Medicine and Health Sciences | Open Access Articles

Implementing Evidence-Based Practices: Considerations For The Hospice Setting, S. Sanders, Melissa Lehan Mackin, J. Reyes, Keela Herr, M. Titler, P. Fine, C. Forcucci

Melissa Lehan Mackin

No abstract provided.

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Practice Theory Development: A Model For Person-Centered Care, S. Cumbie, Virginia Conley, M. Burman, C. Weinert

Virginia M. Conley

No abstract provided.

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Promoting Healthy Behaviors Through Process Engagement: Chronic Illness: Clarifying The Concepts Of Information And Information Seeking And Usage... Proceedings Of The Communicating Nursing Research Conference And Win Assembly, "Responding To Societal Imperatives Through Discovery And Innovation", Held April 10-12, 2003, Scottsdale, Arizona, Virginia Conley

Virginia M. Conley

No abstract provided.

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The Role Of Values In Caregiver Information-Seeking Behavior, Virginia Conley

Virginia M. Conley

Significance of findings include important relationships noted between values, actions, outcomes, and assigned meaning. Providers' awareness and understanding of involved values may clarify perceived erratic or noncompliant behaviors and provide the means for providing caregivers with information that will enable terminal values to be fulfilled, thereby facilitating the assignment of meaning to their experiences and the death of their loved ones.

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Family Caregiver Provided Massage For Rural-Dwelling Chronically Ill Persons, D. Kempson, Virginia Conley

Virginia M. Conley

Family caregivers attending to chronically ill family members within the community are vulnerable to psychological and medical health issues. Rural caregivers may be at increased risk because of fewer resources. This pilot study explored whether rural caregivers would learn and provide gentle massage to their chronically ill loved ones, would find study participation burdensome, and would realize benefits from providing the massage. Positive results in each of the three areas suggest that providing caregivers with instruction on gentle massage techniques for their chronically ill loved ones may support and enhance rural caregivers' perceptions of self-efficacy and self-agency and thus possibly …

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Iowa Case Management For Rural Drug Abuse, J. Hall, Msv Sarrazin, Diane Huber, T. Vaughn, R. Block, A. Reedy, M. Jang

Diane Huber

Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. Results: Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to …

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Psychometric Evaluation Of The Structured Clinical Interview For Dsm-Iv Childhood Diagnoses (Kid-Scid), D. Smith, Diane Huber, J. Hall

Diane Huber

The purpose of this study was to evaluate the reliability and validity of selected modules of the Structured Clinical Interview for DSM IV (KID-SCID, Version 1.0). The Disruptive Behavior Disorders (i.e., ADHD, ODD, CD) and Substance Related Disorders modules of the KID-SCID were administered to 50 adolescents receiving residential treatment for substance abuse and severe behavioral problems. This study examined available evidence for inter-rater reliability and convergent validity. Convergent validity was demonstrated for the Disruptive Behavior Disorders module, however, the Substance Abuse Disorders module failed to converge with frequency of use for most substances. Inter-rater reliability was generally high. This …

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Catastrophic Reactions And Other Behaviors Of Alzheimer's Residents: Special Unit Compared With Traditional Units, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter

Elizabeth A. Swanson

Using a quasi-experimental pretest/posttest design, the effects of a Special Care Unit (SCU) on the incidence of catastrophic reactions and other behaviors of nursing home residents with Alzheimer's disease (AD) were examined. Findings indicate significantly fewer catastrophic reactions and other selected behavior changes occurred during the posttest period for subjects in the experimental group compared with the subjects in the control group. Implications for psychiatric consultation/liaison nurses (PCLNs) working with this vulnerable population are discussed.

