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The Association Between Hospital Obstetrical Volume And Maternal Postpartum Complications, Kathy Kyser, Xin Lu, Donna Santillan, Mark Santillan, Stephen Hunter, Alison Cahill, Peter Cram Sep 2013

The Association Between Hospital Obstetrical Volume And Maternal Postpartum Complications, Kathy Kyser, Xin Lu, Donna Santillan, Mark Santillan, Stephen Hunter, Alison Cahill, Peter Cram

Stephen K. Hunter

OBJECTIVE: The purpose of this study was to examine the relationship between delivery volume and maternal complications. STUDY DESIGN: We used administrative data to identify women who had been admitted for childbirth in 2006. Hospitals were stratified into deciles that were based on delivery volume. We compared composite complication rates across deciles. RESULTS: We evaluated 1,683,754 childbirths in 1045 hospitals. Decile 1 and 2 hospitals had significantly higher rates of composite complications than decile 10 (11.8% and 10.1% vs 8.5%, respectively; P < .0001). Decile 9 and 10 hospitals had modestly higher composite complications as compared with decile 6 (8.8% and …


A Mandatory Single Blastocyst Transfer Policy With Educational Campaign In A United States Ivf Program Reduces Multiple Gestation Rates Without Sacrificing Pregnancy Rates, Ginny Ryan, Amy Sparks, C. Sipe, Craig Syrop, A. Dokras, Bradley Van Voorhis Jun 2013

A Mandatory Single Blastocyst Transfer Policy With Educational Campaign In A United States Ivf Program Reduces Multiple Gestation Rates Without Sacrificing Pregnancy Rates, Ginny Ryan, Amy Sparks, C. Sipe, Craig Syrop, A. Dokras, Bradley Van Voorhis

Amy E.T. Sparks

OBJECTIVE: To reduce the twin rate in our IVF program. DESIGN: A prospective educational study of infertile couples; a retrospective review of IVF outcomes before vs. after mandatory single embryo transfer (mSBT) policy change. SETTING: University-based infertility center. PATIENT(S): One hundred ten of 120 consecutive new infertile couples completed the educational study. Outcomes of all embryo transfers (n = 693) performed 17 months before and 17 months after mSBT were evaluated. INTERVENTION(S): A 1-page educational summary of comparative risks of twins vs. singletons to maternal and child health. MAIN OUTCOME MEASURE(S): Knowledge of twin risks and desired number of embryos …


A Mandatory Single Blastocyst Transfer Policy With Educational Campaign In A United States Ivf Program Reduces Multiple Gestation Rates Without Sacrificing Pregnancy Rates, Ginny Ryan, Amy Sparks, C. Sipe, Craig Syrop, A. Dokras, Bradley Van Voorhis Jun 2013

A Mandatory Single Blastocyst Transfer Policy With Educational Campaign In A United States Ivf Program Reduces Multiple Gestation Rates Without Sacrificing Pregnancy Rates, Ginny Ryan, Amy Sparks, C. Sipe, Craig Syrop, A. Dokras, Bradley Van Voorhis

Bradley J Van Voorhis

OBJECTIVE: To reduce the twin rate in our IVF program. DESIGN: A prospective educational study of infertile couples; a retrospective review of IVF outcomes before vs. after mandatory single embryo transfer (mSBT) policy change. SETTING: University-based infertility center. PATIENT(S): One hundred ten of 120 consecutive new infertile couples completed the educational study. Outcomes of all embryo transfers (n = 693) performed 17 months before and 17 months after mSBT were evaluated. INTERVENTION(S): A 1-page educational summary of comparative risks of twins vs. singletons to maternal and child health. MAIN OUTCOME MEASURE(S): Knowledge of twin risks and desired number of embryos …


