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Full-Text Articles in Nursing

Iowa Case Management For Rural Drug Abuse, J. Hall, Msv Sarrazin, Diane Huber, T. Vaughn, R. Block, A. Reedy, M. Jang Nov 2011

Iowa Case Management For Rural Drug Abuse, J. Hall, Msv Sarrazin, Diane Huber, T. Vaughn, R. Block, A. Reedy, M. Jang

Diane Huber

Objective: The purpose of this research was to evaluate the effectiveness of a comprehensive, strengths-based model of case management for clients in drug abuse treatment. Method: 503 volunteers from residential or intensive outpatient treatment were randomly assigned to one of three conditions of Iowa Case Management (ICM) plus treatment as usual (TAU), or to a fourth condition of TAU only. All were assessed at intake and followed at 3, 6, and 12 months. Results: Clients in all four conditions significantly decreased substance use by 3 months after intake and maintained most gains over time. However, the addition of ICM to …


Iowa Case Management: Innovative Social Casework, J. Hall, C. Carswell, E. Walsh, Diane Huber, J. Jampoler Nov 2011

Iowa Case Management: Innovative Social Casework, J. Hall, C. Carswell, E. Walsh, Diane Huber, J. Jampoler

Diane Huber

This article describes the development of an innovative approach to case management for rural clients in drug abuse treatment. This innovative approach is discussed in the context of the broader field of case management-including social casework, public health, nursing, modern case management, and managed care. Because case management has been defined in many different ways, making comparisons of programs and models is difficult. The article presents an expanded set of criteria for comparing case management models. The Iowa Case Management model is compared with these other models across several dimensions. This article also describes the philosophy and goals of the …


Outcomes Of An Adjunct Executive Appointment For Faculty, Diane Huber, J. Maske Nov 2011

Outcomes Of An Adjunct Executive Appointment For Faculty, Diane Huber, J. Maske

Diane Huber

The Council on Graduate Education for Administration in Nursing (CGEAN) was established to further develop and improve graduate education for administration in nursing. The Council seeks to identify the nature and direction of education for administration in nursing in various healthcare systems, providing guidelines for programs offering administration. A major goal of CGEAN is facilitating dialogue between nursing service administrators and graduate level educators who are engaged in teaching and research related to administration in nursing. This column, sponsored by the members of the Council, analyzes and responds to position statements and trends related to the delivery of health services …


Participation And Retention In Drug Abuse Treatment Services Research, T. Vaughn, M. Sarrazin, S. Saleh, Diane Huber, J. Hall Nov 2011

Participation And Retention In Drug Abuse Treatment Services Research, T. Vaughn, M. Sarrazin, S. Saleh, Diane Huber, J. Hall

Diane Huber

We examined potential bias in treatment effectiveness research by studying client characteristics associated with initial participation and subsequent retention in research assessments among clients in substance abuse treatment receiving case management. Six hundred thirty-four residential and 429 outpatient clients were invited to participate. Participants were randomly assigned to one of four conditions. Logistic regression examined the relation between client characteristics and initial participation and retention in follow-up assessments. Females and clients with significant others were more likely to participate and remain in the study. Older persons and criminal justice-referred clients were less likely to participate. Older clients and urban outpatient …


Client Satisfaction With Rural Substance Abuse Case Management Services, T. Kopelman, Diane Huber, B. Kopelman, M. Sarrazin, J. Hall Nov 2011

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 …


Adjunct Executive Appointment For Faculty. An Innovation In Nursing Collaboration, K. Kelly, Diane Gardner, M. Johnson, Meridean Maas, J. Mccloskey, M. Bowers, J. Maske, S. Mathis, Janet Specht, Carol Watson Nov 2011

Adjunct Executive Appointment For Faculty. An Innovation In Nursing Collaboration, K. Kelly, Diane Gardner, M. Johnson, Meridean Maas, J. Mccloskey, M. Bowers, J. Maske, S. Mathis, Janet Specht, Carol Watson

Diane Huber

The need for collaboration has never been greater. The healthcare delivery system faces unprecedented challenges arising from prospective payment, competition in the marketplace, higher patient acuity levels, and a shortage of professional nursing staff. The authors discuss a service-education collaboration model based on adjunct executive appointments of faculty members to healthcare organizations. The authors describe the model, a conceptual framework to guide its development, case studies of its implementation, and a summary of the benefits and risks associated with the initial implementation of the model.


