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Full-Text Articles in Medicine and Health Sciences
Becoming A Registered Nurse: The Nurse Extern Experience, K. Starr, Virginia Conley
Becoming A Registered Nurse: The Nurse Extern Experience, K. Starr, Virginia Conley
Virginia M. Conley
Little is known about the perceptions of nursing students externing in newly developed hospital-based programs that focus on socialization and transition to the registered nurse (RN) role rather than on institutional recruitment and retention goals. This qualitative study explored student nurse externs' expectations, experiences, and benefits of participation in a student-focused externship program. Externs wanted to gain experience with skills and learn what it was like to be an RN. Goals were met or exceeded by becoming comfortable in the externship role, growing in skill performance and confidence, and becoming members of the healthcare team. The experience fostered growth from …
Conflict And Retention Of New Graduate Nurses, Diane Gardner
Conflict And Retention Of New Graduate Nurses, Diane Gardner
Diane Huber
No abstract provided.
Survey Results. Who Helps You With Your Work?, M. Blegen, Diane Gardner, J. Mccloskey
Survey Results. Who Helps You With Your Work?, M. Blegen, Diane Gardner, J. Mccloskey
Diane Huber
No abstract provided.
Patient Preferences And Discharge Planning Transitions, Diane Huber, E. Mcclelland
Patient Preferences And Discharge Planning Transitions, Diane Huber, E. Mcclelland
Diane Huber
Discharge planning is an urgently needed nursing intervention. The purpose of this article is to investigate the importance of patient and family preferences and participation for discharge planning and to describe the pilot testing of an instrument to measure patient preferences for discharge planning. The results identified a lack of congruence between patients' and caregivers' preferences, suggesting the need to assess both patients' and families' preferences early and incorporate this in discharge planning that begins at admission to a hospital. The instrument, Patient Participation Preferences Assessment (PPPA), is shown to be a useful, reliable, and valid instrument that can be …
Acuity And Case Management: A Healthy Dose Of Outcomes, Part Iii, Diane Huber, K. Craig
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 …
Case Managers' Roles And Functions: Commission For Case Manager Certification's 2004 Research, Part I, H. Tahan, Diane Huber, W. Downey
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 …
Evaluating The Impact Of Case Management Dosage, Diane Huber, M. Sarrazin, T. Vaughn, J. Hall
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 …
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
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 …
Russian Citizens' Trusted Sources Of Health Promotion Information, C. Goody, Elizabeth Swanson, A. Bossen, E. Frolova, O. Kuznetsova, S. Plavinski
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 …
Medication Management By Recently Hospitalized Older Adults, V. Conn, S. Taylor, Anita Stineman
Medication Management By Recently Hospitalized Older Adults, V. Conn, S. Taylor, Anita Stineman
Anita Stineman
Community-dwelling older adults often manage numerous prescriptive medications. The purpose of this study was to describe prescriptive medication management by older adults recently discharged from hospitals. The sample (N = 179) included adults, 65 to 101 years old, who managed a total of 950 prescriptive medications. Overall, subjects reported high confidence in their ability to manage medications. The lowest confidence levels were reported for recognizing unwanted side effects of medications. Although "forgetting" was the most commonly given reason for missed doses, one fourth of the reasons for missed doses indicated deliberate omission. Almost half of the subjects received assistance from …
An Approach To Managing Latex Allergy In The Health Care Worker, B. Muller, Victoria Steelman, P. Hartley, T. Casale
An Approach To Managing Latex Allergy In The Health Care Worker, B. Muller, Victoria Steelman, P. Hartley, T. Casale
Victoria J. Steelman
IgE-mediated sensitivity (true allergy) to latex occurs in well-defined groups. The common feature is a high degree of repeated exposure to latex. Approximately one percent of the total U.S. population and five to 17 percent of health care workers are affected. The objective of this article is to provide a rational approach to managing latex allergy in health care workers. Information is provided on the basis of a review of recent literature (primarily since 1986) and on the basis of work by the University of Iowa Hospitals and Clinics Multidisciplinary Latex Allergy Committee. This article summarizes a proactive, hospital-wide approach …
