Medicine and Health Sciences Commons^™

Transdisciplinary Assignments In Graduate Health Education As A Model For Future Collaboration, Catherine Christie, A Russell Smith Jr., Michele Bednarzyk

Catherine Christie

Transdisciplinary health care continues to be at the forefront of patient treatment in the medical arena, in part due to escalating health care costs, an increasing aging population, and the development of multiple chronic diseases. Gaining the knowledge, experience, and principles associated with transdisciplinary teamwork to successfully prepare for modern-day practice is therefore essential for individuals of various health care professions. This report describes an assignment developed and implemented to facilitate professional interaction between graduate physical therapy, nutrition, and nursing students. The objectives of this assignment were to determine through student evaluation the effects of a transdisciplinary experience on students' …

Wnt Signaling Exerts An Antiproliferative Effect On Adult Cardiac Progenitor Cells Through Igfbp3., Angelos Oikonomopoulos, Konstantina-Ioanna Sereti, Frank Conyers, Michael Bauer, Annette Liao, Jian Guan, Dylan Crapps, Jung-Kyu Han, Hanhua Dong, Ahmad F Bayomy, Gabriel C Fine, Karen Westerman, Travis L Biechele, Randall T Moon, Thomas Force, Ronglih Liao

Center for Translational Medicine Faculty Papers

RATIONALE: Recent work in animal models and humans has demonstrated the presence of organ-specific progenitor cells required for the regenerative capacity of the adult heart. In response to tissue injury, progenitor cells differentiate into specialized cells, while their numbers are maintained through mechanisms of self-renewal. The molecular cues that dictate the self-renewal of adult progenitor cells in the heart, however, remain unclear.

OBJECTIVE: We investigate the role of canonical Wnt signaling on adult cardiac side population (CSP) cells under physiological and disease conditions.

METHODS AND RESULTS: CSP cells isolated from C57BL/6J mice were used to study the effects of canonical …

Specific Contributions Of Ventromedial, Anterior Cingulate, And Lateral Prefrontal Cortex For Attentional Selection And Stimulus Valuation., Daniel Kaping, Martin Vinck, R Matthew Hutchison, Stefan Everling, Thilo Womelsdorf

Brain and Mind Institute Researchers' Publications

Attentional control ensures that neuronal processes prioritize the most relevant stimulus in a given environment. Controlling which stimulus is attended thus originates from neurons encoding the relevance of stimuli, i.e. their expected value, in hand with neurons encoding contextual information about stimulus locations, features, and rules that guide the conditional allocation of attention. Here, we examined how these distinct processes are encoded and integrated in macaque prefrontal cortex (PFC) by mapping their functional topographies at the time of attentional stimulus selection. We find confined clusters of neurons in ventromedial PFC (vmPFC) that predominantly convey stimulus valuation information during attention shifts. …

Reconceptualizing The Core Of Nurse Practitioner Education And Practice, M. Burman, A. Hart, Virginia Conley, J. Brown, P. Sherard, P. Clarke

Virginia M. Conley

PURPOSE: The movement to the doctor of nursing practice (DNP) is progressing rapidly with new programs emerging and curricular documents being developed. We argue that the implementation of the DNP is a good move for nursing, provided that we use the opportunity to reconceptualize the core of advanced practice nursing, especially nurse practitioner (NP) practice. DATA SOURCES: Theory and research articles from nursing focused on advanced practice nursing, NPs, and doctoral education. CONCLUSIONS: The foundation of NP education is currently based essentially on borrowed or shared content in assessment, pharmacology, and pathophysiology. We argue that the heart and soul of …

Acuity And Case Management: A Healthy Dose Of Outcomes, Part I, Diane Huber, K. Craig

Diane Huber

PURPOSE OF STUDY: This article presents acuity and dosage as two concepts that describe how the business case for case management (CM) can be made. Dosage and acuity concepts are explained as client need-severity, CM intervention-intensity, and CM activity-dose by amount, duration, extent, and timing. Concepts are related to the practice of CM using evidence-based knowledge and methods to develop instruments that measure and score pivotal CM actions. The purpose of this series of three articles is to introduce the two concepts of dosage and acuity, discuss their importance for making the business case for CM and for translation into …

The Diversity Of Case Management Models, Diane Huber

Diane Huber

Case management is experiencing rapid growth and evolutionary transition. This article explores the diversity and richness of case management models found in practice. Interdisciplinary communication in case management programs can be facilitated by an awareness of discipline-specific definitions and models. A categorization of models is described as a device to stimulate multidisciplinary case management collaboration.

