Medicine and Health Sciences Commons^™

Discharge Checklist To Enhance Rn Role And Prevent Unnecessary Readmissions, Rachel Keene

Rachel Keene, RN, MSN

Discharge is included in every patient's plan of care. It is considered a basic procedure but, without a clear definition of each provider's responsibilities during discharge, duplication of tasks and errors of omission occur (Byrnes et al., 2009; Gawande, 2009). On a medical unit in a Silicon Valley hospital, RNs (Registered Nurse) are often inundated with auxiliary tasks in the hours before discharge. This is partly due to their proximity to the patient, but is mainly from the lack of a standard RN discharge procedure. Such norms jeopardize the RN's ability to provide care and can increase hospital readmissions (Jack …

Power Distance, Cultural Communication And Medication/Medical Errors: The Avoidance Of An Ethical Dilema, Luanne Linnard-Palmer

Luanne Linnard-Palmer

Neonatal Respiratory Distress In The Community Hospital: When To Transport, When To Keep., H. Hein, J. Ely, Maria Lofgren

Maria A Lofgren

Neonatal respiratory distress is a common problem confronting family physicians. Although respiratory distress may represent a benign, self-limited process, it may also be the first sign of sepsis or serious cardiopulmonary disease. Because it is crucial to differentiate the two, we offer a practical approach to the treatment of neonatal respiratory distress at community hospitals. Our method, the Rule of 2 Hours, is based on readily accessible clinical findings. We believe it will help physicians detect babies at risk for serious problems, but will not result in unnecessary referral of neonates that are simply adapting to extrauterine life.

The Changing Pattern Of Neonatal Mortality In A Regionalized System Of Perinatal Care: A Current Update., H. Hein, Maria Lofgren

Maria A Lofgren

OBJECTIVE: Our earlier studies about the changing pattern of neonatal mortality were based on data from 1978-1979 and 1982-1983. In this report, we provide a modern update of the causes of neonatal deaths to help focus prevention measures. STUDY DESIGN: We reviewed neonatal deaths for the years 1995 and 1996 and assigned a clinical cause of death. Deaths were reviewed and analyzed by place of birth and death, according to level of care. We provided an estimate of the change in causes of death between 1982-1983 and 1995-1996 and calculated an idealized neonatal mortality rate for each level of care …

Development Of A Resource Manual For Returning Neonates To Community Hospitals., Maria Lofgren

Maria A Lofgren

To facilitate the transfer of an infant from a tertiary NICU to a community Level II hospital for convalescing follow-up care, the tertiary staff must know the referral center's capabilities. This will help to establish a trusting relationship between hospitals, will enable the tertiary staff to send infants back to the referral center in a timely manner, will enable them to reassure the patient's parents concerning the transfer, and will facilitate communication between the hospitals and the patient's family. This article describes the development of a referring hospital resource manual designed to facilitate the transfer process.

Neonatal Transport And Stabilization: Part I, Maria Lofgren

Maria A Lofgren

No abstract provided.

Neonatal Transport And Stabilization: Part Ii, Maria Lofgren

Maria A Lofgren

No abstract provided.

The Significance Of The Neutrophil In The Diagnosis Of Neonatal Sepsis: Using A Metaphor, Maria Lofgren

Maria A Lofgren

No abstract provided.

How Fast Is Too Fast? A Practice Change In Umbilical Arterial Catheter Blood Sampling Using The Iowa Model For Evidence-Based Practice., Myrna Gordon, Lisa Bartruff, Sara Gordon, Maria Lofgren, John Widness

Maria A Lofgren

A multidisciplinary team at the University of Iowa Children's Hospital utilized the Iowa Model of Evidence-Based Practice to Promote Quality Care as a basis for changing practice related to the rate of drawing and flushing umbilical artery catheters in very low birth-weight infants. Research indicates that rapid withdrawal of blood or flushing of catheters that are placed in the aorta can affect cerebral blood flow velocity, volume, and oxygenation. Alteration of cerebral blood flow in premature infants has been correlated with the incidence of intraventricular hemorrhage and periventricular leukomalacia, which can be a significant cause of morbidity and mortality in …

Evidence-Based Practice: Examining The Risk Of Toys In The Microenvironment Of Infants In The Neonatal Intensive Care Unit., Kirsten Hanrahan, Maria Lofgren

Maria A Lofgren

No abstract provided.