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Outcomes Of Family Involvement In Care Intervention For Caregivers Of Individuals With Dementia, Meridean Maas, D. Reed, M. Park, Janet Specht, D. Schutte, Lisa Skemp Kelley, Elizabeth Swanson, Toni Tripp-Reimer, Kathleen Buckwalter

Elizabeth A. Swanson

BACKGROUND: Despite the increasing number of individuals with dementia relocated from caregiving at home to a nursing home, there is only a small body of literature examining the influence of institutional family-oriented practices on family member perceptions of care and family-staff relationships. OBJECTIVE: The study tested the effects of the Family Involvement in Care partnership intervention on family members' perceptions of their caregiving role, relationships with staff, and satisfaction with the care of relatives with dementia residing in special care units as well as the effects on staff attitudes toward families and staff satisfaction with a caregiving role. METHODS: A …

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Family Visitation On Special Care Units, Lisa Skemp Kelley, Elizabeth Swanson, Meridean Maas, Toni Tripp-Reimer

Elizabeth A. Swanson

With placement of a family member with Alzheimer's disease on a SCU, the family does not relinquish the caregiving role, rather they take on different roles in relation to the residents. Family visitation of the residents on the SCU is an integral part of family involvement in care of individuals with Alzheimer's disease, as well as SCU functioning. Within the context of changing relationships with the residents, family members visited the residents as a sense of duty to "be faithful," to monitor care by "being their eyes and ears," and to foster a sense of family through ongoing relationships and …

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Special Care Units For Persons With Alzheimer's Disease: A Successful Intervention?, Kathleen Buckwalter, Meridean Maas, Elizabeth Swanson, G. Hall

Elizabeth A. Swanson

No abstract provided.

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Russian Citizens' Trusted Sources Of Health Promotion Information, C. Goody, Elizabeth Swanson, A. Bossen, E. Frolova, O. Kuznetsova, S. Plavinski

Elizabeth A. Swanson

This study examined Russian citizens' trusted sources of health information. A random sample of 906 people, from two villages in St. Petersburg, Russia, responded to a health needs assessment questionnaire. Results suggest that medical professionals and special books, such as informational pamphlets about treating a myriad of illnesses, are significant trusted sources of health information for people in Russia. Further, these data suggest differences between trusted sources of health information exist between villages rather than by gender or age group. This work has implications for health care practitioners in Russia, who are advancing the discipline of family practice, as well …

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Prevalence And Risk Factors Of Adverse Reactions To Natural Rubber Latex Among Nursing Personnel, Victoria Steelman

Victoria J. Steelman

Allergic reactions to products containing natural rubber latex (NRL), ranging in severity from contact dermatitis, rhinoconjunctivitis to asthma and anaphylaxis, are becoming increasingly common among healthcare workers. These reactions may be life threatening. Yet, little is known about the prevalence or risk factors for development of sensitization in nursing staff. Specific aims of this study were to: (1) determine prevalence of symptoms resulting from exposure to NRL and (2) identify risk factors (allergic predisposition, air latex content, glove use, frequency of NRL exposure in workplace, non-workplace exposures) for severity of symptoms to NRL contact among nursing staff. Hypotheses were, nursing …

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Guiding Inpatient Quality Improvement: A Systematic Review Of Lean And Six Sigma, Justin Glasgow, Jill Scott-Caziewell, Peter Kaboli

Jill Scott-Cawiezell

Background: Two popular quality improvement (QI) approaches in health care are Lean and Six Sigma. Hospitals continue to adopt these QI approaches -- or the hybrid Lean Sigma approach -- with little knowledge on how well they produce sustainable improvements. A systematic literature review was conducted to determine whether Lean, Six Sigma, or Lean Sigma have been effectively used to create and sustain improvements in the acute care setting. Methods: Databases were searched for articles published in the health care, business, and engineering literatures. Study inclusion criteria required identification of a Six Sigma, Lean, or Lean Sigma project; QI efforts …

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Technology Innovations. Barriers To Safe Medication Administration In The Nursing Home: Exploring Staff Perceptions And Concerns About The Medication Use Process, A. Vogelsmeier, Jill Scott-Cawiezell, D. Zellmer