Prevalence And Risk Factors Of Adverse Reactions To Natural Rubber Latex Among Nursing Personnel, Victoria Steelman
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 …
Screening And Counseling For Postpartum Depression By Nurses: The Women's Views, Lisa Segre, M. O'Hara, S. Arndt, C. Beck
Screening And Counseling For Postpartum Depression By Nurses: The Women's Views, Lisa Segre, M. O'Hara, S. Arndt, C. Beck
Lisa S. Segre
PURPOSE: In this part 2 article of research examining a model of care in which nurses screen and counsel postpartum women for postpartum depression, acceptability of such a model to postpartum patients was evaluated with a diverse sample of American women. STUDY DESIGN AND METHODS: Descriptive survey of two groups: 691 predominately white postpartum women with relatively high annual incomes (Sample 1) and 132 low-income women, some of whom were ethnic minorities (Sample 2). The surveys were distributed and needed to be mailed back to the investigators. The response rate was 72% in Sample 1 and 30% in Sample 2. …
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
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 …
The Prevalence Of Postpartum Depression: The Relative Significance Of Three Social Status Indices, Lisa Segre, Michael O'Hara, Stephan Arndt, Scott Stuart
The Prevalence Of Postpartum Depression: The Relative Significance Of Three Social Status Indices, Lisa Segre, Michael O'Hara, Stephan Arndt, Scott Stuart
Lisa S. Segre
BACKGROUND: Little is known about the prevalence of clinically significant postpartum depression in women of varying social status. The purpose of the present study was to examine the prevalence of postpartum depression as a function of three indices of social status: income, education and occupational prestige. METHOD: A sample of 4,332 postpartum women completed a demographic interview and the Inventory to Diagnose Depression, a self-report scale developed to identify a major depressive episode in accordance with DSM diagnostic criteria. Logistic regression was used to assess the relative significance of the three social status variables as risk factors for postpartum depression …
Listening Visits: An Evaluation Of The Effectiveness And Acceptability Of A Home-Based Depression Treatment, Lisa Segre, S. Stasik, M. O'Hara, S. Arndt
Listening Visits: An Evaluation Of The Effectiveness And Acceptability Of A Home-Based Depression Treatment, Lisa Segre, S. Stasik, M. O'Hara, S. Arndt
Lisa S. Segre
Maternal depression affects approximately one in five women, is undertreated, and compromises infant development. In the United Kingdom, public health nurses provide an empirically supported intervention (Listening Visits [LV]) to depressed postpartum women. This study evaluates the effectiveness of LV when delivered by U.S. home visitors. Nineteen women with depressive symptoms received LV. Pre-, post-, and follow-up assessments evaluated depression status, life satisfaction, and treatment acceptability. Listening Visits were associated with a statistically and clinically significant reduction in depression, improvement in life satisfaction, and were acceptable to this sample of postpartum women. The LV intervention shows considerable promise as an …
Measuring Pain Intensity In Nursing Home Residents, K. Jones, R. Fink, E. Hutt, C. Vojir, G. Pepper, Jill Scott-Cawiezell, B. Mellis
Measuring Pain Intensity In Nursing Home Residents, K. Jones, R. Fink, E. Hutt, C. Vojir, G. Pepper, Jill Scott-Cawiezell, B. Mellis
Jill Scott-Cawiezell
Assessing pain intensity in nursing home residents remains a challenge. As part of a multifaceted intervention study to improve pain practices in nursing homes, quarterly pain assessments were conducted in 12 Colorado nursing homes. Residents who reported pain or discomfort of any kind in the past 24 hours were asked to choose one of three pain intensity scales to quantify their current and highest level of pain intensity. They were also observed for pain behaviors using Feldt's Checklist of Nonverbal Pain Indicators. Residents preferred the Verbal Descriptor Scale almost 2:1 over the 11-point Verbal Numeric Rating Scale and the Faces …
Nursing Home Culture: A Critical Component In Sustained Improvement, Jill Scott-Cawiezell, K. Jones, L. Moore, C. Vojir
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.
