Journal articles: 'Nursing sensitive outcome'

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Grant, Susan M., Lorie Wild, and Jeanne Vincent. "Process and outcome measures using nursing sensitive indicators." Nurse Leader 2, no. 2 (April 2004): 46–49. http://dx.doi.org/10.1016/j.mnl.2004.01.013.

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Gonçalves, Isabel, Diana Arvelos Mendes, Sílvia Caldeira, Élvio Jesus, and Elisabete Nunes. "The Primary Nursing Care Model and Inpatients’ Nursing-Sensitive Outcomes: A Systematic Review and Narrative Synthesis of Quantitative Studies." International Journal of Environmental Research and Public Health 20, no. 3 (January 29, 2023): 2391. http://dx.doi.org/10.3390/ijerph20032391.

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Background: The delivery of quality, safe, and patient-centered care is foundational for professional practice. The primary nursing model allows nurses to have excellent knowledge about patients and families and to plan and coordinate care from admission to discharge, with better management of health situations. Nurses play a crucial role in improving patients’ outcomes, namely those sensitive to nursing care. The knowledge of the relationship between the primary nursing model and the nursing-sensitive outcomes provides new scientific evidence that strengthens the relevance of this nursing care organization model in the inpatients’ health outcomes. This systematic review describes the relationship between nurse-sensitive inpatients’ outcomes and the primary nursing care model. Methods: A systematic review was conducted with a narrative synthesis, and the following databases were searched: MEDLINE, CINAHL, Web of Science, Nursing & Allied Health Collection, SciELO Collections, and Cochrane. Results: A total of 22 full texts were assessed, of which five were included in the study according to the selection criteria. The analysis results indicated that the primary nursing care model was related to nursing-sensitive patient safety outcomes. Patients’ experience was also considered a nursing-sensitive outcome, namely in the satisfaction with nursing care. Conclusion: The negative outcomes are clearly related to the primary nursing care model. There is scarce research that relates primary nursing to positive outcomes, such as patients’ functional status and self-care abilities, and more studies are needed.

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Yassien, Sahar, and Mona Hamdi. "Measuring Nursing Sensitive Outcomes in Patient with Acute Myocardial Infarction: Tool Development and Validation." Evidence-Based Nursing Research 1, no. 1 (April 11, 2019): 12. http://dx.doi.org/10.47104/ebnrojs3.v1i1.32.

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Context: The outcomes movement is a young science, improving care by determining the outcomes of nursing interventions will give scientific validity to strategies that are used by nursing in a variety of venues. Cardiovascular nurses contribute significantly to health outcomes and frequently assume responsibility for the clinical and organizational processes to ensure positive outcomes for patients and families Aims: The aims of this study were to identify nursing-sensitive outcomes in patients with acute myocardial infarction, to develop a tool to measure nursing-sensitive outcomes of caring patients with myocardial infarction, and to evaluate the content, face validity, reliability and nursing sensitivity of 46 nursing sensitive-outcomes concerning bio-psycho-socio- educational aspects of care for patients with myocardial infarction from the Nursing Outcomes Classification (NOC). Methods: A survey research design was used in this study to assess the content and face validity of the designed instrument and inter-rater reliability was utilized to assure its reliability. Thirty patients with acute myocardial infarction subjected to measuring their nursing-sensitive outcomes during their stay in the CCUs or intermediate units. Fifty-nine experts were invited to participate in this study. Nursing-Sensitive Outcomes Measuring Scale was developed and subjected to testing reliability, validity, and sensitivity Results: Most of the studied outcomes showed a high degree of consistency as indicated by ICC that was above 0.900. 100% of the experts rated 14 out of 46 outcomes as very important; the remaining outcomes were assessed by more than 75% of the experts as important. Also, 18 out of 46 outcomes were rated by the 100% experts as very sensitive to the contribution of nursing intervention; no one outcome was rated as not important or not sensitive for nursing contribution. Conclusions: The study provided evidence of outcomes content validity, reliability, and nursing sensitivity of the studied outcomes. The study recommended the testing of NOC outcomes in various clinical settings with appropriate training for nurses, and the inclusion of NOC into nursing curricula to utilized in clinical education as a continuum for nursing diagno- ses classification.