Outcomes From Assisted Reproductive Technology, Bradley Van Voorhis Jun 2013

Outcomes From Assisted Reproductive Technology, Bradley Van Voorhis

Bradley J Van Voorhis

The use of assisted reproductive technology (ART) for treating the infertile couple is increasing in the United States. The purpose of this paper is to review the short-term outcomes after ART. Pregnancy rates after ART have shown nearly continuous improvement in the years since its inception. A number of factors affect the pregnancy rate, with the most important being a woman's age. Certain clinical diagnoses are associated with a poorer outcome from ART, including the presence of hydrosalpinges, uterine leiomyomata that distort the endometrial cavity, and decreased ovarian reserve. Multiple gestations are the major complication after ART. New laboratory techniques, …


A Mandatory Single Blastocyst Transfer Policy With Educational Campaign In A United States Ivf Program Reduces Multiple Gestation Rates Without Sacrificing Pregnancy Rates, Ginny Ryan, Amy Sparks, C. Sipe, Craig Syrop, A. Dokras, Bradley Van Voorhis May 2013

A Mandatory Single Blastocyst Transfer Policy With Educational Campaign In A United States Ivf Program Reduces Multiple Gestation Rates Without Sacrificing Pregnancy Rates, Ginny Ryan, Amy Sparks, C. Sipe, Craig Syrop, A. Dokras, Bradley Van Voorhis

Ginny L. Ryan

OBJECTIVE: To reduce the twin rate in our IVF program. DESIGN: A prospective educational study of infertile couples; a retrospective review of IVF outcomes before vs. after mandatory single embryo transfer (mSBT) policy change. SETTING: University-based infertility center. PATIENT(S): One hundred ten of 120 consecutive new infertile couples completed the educational study. Outcomes of all embryo transfers (n = 693) performed 17 months before and 17 months after mSBT were evaluated. INTERVENTION(S): A 1-page educational summary of comparative risks of twins vs. singletons to maternal and child health. MAIN OUTCOME MEASURE(S): Knowledge of twin risks and desired number of embryos …


Embryo Transfer Practices In The United States: A Survey Of Clinics Registered With The Society For Assisted Reproductive Technology, E. Jungheim, Ginny Ryan, E. Levens, A. Cunningham, G. Macones, K. Carson, A. Beltsos, R. Odem May 2013

Embryo Transfer Practices In The United States: A Survey Of Clinics Registered With The Society For Assisted Reproductive Technology, E. Jungheim, Ginny Ryan, E. Levens, A. Cunningham, G. Macones, K. Carson, A. Beltsos, R. Odem

Ginny L. Ryan

OBJECTIVE: To gain a better understanding of factors influencing clinicians' embryo transfer practices. DESIGN: Cross-sectional survey. SETTING: Web-based survey conducted in December 2008 of individuals practicing IVF in centers registered with the Society for Assisted Reproductive Technology (SART). PATIENT(S): None. INTERVENTION(S): None. MAIN OUTCOME MEASURE(S): Prevalence of clinicians reporting following embryo transfer guidelines recommended by the American Society for Reproductive Medicine (ASRM), prevalence among these clinicians to deviate from ASRM guidelines in commonly encountered clinical scenarios, and practice patterns related to single embryo transfer. RESULT(S): Six percent of respondents reported following their own, independent guidelines for the number of embryos …


The Pharmaceutical Industry: Friend Or Foe?, Jennifer Niebyl May 2013

The Pharmaceutical Industry: Friend Or Foe?, Jennifer Niebyl

Jennifer R Niebyl

No abstract provided.


