Digital Commons Network^™

Homesafe: Supportive Assistance For Elderly Individuals Through A Nurse-Managed Plan, Deborah Schoenfelder, Meridean Maas, Janet Specht

Deborah P. Schoenfelder

A lack of quality, cost-effective alternatives to nursing home care for community-dwelling older adults exists. The evidence suggests that case management provides quality care in a cost-efficient manner to help older adults remain at home safely and as independently as possible. This article describes HomeSafe, a nurse-managed membership plan that assists older individuals to enhance their health and quality of life, and to age in place in their homes and communities. HomeSafe serves as an innovative model of care and a teaching site for undergraduate and graduate nursing students and nursing faculty at The University of Iowa.

Economics And The Education Of Nurse Anesthetists: Part 2, Cormac O'Sullivan, E. Thompson

Cormac T. O'Sullivan

Economic assumptions and other factors affecting the economics of nurse anesthesia education are presented in Part 2 of this 2-part column. In Part 1, published in the October 2004 issue of the AANA Journal, general economic principles and healthcare economic principles in particular were described, explained, and related to the current US healthcare system.

Evidence-Based Management Assessment Of Return On Investment From Anesthesia Information Management Systems, Cormac O'Sullivan, F. Dexter, D. Lubarsky, M. Vigoda

Cormac T. O'Sullivan

A systematic and comprehensive review of the scientific literature revealed 4 evidence-based methods that contribute to a positive return on investment from anesthesia information management systems (AIMS): reducing anesthetic-related drug costs, improving staff scheduling and reducing staffing costs, increasing anesthesia billing and capture of anesthesia-related charges, and increased hospital reimbursement through improved hospital coding. There were common features to these interventions. Whereas an AIMS may be the ideal choice to achieve these cost reductions and revenue increases, alternative existing systems may be satisfactory for the studied applications (i.e., the incremental advantage to the AIMS may be less than predicted from …

An Examination Of The Sustainable Adoption Of Whole-Person Care (Wpc), Maria Joseph, D. Laughon, Richard Bogue

Maria (Lindell) Joseph

AIM: This study illustrates how King's theory of goal attainment was used to focus an examination of whole-person care (WPC) and to extend the range of knowledge needed for WPC and nursing practice. BACKGROUND: Leadership implemented a faith-based innovation using continuing education for patient care that incorporates body-mind-spirit and eight principles called CREATION. Three questions arose: (1) Is there an evidence-based framework to determine whether the philosophy supports the discipline of nursing? (2) How extensive is the adoption and application of WPC? (3) Does the model make a difference in the context of nurse-patient interactions and outcomes in support of …

Work Environment Characteristics Of High-Quality Home Health Agencies, S. Tullai-Mcguinness, J. Riggs, Amany Farag

Amany A. Farag

This concurrent mixed-method study examines the nurse work environment of high-quality Medicare-certified home health agencies. High-quality (n=6) and low-quality (n=6) home health agencies were recruited using agency-level publicly reported patient outcomes. Direct care registered nurses (RNs) from each agency participated in a focus group and completed the Practice Environment Scale of the Nurse Work Index (PES-NWI). No significant differences were found in the PES-NWI results between nurses working in high- and low-quality agencies, though nurses in high-quality agencies scored higher on all subscales. Nurses working in all the high-quality agencies identified themes of adequate staffing, supportive managers, and team work. …

Expanded Adult Day Program As A Transition Option From Hospital To Home, K. Jones, S. Tullai-Mcguinness, M. Dolansky, Amany Farag, M. Krivanek, L. Matthews

Amany A. Farag

This article describes a pilot program for provision of postacute care (PAC) in an established adult day program. Demographic, clinical, utilization, and satisfaction data were abstracted retrospectively from program records; postdischarge readmission and emergency department visit data were obtained from the electronic health record. Comparative data were obtained from the health records of patients who were offered but declined the adult day program. Between 2005 and 2008, 78 patients requiring PAC were approached by the RN coordinator; 33 selected the adult day program, and 45 selected alternative destinations. The majority of patients had a neurological diagnosis, most commonly stroke. Participants …

Contexts For The Study Of The Economic Influence Of Nursing Diagnoses On Patient Outcomes, M. Lavin, K. Avant, Martha Craft-Rosenberg, T. Herdman, K. Gebbie

Martha J. Craft-Rosenberg

PURPOSE: To examine the historical, legal/ organizational, informatics, clinical, economic, and policy contexts underlying economic consequences of nursing diagnoses on patient outcomes. DATA SOURCES: Published literature, online material. DATA SYNTHESIS: Nursing diagnoses influence diagnostic-specific patient outcomes and other outcome variables such as length of hospital stay, morbidity, and mortality. CONCLUSIONS: Examination of the economic ramifications of nursing diagnosis on patient outcomes can be facilitated using standardized language and databases containing nursing-sensitive measures.