Jill Scott-Cawiezell

The purpose of this study was to explore staff perceptions and concerns about the medication use process in the nursing home setting. A total of 76 staff members from 5 nursing homes in 3 Midwestern states participated in key informant interviews and focus groups. Common themes included issues related to communication, competing demands, and the challenges of a paper-based medication administration record. Concerns frequently were associated with the timeliness and accuracy of the medication administration process. Recognition of staff concerns are an important first step in improving the nursing home medication use process. Staff insight provided clarification related to impediments …

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Psychometric Properties Of The Beginning Breastfeeding Survey, Pamela Mulder

Pamela J. Mulder

The Beginning Breastfeeding Survey is a reliable and valid measure of breastfeeding effectiveness during the postpartum hospitalization. Providing an accurate assessment of a mother's perception of breastfeeding effectiveness, the Beginning Breastfeeding Survey will guide targeted interventions to increase breastfeeding effectiveness and duration.

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A Concept Analysis Of Effective Breastfeeding, Pamela Mulder

Pamela J. Mulder

OBJECTIVE: To provide a concept analysis of effective breastfeeding. DATA SOURCES: Medline and CINAHL electronic databases, reference lists from selected articles, and 7 breastfeeding assessment tools. Search terms included the following: breastfeeding and effective, adequate, successful. STUDY SELECTION: Literature was selected according to whether the concept of effective breastfeeding was defined or described. DATA EXTRACTION: Literature was reviewed and data organized as definitions or descriptions, with descriptions grouped into categories sharing similar characteristics. DATA SYNTHESIS: Four characteristics were chosen as essential attributes of effective breastfeeding: positioning, latch, sucking, and milk transfer. CONCLUSIONS: The concept of effective breastfeeding requires further concept …

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An Epidemiologic Analysis Of Pain In The Elderly: The Iowa 65+ Rural Health Study, Paula Mobily, Keela Herr, M. Clark, R. Wallace

Paula Mobily

No abstract provided.

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Geriatric Mental Health: Staff Stress On An Alzheimer's Unit, Paula Mobily, Meridean Maas, Kathleen Buckwalter, Lisa Skemp Kelley

Paula Mobily

Nurses who work with patients with Alzheimer's disease (AD) are especially vulnerable to the effects of stress and burnout. Many are poorly trained to cope with the emotional and behavioral problems of these residents and are repeatedly frustrated by their inability to manage these recurrent problems. Specialized care units (SCUs) reduced stress in the areas of staff knowledge, abilities, and resources. The SCU was designed specifically to provide the special environmental structures, support, and service systems required for the care of persons with AD that would enhance functioning and decrease associated behavioral problems. Support groups can assist nurses to recognize …

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Practice Concepts. Unit-Based Acute Confusion Resource Nurse: An Educational Program To Train Staff Nurses, C. Rapp, L. Onega, Toni Tripp-Reimer, N. Morrow-Howell, Paula Mobily, B. Wakefield, M. Kundrat, J. Akins, K. Wadle, J. Mentes, Kennith Culp, J. Meyer, J. Waterman

Paula Mobily

No abstract provided.

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Strength Training And Falls Among Older Adults: A Community-Based Tr Intervention, K. Mobily, Paula Mobily, R. Raimondi, K. Walter, L. Rubenstein

Paula Mobily

The purpose of this study was to determine the effectiveness of a community-based strength training program for older adults in decreasing falls. Subjects who completed a strength training program and an age and gender matched comparison group of older adults who did not participate in the strength training program were questioned about falls during the preceding year. Functional fitness measures for coordination, balance, and strength significantly improved in strength training subjects after completion of a six week program. Furthermore, after controlling for gender effects, the findings revealed that the strength training group reported significantly fewer falls in the preceding year …

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Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega

Paula Mobily

Acute confusion (AC), also referred to as delirium (AC/delirium), is a common problem seen by health professionals who work in a variety of care settings. This is an evaluative report on the clinical usability of instruments to assess AC/delirium as a part of nursing practice. Specifically, five instruments [the Confusion Assessment Method (CAM), Delirium Rating Scale (DRS), Delirium Symptom Inventory (DSI), Mini-Mental State Examination (MMSE), and Neelon/Champagne (NEECHAM) Confusion Scale] are discussed. The work demonstrates how the cooperation of nurses in practice, education, and research can improve both patient and staff outcomes.