Nursing Management Minimum Data Set (Nmmds), Diane Huber, L. Schumacher, C. Delaney

Diane Huber

The Nursing Management Minimum Data Set (NMMDS) is the research-based management data set that meets the nurse executives need for a specific nursing management data capture system that will produce accurate, reliable, and useful data for decision making. The authors update the development of the NMMDS and discuss the 17 NMMDS across-settings elements. Also discussed are the applications of the NMMDS to clinical practice and some ways in which the NMMDS can benefit both nurses and patient/client care.

Nursing Administration Model For Administrative Practice, Diane Gardner, K. Kelly, M. Johnson, J. Mccloskey, Meridean Maas

Diane Huber

The winds of change have swept in a new era for nursing. Complex decisions can be aided by a conceptual model for nursing administration practice. The authors discuss how the Iowa Model of Nursing Administration can be used by nurse administrators to solve administrative problems. Two practical examples are described.

The Iowa Model: A Proposed Model For Nursing Administration, M. Johnson, Diane Gardner, K. Kelly, Meridean Maas, J. Mccloskey

Diane Huber

The purpose of the Iowa Model is to serve both as a heuristic device and as a framework for articulating knowledge for nursing administration research, practice, and education. The model delineates two domains of knowledge (systems and outcomes), each with three levels (patient aggregates, the organization, and the health care system). Concepts useful for knowledge development are identified for each level. Practice, research, and curricular applications of the model are made.

Acuity And Case Management: A Healthy Dose Of Outcomes, Part Iii, Diane Huber, K. Craig

Diane Huber

PURPOSE OF STUDY: This is the third of a 3-part series presenting 2 effective applications--acuity and dosage--that describe how the business case for case management (CM) can be made. In Part I, dosage and acuity concepts were explained as client need-severity, CM intervention-intensity, and CM activity-dose prescribed by amount, frequency, duration, and breadth of activities. Concepts were presented that related the practice of CM to the use of evidence-based practice (EBP), knowledge, and methods and the development of instruments that measure and score pivotal CM actions. Part I also featured a specific exemplar, the CM Acuity Tool, and described how …

Outcomes Of An Adjunct Executive Appointment For Faculty, Diane Huber, J. Maske

Diane Huber

The Council on Graduate Education for Administration in Nursing (CGEAN) was established to further develop and improve graduate education for administration in nursing. The Council seeks to identify the nature and direction of education for administration in nursing in various healthcare systems, providing guidelines for programs offering administration. A major goal of CGEAN is facilitating dialogue between nursing service administrators and graduate level educators who are engaged in teaching and research related to administration in nursing. This column, sponsored by the members of the Council, analyzes and responds to position statements and trends related to the delivery of health services …

Catastrophe And Nursing Turnover: Nonlinear Models, C. Wagner, Diane Huber

Diane Huber

Creating a culture of retention is one antidote to high costs of nurse turnover. However, nurse turnover behavior has proven to be largely uncertain and unpredictable. A new approach to analyzing nurse turnover attitudes and behavior is discussed. A cusp catastrophe nonlinear model of nurse turnover is presented as having usefulness for the prediction of turnover for managerial decision making in nursing care delivery systems. Viewing nursing from the perspective of nonlinear dynamics can create new strategies for effective and efficient nursing services.

Dose Of Case Management Interventions, Diane Huber, J. Hall, T. Vaughn

Diane Huber

Case management programs need to be evaluated for outcomes achievement and efficient use of resources. As a provider intervention, case management is interactional and situational. Little is known about how to measure the actual dose delivered in order to assess quality and manage outcomes. Case management is interdisciplinary, has identifiable dimensions, and serves as a practical example of conceptualizing and measuring the dosage of a provider's intervention. The basic elements of the dosage of an intervention are amount, frequency, duration, and breadth. A three-dimensional model illustrates dosage of case management.