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Krapohl, Greta, Milisa Manojlovich, Richard Redman, and Lingling Zhang. "Nursing Specialty Certification and Nursing-Sensitive Patient Outcomes in the Intensive Care Unit." American Journal of Critical Care 19, no. 6 (November 1, 2010): 490–98. http://dx.doi.org/10.4037/ajcc2010406.

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Background To the public and to individual nurses, certification usually means expert, high-quality, competent nursing care. Little research, however, has yielded results that support, or refute, any differences in clinical practice between certified and noncertified nurses. Objectives To determine whether the proportion of certified nurses on a unit is associated with the rate of nurse-sensitive patient outcomes. Methods A nonexperimental, correlational, descriptive design was used to anonymously survey 866 nurses working in 25 intensive care units in Southeast Michigan. The Conditions for Work Effectiveness Questionnaire-II was used to measure workplace empowerment, and an additional question was asked about certification status. Outcome data were simultaneously collected on 3 nurse-sensitive patient outcomes: (1) rate of central line catheter-associated blood stream infection, (2) rate of ventilator-associated pneumonia, and (3) prevalence of pressure ulcers. Data were aggregated and analyzed at the unit level. Results No significant relationship was found between the proportion of certified nurses on a unit and patients’ outcomes. The association between nurses’ perception of overall work-place empowerment and certification, however, was positive and statistically significant (r=.397, P=.05). Conclusions Although a link between certification and nurse-sensitive outcomes was not established, the association between workplace empowerment and the proportion of certified nurses on a unit underscores the importance of organizational factors in the promotion of nursing certification.

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Behrenbeck, Julia G., Jane A. Timm, Linda K. Griebenow, and Kathy A. Demmer. "Nursing-Sensitive Outcome Reliability Testing in a Tertiary Care Setting." International Journal of Nursing Terminologies and Classifications 16, no. 1 (January 2005): 14–20. http://dx.doi.org/10.1111/j.1744-618x.2005.00002.x.

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El-Sayed, Reham, Tahany El-Senousy, and Sahar Yassien. "Effect of Self-Care Management on Nursing-Sensitive Patients’ Outcomes after Permanent Pacemaker Implantation." Evidence-Based Nursing Research 1, no. 1 (April 11, 2019): 11. http://dx.doi.org/10.47104/ebnrojs3.v1i1.29.

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Context: Nursing is striving to build a knowledge base that supports professional practice and improves the quality of care. Aim: This study aimed to evaluate the effect of self-care management guidelines on nursing-sensitive patients' outcomes after permanent pacemaker implantation. Methods: A quasi-experimental design was utilized in this study. A purposive sample of 50 patients admitted to the cardiac catheterization unit at Ain Shams University Hospital after permanent pacemaker implantation during their follow up visit. They are divided into two matched group study and control groups. Their mean age ±SD was 45.37±5.76, and 48.75±4.27 successively. Patient socio-demographic characteristic and medical data sheet, self-care management level assessment scale, and nursing-sensitive outcomes measuring scale were utilized to achieve the study aim. Results: The study results revealed positive outcomes for patients of the study group compared to the controls and their pre-implementation level of self-care guidelines. Conclusion: The study concludes that implementation of self-care management guidelines reflected positively on enhancing all dimensions of nursing-sensitive patients' outcomes recommending that it should be applied in all cardiac catheterization units and should be updated periodically to enhance self-care management for those patients based on nursing-sensitive outcome classification.

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Haun, Courtney N., Zachary B. Mahafza, Chassidy L. Cook, and Geoffrey A. Silvera. "A Study Examining the Influence of Proximity to Nurse Education Resources on Quality of Care Outcomes in Nursing Homes." INQUIRY: The Journal of Health Care Organization, Provision, and Financing 55 (January 1, 2018): 004695801878769. http://dx.doi.org/10.1177/0046958018787694.

