient characteristics on hospital admission predicted three outcomes (site of residence, function, and walking status) 12 months later. At 12 months fewer patients resided at home. They had declined functionally. Baseline cognition, residence site, function, and walking individually predicted outcomes. However, outcomes were predicted best by multiple variables. These findings can be used to educate patients, their families, and the public on outcomes and their determinants after hip fracture.
    Outcomes management for nursing practice 01/2001; 5(3):121-6.
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    ABSTRACT: Pain sensation and distress in 38 intestinal surgical patients were moderate to severe on postoperative day 1, ranging from 34 to 49 mm and 33 to 45 mm, respectively, on 100-mm scales. During ambulation, both increased from baseline to post-ambulation, P < 0.01. Half of the patients reported severe pain not relieved by analgesics, and although 44% learned a relaxation technique in the past, only 8% used one for pain after this surgery. Pain disturbed the sleep of 34% of the patients, and pain was related to respiratory, intestinal, febrile, and other complications in 18 (47%) subjects. Attentive analgesic use and nonpharmacologic therapies are recommended.
    Outcomes management for nursing practice 01/2001; 5(1):41-6.
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    ABSTRACT: The Minimum Data Set (MDS) is a standardized assessment tool designed to provide a comprehensive biopsychosocial assessment of medical, behavioral, and cognitive status of nursing home residents. This pilot study examined the relationships of three MDS subscales--cognition, depressive symptoms, and behavioral disruptions--to other measures of the same domains (e.g., diagnosed dementia and depression and caregiver ratings on the Revised Memory and Behavior Problems Checklist [RMBPC]). The sample consisted of 135 nursing home residents with a mean age of 84 years. Based on the MDS, there was a high prevalence of cognition-related behaviors but a low prevalence of disruptive and depressed behaviors. The prevalence rates were substantially different according to the RMBPC. In addition, most of the MDS subscales failed to differentiate between residents with and without diagnosed dementia and depression, whereas caregiver ratings on the RMBPC did. The MDS and RMBPC subscales were modestly related but only in residents without dementia. These findings raise questions about the validity of the MDS in measuring nursing home residents' behavior, especially depressive and disruptive behaviors. Thus, caution should be employed in using the MDS as a sole outcome measure for these behaviors, and the use of multiple measures is suggested.
    Outcomes management for nursing practice 01/2001; 5(1):28-35.
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    ABSTRACT: The 12-item Short-Form Health Survey was developed to describe mental and physical health status of adults and to measure the outcomes of healthcare services. Based on testing of the original SF-12 with a group of older adults, a revised scoring system and measurement model of the SF-12 Health Survey was proposed. The purpose of this study was to test the reliability and validity of this revised measurement model and scoring system. Testing was done with a sample of 187 older adults in a continuing care retirement community and a sample of 211 older adults discharged from an acute care setting. There was sufficient evidence for the internal consistency of the revised SF-12 (Cronbach alpha coefficients of 0.72 to 0.89); test retest reliability (r = 0.73-0.86); reliability based on R2 values; and validity based on confirmatory factor analysis, contrasted groups, and hypothesis testing. The revised SF-12 is a valid and reliable measure that can be used with confidence to measure outcomes for older adults.
    Outcomes management for nursing practice 01/2001; 5(4):161-6.
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    ABSTRACT: There are several skills nurses can develop or expand to improve their ability to manage outcomes. This is an exciting area for nurses and one that is valued during times of cost reduction in healthcare. In addition to increasing skills in the health outcomes management arena, nurses will benefit from a continual increase in knowledge of case management, clinical pathways, and guidelines. The healthcare market-place is likely to reward nurses with these skills.
    Outcomes management for nursing practice 01/2001; 5(4):146-9.
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    ABSTRACT: Measurement of the outcomes associated with implementation of evidence-based practice changes is becoming increasingly emphasized by multiple health care disciplines. A final step to the process of implementing and sustaining evidence-supported practice changes is that of outcomes evaluation and monitoring. The comparison of outcomes to internal and external measures is known as benchmarking. This article discusses evidence-based practice, provides an overview of outcomes evaluation, and describes the process of benchmarking to improve practice. A case study is used to illustrate this concept.
    Outcomes management for nursing practice 01/2001; 5(2):70-4.
  • Outcomes management for nursing practice 01/2001; 5(2):52-6.
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    ABSTRACT: Throughout the literature on hospital readmission, little has been written about what is an optimal rate of rehospitalization and the definition of preventable hospitalization. Therefore, the research on hospital readmissions aids in the understanding of variation in the phenomenon but does not necessarily set goals or standards of practice. Using secondary data rather than primary data does not preclude careful thought regarding the operationalization of each variable under study. The optimal time to initiate that process is at the early conceptual phase of a project. As researchers and clinicians proceed with planning a readmission study, reviewing these six categories of methodological issues will assist in producing a carefully designed definition of readmission.
    Outcomes management for nursing practice 01/2001; 5(4):150-2.
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    ABSTRACT: The purposes of this article are to present a case study that demonstrates the use of OASIS data in evaluating a cardiac disease management program and to identify the problems encountered and the knowledge gained. It was found that OASIS data can be useful in the description of patients in disease management program development. The analysis of patient end-result outcomes (comparing start of care and discharge information) proved to be the greatest challenge. Recommendations for future studies are included.
    Outcomes management for nursing practice 01/2001; 5(4):167-72.
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    ABSTRACT: Studies in the field of outcomes research often use very large data sets. Before data collection, specific issues related to data storage, data collection, and data retrieval should receive careful consideration. New technologies have made the process more cost-effective, efficient, and under the direct control of the researcher.