The Medical Outcomes Study: A Nursing Perspective, K. Kelly, Diane Huber, M. Johnson, J. Mccloskey, Meridean Maas

Diane Huber

The authors analyze the Medical Outcomes Study framework as a means of measuring the effectiveness of a multidimensional, interdisciplinary health care delivery system. The potential for this model to measure outcomes resulting from the interventions of nurses is demonstrated. The similarities between variables in the Medical Outcomes Study (MOS) framework and in research in nursing are presented. Modifications in the framework are suggested that would represent the collaboration among physicians, nurses, and allied health practitioners and the influence of their interaction on patient outcomes. The authors also suggest adding the domain of societal outcomes to include such outcome variables as …

Case Managers' Roles And Functions: Commission For Case Manager Certification's 2004 Research, Part I, H. Tahan, Diane Huber, W. Downey

Diane Huber

The Commission for Case Manager Certification (CCMC) conducted its third case managers' role and functions study in 2004. The purpose of this research was to validate the currency and relevancy of the certified case manager examination. The results of this study are shared in 2 parts of an article. Part I discusses the process the CCMC used for the development of the Case Manager's Role and Functions Survey Instrument (CMRFSI). The research leads to the identification of 6 new essential functions and 6 new knowledge areas, which describe case management practice. These findings were based on the survey of a …

Acuity And Case Management: A Healthy Dose Of Outcomes, Part Ii, K. Craig, Diane Huber

Diane Huber

PURPOSE: This is the second of a 3-part series presenting 2 effective applications-acuity and dosage-that describe how the business case for case management (CM) can be made. In Part I, dosage and acuity concepts were explained as client need-severity, CM intervention-intensity, and CM activity-dose prescribed by amount, frequency, duration, and breadth of activities. Part I also featured a specific exemplar, the CM Acuity Tool, and described how to use acuity to identify and score the complexity of a CM case. Appropriate dosage prescription of CM activity was discussed. Part II further explains dosage and presents two acuity instruments, the Acuity …

Evaluating The Impact Of Case Management Dosage, Diane Huber, M. Sarrazin, T. Vaughn, J. Hall

Diane Huber

BACKGROUND: Because of the broad range of activities involved and high variance in clients' needs, it is challenging to measure the actual dose of case management in order to assess quality and manage outcomes. OBJECTIVE: The purpose of this research is to evaluate the impact of intervention dosage on client outcomes in different case management models within substance abuse treatment. METHOD: A descriptive and repeated measures analysis from a clinical trials data set measured the dosage of case management and evaluated impact on client outcomes. A sample of 598 clients from a substance abuse treatment facility was randomized into one …

Issues Related To The Use Of Nurse Extenders, Diane Gardner

Diane Huber

The nursing shortage has prompted a recurring discussion about the appropriate mix of bedside care givers in nursing that can be constructed to ensure quality patient care. As nursing's role has become more professional, there has arisen a need to differentiate work tasks and develop nurse extenders. The author discusses nursing and non-nursing duties as they relate to a model of nurse extenders and related practice issues.

Client Satisfaction With Rural Substance Abuse Case Management Services, T. Kopelman, Diane Huber, B. Kopelman, M. Sarrazin, J. Hall

Diane Huber

Although many substance abuse organizations offer case management services, little is known about clients' satisfaction as consumers of case management services. The purpose of this study was to evaluate consumer preferences regarding the delivery of case management services in a rural substance abuse treatment program. For this study, 120 clients (30 in each of four research conditions) were interviewed about their experiences in the Iowa Case Management Project (ICMP), a field-based clinical trial evaluating a strengths-based model of case management for rural clients in drug abuse treatment. A mixed-method approach evaluated clients' responses from a semistructured interview. Most clients preferred …

Adjunct Executive Appointment For Faculty. An Innovation In Nursing Collaboration, K. Kelly, Diane Gardner, M. Johnson, Meridean Maas, J. Mccloskey, M. Bowers, J. Maske, S. Mathis, Janet Specht, Carol Watson

Diane Huber

The need for collaboration has never been greater. The healthcare delivery system faces unprecedented challenges arising from prospective payment, competition in the marketplace, higher patient acuity levels, and a shortage of professional nursing staff. The authors discuss a service-education collaboration model based on adjunct executive appointments of faculty members to healthcare organizations. The authors describe the model, a conceptual framework to guide its development, case studies of its implementation, and a summary of the benefits and risks associated with the initial implementation of the model.

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.