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 Nov 2011

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 …


An Approach To Managing Latex Allergy In The Health Care Worker, B. Muller, Victoria Steelman, P. Hartley, T. Casale Nov 2011

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 …


Using Existing Databases For Product Evaluation: Silver-Treated Catheter Trial, M. Wagner, L. Dolan, Victoria Steelman, M. Boyd Nov 2011

Using Existing Databases For Product Evaluation: Silver-Treated Catheter Trial, M. Wagner, L. Dolan, Victoria Steelman, M. Boyd

Victoria J. Steelman

No abstract provided.


Infection Control. Quality Assessment, Improvement, Victoria Steelman Nov 2011

Infection Control. Quality Assessment, Improvement, Victoria Steelman

Victoria J. Steelman

No abstract provided.


Prion Diseases--An Evidence-Based Protocol For Infection Control, Victoria Steelman Nov 2011

Prion Diseases--An Evidence-Based Protocol For Infection Control, Victoria Steelman

Victoria J. Steelman

Prion diseases are fatal, infectious, neurodegenerative disorders with special implications for infection control in the OR. The causative agent is highly resistant to disinfection and sterilization processes and has been transmitted during health care interactions. It is important to use evidence gained through research and case reports to minimize risk of infection. This article describes an infection control protocol developed for identifying high-risk patients, providing perioperative care, decontaminating the OR, and protecting health care personnel. This protocol provides multidisciplinary team members with a guideline for preventing transmission of these fatal diseases.


Ethylene Oxide. The Importance Of Aeration, Victoria Steelman Nov 2011

Ethylene Oxide. The Importance Of Aeration, Victoria Steelman

Victoria J. Steelman

Residual EO on instruments and supplies can cause serious patient injuries. It is imperative that these items be adequately aerated before they are used. Removing instruments prematurely from an aerator is, indeed, "a blatant disregard for patient safety." The perioperative nurse has the responsibility and accountability for patient protection. Preventive measures and alternatives to using improperly aerated instruments have been described. If these measures do not resolve the problem, the surgery must be postponed until adequately aerated instruments are available.


Innovative University Partnership Meets Neonatal Nurse Practitioner Program Need Amid Faculty Shortage, Rebecca Siewert, L. B. Rasmussen, M. A. Lofgren, Patricia Clinton Nov 2011

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

Rebecca Siewert

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 …


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 Nov 2011

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 …


University Of Iowa Hospital And Clinics: Outcomes Management, Mary Berg, M. Dreher, K. Davenport, J. Greiner, R. Howell, A. Mutnick, G. Jensen, Barbara Rakel, F. Johlin, V. Kraus, R. Reiter, K. Leo, J. Ryan, J. Mccloskey Nov 2011

University Of Iowa Hospital And Clinics: Outcomes Management, Mary Berg, M. Dreher, K. Davenport, J. Greiner, R. Howell, A. Mutnick, G. Jensen, Barbara Rakel, F. Johlin, V. Kraus, R. Reiter, K. Leo, J. Ryan, J. Mccloskey

Barbara A. Rakel

Delivery of quality patient care and management of patient outcomes is critical to the success of academic medical centers in the ever-changing health care market. The University of Iowa Hospitals and Clinics (UIHC) promotes quality care through the provision of organizational structures and processes that are described in this article. In addition, quality of care and outcomes management are described by members in various roles within the UIHC health care system. It is the authors' belief that understanding quality from these various perspectives helps UIHC work across departments to achieve excellence in patient care.


