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Articles 1 - 30 of 78
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 …
Informational Needs Of Caregivers Of Terminal Patients In A Rural State, Virginia Conley, M. Burman
Informational Needs Of Caregivers Of Terminal Patients In A Rural State, Virginia Conley, M. Burman
Virginia M. Conley
Home care of a terminally ill family member is stressful, especially in rural areas. This qualitative study sought to determine informational needs of rural caregivers and how that information is obtained. Although most caregivers stated satisfaction with available information, mostly obtained from physicians and nurses, their behavior belied their satisfaction. Assertive and self-reliant, they used informal communications rather than written information to meet most of their needs. Approaches home care nurses can use to help caregivers obtain important information are presented.
National Health Policy Influence On Medicare Home Health, Virginia Conley, M. Walker
National Health Policy Influence On Medicare Home Health, Virginia Conley, M. Walker
Virginia M. Conley
National health policy regulates the delivery of Medicare home health services. These services have grown exponentially over the past several years. Current challenges to service delivery revolve around attempts to contain costs while ensuring quality of and access to care. To meet these challenges, providers must be aware of the societal and ideological influences on national health policies that impact service delivery. This article uses Wong's model of the progression of health care reform to address past health policy influences on Medicare home health delivery, investigate recent sociological trends for relevance to health policy, and propose changes based on current …
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 …
Client Satisfaction With Rural Substance Abuse Case Management Services, T. Kopelman, Diane Huber, B. Kopelman, M. Sarrazin, J. Hall
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 …
Catastrophic Reactions And Other Behaviors Of Alzheimer's Residents: Special Unit Compared With Traditional Units, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter
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
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 …
Mentoring Geriatric Nurse Scientists, Educators, Clinicians, And Leaders In The John A. Hartford Foundation Centers For Geriatric Nursing Excellence, Meridean Maas, N. Strumpf, C. Beck, D. Jennings, D. Messecar, Elizabeth Swanson
Mentoring Geriatric Nurse Scientists, Educators, Clinicians, And Leaders In The John A. Hartford Foundation Centers For Geriatric Nursing Excellence, Meridean Maas, N. Strumpf, C. Beck, D. Jennings, D. Messecar, Elizabeth Swanson
Elizabeth A. Swanson
No abstract provided.
Culturally Competent Care For Older Adults: We Are Making Progress, Elizabeth Swanson
Culturally Competent Care For Older Adults: We Are Making Progress, Elizabeth Swanson
Elizabeth A. Swanson
No abstract provided.
Alzheimer's Residents' Cognitive And Functional Measures: Special And Traditional Care Unit Comparison, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter
Alzheimer's Residents' Cognitive And Functional Measures: Special And Traditional Care Unit Comparison, Elizabeth Swanson, Meridean Maas, Kathleen Buckwalter
Elizabeth A. Swanson
The aim of this field experiment was to compare the effects of a special care unit (SCU) on residents with Alzheimer's disease (AD) who lived on the SCU and on traditional (integrated) nursing home units. Twenty-two subjects, 13 on the SCU and 9 on traditional integrated units were compared. Repeated measures ANOVA was used to assess differences between the two groups and within the groups over two bimonthly pretests and two bimonthly posttests. No significant differences on cognitive or functional abilities scores were evident for the groups and no significant differences were found over time. However, consistent with the prediction …
Family Visitation On Special Care Units, Lisa Skemp Kelley, Elizabeth Swanson, Meridean Maas, Toni Tripp-Reimer
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 …
Special Care Units For Persons With Alzheimer's Disease: A Successful Intervention?, Kathleen Buckwalter, Meridean Maas, Elizabeth Swanson, G. Hall
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.
Most Frequent Nursing Diagnoses, Nursing Interventions, And Nursing-Sensitive Patient Outcomes Of Hospitalized Older Adults With Heart Failure: Part 1, C. Scherb, B. Head, Meridean Maas, Elizabeth Swanson, Sue Moorhead, D. Reed, D. Conley, M. Kozel
Most Frequent Nursing Diagnoses, Nursing Interventions, And Nursing-Sensitive Patient Outcomes Of Hospitalized Older Adults With Heart Failure: Part 1, C. Scherb, B. Head, Meridean Maas, Elizabeth Swanson, Sue Moorhead, D. Reed, D. Conley, M. Kozel
Elizabeth A. Swanson
PURPOSE: Rank and compare the 10 most frequently documented nursing diagnoses, interventions, and patient outcomes using NANDA International, Nursing Interventions Classification, and Nursing Outcomes Classification for care of patients with heart failure (HF). METHODS: A descriptive comparative multisite study of documented care for 302 older adults with HF. FINDINGS: There were four common nursing diagnoses, two interventions, and only three common outcomes across three sites. CONCLUSIONS: This and similar analyses of clinical nursing data can be used by nursing administrators and clinicians to monitor the quality and effectiveness of nursing care. IMPLICATIONS: Similar analyses may be used for continuing education, …
Extending Influence In Gerontological Nursing Through Partnerships: Experiences From The John A. Hartford Foundation Centers Of Geriatric Nursing Excellence, H. Young, Elizabeth Swanson, K. Richards, M. Wallhagen, P. Archbold, M. Spool, M. Flaherty-Robb
Extending Influence In Gerontological Nursing Through Partnerships: Experiences From The John A. Hartford Foundation Centers Of Geriatric Nursing Excellence, H. Young, Elizabeth Swanson, K. Richards, M. Wallhagen, P. Archbold, M. Spool, M. Flaherty-Robb
Elizabeth A. Swanson
No abstract provided.
