Outcomes management最新文献

A need to capture patient-specific data related to heart failure outcomes led to the development of a relational database to allow for data entry at the point of care. This database provided standardization of data collection at four of the system's acute care hospitals. The data are reported to the Heart Failure Clinical Effectiveness Team to track indicators for demonstration of best practice outcomes, internal benchmarking, and identification of opportunities for performance improvement on a healthcare system level. The database development, steps toward implementation, data collection tools, and the utilization of the outcomes data are discussed.

The purpose of this study was to provide evidence of the inter-rater reliability, validity, and sensitivity of a subset of Nursing Outcomes Classification (NOC) measures, including 26 found to be "most clinically useful" in a nurse practitioner setting (NPS). Selected NPS results are compared to those obtained from a larger 10-site study. Results indicated that the measures are valid, reliable, and sensitive as clinical measures of nursing outcomes. Proper education of users can enhance psychometrics. Suggestions for strengthening the measures and further study are outlined.

The academic community-based nurse-managed center (CNC) in this study represents an innovative "nontraditional" model of primary healthcare that seeks to improve access for vulnerable uninsured urban populations. This article describes the nature of the services delivered by an academic CNC, the users of these services, and interventions provided by nurses in the CNC.

Staffing data (staff mix and nursing care hours) and patient outcome indicator data (falls, skin integrity, nosocomial infections, and satisfaction) from a pilot study are presented. These data provide a compelling case for developing databases and collection systems that capture standardized indicator and staffing data to address issues about the quality of nursing care. They also underscore the need for establishing benchmarks that represent targets of excellence as well as determining what constitutes adequate staffing.

Action research can be employed effectively when embarking on quality improvement in healthcare. This article has two aims. The first is to describe and analyze the processes taking place during an action research project that focused on evaluating and improving discharge planning at a large metropolitan teaching hospital in Sydney, Australia. The second is to discuss the factors required to improve health services through action research and the benefits of this as opposed to the traditional quality management approach (EQuIP) employed by Australian health services.

Quality of life is a term frequently used but seldom well defined in nursing research. The lack of a consistent definition and measures to assess the various quality of life dimensions makes it difficult to compare research findings across multiple studies. The aim of this article was to identify the factors that constitute quality of life as perceived by Chinese dialysis patients in Hong Kong.

Accurate prediction of fall-prone hospitalized older adults may be integral to reducing falls. The STRATIFY, a simple 5-point falls prediction tool, was prospectively validated on a Geriatric Assessment and Rehabilitation Unit as a one-time initial predictor of patients likely to fall. Sensitivity and specificity were lower than in the original British study. Introducing risk assessments validated elsewhere on a patient care unit or on a hospital-wide scale requires caution.

Chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in this country, with a total annual cost of approximately $23 billion. This study examined the impact on total resource utilization when a pulmonary specialty team manages the in-home healthcare of the patient suffering from advanced COPD. Following implementation of the pulmonary specialty team, the use of hospital, emergency department, and skilled nursing facility resources decreased while home healthcare resource use increased. The overall costs were reduced on average by more than $13,000 per patient.