An Epidemiologic Analysis Of Pain In The Elderly: The Iowa 65+ Rural Health Study, Paula Mobily, Keela Herr, M. Clark, R. Wallace Oct 2011

An Epidemiologic Analysis Of Pain In The Elderly: The Iowa 65+ Rural Health Study, Paula Mobily, Keela Herr, M. Clark, R. Wallace

Paula Mobily

No abstract provided.


Young Nurse Clinician Programs: Geriatric, Pediatric, And Community Health, Mary Berg, S. Lehmann, Paula Mobily Oct 2011

Young Nurse Clinician Programs: Geriatric, Pediatric, And Community Health, Mary Berg, S. Lehmann, Paula Mobily

Paula Mobily

In most nursing programs, limited options exist beyond the required nursing curricula for students to continue career growth in a nursing specialty area at the undergraduate level. The authors describe the Young Nurse Clinician Programs, an innovative approach that provides individualized educational opportunities to select nursing students to promote leadership and foster interest in geriatric, pediatric, and community health nursing.


The Young Gerontological Nurse Clinician Program: An Innovative Geropsychiatric Nursing Recruitment Strategy, Janet Specht, Paula Mobily Oct 2011

The Young Gerontological Nurse Clinician Program: An Innovative Geropsychiatric Nursing Recruitment Strategy, Janet Specht, Paula Mobily

Paula Mobily

Historically, graduate nurses are not attracted to older adults or geriatric care. Innovative strategies, such as the Young Gerontological Nurse Clinician Program (YGNCP) initiated by the John A. Hartford Center for Geriatric Nursing Excellence at the University of Iowa, are needed to promote geriatric nursing as a challenging and rewarding practice focus. The YGNCP, which provides early, positive, self-directed experiences for nursing students under the direction and supervision of faculty and expert clinical mentors, shows excellent potential for recruiting nurses to clinical and leadership positions in geriatric and geropsychiatric care.


Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega Oct 2011

Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega

Paula Mobily

Acute confusion (AC), also referred to as delirium (AC/delirium), is a common problem seen by health professionals who work in a variety of care settings. This is an evaluative report on the clinical usability of instruments to assess AC/delirium as a part of nursing practice. Specifically, five instruments [the Confusion Assessment Method (CAM), Delirium Rating Scale (DRS), Delirium Symptom Inventory (DSI), Mini-Mental State Examination (MMSE), and Neelon/Champagne (NEECHAM) Confusion Scale] are discussed. The work demonstrates how the cooperation of nurses in practice, education, and research can improve both patient and staff outcomes.


Clinical Methods. Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega Oct 2011

Clinical Methods. Acute Confusion Assessment Instruments: Clinical Versus Research Usability, C. Rapp, B. Wakefield, M. Kundrat, J. Mentes, Toni Tripp-Reimer, Kennith Culp, Paula Mobily, J. Akins, L. Onega

Paula Mobily

Acute confusion (AC), also referred to as delirium (AC/delirium), is a common problem seen by health professionals who work in a variety of care settings. This is an evaluative report on the clinical usability of instruments to assess AC/delirium as a part of nursing practice. Specifically, five instruments [the Confusion Assessment Method (CAM), Delirium Rating Scale (DRS), Delirium Symptom Inventory (DSI), Mini-Mental State Examination (MMSE), and Neelon/Champagne (NEECHAM) Confusion Scale] are discussed. The work demonstrates how the cooperation of nurses in practice, education, and research can improve both patient and staff outcomes.


