Outcomes management最新文献

The investigation of healthcare professionals' practice patterns has increased sharply, in part driven by the development of practice guidelines; however, the optimal way to select providers is not known. We evaluated three distinct sources of physician specialists for completeness and potential biases. Professional society directories, which are frequently used to identify providers, provided biased populations. A national registry, the American Medical Association master file, produced the most comprehensive, least-biased single source.

A study was undertaken on the use of the Nursing Outcomes Classification (NOC) in different practice settings in Israel that included an analysis of problems that can arise in using NOC and a proposed solution. The results indicated four main problems with using the NOC in nursing practice: It is not possible to build from several indicators a weighted index for estimating patient outcomes; some of the indicators are not identical to the clinical guidelines; the grading scales depend largely on subjective judgment; and we question whether an evaluation scale of 5 grades is necessary for such numerical values as vital signs. We suggest dividing the NOC into three main categories (based on original values, objective values as suggested in the clinical guidelines, and values that require the development of quantitative indices) to enable better implementation.

Viable strategies are needed to move toward collection of a standardized nursing data set across settings for eventual use in examining nursing effectiveness. One strategy is to introduce potential nurse adopters to subsets of valid setting-specific standardized terms and measures to support adoption and initial implementation. The present study was designed to identify the "most clinically useful" NANDA (North American Nursing Diagnoses Association) diagnoses, NOC (Nursing Outcomes Classifications) outcomes, and NIC (Nursing Intervention Classifications) interventions pertinent to the adult care nurse practitioner setting. Ultimately, clinicians must recognize, however, that they will need to use additional terms and measures outside the subsets to more fully describe the nursing care provided.

Seventy-five predominately African American volunteers were enrolled in a community-based intervention program designed to lower blood pressure and HgbA1C levels in an African American population. Program components consisted of exercise, meal planning, weekly support groups, periodic cooking schools, and service coordination. Significant decreases in initial and 1-year values were seen in both systolic blood pressure (P < .0001) and diastolic blood pressure (P = .000) and HgbA1Cs for those with initial values > 7% (P = .013).

Many healthcare services, including nursing, aspire to make evidence-based practice a part of their operations. Little systematic attention, however, has been paid as to how to effectively make this happen. This article presents a conceptual framework to assist those attempting to bring about widespread evidence-based practice. In light of supportive translation research and evaluation, it emphasizes the role of culture, capacity, and infrastructure as integral to the long-term, sustained success of such efforts.

In summary, many persons have an impact on the outcomes of care and services, although some are more directly involved in day-to-day clinical care; whereas others are in support roles more removed from the clinical area. To manage outcomes effectively and ensure quality care, key stakeholders must be active participants, and an infrastructure must be in place to support the entire effort.

The ecological momentary assessment method proved to be an effective and efficient method for conducting a study to assess nursing activities across a number of hospital settings and geographic distances. Nurse administrators and outcomes researchers who are seeking to measure and assess nurse activities should consider using this approach.