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This examination seeks to determine the influence of proximal density to nurse education resources (nursing schools) on nursing home care quality outcomes in Alabama. Motivated by the social network theory, which highlights the influence of relational closeness on shared resources and values, we hypothesize that nursing homes that have higher levels of nursing education resources within a close proximity will exhibit significantly higher nursing home quality outcomes. As proximal density to nurse education resources increases, the opportunity for nursing homes to build closer, stronger ties increase, leading to higher quality outcomes. We examine this hypothesis via ordered logistic regressions of proximal density measures developed through geographic information systems (GIS) software, nurse education resource data from Johnson & Johnson’s Campaign for Nursing’s Future (n = 37), and nursing home quality outcome data from Centers for Medicare and Medicaid Services’s (CMS) Nursing Home Compare from 2016 (n = 226). The results find that increases in proximal density to nurse education resources have a negative and significant association with nursing home quality outcomes in Alabama. Additional sensitivity analysis, which examines the degree to which the nature of this relationship is sensitive to health care facilities’ location in high-density areas, is offered and confirms principal findings. Because nursing programs generally have stronger ties with hospitals, the findings suggest that the nursing homes in areas with higher nurse education resources may actually face greater competition for nurses.

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Behrenbeck, Julia G. "Nursing-Sensitive Outcome Implementation and Reliability Testing in a Tertiary Care Setting." International Journal of Nursing Terminologies and Classifications 14, s4 (October 2003): 12. http://dx.doi.org/10.1111/j.1744-618x.2003.012_1.x.

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Héon, Marjolaine, Marilyn Aita, Andréane Lavallée, Gwenaëlle De Clifford-Faugère, Geneviève Laporte, Annie Boisvert, and Nancy Feeley. "Comprehensive mapping of NICU developmental care nursing interventions and related sensitive outcome indicators: a scoping review protocol." BMJ Open 12, no. 1 (January 2022): e046807. http://dx.doi.org/10.1136/bmjopen-2020-046807.

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IntroductionNeurodevelopmental outcomes of preterm infant are still a contemporary concern. To counter the detrimental effects resulting from the hospitalisation in the neonatal intensive care unit (NICU), developmental care (DC) interventions have emerged as a philosophy of care aimed at protecting and enhancing preterm infant’s development and promoting parental outcomes. In the past two decades, many authors have suggested DC models, core measures, practice guidelines and standards of care but outlined different groupings of interventions rather than specific interventions that can be used in NICU clinical practice. Moreover, as these DC interventions are mostly implemented by neonatal nurses, it would be strategic and valuable to identify specific outcome indicators to make visible the contribution of NICU nurses to DC.ObjectivesThe overarching objective of this review is to identify the nature, range, and extent of the literature regarding DC nursing interventions for preterm infants in the NICU. The secondary twofold objectives are to highlight interventions that fall into identified categories of DC interventions and suggest nursing-sensitive outcome indicators related to DC interventions in the NICU.Inclusion criteriaPapers reporting on or discussing a DC nursing intervention during NICU hospitalisation will be included.Methods and analysisThe Joanna Briggs Institute’s methodology for scoping reviews will be followed. CINAHL, MEDLINE, Embase, PubMed, Web of Science, Scopus, ProQuest and PsycInfo databases from 2009 to the present will be searched. Any type of paper, published in English or French, will be considered. Study selection and data extraction will be conducted by pairs of two review authors independently. A qualitative content analysis will be conducted.Ethics and disseminationNo Institutional Review Board ethical approbation is needed. Results of this review will be presented in scientific meetings and published in refereed papers.

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Stewart, Barbara J., and Patricia G. Archbold. "Nursing intervention studies require outcome measures that are sensitive to change: Part two." Research in Nursing & Health 16, no. 1 (February 1993): 77–81. http://dx.doi.org/10.1002/nur.4770160110.