Perinatal Management Of Women With Immune Thrombocytopenic Purpura: Survey Of United States Perinatologists, D. Peleg, Stephen Hunter May 2013

Perinatal Management Of Women With Immune Thrombocytopenic Purpura: Survey Of United States Perinatologists, D. Peleg, Stephen Hunter

Stephen K. Hunter

OBJECTIVE: The aim of the study was to determine how perinatologists in the United States manage the care of women with immune thrombocytopenic purpura with respect to mode of delivery. Study Design: US members of the Society of Perinatal Obstetricians were surveyed with a 4-question questionnaire. Two mailings were sent. Questions 1 and 2 asked for a response regarding the perinatal management of delivery for women with chronic immune thrombocytopenic purpura and new-onset disease. The options were cordocentesis or fetal scalp blood sampling and cesarean delivery if the platelet count was <50,000 cells/microL, cesarean delivery if the maternal platelet count …


Group B Streptococci Causing Neonatal Bloodstream Infection: Antimicrobial Susceptibility And Serotyping Results From Sentry Centers In The Western Hemisphere, J. Andrews, D. Diekema, Stephen Hunter, P. Rhomberg, M. Pfaller, R. Jones, G. Doern May 2013

Group B Streptococci Causing Neonatal Bloodstream Infection: Antimicrobial Susceptibility And Serotyping Results From Sentry Centers In The Western Hemisphere, J. Andrews, D. Diekema, Stephen Hunter, P. Rhomberg, M. Pfaller, R. Jones, G. Doern

Stephen K. Hunter

OBJECTIVE: Group B streptococcal infection is a common cause of neonatal sepsis. Surveillance of antimicrobial susceptibility and serotype frequencies of invasive group B streptococci is important to ensure the effectiveness of therapeutic regimens and to guide vaccine development. STUDY DESIGN: Prospective surveillance of neonatal bloodstream infection was performed at all Western Hemisphere sites participating in the SENTRY Program. From January 1997 through December 1999, a total of 122 isolates of bloodstream infections with group B streptococci were collected and sent to the University of Iowa for antimicrobial susceptibility testing and serotyping. RESULTS: No isolates were resistant to penicillin. More than …


The Sensitivity And Specificity Of A Simple Test To Distinguish Between Urge And Stress Urinary Incontinence, J. S. Brown, Catherine Bradley, L. L. Subak, H. E. Richter, S. R. Kraus, L. Brubaker, F. Lin, E. Vittinghoff, D. Grady Apr 2013

The Sensitivity And Specificity Of A Simple Test To Distinguish Between Urge And Stress Urinary Incontinence, J. S. Brown, Catherine Bradley, L. L. Subak, H. E. Richter, S. R. Kraus, L. Brubaker, F. Lin, E. Vittinghoff, D. Grady

Catherine S. Bradley

BACKGROUND: Urinary incontinence is common in women. Because treatments differ, urge incontinence should be distinguished from stress incontinence. To make this distinction, current guidelines recommend an extensive evaluation that is too time-consuming for primary care practice. OBJECTIVE: To test the accuracy of a simple questionnaire to categorize type of urinary incontinence in women. DESIGN: Multicenter, prospective study of the accuracy of the 3 Incontinence Questions (3IQ) compared with an extended evaluation to distinguish between urge incontinence and stress incontinence. SETTING: 5 academic medical centers in the United States. PARTICIPANTS: 301 women enrolled from April to December 2004 who were older …


A Comparison Of Hospice In The Us And Uk: Implications For Policy And Practice, Ruth Remington, G Wakim Feb 2013

A Comparison Of Hospice In The Us And Uk: Implications For Policy And Practice, Ruth Remington, G Wakim

Ruth Remington

The modern hospice movement in the United States was modeled on the specialized care for dying individuals that was championed by Dame Cicely Saunders, a social worker, nurse, and physician, in London in the 1960s. A collaboration between Saunders and Florence Wald, then at Yale University, led to the establishment of the first hospice in the United States in 1974. Despite similar foundations, the provision of hospice care differs in the United States and the United Kingdom with regard to financing and access. This article reviews these similarities and differences and discusses implications for U.S. hospice policy.


The Independent Nurse Role In Community Care Gerontological Nursing, Deborah Schoenfelder, Janet Specht, Meridean Maas Oct 2012

The Independent Nurse Role In Community Care Gerontological Nursing, Deborah Schoenfelder, Janet Specht, Meridean Maas

Deborah P. Schoenfelder

No abstract provided.