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
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 …
Measuring Organizational Attributes Of Primary Care Practices: Development Of A New Instrument, P. Ohman-Strickland, A. Orzano, P. Nutting, W. Perry Dickinson, Jill Scott-Cawiezell, K. Hahn, M. Gibel, B. Crabtree
Measuring Organizational Attributes Of Primary Care Practices: Development Of A New Instrument, P. Ohman-Strickland, A. Orzano, P. Nutting, W. Perry Dickinson, Jill Scott-Cawiezell, K. Hahn, M. Gibel, B. Crabtree
Jill Scott-Cawiezell
OBJECTIVE: To develop an instrument to measure organizational attributes relevant for family practices using the perspectives of clinicians, nurses, and staff. DATA SOURCES/STUDY SETTING: Clinicians, nurses, and office staff (n=640) from 51 community family medicine practices. DESIGN: A survey, designed to measure a practices' internal resources for change, for use in family medicine practices was created by a multidisciplinary panel of experts in primary care research and health care organizational performance. This survey was administered in a cross-sectional study to a sample of diverse practices participating in an intervention trial. A factor analysis identified groups of questions relating to latent …
Psychometric Properties Of The Beginning Breastfeeding Survey, Pamela Mulder
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.
The Beginning Breastfeeding Survey: Measuring Mothers' Perceptions Of Breastfeeding Effectiveness During The Postpartum Hospitalization, Pamela Mulder, T. Johnson
The Beginning Breastfeeding Survey: Measuring Mothers' Perceptions Of Breastfeeding Effectiveness During The Postpartum Hospitalization, Pamela Mulder, T. Johnson
Pamela J. Mulder
No current breastfeeding assessment tool assesses the mother's perception of breastfeeding effectiveness during the early postpartum. Psychometric analysis of a new tool, the Beginning Breastfeeding Survey (BBS), in a multi-racial sample of 131 women revealed a coefficient alpha of .90. Factor analysis yielded three factors, (a) Maternal Breastfeeding Competence and Emotional Satisfaction, (b) Maternal Discomfort and Anxiety, and (c) Infant Breastfeeding Skill and Emotional Satisfaction. The BBS demonstrated discriminant validity in known group analyses and convergent validity with breastfeeding self-efficacy and postpartum fatigue. Future research will focus on improving the internal consistency reliability of the BBS and examining its ability …
Strength Training And Falls Among Older Adults: A Community-Based Tr Intervention, K. Mobily, Paula Mobily, R. Raimondi, K. Walter, L. Rubenstein
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 …
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
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 …
An Examination Of Role Strain For University Nurse Faculty And Its Relation To Socialization Experiences And Personal Characteristics, Paula Mobily
Paula Mobily
The purpose of this study is to describe the degree of perceived role strain and the major sources of role strain in nurse faculty employed in major universities; and to explore the relationship between selected socialization experiences and personal characteristics and the degree of role strain experienced. The sample (N = 102) was comprised of full-time tenure track nurse faculty employed in major universities that offered National League for Nursing-accredited undergraduate and graduate programs in nursing, and were located in institutions classified as Research Universities I by the Carnegie Council on Policy Studies in Higher Education (1987). The majority of …
Staff Stress On An Alzheimer's Unit, Paula Mobily, Meridean Maas, Kathleen Buckwalter, Lisa Skemp Kelley
Staff Stress On An Alzheimer's Unit, Paula Mobily, Meridean Maas, Kathleen Buckwalter, Lisa Skemp Kelley
Paula Mobily