The Disclosure Decisions Of Parents Who Conceive Children Using Donor Eggs, S. Hahn, Martha Craft-Rosenberg

Martha J. Craft-Rosenberg

STUDY OBJECTIVE: To identify variables that influence the disclosure decisions of parents who conceive children using donor eggs and to compare such variables among disclosing, nondisclosing, and undecided families. DESIGN: Exploratory, comparative, descriptive. SETTING: A university hospital-assisted reproductive technology program in the Midwest. PARTICIPANTS: Thirty-one couples with children conceived with anonymously donated eggs. METHODS: Audiotaped telephone interviews, measures of social support and family environment, and a demographic survey. MAIN OUTCOME MEASURES: Content analysis of interview transcripts and comparison of recurring themes among groups. RESULTS: The majority of parents intended disclosure. Dominant themes among disclosing parents included the belief that a …

Report Of The American Academy Of Nursing Child-Family Expert Panel: Identification Of Quality And Outcome Indicators For Maternal Child Nursing, Martha Craft-Rosenberg, M. Krajicek, D. Shin

Martha J. Craft-Rosenberg

Core values and assumptions regarding child health care are identified. Concepts that are generalized across settings are defined. The dimensions of care involve the child, the family, the system, and the community. The Child-Family Expert Panel will continue to work within specialties on standards, processes, and outcomes.

Academic Freedom: Protecting "Liberal Science" In Nursing In The 21st Century, S. Kneipp, M. Canales, N. Fahrenwald, Janette Taylor

Janette Y. Taylor

Generating new knowledge through science is one of the most valued contributions of American universities, and is wholly dependent on the tenets of academic freedom. This article provides an overview of academic freedom in the United States, lack of attentiveness to academic freedom in the discipline of nursing, and its relevance for advancing nursing science. Three issues are critically evaluated as they relate to "the free search for truth" that is imperative for scientific progress to occur, including (a) its importance in a liberal science system, (b) recent trends to politically manipulate science, and (c) movements to restrict speech on …

Colonizing Images And Diagnostic Labels: Oppressive Mechanisms For African American Women's Health, Janette Taylor

Janette Y. Taylor

The purpose of this article is to present colonizing images of African American women and describe how colonizing images and diagnostic labels function together to serve as oppressive mechanisms for African American women's health. The mammy, the matriarch, the welfare mother, the Jezebel, and the Black lady overachiever are representational images of African American women that contribute to how they are viewed and treated within the health care arena.

Assessing Intimate Partner Violence In Incarcerated Women, M. Eliason, Janette Taylor, S. Arndt

Janette Y. Taylor

The purpose of this study to assess the psychometric qualities of a screening instrument for intimate partner violence, the Index of Spouse Abuse (ISA), for use with incarcerated women. Principal components factor analysis was conducted on data collected from 149 incarcerated women. The ISA demonstrated excellent internal consistency with this population and appears to be a psychometrically sound instrument that can be given in a short period of time.

Engaging Racial Autoethnography As A Teaching Tool For Womanist Inquiry, Janette Taylor, Melissa Lehan Mackin, A. Oldenburg

Janette Y. Taylor

Racial autobiography, self-narratives on how one learned about the idea of race, has been underutilized as a tool to familiarize and orient students in the process of critical inquiry for nursing research. The aims of this article are to explore how racial autoethnography: (1) repositions students to effect an epistemological change, (2) challenges dominant ideology, and (3) functions as a link between the student and critical theories for use in nursing research. Students engage in and share reflective narrative about a variety of instructional materials used in the course. Reflective narratives are presented in a framework that addresses white racial …

Race And Ethnicity As Variables In Nursing Research, 1952-2000, D. Drevdahl, Janette Taylor, D. Phillips