Interventions For Residents With Dementia And Their Family And Staff Caregivers: Evaluating The Effectiveness Of Measures Of Outcomes In Long-Term Care, Janet Specht, M. Park, Meridean Maas, D. Reed, Elizabeth Swanson, Kathleen Buckwalter
Interventions For Residents With Dementia And Their Family And Staff Caregivers: Evaluating The Effectiveness Of Measures Of Outcomes In Long-Term Care, Janet Specht, M. Park, Meridean Maas, D. Reed, Elizabeth Swanson, Kathleen Buckwalter
Elizabeth A. Swanson
This article describes six instruments developed for programs of research testing nursing interventions for individuals with dementia in Special Care Units and their family and staff caregivers. The Functional Abilities Checklist measures the functional abilities of residents with dementia. The Family Perceptions of Care Tool assesses family member satisfaction with care of the institutionalized relative with dementia. The Family Perceptions of Caregiving Role instrument evaluates stress experienced by family members of individuals with dementia related to their caregiving roles in long-term care settings. The Caregiver Stress Inventory and Staff Perceptions of Caregiving Role tools measure staff stress related to caring …
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 …
Sensitivity Of Detection Of Radiofrequency Surgical Sponges: A Prospective, Cross-Over Study, Victoria Steelman
Sensitivity Of Detection Of Radiofrequency Surgical Sponges: A Prospective, Cross-Over Study, Victoria Steelman
Victoria J. Steelman
BACKGROUND: A retained surgical sponge is a serious medical error that results in negative patient outcomes. Radiofrequency (RF) technology has recently been introduced to evaluate for the presence of a retained sponge. The aim of this study was to evaluate the sensitivity and specificity of the detection of surgical sponges embedded with an RF chip through the torsos of subjects of varying body habitus, including the morbidly obese. METHODS: A prospective, crossover, and observer blinded study design was used. Subjects served as their own controls. With the subject supine, 4 surgical sponges were sequentially placed behind the subject's torso in …
Psychogeriatric Outreach To Rural Families: The Iowa And Virginia Models, I. L. Abraham, Kathleen C. Buckwalter, D. G. Snustad, D. E. Smullen, A. A. Thompson-Heisterman, J. B. Neese, Marianne Smith
Psychogeriatric Outreach To Rural Families: The Iowa And Virginia Models, I. L. Abraham, Kathleen C. Buckwalter, D. G. Snustad, D. E. Smullen, A. A. Thompson-Heisterman, J. B. Neese, Marianne Smith
Marianne Smith
Elderly residents of rural areas are at significant risk for mental health problems, yet have less access to mental health services. Thus, most mental health problems among rural elderly remain either undiagnosed or untreated. We describe two models of mental health outreach programs to rural elderly in Iowa and Virginia, serving demographically, culturally, and epidemiologically different populations in geographically and economically dissimilar regions. Programs are compared on the basis of initiation, community partnerships, target population, target region, clinical disciplines involved, coordinating discipline, referral sources, operational model, initial home assessment, care planning, sustainability, cost, patient demographics, and primary and secondary diagnosed. …
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
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 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 …
Entrepreneurial Program Of Research And Service To Improve Nursing Home Care, M. Rantz, D. Mehr, L. Hicks, Jill Scott-Cawiezell, G. Petroski, R. Madsen, R. Porter, M. Zwygart-Stauffacher
Entrepreneurial Program Of Research And Service To Improve Nursing Home Care, M. Rantz, D. Mehr, L. Hicks, Jill Scott-Cawiezell, G. Petroski, R. Madsen, R. Porter, M. Zwygart-Stauffacher
Jill Scott-Cawiezell
This is a methodological article intended to demonstrate the integration of multiple goals, multiple projects with diverse foci, and multiple funding sources to develop an entrepreneurial program of research and service to directly affect and improve the quality of care of older adults, particularly nursing home residents. Examples that illustrate how clinical ideas build on one another and how the research ideas and results build on one another are provided. Results from one study are applied to the next and are also applied to the development of service delivery initiatives to test results in the real world. Descriptions of the …
Are Nursing Homes Ready To Create Sustainable Improvement?, Jill Scott-Cawiezell
Are Nursing Homes Ready To Create Sustainable Improvement?, Jill Scott-Cawiezell
Jill Scott-Cawiezell
No abstract provided.