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Training Of Acute Confusion Resource Nurses: Knowledge, Perceived Confidence, And Role, C. Rapp, L. Onega, Toni Tripp-Reimer, Paula Mobily, B. Wakefield, M. Kundrat, J. Akins, K. Wadle, J. Mentes, Kennith Culp, J. Meyer, J. Waterman

Paula Mobily

Most nurses function as generalists; however, some function in "expert" roles based on informal training as Resource Nurses. Training usually focuses on assessment and management of a specific problem, with the goal of creating a readily available "expert" for every unit. The primary activity of the Resource Nurse is to provide expert care, education, and consultation for patients, families, and staff. The Iowa-Veterans Affairs Nursing Research Consortium (IVANRC) addressed the need to manage acutely confused/delirious clients by training staff nurse volunteers (N = 129) from all units of the four Iowa Veterans Affairs facilities to act as unit-based acute confusion …

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Screening For Acute Confusion In Elderly Long-Term Care Residents, Kennith Culp, Toni Tripp-Reimer, K. Wadle, B. Wakefield, J. Akins, Paula Mobily, M. Kundradt

Paula Mobily

While acute confusion (AC) is frequently studied in the hospitalized elderly population, this phenomena has been largely ignored in elders who are residents in long-term care (LTC) facilities. The purpose of this study was to estimate the prevalence of AC in older LTC residents, the antecedent conditions present at the time of the AC event and the recognition rate of AC when assessed by staff nurses in two LTC facilities. This is a descriptive, longitudinal study with a 14 day follow-up period which incorporates a screening algorithm using AC instruments with established psychometric properties. A behavioral symptom instrument was also …

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Clinical Methods. Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega

Paula Mobily

Acute confusion (AC), also referred to as delirium (AC/delirium), is a common problem seen by health professionals who work in a variety of care settings. This is an evaluative report on the clinical usability of instruments to assess AC/delirium as a part of nursing practice. Specifically, five instruments [the Confusion Assessment Method (CAM), Delirium Rating Scale (DRS), Delirium Symptom Inventory (DSI), Mini-Mental State Examination (MMSE), and Neelon/Champagne (NEECHAM) Confusion Scale] are discussed. The work demonstrates how the cooperation of nurses in practice, education, and research can improve both patient and staff outcomes.

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Development Of The Distraction Coaching Index, Charmaine Kleiber, Ann Mccarthy, Kirsten Hanrahan, L. Myers, N. Weathers

Ann Marie McCarthy

Children's distress during medical procedures can be decreased when professionals or parents provide distraction coaching, but the quality of distraction may contribute to the variation in the results. This article describes the development of the Distraction Coaching Index (DCI), a tool for measuring the quality and frequency of distraction coaching. Nominal group technique and consensus agreement were used for concept clarification and development of behavioral indicators and descriptors. Videotapes of untrained parents, trained parents, and expert professional coaches, who provided distraction to children (4-10 years old) undergoing peripheral intravenous catheter insertion, were used to assess interrater reliability and construct validity. …

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Impact Of Parent-Provided Distraction On Child Responses To An Iv Insertion, Ann Mccarthy, Charmaine Kleiber, Kirsten Hanrahan, M. Zimmerman, N. Westhus, S. Allen

Ann Marie McCarthy

This study evaluates the impact of parent-provided distraction on children's responses (behavioral, physiological, parent, and self-report) during an IV insertion. Participants were 542 children, 4 to 10 years old, randomized to an experimental group that received a parent distraction coaching intervention or to routine care. Experimental group children had significantly less cortisol responsivity (p = .026). Children that received the highest level of distraction coaching had the lowest distress on behavioral, parent report, and cortisol measures. When parents provide a higher frequency and quality of distraction, children have lower distress responses on most measures.