Janette Y. Taylor

BACKGROUND: Although the use of race and ethnicity as variables in research has increased over the past five decades, there is confusion regarding the meaning of the terms, as well as how the words are defined and determined in scientific inquiry. OBJECTIVE: To review the use of race and ethnicity as variables in nursing research literature. METHODS: Original research articles published in Nursing Research in the years, 1952, 1955, and every 5 years thereafter through 2000 were reviewed. Those articles describing human characteristics (N = 337) were analyzed for content concerning: (a) frequency of racial and ethnic terms, (b) words …

Womanism: A Methodologic Framework For African American Women, Janette Taylor

Janette Y. Taylor

Although nurse scholars have become increasingly engaged in feminist research and theory development, only a few have included important feminist thoughts expressed by African American womanist theorists. This article presents an abbreviated review and synthesis of Afrocentric ways of knowing, which includes Black feminist, womanist, and Afrocentric perspectives. A developing methodology for use with African American women is also described.

Nursing Work: Understanding A Scarce Resource, Patricia Groves

Patricia S. Groves

No abstract provided.

Implementation Of The Agency For Health Care Policy And Research Pain Guidelines, K. Schmidt, M. Alpen, Barbara Rakel

Barbara A. Rakel

Implementation of clinical practice guidelines in a large setting is a complex process. This article describes the many issues encountered in trying to implement Agency for Health Care Policy and Research acute pain and cancer pain guidelines in an academic medical center. Issues addressed include the membership of the task forces involved, incorporation of the guidelines into the institution-specific standards of care, selection and implementation of self-reporting tools for assessment of pain throughout the institution, issues involved in standardizing documentation of pain throughout the institution, measurement of the current status of pain control and integration into the existing quality assessment …

Efficiency And Equity As Goals For Contemporary U.S. Immigration Policy, Vernon Briggs

Vernon M Briggs Jr

As the United States has entered its postindustrial stage of economic development, mass immigration has again become a distinguishing feature of the U.S. economy. In all of its diverse forms, immigration presently accounts for anywhere from one-quarter to one-third of the annual growth of the U.S. labor force. By the turn of the 21st century, it could conceivably comprise all of such growth.

Immigration is the one aspect of population and labor force growth that public policy should be able to shape and control. Unfortunately, however, the extant public policies that govern the size and composition of the immigrant and …

Illegal Aliens: The Need For A More Restrictive Border Policy, Vernon Briggs

Vernon M Briggs Jr

[Excerpt] In late 1974, the commissioner of the Immigration and Naturalization Service of the U.S. Department of Justice publicly stated that “the United States us being overrun by illegal aliens” and, he warned, “we are seeing just the beginning of the problem.” During that 1974 fiscal year, 788,000 illegal aliens were actually apprehended by INS. Of greater significance, however, is the fact that INS estimated that the number of undetected illegal aliens who entered the United States in that year ranged upwards to 4 million people. Moreover, the INS estimated the accumulated number of illegal aliens currently residing in the …

Methods Of Analysis Of Illegal Immigration Into The United States, Vernon Briggs

Vernon M Briggs Jr

"A major barrier to the discussion of the scope and impact of illegal immigration on the American economy has been the inadequacy of existing data. Although data problems are not unique to this topic, the limited availability of macro-data on the size of the annual flows and of the accumulated stock of individuals as well as of micro-data on their influences on selected labor markets has been effectively used to forestall policy reform efforts."

The Growth And Composition Of The U.S. Labor Force, Vernon Briggs

Vernon M Briggs Jr

[Excerpt] In sharp contrast with the experiences of all other industrialized nations, the size of the labor force of the United States is growing rapidly while, simultaneously, its age, gender, and ethnic composition are changing markedly. Consequently, human resource issues present an unprecedented challenge in the nation's quest to achieve a fully employed and equitable society. New public policies that focus on labor market adjustment policies will be required if these developments are to be a boon rather than a bane to the emerging postindustrial economy.