Homesafe: Supportive Assistance For Elderly Individuals Through A Nurse-Managed Plan, Deborah Schoenfelder, Meridean Maas, Janet Specht Oct 2012

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 1, Cormac O'Sullivan, E. Thompson Sep 2012

Economics And The Education Of Nurse Anesthetists: Part 1, Cormac O'Sullivan, E. Thompson

Cormac T. O'Sullivan

No abstract provided.


Economics And The Education Of Nurse Anesthetists: Part 2, Cormac O'Sullivan, E. Thompson Sep 2012

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 Sep 2012

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 …


Innovativeness In Nursing: A Phenomenological And Constructivist Study, Maria Joseph Sep 2012

Innovativeness In Nursing: A Phenomenological And Constructivist Study, Maria Joseph

Maria (Lindell) Joseph

Hospital administration and the medical field have maintained the status quo of nursing practice, in which nurses have adopted bureaucratic structures where conformity and regimentation are maintained to ensure large-scale efficiency. The lack of control to act on nursing knowledge and expert judgment is linked to work conditions of oppression, lack of autonomy, dissatisfaction, concomitant patient mortality, and morbidity. A climate of innovativeness is one strategy to reverse the negative impact caused by hospital administration and the medical field. The purpose of this phenomenological study was to explore the behavioral characteristics of lived experiences and knowledge of innovativeness among nurses …


An Examination Of The Sustainable Adoption Of Whole-Person Care (Wpc), Maria Joseph, D. Laughon, Richard Bogue Sep 2012

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 Sep 2012

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 Sep 2012

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 …


Ndec Guidelines For Development And Evaluation Of Diagnoses, Martha Craft-Rosenberg, Connie Delaney, J. Denehy Aug 2012

Ndec Guidelines For Development And Evaluation Of Diagnoses, Martha Craft-Rosenberg, Connie Delaney, J. Denehy

Martha J. Craft-Rosenberg

No abstract provided.


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 Aug 2012

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.


Health Care Quality And Outcome Guidelines For Nursing Of Children And Families: Implications For Pediatric Nurse Practitioner Practice, Research, And Policy, C. Betz, J. Cowell, Martha Craft-Rosenberg, M. Krajicek, M. Lobo Aug 2012

Health Care Quality And Outcome Guidelines For Nursing Of Children And Families: Implications For Pediatric Nurse Practitioner Practice, Research, And Policy, C. Betz, J. Cowell, Martha Craft-Rosenberg, M. Krajicek, M. Lobo

Martha J. Craft-Rosenberg

No abstract provided.


The Disclosure Decisions Of Parents Who Conceive Children Using Donor Eggs, S. Hahn, Martha Craft-Rosenberg Aug 2012

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 Aug 2012

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 Aug 2012

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 Aug 2012

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.


Academic Freedom And Academic Duty To Teach Social Justice: A Perspective And Pedagogy For Public Health Nursing Faculty, N. Fahrenwald, Janette Taylor, S. Kneipp, M. Canales Aug 2012

Academic Freedom And Academic Duty To Teach Social Justice: A Perspective And Pedagogy For Public Health Nursing Faculty, N. Fahrenwald, Janette Taylor, S. Kneipp, M. Canales

Janette Y. Taylor

Public health nursing practice is rooted in the core value of social justice. Nursing faculty whose expertise is in public health are often the content experts responsible for teaching this essential, yet potentially controversial, value. Contemporary threats to academic freedom remind us that the disciplinary autonomy and academic duty to teach social justice may be construed as politically ideological. These threats are of particular concern when faculty members guide students through a scientific exploration of sociopolitical factors that lead to health-related social injustices and encourage students to improve and transform injustices in their professional careers. This article (a) reviews recent …


Assessing Intimate Partner Violence In Incarcerated Women, M. Eliason, Janette Taylor, S. Arndt Aug 2012

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 Aug 2012

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 …