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Murray, Theresa. "Ventilator-associated Pneumonia as a Nurse-sensitive Outcome." Clinical Nurse Specialist 19, no. 2 (March 2005): 80. http://dx.doi.org/10.1097/00002800-200503000-00053.

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Milstein, Ricarda, and Jonas Schreyoegg. "The relationship between nurse staffing levels and nursing-sensitive outcomes in hospitals: Assessing heterogeneity among unit and outcome types." Health Policy 124, no. 10 (October 2020): 1056–63. http://dx.doi.org/10.1016/j.healthpol.2020.07.013.

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Liu, Li-Fang, Sheuan Lee, Pei-Fang Chia, Shu-Ching Chi, and Yu-Chun Yin. "Exploring the Association Between Nurse Workload and Nurse-Sensitive Patient Safety Outcome Indicators." Journal of Nursing Research 20, no. 4 (December 2012): 300–309. http://dx.doi.org/10.1097/jnr.0b013e3182736363.

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Twigg, Diane E., Judith D. Pugh, Lucy Gelder, and Helen Myers. "Foundations of a nursing-sensitive outcome indicator suite for monitoring public patient safety in Western Australia." Collegian 23, no. 2 (June 2016): 167–81. http://dx.doi.org/10.1016/j.colegn.2015.03.007.

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Stewart, Barbara J., and Patricia G. Archbold. "Focus on psychometrics nursing intervention studies require outcome measures that are sensitive to change: Part one." Research in Nursing & Health 15, no. 6 (December 1992): 477–81. http://dx.doi.org/10.1002/nur.4770150610.

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Park, Hyejin. "Nursing-Sensitive Outcome Change Scores for Hospitalized Older Adults with Heart Failure: A Preliminary Descriptive Study." Research in Gerontological Nursing 6, no. 4 (August 14, 2013): 234–41. http://dx.doi.org/10.3928/19404921-20130802-01.

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Koon, Jenel. "Staff Nurses’ Perception of the Hemodialysis Unit as Practice Environment and Patients’ Perception of Nurse Caring Behaviors and their Level of Satisfaction." Journal of Health and Caring Sciences 2, no. 1 (June 26, 2020): 4–18. http://dx.doi.org/10.37719/jhcs.2020.v2i1.oa001.

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Background: Despite the concomitant rise of kidney diseases and hemodialysis services nationwide, the Philippines still lacks research on hemodialysis nursing care quality. Using nursing-sensitive indicators under the Nursing Role Effectiveness Model, this study aimed to describe hemodialysis nurses’ perception of their unit as practice environment; patients’ perception of nurse caring behaviors based on Jean Watson’s 10 Caritas Processes; patients’ level of satisfaction on nursing care; and determine the association between perceived nurse caring behaviors and satisfaction levels. Methodology: This descriptive cross-sectional study purposely selected seven free-standing hemodialysis centers in Metro Manila. Ninety-four nurses were surveyed via complete enumeration using the Practice Environment Scale of Nursing Work Index (PES-NWI) while 345 randomly selected patients answered the Caring Factor Survey-Tagalog (CFS-T) and Patient Satisfaction of Nursing Care Quality Questionnaire-Tagalog (PSNCQQ-T). Pearson’s correlation was used to analyze the gathered data. Results: The study revealed that nurses perceived their respective work unit as a favorable practice environment while hemodialysis patients perceived nurse caring behaviors as practiced to a great extent and their satisfaction with nursing care as very good. The study also revealed a significant positive correlation between the process and outcome indicators (r=0.64, p=<0.0001). Conclusion: The study reflected positive nursing-sensitive indicators in hemodialysis. However, hemodi alysis facilities should improve nurse staffing, spiritual nurse caring behavior, and facilitate a more healing environment while maintaining their current favorable qualities.

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Gerolamo, Angela M. "The Conceptualization of Physical Restraint as a Nursing-Sensitive Adverse Outcome in Acute Care Psychiatric Treatment Settings." Archives of Psychiatric Nursing 20, no. 4 (August 2006): 175–85. http://dx.doi.org/10.1016/j.apnu.2005.12.005.