Issues Of Medication Administration And Control In Iowa Schools, K. Farris, Ann Mccarthy, M. Kelly, D. Clay, J. Gross Oct 2011

Issues Of Medication Administration And Control In Iowa Schools, K. Farris, Ann Mccarthy, M. Kelly, D. Clay, J. Gross

Ann Marie McCarthy

Who is responsible for medication administration at school? To answer this question, a descriptive, self-administered survey was mailed to a random sample of 850 school principals in Iowa. The eight-page, 57-item, anonymous survey was mailed first class, and a follow-up reminder post card was mailed two weeks later. Descriptive analyses were conducted, with type of respondent (principal versus school nurse), grade level, and size of school examined to explore differences. A 46.6% response rate was obtained; 97% of respondents indicated their schools had written guidelines for medication administration. Principals (41%) and school nurses (34%) reported that they have the ultimate …


Psychological Screening Of Children For Participation In Nontherapeutic Invasive Research, Ann Mccarthy, L. Richman, R. Hoffman, L. Rubenstein Oct 2011

Psychological Screening Of Children For Participation In Nontherapeutic Invasive Research, Ann Mccarthy, L. Richman, R. Hoffman, L. Rubenstein

Ann Marie McCarthy

BACKGROUND: The need for children to participate in research has raised concerns about ethical issues surrounding their participation. OBJECTIVES: To describe a protocol of preresearch psychological screening and postresearch outcomes and to present the results of the screening process for a nontherapeutic, invasive research study. DESIGN AND SETTING: Descriptive study carried out at The University of Iowa Hospitals and Clinics, Iowa City. PARTICIPANTS: Twenty-eight children (mean age, 10.6 years) were screened, with 4 not completing the research study and another 4 unavailable for psychological follow-up. MAIN OUTCOME MEASURES: Prescreening interviews with parent and child and screening measures of appropriate child …


A Policy Change Strategy For Head Lice Management, K. Andresen, Ann Mccarthy Oct 2011

A Policy Change Strategy For Head Lice Management, K. Andresen, Ann Mccarthy

Ann Marie McCarthy

The purpose of this project was to formulate an effective change strategy for head lice management in a group of five separate school districts within one county. Despite a desire to use evidence to support their practice, school nurses often encounter educational system barriers that prevent independent management of health conditions. The use of collaborative community relationships, identification of underlying hierarchy structures in school policy development, and targeted system education were the catalysts for changing beliefs and ultimately policy within these school districts. The focus of this project was to develop a policy change strategy for head lice. The strategy …


Iowa Certified Nursing Assistants Study: Self-Reported Ratings Of The Nursing Home Work Environment, Kennith Culp, S. Ramey, S. Karlman Oct 2011

Iowa Certified Nursing Assistants Study: Self-Reported Ratings Of The Nursing Home Work Environment, Kennith Culp, S. Ramey, S. Karlman

Kennith R. Culp

No abstract provided.


Risk For Acute Confusion In Sensory-Impaired, Rural, Long-Term-Care Elders, P. Cacchione, Kennith Culp, M. Dyck, J. Laing Oct 2011

Risk For Acute Confusion In Sensory-Impaired, Rural, Long-Term-Care Elders, P. Cacchione, Kennith Culp, M. Dyck, J. Laing

Kennith R. Culp

Acute confusion is a common geriatric syndrome in long-term care (LTC) elders with prevalence rates of 10% to 39%. Sensory impairment, specifically vision and hearing impairment, is even more common in LTC, with prevalence rates of 40% to 90%. The purpose of this study was to investigate the risk relationship between sensory impairment and the development of acute confusion in LTC elders. Each resident (N = 114) underwent sensory screening and then was followed for 28 days to monitor for the onset of acute confusion. Twenty residents (17.5%) developed acute confusion, 60 residents (52.6%) were found to be visually impaired, …


Hydration And Acute Confusion In Long-Term Care Residents... Including Commentary By Lindgren Cl And Mills Em With Author Response, Kennith Culp, J. Mentes, B. Wakefield Oct 2011

Hydration And Acute Confusion In Long-Term Care Residents... Including Commentary By Lindgren Cl And Mills Em With Author Response, Kennith Culp, J. Mentes, B. Wakefield