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A Pilot Study Of Immune And Mood Outcomes Of A Community-Based Intervention For Dementia Caregivers: The Plst Intervention, L. Garand, Kathleen Buckwalter, D. Lubaroff, Toni Tripp-Reimer, Rita Frantz, T. Ansley

Rita A. Frantz

Providing care to a family member with dementia is conceptualized as a chronic stressor with adverse psychological and physical effects. The purpose of this pilot study was to evaluate mood and immune outcomes of caregivers exposed to a community-based psychoeducational nursing intervention based on the progressively lowered stress threshold (PLST) model. The PLST intervention is designed to strengthen the psychological resources of dementia caregivers by teaching methods of preventing and/or managing behavioral problems exhibited by the person with dementia. Mood and immune outcomes were compared between caregivers randomly assigned to receive either the PLST or a comparison intervention. Results of …

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Nursing Assessment: Impact On Type And Cost Of Interventions To Prevent Pressure Ulcers, G. Richardson, Sue Gardner, Rita Frantz

Rita A. Frantz

Objective: To describe pressure ulcer preventive interventions and their cost, and to compare the preventive intervention use and cost with level of risk. Design: Comparative, descriptive design. Setting and Subjects: A large midwestern Veteran's Affairs Medical Center with 260 long-term care beds. Thirty-one chair- or bed-bound residents from 1 long-term care unit comprised the study sample. Main Outcome Measures: The outcome variables included demographic information (patient record), Braden Risk Assessment score, institutional risk assessment score (Pressure Ulcer Risk Tool), type and frequency of preventive interventions, and the related costs. Methods: Subjects were assessed on a weekly basis for type and …

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The Cost Of Treating Pressure Ulcers Following Implementation Of A Research-Based Skin Care Protocol In A Long-Term Care Facility, Rita Frantz, S. Bergquist, Janet Specht

Rita A. Frantz

Although concern for the costs associated with pressure ulcer treatments persists, studies that precisely quantify costs are limited. A retrospective research design was used to describe the costs incurred by an 830-bed, long-term care facility to treat 81 pressure ulcers over a one-year period following implementation of a research-based, skin care protocol. The total cost for the study period was $30,079 with 73% of these expenditures attributable to nursing care. Mean cost of treatment was $3.74/pressure ulcer/day, which was a reduction from the $5.35/pressure ulcer/day cost prior to implementation of the skin care protocol. These findings suggest that implementing a …

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Full-Text Articles in Medicine and Health Sciences

Implementing Evidence-Based Practices: Considerations For The Hospice Setting, S. Sanders, Melissa Lehan Mackin, J. Reyes, Keela Herr, M. Titler, P. Fine, C. Forcucci

Melissa Lehan Mackin

Practice Theory Development: A Model For Person-Centered Care, S. Cumbie, Virginia Conley, M. Burman, C. Weinert

Virginia M. Conley

Virginia M. Conley

The Role Of Values In Caregiver Information-Seeking Behavior, Virginia Conley

Virginia M. Conley

Family Caregiver Provided Massage For Rural-Dwelling Chronically Ill Persons, D. Kempson, Virginia Conley

Virginia M. Conley

Iowa Case Management For Rural Drug Abuse, J. Hall, Msv Sarrazin, Diane Huber, T. Vaughn, R. Block, A. Reedy, M. Jang

Diane Huber

Psychometric Evaluation Of The Structured Clinical Interview For Dsm-Iv Childhood Diagnoses (Kid-Scid), D. Smith, Diane Huber, J. Hall

Diane Huber

Catastrophic Reactions And Other Behaviors Of Alzheimer's Residents: Special Unit Compared With Traditional Units, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter

Elizabeth A. Swanson

Outcomes Of Family Involvement In Care Intervention For Caregivers Of Individuals With Dementia, Meridean Maas, D. Reed, M. Park, Janet Specht, D. Schutte, Lisa Skemp Kelley, Elizabeth Swanson, Toni Tripp-Reimer, Kathleen Buckwalter

Elizabeth A. Swanson

Family Visitation On Special Care Units, Lisa Skemp Kelley, Elizabeth Swanson, Meridean Maas, Toni Tripp-Reimer

