Outcomes management for nursing practice (Outcome Manag Nurs Pract )


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    Outcomes management for nursing practice
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Publications in this journal

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    ABSTRACT: In recent years, there has been an increased focus on end-of-life decisions and the use of medical technology. It is not well documented in the literature whether or not and to what extent patients' advance directives are used for directing resuscitative efforts. The purpose of this study was to determine how useful patients' advance directives were to members of the health care team in determining treatment and end-of-life decisions among patients who received cardiopulmonary resuscitation (CPR) efforts. Medical records of 135 adult patients who had undergone CPR efforts within the previous year were reviewed to determine if and to what extent advance directives were useful in directing end-of-life care and treatment decisions. Only 35 of these patients had advance directives. Three categories for advance directives emerged: those that were "independently directive," those that were "vague and required further clarification," and those that were "nondirective." Information from this study may be used to clarify treatment options for end-of-life care and to determine if and what further interventions are required to ensure that advance directives can be executed as meaningful documents.
    Outcomes management for nursing practice 01/2001; 5(2):87-92.
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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: 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: Retaining women in substance abuse treatment is difficult. Increased length of stay (LOS) has been found to be predictive of positive treatment outcomes, including lower drug use, criminal behavior, and unemployment among adults, and improved growth and development for children. This study used survival analysis statistical methods to examine LOS in a residential treatment program for women and children as the program shifted from a traditional therapeutic community, to gender-specific programming, to interdisciplinary, family-focused treatment. Results suggest that with implementation of family-focused treatment, LOS increases more than with gender-specific programming alone.
    Outcomes management for nursing practice 01/2000; 4(2):71-7.
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    ABSTRACT: Four constructs used to build a framework for outcomes management for a large midwestern tertiary hospital are described in this article. A system framework outlining a model of clinical integration and population management based in Steven Shortell's work is discussed. This framework includes key definitions of high-risk patients, target groups, populations and community. Roles for each level of population management and how they were implemented in the health care system are described. A point of service framework centered on seven dimensions of care is the next construct applied on each nursing unit. The third construct outlines the framework for role development. Three roles for nursing were created to implement strategies for target groups that are strategic disease categories; two of those roles are described in depth. The philosophy of nursing practice is centered on caring and existential advocacy. The final construct is the modification of the Dartmouth model as a common framework for outcomes. System applications of the scorecard and lessons learned in the 2-year process of implementation are shared
    Outcomes management for nursing practice 01/2000; 4(1):28-33.
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    ABSTRACT: The measurement of many outcomes relies on patients and their families for information that can best be collected through interviews. The authors describe 12 practical suggestions that help ensure achievement of subject enrollment and interview goals.
    Outcomes management for nursing practice 01/2000; 4(4):182-6.
  • Outcomes management for nursing practice 01/1999; 3(1):4-6.
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    ABSTRACT: Outcomes management has received increased attention in the current health care environment, but nursing participation has been limited due to the lack of standardized data about the effects of nursing practice. The Nursing Outcomes Classification (NOC) provides a standardized language that can be used to measure the effects of nursing practice on patient outcomes. An overview of the classification and implementation methods is provided.
    Outcomes management for nursing practice 01/1999; 2(3):99-104.
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    ABSTRACT: This study demonstrated the effectiveness of the implementation of the Acute Care Nurse Practitioner (ACNP) role in the management of patients with seizure disorders in an Epilepsy Monitoring Unit. Findings indicated that the ACNP, functioning in an expanded role in the epilepsy program, can make a substantial contribution to organizational outcomes. This is achieved through patient satisfaction and reduction in the number of laboratory tests performed, hospital length of stay, and overall costs.
    Outcomes management for nursing practice 01/1999; 3(4):161-6.
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    ABSTRACT: Health care organizations are rethinking how care is delivered because of incentives generated by managed care and a competitive marketplace. An evaluation of a work redesign project that involved the creation of redesigned unlicensed caregiver roles is described. The effect of model implementation on patients, multiple categories of caregivers, and physicians was measured using several different approaches to data collection. In this evaluation, caregivers perceived the institutional culture to be both market-driven and hierarchical. The work redesign, along with significant changes in unit configuration and leadership over the same period, significantly reduced job security and satisfaction with supervision. Quality indicators suggested short-term declines in quality during model implementation with higher levels of quality after implementation issues were resolved. Objective measurement of the outcomes of work redesign initiatives is imperative to assure appropriate adjustments and responses to caregiver concerns.
    Outcomes management for nursing practice 01/1999; 3(3):128-35.
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    ABSTRACT: A Fall Prevention Program was initiated at an acute care academic medical center grounded on a dynamic evidence-based framework. Multiple sources of evidence were collected and integrated to engage clinical managers and staff in an evolving process designed to both reduce falls and enhance evidence-based thinking. Clinical practice now is based more frequently on evidence rather than ritual, unsystematic clinical experiences, or tradition. This article provides details on this replicable method of enhancing professional practice.