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

Maria A Lofgren

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 …

Multiple Dimensions Of The Symptom Experience In Patients With Advanced Cancer And Their Impact On Quality Of Life, Stephanie Gilbertson-White

Stephanie Gilbertson-White

Many people with advanced cancer experience multiple severe symptoms as their disease progresses such as pain, sleep problems, fatigue, and depression. These symptoms can be a result of the cancer itself, cancer treatment or an interaction of the two. The studies reported in this dissertation uses the patients' own responses to survey questions to describe the multiple dimensions of the symptom experience; the factors that predict the total number of symptoms; as well as the optimal cutpoint between a low and a high number of symptoms and the between group differences in patient outcomes (i.e., depression, anxiety, quality-of-life).

Wna Research Council: Best Project Poster... 2004 Convention, Stephanie Gilbertson-White, J. Griffie, D. Radsek

Stephanie Gilbertson-White

No abstract provided.

A Review Of The Literature On Multiple Symptoms, Their Predictors, And Associated Outcomes In Patients With Advanced Cancer, Stephanie Gilbertson-White, B. Aouizerat, T. Jahan, C. Miaskowski

Stephanie Gilbertson-White

OBJECTIVE: The findings from several studies suggest that palliative care patients with advanced cancer experience multiple symptoms, and that these symptoms may be related to demographic and clinical factors as well as to patient outcomes. However, no systematic review has summarized the findings from studies that assessed multiple symptoms, predictors, and outcomes in these patients. The purposes of this review, focused on palliative care patients with advanced cancer, are to: 1) describe the relationships among multiple symptoms; 2) describe the predictors of multiple symptoms; and 3) describe the relationships between multiple symptoms and patient outcomes. METHOD: Comprehensive literature searches were …

Relationships Among Specific Viral Pathogens, Virus-Induced Interleukin-8, And Respiratory Symptoms In Infancy, J. Gern, M. Martin, K. Anklam, K. Shen, K. Roberg, K. Carlson-Dakes, K. Adler, Stephanie Gilbertson-White, R. Hamilton, P. Shult, C. Kirk, D. Da Silva, S. Sund, M. Kosorok, R. Lemanske

Stephanie Gilbertson-White

No abstract provided.

Electronic Documentation Systems: The Impact On Pain Documentation, Stephanie Gilbertson-White, S. Shapiro

Stephanie Gilbertson-White

No abstract provided.

Effects Of Dog Ownership And Genotype On Immune Development And Atopy In Infancy, J. Gern, C. Reardon, S. Hoffjan, D. Nicolae, Z. Li, K. Roberg, W. Neaville, K. Carlson-Dakes, K. Adler, R. Hamilton, E. Anderson, Stephanie Gilbertson-White, C. Tisler, D. Dasilva, K. Anklam, L. Mikus, L. Rosenthal, C. Ober, R. Gangnon, R. Lemanske

Stephanie Gilbertson-White

No abstract provided.

Clinical Education Adapts To Changing Times, P. Jarzemsky, S. Kruger, Stephanie Gilbertson-White

Stephanie Gilbertson-White

No abstract provided.

Determination Of Cutpoints For Low And High Number Of Symptoms In Patients With Advanced Cancer, Stephanie Gilbertson-White, B. Aouizerat, T. Jahan, S. Paul, C. West, K. Schumacher, M. Dodd, M. Rabow, A. Abu Raddaha, C. Miaskowski

Stephanie Gilbertson-White

While patients with advanced cancer experience a wide range of symptoms, no work has been done to determine an optimal cutpoint for a low versus a high number of symptoms. Analytic approaches that established clinically meaningful cutpoints for the severity of cancer pain and fatigue provided the foundation for this study. The purpose of this study was to determine the optimal cutpoint for low and high numbers of symptoms using a range of potential cutpoints and to determine if those cutpoints distinguished between the two symptom groups on demographic and clinical characteristics and depression, anxiety, and quality of life (QOL). …