    Outcomes management for nursing practice 01/2001; 5(1):6-10.
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    ABSTRACT: Outcomes of a work site disease management program managed by an advanced practice nurse were evaluated. Fifty-four participants were surveyed. A significant number of participants with dyslipidemia and diabetes reported that the program positively changed individual health behaviors. Those with dyslipidemia and hypertension reported improved understanding of their condition after being involved with the program, and participants with asthma indicated more control of their condition. Program satisfaction was high. Continued development and implementation of work site programs are indicated to improve health outcomes of employees.
    Outcomes management for nursing practice 01/2001; 5(4):179-84.
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    ABSTRACT: Health care is an ever-present concern for homeless individuals. Health-Seeking Behaviors within this population are examined from a nursing perspective. Complex Relationship Building, considered essential in addressing Health-seeking Behaviors for the homeless, is examined in regard to access, trust, and follow-up. It is believed that access and follow-up are related to convenience of site and the matter of trust. A pilot study of how to measure the concept of trust was conducted. Factor analysis for the Gibson Trust Instrument shows two factors: (1) interpersonal attributes and (2) behavior attributes. The Gibson Trust Instrument can be used to measure trust, which is crucial for Complex Relationship Building.
    Outcomes management for nursing practice 01/2001; 5(3):140-4.
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    ABSTRACT: The Colleges of Nursing and Engineering in a southwest Florida university combined efforts to design a project to use time/motion techniques and focus groups to assess patent flow and effective and efficient use of human resources in public health clinics. Data for 877 observations were entered into a computer simulation program that displayed alternative configurations for health resource management. Information from focus groups was used to plan for ways to use clinic wait time more effectively. This article describes data collection and findings.
    Outcomes management for nursing practice 01/2001; 5(3):134-9.
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    ABSTRACT: Using an outcomes management approach, St. Luke's Episcopal Hospital has achieved positive outcomes in the interventional cardiology patient population. In this article the authors describe a decade of experiences related to the processes they implemented and the outcomes achieved in this patient population.
    Outcomes management for nursing practice 01/2001; 5(4):173-8.
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    ABSTRACT: In 1994, concerns about the effects of hospital restructuring on patient care resulted in the American Nurses Association (ANA) undertaking a major, long-term initiative. Nursing's Safety & Quality Initiative (the Initiative) was designed to measure the impact of such changes on patient care. The Initiative has three major foci: research, continuing education, and legislation/policy. This article addresses a recent development in the research component of the Initiative, involving the identification of nursing-sensitive indicators for community-based nonacute care.
    Outcomes management for nursing practice 01/2001; 5(1):24-7.
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    ABSTRACT: This article describes actual reported uses for patient acuity data that go beyond historical uses in determining staffing allocations. These expanded uses include managing patient care outcomes and health care costs. The article offers the patient care executive examples of how objective, valid, and reliable data are used to drive approaches to effectively influence decision making in an increasingly competitive health care environment.
    Outcomes management for nursing practice 01/2001; 5(1):36-40.
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    ABSTRACT: A continuous quality improvement in health care, combined with measurement of patient and organizational outcomes, is an international trend that promises improvement in meeting the needs of health care consumers in a cost-effective manner. A clinical improvement workshop was conducted in our institution to study the practical methods that can be used by clinical teams to improve the quality and value of health care. This workshop enabled the Epilepsy Team to identify change strategies that potentially could accelerate clinical improvement efforts in the epilepsy monitoring unit (EMU). The Team was able to develop, plan, and test improvements and link these improvements to patient outcomes.
    Outcomes management for nursing practice 01/2001; 5(1):11-6; quiz 16-7.
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    ABSTRACT: The purpose of this comparative study was to evaluate patient outcomes for wound healing and home health care service use for patients whose care was paid for by the traditional Medicare program versus a Medicare managed care organization (MCO). Results showed that there were no differences between the groups in wound healing at discharge, functional ability at discharge, or the numbers of home visits. Changes in the Medicare reimbursement system for home health care may have provided an equalizing effect between Medicare MCO and traditional Medicare patients with wound/skin diagnoses in home health care agencies in the Midwest.
    Outcomes management for nursing practice 01/2001; 5(2):63-7; quiz 68-9.
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    ABSTRACT: The devastating effects from cardiovascular disease are the largest contributors to employers' health care costs, insurance premiums, disability insurance, and worker's compensation. The purpose of this study was to establish baseline data regarding physiological outcomes comparing two participant groups in a corporate wellness program. Results suggest that a corporate wellness program can be beneficial in assisting employees to improve their health behaviors and outcomes.
    Outcomes management for nursing practice 01/2001; 5(2):82-6.
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    ABSTRACT: In recent years, regulatory and governmental initiatives have focused increased scrutiny on the use and practices associated with mechanical restraints. Consequently, hospitals are increasingly measuring and comparing both internally and externally their restraint practices as they strive to optimize their use and assure the safe care of patients being restrained. This study analyzes 12,860 restraint episodes from 10 acute care hospitals in a single health care system. Overall findings support many previously identified trends related to the types of restraints used and reasons for application. However, findings from this study also suggest that there are differences among rural, community, and tertiary hospitals. This study also provides the first widespread documentation of rates and types of alternative methods attempted and common patient care practices carried out during restraint application. These results can serve as external comparisons for other acute care settings as they strive to minimize and assure safety in restraint application.
    Outcomes management for nursing practice 01/2001; 5(3):102-9; quiz 110-1.