Elizabeth A. Swanson

Special Care Units For Persons With Alzheimer's Disease: A Successful Intervention?, Kathleen Buckwalter, Meridean Maas, Elizabeth Swanson, G. Hall

Elizabeth A. Swanson

Russian Citizens' Trusted Sources Of Health Promotion Information, C. Goody, Elizabeth Swanson, A. Bossen, E. Frolova, O. Kuznetsova, S. Plavinski

Elizabeth A. Swanson

Prevalence And Risk Factors Of Adverse Reactions To Natural Rubber Latex Among Nursing Personnel, Victoria Steelman

Victoria J. Steelman

Guiding Inpatient Quality Improvement: A Systematic Review Of Lean And Six Sigma, Justin Glasgow, Jill Scott-Caziewell, Peter Kaboli

Jill Scott-Cawiezell

Technology Innovations. Barriers To Safe Medication Administration In The Nursing Home: Exploring Staff Perceptions And Concerns About The Medication Use Process, A. Vogelsmeier, Jill Scott-Cawiezell, D. Zellmer

Jill Scott-Cawiezell

Psychometric Properties Of The Beginning Breastfeeding Survey, Pamela Mulder

Pamela J. Mulder

A Concept Analysis Of Effective Breastfeeding, Pamela Mulder

Pamela J. Mulder

An Epidemiologic Analysis Of Pain In The Elderly: The Iowa 65+ Rural Health Study, Paula Mobily, Keela Herr, M. Clark, R. Wallace

Paula Mobily

Geriatric Mental Health: Staff Stress On An Alzheimer's Unit, Paula Mobily, Meridean Maas, Kathleen Buckwalter, Lisa Skemp Kelley

Paula Mobily

Practice Concepts. Unit-Based Acute Confusion Resource Nurse: An Educational Program To Train Staff Nurses, C. Rapp, L. Onega, Toni Tripp-Reimer, N. Morrow-Howell, Paula Mobily, B. Wakefield, M. Kundrat, J. Akins, K. Wadle, J. Mentes, Kennith Culp, J. Meyer, J. Waterman

Paula Mobily

Strength Training And Falls Among Older Adults: A Community-Based Tr Intervention, K. Mobily, Paula Mobily, R. Raimondi, K. Walter, L. Rubenstein

Paula Mobily

Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega

Paula Mobily

Training Of Acute Confusion Resource Nurses: Knowledge, Perceived Confidence, And Role, C. Rapp, L. Onega, Toni Tripp-Reimer, Paula Mobily, B. Wakefield, M. Kundrat, J. Akins, K. Wadle, J. Mentes, Kennith Culp, J. Meyer, J. Waterman

Paula Mobily

Screening For Acute Confusion In Elderly Long-Term Care Residents, Kennith Culp, Toni Tripp-Reimer, K. Wadle, B. Wakefield, J. Akins, Paula Mobily, M. Kundradt

Paula Mobily

Clinical Methods. Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega

Paula Mobily

Development Of The Distraction Coaching Index, Charmaine Kleiber, Ann Mccarthy, Kirsten Hanrahan, L. Myers, N. Weathers

Ann Marie McCarthy

Impact Of Parent-Provided Distraction On Child Responses To An Iv Insertion, Ann Mccarthy, Charmaine Kleiber, Kirsten Hanrahan, M. Zimmerman, N. Westhus, S. Allen

Ann Marie McCarthy

A Pilot Study Of Immune And Mood Outcomes Of A Community-Based Intervention For Dementia Caregivers: The Plst Intervention, L. Garand, Kathleen Buckwalter, D. Lubaroff, Toni Tripp-Reimer, Rita Frantz, T. Ansley

Rita A. Frantz

Nursing Assessment: Impact On Type And Cost Of Interventions To Prevent Pressure Ulcers, G. Richardson, Sue Gardner, Rita Frantz

Rita A. Frantz

The Cost Of Treating Pressure Ulcers Following Implementation Of A Research-Based Skin Care Protocol In A Long-Term Care Facility, Rita Frantz, S. Bergquist, Janet Specht

Rita A. Frantz