    Outcomes management for nursing practice 01/1999; 3(3):102-11.
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    ABSTRACT: This pilot study examined the influence of a mandatory hospital in-service pediatric pain management program on nurses' administration of analgesics. Chart audits were conducted using a convenience sample of all children who had undergone tonsillectomies during a 2-week period before and after the in-service. In contrast to what was expected, after the educational program, there was an increased length of time before the first dose of analgesic was given and between doses of analgesics given to patients.
    Outcomes management for nursing practice 01/1999; 3(2):87-9.
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    ABSTRACT: The authors define treatment effectiveness and outcomes research, then discuss three critical methodological issues that if not appropriately resolved, can invalidate the findings of such studies. The three issues are research design, comparability of treatment groups, and approaches to measurement. These issues must be considered when the quality and contribution of findings from treatment effectiveness and outcomes research are evaluated.
    Outcomes management for nursing practice 01/1999; 3(1):12-8; quiz 18-9.
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    ABSTRACT: The question of when to survey patients is the subject of ongoing debate because of the rising interest in monitoring quality from the consumer's perspective. This study of 772 randomly assigned patients from 17 hospitals compared results from predischarge in-person interviews (HI) and postdischarge telephone interviews (PHTI) for differences in participation rates, respondents' characteristics, and reports of quality most affected by nursing. The methods were equally costly. The results suggest that hospital interviews may enhance response rates of some vulnerable patient groups without jeopardizing the results.
    Outcomes management for nursing practice 01/1999; 3(1):32-7.
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    ABSTRACT: The goal for humanistic end-of-life care is to maintain quality of life and personal dignity. The nursing outcome called "dignified dying" is defined as maintaining personal control and comfort with the approaching end of life and lists indicators for measuring this. These criteria enable nurses to measure the effectiveness of their nursing interventions, monitor patient progress over time, and summarize research data. This article describes the development of this outcome and illustrates its use with a case study.
    Outcomes management for nursing practice 01/1998; 2(3):105-10.
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    ABSTRACT: This article describes the Outcomes Research in Nursing Administration (ORNA) project--a longitudinal, multisite study investigating the interrelationships of various hospital-level and nursing-unit-level characteristics, nursing unit organizational structure, and administrative and patient outcomes. A variety of methodological challenges were encountered in the actual conduct of the project in relation to the design, sampling plan, management of attrition, and data collection. The article describes these challenges and how they were successfully resolved.
    Outcomes management for nursing practice 01/1998; 2(3):111-6.
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    ABSTRACT: Lack of standardized data collection procedures in multi-center longitudinal research poses potential threats to the internal validity of the study. This article addresses several key issues in data collection that can affect the results of longitudinal research. The authors describe these issues in relation to the study currently in progress and cite specific strategies used during data collection to reduce or eliminate data collection inconsistencies. Use of these strategies is not limited to longitudinal, nonexperimental causal models. Outcomes managers and clinical nursing researchers may find some of the strategies useful to enhance the internal consistency of experimental and nonexperimental cross-sectional research.
    Outcomes management for nursing practice 01/1998; 2(4):174-9.
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    ABSTRACT: In the context of market-driven health care reform, interest in cost and quality outcomes has increased. Quality, as defined by Donabedian, includes assessment of structure, process, and outcomes. However, the definition of quality in health care must be expanded to include the expectations and opinions of patients, their representatives, and society. The purpose of this article is to examine the outcome variable of costs in a specific nursing practice setting. Cost is frequently defined as the judicious use of resources consumed by structures and processes of care. This article presents activity-based costing methodology and results of a cost study of primary care and mental health services provided by advanced practice nurses (APNs) in a school-based health center. The application of the methods and outcomes of this pilot study has significant implications for the delivery of health care by APNs in a variety of settings, including community nursing centers, freestanding birthing centers, and rural and urban neighborhood centers. Because much of the health care delivered by APNs in these community-based settings includes health promotion, screening, counseling, and anticipatory guidance, it is important to explore methods such as activity-based costing to identify actual costs of care (versus charges) in emerging community-based practices where primary care is delivered by APNs.
    Outcomes management for nursing practice 01/1998; 2(1):37-44.
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    ABSTRACT: Using nurse practitioners in acute care is a relatively new phenomenon with little existing data on related expectations and effectiveness. This article describes one organization's program evaluation of the Advanced Practice Registered Nurse (APRN) role. It includes a conceptual model as well as pragmatic data on: perception of the performance of agreed-upon role expectations, influence on targeted aspects of care, retention of a focus on nursing, and factors facilitating or hindering APRN effectiveness.
    Outcomes management for nursing practice 01/1998; 2(4):152-60; quiz 160-1.
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    ABSTRACT: An overriding concern of many health care providers is how to maintain quality in such a turbulent, cost-driven environment. It is essential for health care providers to determine the effectiveness of their care and to institute changes in practice to affect patient outcomes in a positive fashion. Determining the appropriate outcomes to measure and formatting the report in an easy-to-read manner with meaningful information is important for presentation to a variety of audiences. We describe a report card methodology for disseminating outcome information that can easily be adapted in other settings.
    Outcomes management for nursing practice 01/1997; 1(1):14-9.

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