Nurses working with the elderly encounter many complex and potentially stressful care situations. Nowhere is this more true than for nursing home staff who work in highly demanding, labor- and client-intensive jobs. A number of factors contribute to the high levels of stress found among nurses who work with the elderly, including continual exposure to physical and emotional pathology and death, and conflict with families, co-workers, supervisors, and representatives from other departments or professions (Goldin, 1985; Klus, 1980). When the stress level in a long-term care facility becomes overwhelming, role conflict, ambiguity, poor self-esteem, and burnout may ensue (Goldin, 1985; …
Changes In Medications Administered In Schools, Ann Mccarthy, M. Kelly, S. Johnson, J. Roman, M. Zimmerman
Changes In Medications Administered In Schools, Ann Mccarthy, M. Kelly, S. Johnson, J. Roman, M. Zimmerman
Ann Marie McCarthy
The purpose of this descriptive, cross-sectional study was to determine if there have been changes in the type and number of attention deficit/hyperactivity disorder (AD/HD) medications administered in schools since the introduction of long-acting stimulants. A survey was sent to 1,000 school nurses randomly selected from the National Association of School Nurses membership, with 339 returned (34%). Between 2000 and 2003 the proportion of students receiving any prescription medication (2.9/100 vs. 1.0/100), methylphenidate (1.2 vs. 0.2), or amphetamine/dextroamphetamine (0.3/100 vs. 0.1/100) was significantly reduced ( p < .0001). High school students took fewer prescription ( p < .0001) and AD/HD medications ( p < .0001), but more nonprescription medications than other students. A total of 163 different prescription medications and 28 nonprescription medications were administered during the typical school day. This study suggests that the use of long-acting stimulants has significantly reduced the number of prescription medications administered in schools. This reduction has been accompanied by a dramatic increase in the range of medications administered, making the medication administration process in schools more complex, not less.
Family Perceptions Of Medication Administration At School: Errors, Risk Factors, And Consequences, D. Clay, K. Farris, Ann Mccarthy, M. Kelly, R. Howarth
Family Perceptions Of Medication Administration At School: Errors, Risk Factors, And Consequences, D. Clay, K. Farris, Ann Mccarthy, M. Kelly, R. Howarth
Ann Marie McCarthy
Medications are administered every day in schools across the country. Researchers and clinicians have studied school nurses' and educators' experiences with medication administration, but not the experiences of children or their parents. This study examined medication administration from the child and parent perspectives to (a) determine problems children experience with medicines at school, (b) clarify risk factors for medication errors, and (c) examine the perceived impact of medication errors on school performance and social relationships. Participants included children ages 8 to 18 years (n=157) being treated at a large Midwestern Children's Hospital in diabetes, asthma, and Attention Deficit Hyperactivity Disorder …
School Nurses' Experiences, Concerns, And Knowledge Of Growth Disorders In Children: Development Of A Monograph, Janet Williams, Ann Mccarthy, H. Bragadottir, D. Reed
School Nurses' Experiences, Concerns, And Knowledge Of Growth Disorders In Children: Development Of A Monograph, Janet Williams, Ann Mccarthy, H. Bragadottir, D. Reed
Ann Marie McCarthy
Growth disorders may be associated with difficult psychosocial adjustment, learning problems, and specific health risks. Appropriate school health programming relies on school nurses who are skilled in growth assessment, management of psychosocial and behavioral problems, and effective communication with school personnel, children, families, and health care resources. A monograph and model individualized healthcare plans were developed for growth disorders in school-age children as an educational resource for school nurses. Knowledge of growth disorders among nurses receiving the monograph was evaluated in a random sample of 336 school nurses, members of the National Association of School Nurses. Knowledge of growth assessment …
Impact Of Parent-Provided Distraction On Child Responses To An Iv Insertion, Ann Mccarthy, Charmaine Kleiber, Kirsten Hanrahan, M. Zimmerman, N. Westhus, S. Allen
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.