Viral Infections, Cytokine Dysregulation And The Origins Of Childhood Asthma And Allergic Diseases., Samuel L. Friedlander, Daniel Jackson, Ronald Gangnon, Michael Evans, Zhanhai Li, Kathy Roberg, Elizabeth Anderson, Kirstin Carlson-Dakes, Kiva Adler, Stephanie Gilbertson-White, Tressa Pappas, Douglas Dasilva, Christopher Tisler, Lisa Pleiss, Lance Mikus, Louis Rosenthal, Peter Shult, Carol Kirk, Erik Reisdorf, Sabine Hoffjan, James Gern, Robert Lemanske

Stephanie Gilbertson-White

No abstract provided.

Methodologic Issues In The Measurement Of Cytokines To Elucidate The Biological Basis For Cancer Symptoms, Stephanie Gilbertson-White, B. Aouizerat, C. Miaskowski

Stephanie Gilbertson-White

No abstract provided.

Building Organizational Capacity For Evidence-Based Practice, S. Shapiro, N. Donaldson, J. Stotts, Stephanie Gilbertson-White

Stephanie Gilbertson-White

No abstract provided.

Documentation On Withdrawal Of Life Support In Adult Patients In The Intensive Care Unit [Corrected] [Published Erratum Appears In Am J Crit Care 2004 Sep;13(5):370], K. Kirchhoff, P. Anumandla, K. Foth, S. Lues, Stephanie Gilbertson-White

Stephanie Gilbertson-White

BACKGROUND: Patients' charts have been a source of data for retrospective studies of the quality of end-of-life care. In the intensive care unit, most patients die after withdrawal of life support. Chart reviews of this process could be used not only to assess the quality of documentation but also to provide information for quality improvement and research. OBJECTIVE: To assess the documentation of end-of-life care of patients and their families by care providers in the intensive care unit. METHOD: Charts of 50 adult patients who died in the intensive care unit at a large midwestern hospital after initiation of withdrawal …

The Stability Of Patient Subgroups Identified Using Cluster Analysis, Stephanie Gilbertson-White, C. Miaskowski, K. Lee, M. Dodd, C. West, B. Cooper

Stephanie Gilbertson-White

No abstract provided.

Developmental Cytokine Response Profiles And The Clinical And Immunologic Expression Of Atopy During The First Year Of Life, W. Neaville, C. Tisler, A. Bhattacharya, K. Anklam, Stephanie Gilbertson-White, R. Hamilton, K. Adler, D. Dasilva, K. Roberg, K. Carlson-Dakes, E. Anderson, D. Yoshihara, R. Gangnon, L. Mikus, L. Rosenthal, J. Gern, R. Lemanske

Stephanie Gilbertson-White

No abstract provided.

A Family To Remember: Ethics, Boundaries, And Conflict, Ralph Primelo, Edward Norris, Brian Shablin, Tresa Marrow, Jennifer Bednar, Sharon Clark, Stephen Lammers

Edward R Norris MD, FAPA, FAPM

No abstract provided.

Nursing Attitudes Regarding Suicidal Patients Before And After Staff Education In Preparation For Hospital-Wide Suicide Assessments, Edward Norris, Ralph Primelo, Gail Stern, Karen Burke, Joanna Bokovoy, Michael Kaufmann, Terry Capuano

Edward R Norris MD, FAPA, FAPM

No abstract provided.

“Nursing Cultural Awareness When Caring For Hispanic Patients And Families”, Erika Metzler Sawin

Erika Metzler Sawin

No abstract provided.

Teaching Care Of A Stroke Patient To International Students Through Simulated Inter-Professional Care And Electronic Documentation, Kitsum Li, Margaret Fink, Barbara Mccamish, Adrienne Opet

Kitsum Li

Teaching Care Of A Stroke Patient To International Students Through Simulated Inter-Professional Care And Electronic Documentation, Kitsum Li, Margaret Fink, Barbara Mccamish, Adrienne Opet

Margaret Fink