Kennith R. Culp

Although it is generally appropriate for a healthy adult to consume 2000 to 2500 ml per day, the literature does not address evaluating any standard. The objective here was to develop a weight-based hydration management intervention and evaluate the impact of this on the incidence of acute confusion (AC) using an N = 98. The intervention consisted of a fluid intake goal based on 100 ml per kg for the first 10 kg, 50 ml/kg for the next 10 kg, and 15 ml for the remaining body weight. The treatment group received instruction and assistance on the fluid goal and …


Risk Factors And Outcomes Associated With Hospital Admission For Dehydration, B. Wakefield, J. Mentes, J. Holman, Kennith Culp Oct 2011

Risk Factors And Outcomes Associated With Hospital Admission For Dehydration, B. Wakefield, J. Mentes, J. Holman, Kennith Culp

Kennith R. Culp

The hospital admission rate for dehydration is one of the Agency for Healthcare Research and Quality Prevention's Quality Indicators, which are considered screening tools for potential quality issues. Thus, admission for dehydration may reflect the quality of care provided in community settings. Using a case-control design, this study estimated the incidence, risk factors, and outcomes of dehydration in adults admitted to the hospital. The overall prevalence rate for three International Classification of Diseases codes for dehydration at admission was 0.55%. Cases and controls differed significantly on a number of clinical variables at admission, including weight, body mass index, pulse, blood …


Comparing The Geriatric Depression Scale, Minimum Data Set, And Primary Care Provider Diagnosis For Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter Oct 2011

Comparing The Geriatric Depression Scale, Minimum Data Set, And Primary Care Provider Diagnosis For Depression In Rural Nursing Home Residents, C. Kerber, M. Dyck, Kennith Culp, Kathleen Buckwalter

Kennith R. Culp

BACKGROUND: Depression has a substantial negative impact on quality of life. Underdiagnosis and undertreatment of depression are major problems in nursing home residents. OBJECTIVES: This study sought to determine the prevalence of depression among older adults in nursing homes in rural Iowa using the Geriatric Depression Scale (GDS), Minimum Data Set (MDS), and primary care provider (PCP) depression diagnosis. DESIGN: This is a secondary analysis of data collected from 279 randomly selected residents of nursing homes in rural Iowa. RESULTS: The prevalence of depression based on the GDS (score of 6 or greater) was 37.3%, the MDS was 21.3%, and …


Reducing Hydration-Linked Events In Nursing Home Residents... Including Commentary By Godkin D, J. Mentes, Kennith Culp Oct 2011

Reducing Hydration-Linked Events In Nursing Home Residents... Including Commentary By Godkin D, J. Mentes, Kennith Culp

Kennith R. Culp

The authors used a quasi-experimental treatment and control group design with 49 participants from four nursing homes to test the effectiveness of an 8-week hydration intervention in reducing hydration-linked events (HLEs). A Kaplan Meier survival curve with log rank test was calculated to determine incidence and time to occurrence of a HLE. Incidence of and time to a HLE did not differ between the treatment and control groups over an 8-week period (p > .05). However, treatment group participants were found to be more frail, more cognitively impaired and more at risk for acute confusion than the control group participants. Although …


Use Of A Urine Color Chart To Monitor Hydration Status In Nursing Home Residents, J. Mentes, B. Wakefield, Kennith Culp Oct 2011

Use Of A Urine Color Chart To Monitor Hydration Status In Nursing Home Residents, J. Mentes, B. Wakefield, Kennith Culp

Kennith R. Culp

To determine whether urine color, as measured by a color chart, might be a valid indicator of hydration status in frail nursing home residents, this study tested the associations between urine color and urine specific gravity. This is a descriptive correlational study set in seven nursing homes in eastern Iowa. Ninety-eight nursing home residents > or =65 years of age participated. Exclusion criteria for the study included: unstable congestive heart failure or diabetes, documented renal disease, hyponatremia (serum sodium or =50 ml/min) had significant associations between average urine color and average Usg. Females with mild renal impairment (CrCl between 30 and …