Labor Market Transformation: The Role Of U.S. Immigration Policy, Vernon Briggs

Vernon M Briggs Jr

[Excerpt] As the United States enters the last decade of the 20th Century, its labor market is in a state of transformation. A marked break has occurred in both the evolutionary patterns of employment growth (i.e., labor demand) and in the growth and composition of the labor force (i.e., labor supply). Unprecedented adjustment requirements are being placed upon the U.S. labor market. In such an environment, there can be no assumption that the labor force can automatically adjust to the changes. Policy priority should be given to comprehensive programmatic efforts to develop the employment potential of the nation's human resources. …

Illegal Immigration And The American Labor Force: The Use Of “Soft” Data For Analysis, Vernon Briggs

Vernon M Briggs Jr

[Excerpt] In late 1974, the commissioner of the Immigration and Naturalization Service (INS) of the U.S. Department of Justice publicly stated that “the United States us being overrun by illegal aliens” and, he warned, “we are seeing just the beginning of the problem.” During that 1974 fiscal year, when 788,000 illegal aliens were actually apprehended by INS, the INS estimated that the number of undetected illegal aliens who entered the United States in that year ranged upward to 4 million people. Moreover, the INS estimated the accumulated number of illegal aliens currently residing in the United States in 1974 to …

Efficiency And Equity As Goals For Contemporary U.S. Immigration Policy, Vernon Briggs

Vernon M Briggs Jr

As the United States has entered its postindustrial stage of economic development, mass immigration has again become a distinguishing feature of the U.S. economy. In all of its diverse forms, immigration presently accounts for anywhere from one-quarter to one-third of the annual growth of the U.S. labor force. By the turn of the 21st century, it could conceivably comprise all of such growth.

Immigration is the one aspect of population and labor force growth that public policy should be able to shape and control. Unfortunately, however, the extant public policies that govern the size and composition of the immigrant and …

Illegal Aliens: The Need For A More Restrictive Border Policy, Vernon Briggs

Vernon M Briggs Jr

[Excerpt] In late 1974, the commissioner of the Immigration and Naturalization Service of the U.S. Department of Justice publicly stated that “the United States us being overrun by illegal aliens” and, he warned, “we are seeing just the beginning of the problem.” During that 1974 fiscal year, 788,000 illegal aliens were actually apprehended by INS. Of greater significance, however, is the fact that INS estimated that the number of undetected illegal aliens who entered the United States in that year ranged upwards to 4 million people. Moreover, the INS estimated the accumulated number of illegal aliens currently residing in the …

Methods Of Analysis Of Illegal Immigration Into The United States, Vernon Briggs

Vernon M Briggs Jr

"A major barrier to the discussion of the scope and impact of illegal immigration on the American economy has been the inadequacy of existing data. Although data problems are not unique to this topic, the limited availability of macro-data on the size of the annual flows and of the accumulated stock of individuals as well as of micro-data on their influences on selected labor markets has been effectively used to forestall policy reform efforts."

The Growth And Composition Of The U.S. Labor Force, Vernon Briggs

Vernon M Briggs Jr

[Excerpt] In sharp contrast with the experiences of all other industrialized nations, the size of the labor force of the United States is growing rapidly while, simultaneously, its age, gender, and ethnic composition are changing markedly. Consequently, human resource issues present an unprecedented challenge in the nation's quest to achieve a fully employed and equitable society. New public policies that focus on labor market adjustment policies will be required if these developments are to be a boon rather than a bane to the emerging postindustrial economy.

Labor Market Transformation: The Role Of U.S. Immigration Policy, Vernon Briggs

Vernon M Briggs Jr

[Excerpt] As the United States enters the last decade of the 20th Century, its labor market is in a state of transformation. A marked break has occurred in both the evolutionary patterns of employment growth (i.e., labor demand) and in the growth and composition of the labor force (i.e., labor supply). Unprecedented adjustment requirements are being placed upon the U.S. labor market. In such an environment, there can be no assumption that the labor force can automatically adjust to the changes. Policy priority should be given to comprehensive programmatic efforts to develop the employment potential of the nation's human resources. …

Illegal Immigration And The American Labor Force: The Use Of “Soft” Data For Analysis, Vernon Briggs

Vernon M Briggs Jr

[Excerpt] In late 1974, the commissioner of the Immigration and Naturalization Service (INS) of the U.S. Department of Justice publicly stated that “the United States us being overrun by illegal aliens” and, he warned, “we are seeing just the beginning of the problem.” During that 1974 fiscal year, when 788,000 illegal aliens were actually apprehended by INS, the INS estimated that the number of undetected illegal aliens who entered the United States in that year ranged upward to 4 million people. Moreover, the INS estimated the accumulated number of illegal aliens currently residing in the United States in 1974 to …

Why Not Support(Ed) Parenting, Joanne Nicholson, William Deveney

Joanne Nicholson

No abstract provided.