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 …
Nursing Home Safety: A Review Of The Literature, Jill Scott-Cawiezell, A. Vogelsmeier
Nursing Home Safety: A Review Of The Literature, Jill Scott-Cawiezell, A. Vogelsmeier
Jill Scott-Cawiezell
The number of older persons in the United States is rapidly growing and, based on this growth projection, the number of consumers needing nursing home (NH) care will likely triple in the next 10 years. Although NHs have been bombarded and scrutinized about the care that they provide, the concept of safety (specifically, error prevention) remains at the margin of most quality improvement efforts. The purpose of this review is to explore what has recently been written (2000-2005) about the evolution of the NH as an organization focused on safety and the most critical clinical processes that must be closely …
Milwaukee Police Department Retirees: Cardiovascular Disease Risk And Morbidity Among Aging Law Enforcement Officers, Sandra L. Ramey, Nancy R. Downing, W. D. Franke
Milwaukee Police Department Retirees: Cardiovascular Disease Risk And Morbidity Among Aging Law Enforcement Officers, Sandra L. Ramey, Nancy R. Downing, W. D. Franke
Sandra L. Ramey
This study explored the self-reported prevalence of cardiovascular disease (CVD) and accompanying risk factors among 165 male retirees 43 years and older (M = 56.2, SD = 7.1) from the Milwaukee Police Department (MPD) compared to 671 individuals of similar age and income who responded to the 2005 Wisconsin Behavioral Risk Factor Surveillance System (BRFSS). CVD and other risk factors were more prevalent in the MPD retirees than the general population (CVD 15.2% vs. 9.5%, p = .036; hypertension 51.5% vs. 36.2%, p = .001; hypercholesterolemia 62.4% vs. 44.4%, p = .001; overweight and obesity 85.1% vs. 74.7%, p = …
Assessment And Treatment Of Postoperative Pain In Older Adults, Barbara Rakel, Keela Herr
Assessment And Treatment Of Postoperative Pain In Older Adults, Barbara Rakel, Keela Herr
Barbara A. Rakel
No abstract provided.
Mother-Infant Breastfeeding Progress Tool: A Guide For Education And Support Of The Breastfeeding Dyad, T. Johnson, Pamela Mulder, K. Strube
Mother-Infant Breastfeeding Progress Tool: A Guide For Education And Support Of The Breastfeeding Dyad, T. Johnson, Pamela Mulder, K. Strube
Pamela J. Mulder
OBJECTIVE: To describe the development of the Mother-Infant Breastfeeding Progress Tool to be used at the bedside by nurses to guide ongoing support and education for the mother-baby dyad. DESIGN: Cross-sectional study. SETTING: Community hospital in a Midwestern city. PARTICIPANTS: Sixty-two English-speaking mother-infant dyads. METHODS: Three nurse raters (two per session) independently scored the eight characteristics on the Mother-Infant Breastfeeding Progress Tool during 81 breastfeeding sessions. MAIN OUTCOME MEASURE: Percent agreement between raters and suggested modifications for the Mother-Infant Breastfeeding Progress Tool. RESULTS: The results support the use of the tool as a checklist for assessment of the breastfeeding mother-infant …
Iatrogenesis In The Elderly. Impaired Skin Integrity, Lisa Skemp Kelley, Paula Mobily
Iatrogenesis In The Elderly. Impaired Skin Integrity, Lisa Skemp Kelley, Paula Mobily
Paula Mobily
Risk factors that contribute to pressure ulcer formation include immobility and inactivity, age, malnutrition, fecal and urinary incontinence, and a decreased level of consciousness. Gerontological nurses should collaborate with other health disciplines (eg, the physician, physical therapist, and dietitian) to plan and provide preventive treatment measures for the elderly person with potential for impaired skin integrity: pressure ulcers. Gerontological nurses must continue the development and refinement of tools with which to predict the degree of risk for impaired skin integrity, as well as use a consistent method of grading pressure ulcers.
Innovations In Geriatric Nursing Curricula: Experiences From The John A. Hartford Foundation Centers Of Geriatric Nursing Excellence, E. Souder, S. Kagan, L. Hansen, L. Macera, Paula Mobily, D. White
Innovations In Geriatric Nursing Curricula: Experiences From The John A. Hartford Foundation Centers Of Geriatric Nursing Excellence, E. Souder, S. Kagan, L. Hansen, L. Macera, Paula Mobily, D. White
Paula Mobily
No abstract provided.