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 …

Caregiving: Concept Analysis And Outcomes, Elizabeth Swanson, Deborah Schoenfelder, Janet Specht, M. Johnson, Meridean Maas, D. Saylor

Elizabeth A. Swanson

More than ever before, caregiving has become a salient public policy issue. A number of recent and anticipated demographic, economic and social changes have occurred that make it imperative for researchers to critically examine the impact of caregiving on family caregivers' health, behavior, emotions, and social status. Researchers at the University of Iowa College of Nursing are working to classify standardized nursing-sensitive patient outcomes for use in language development, practice, research, and education to evaluate the effectiveness of nursing interventions and clinical nursing services. This article focuses on family caregiving and the analysis of caregiver role performance in both direct …

Research Reviews. Mathematical Modeling To Define Optimum Operating Room Staffing Needs For Trauma Centers, Victoria Steelman

Victoria J. Steelman

No abstract provided.

Infusing Research Into Practice To Promote Quality Care, M. G. Titler, Charmaine Kleiber, Victoria Steelman, C. Goode, Barbara Rakel, J. Barry-Walker, S. Small, Kathleen Buckwalter

Victoria J. Steelman

This article describes the Iowa Model of Research in Practice, a heuristic model used at the University of Iowa Hospitals and Clinics for infusing research into practice to improve the quality of care. The components of the model are presented with examples. The impact of the model on patient, staff, and fiscal outcomes is delineated.

Innovative University Partnership Meets Neonatal Nurse Practitioner Program Need Amid Faculty Shortage, Rebecca Siewert, L. B. Rasmussen, M. A. Lofgren, Patricia Clinton

Rebecca Siewert

This nation is facing a significant nursing faculty shortage not only at the undergraduate but also at the graduate level. As nursing faculty, we must be innovative in considering ways of consolidating resources in this time of demand for advanced practice nurses. With the apparent need for qualified neonatal nurse practitioners in Iowa, the University of Iowa understood the importance of starting a neonatal nurse practitioners program. The University of Iowa College of Nursing and the University of Missouri-Kansas City formed a partnership to educate neonatal nurse practitioners. Although this partnership concentrates on a specific subspecialty population, it can serve …

Nursing Care For Postpartum Depression, Part 1: Do Nurses Think They Should Offer Both Screening And Counseling?, Lisa Segre, M. O'Hara, S. Arndt, C. Beck

Lisa S. Segre

PURPOSE: To assess nurses' views of a nursing model in which nurses screen and also treat new mothers who exhibit symptoms of depression. STUDY DESIGN AND METHODS: This is Part 1 of this descriptive survey (Part 2 in MCN 35(5)), in which nurses (n = 520) completed a statewide survey assessing nurses' views of a model of nursing care that both screens and treats postpartum depression. RESULTS: The majority "strongly agreed" or "agreed" with the statement "having nurses screen for depression using a brief screening tool is a good idea." Most (67.1%) chose the Ob-Gyn Clinic as the appropriate site …

Nursing Home Culture: A Critical Component In Sustained Improvement, Jill Scott-Cawiezell, K. Jones, L. Moore, C. Vojir

Jill Scott-Cawiezell

In the third in a series of articles exploring working conditions and quality improvement in nursing homes, 31 nursing homes were surveyed using an adaptation of the Competing Values Framework (CVF) Organizational Assessment. The CVF provides information about the organizational culture through describing dominant perceived values, distribution of values across organizational characteristics, and orientation of values toward flexibility. Staff reported a dominant group culture, reflecting a family and team orientation within their settings. Leaders, however, were more often reported to reflect a hierarchy value orientation, emphasizing efficiency of operations and following rules and procedures.

Detection Of Patient Risk By Nurses: A Theoretical Framework, L. Despins, Jill Scott-Cawiezell, J. Rouder

Jill Scott-Cawiezell

AIM: This paper is a description of a theoretical framework of how nurses detect and interpret patient risk signals in the context of organizational attitudes and procedures related to patient safety. BACKGROUND: The ability to detect when patients are at increased risk for harm is a challenge faced by nurses worldwide. How nurses are able to discriminate patient risk warning signals from background noise is not well understood. Also, the impact of system-level factors on nurses' signal detection capabilities has not been investigated. DATA SOURCES: Computerized database searches were used to identify nursing, organizational science, and cognitive psychology literature from …

Quality Improvement In Long-Term Care. Are Nursing Homes Ready To Create Sustainable Improvement?, Jill Scott-Cawiezell

Jill Scott-Cawiezell

No abstract provided.