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Benham-Hutchins, Marge, Kathleen M. Carley, Barbara B. Brewer, Judith A. Effken, and Jeffrey Reminga. "Nursing Unit Communication During a US Public Health Emergency: Natural Experiment." JMIR Nursing 1, no. 1 (December 6, 2018): e11425. http://dx.doi.org/10.2196/11425.

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Background In the second half of 2014, the first case of Ebola virus disease (EVD) was diagnosed in the United States. During this time period, we were collecting data for the Measuring Network Stability and Fit (NetFIT) longitudinal study, which used social network analysis (SNA) to study relationships between nursing staff communication patterns and patient outcomes. One of the data collection sites was a few blocks away from where the initial EVD diagnosis was made. The EVD public health emergency during the NetFIT data collection time period resulted in the occurrence of a natural experiment. Objective The objectives of the NetFIT study were to examine the structure of nursing unit decision-making and information-sharing networks, identify a parsimonious set of network metrics that can be used to measure the longitudinal stability of these networks, examine the relationship between the contextual features of a unit and network metrics, and identify relationships between key network measures and nursing-sensitive patient-safety and quality outcomes. This paper reports on unit communication and outcome changes that occurred during the EVD natural disaster time period on the 10 hospital units that had data collected before, during, and after the crisis period. Methods For the NetFIT study, data were collected from nursing staff working on 25 patient care units, in three hospitals, and at four data collection points over a 7-month period: Baseline, Month 1, Month 4, and Month 7. Data collection was staggered by hospital and unit. To evaluate the influence of this public health emergency on nursing unit outcomes and communication characteristics, this paper focuses on a subsample of 10 units from two hospitals where data were collected before, during, and after the EVD crisis period. No data were collected from Hospital B during the crisis period. Network data from individual staff were aggregated to the nursing unit level to create 24-hour networks and three unit-level safety outcome measures—fall rate, medication errors, and hospital-acquired pressure ulcers—were collected. Results This analysis includes 40 data collection points and 608 staff members who completed questionnaires. Participants (N=608) included registered nurses (431, 70.9%), licensed vocational nurses (3, 0.5%), patient care technicians (133, 21.9%), unit clerks (28, 4.6%), and monitor watchers (13, 2.1%). Changes in SNA metrics associated with communication (ie, average distance, diffusion, and density) were noted in units that had changes in patient safety outcome measures. Conclusions Units in the hospital site in the same city as the EVD case exhibited multiple changes in patient outcomes, network communication metrics, and response rates. Future research using SNA to examine the influence of public health emergencies on hospital communication networks and relationships to patient outcomes is warranted.

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Li, Jiejie, Xingquan Zhao, Xia Meng, Jinxi Lin, Liping Liu, Chunxue Wang, Anxin Wang, Yilong Wang, and Yongjun Wang. "High-Sensitive C-Reactive Protein Predicts Recurrent Stroke and Poor Functional Outcome." Stroke 47, no. 8 (August 2016): 2025–30. http://dx.doi.org/10.1161/strokeaha.116.012901.

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Westerdahl, Frida, Elisabeth Carlson, Anne Wennick, and Gunilla Borglin. "Teaching strategies and outcome assessments targeting critical thinking in bachelor nursing students: a scoping review protocol." BMJ Open 10, no. 1 (January 2020): e033214. http://dx.doi.org/10.1136/bmjopen-2019-033214.

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IntroductionApplying critical thinking is essential for nursing students both in an academic and clinical context. Particularly, as critical thinking is a vital part of nurses’ everyday problem-solving and decision-making processes. Therefore, regardless of the topic taught or the setting in which it is taught, it requires teaching strategies especially targeting students’ critical thinking skills and abilities. One challenge with the latter is the difficulties to assess and evaluate the impact of such teaching strategies on the students’ critical thinking disposition. Hence, our objective will be to review published literature on; existing teaching strategies and outcomes assessments targeting nursing students’ critical thinking skills and abilities.Methods and analysisOur scoping review will be conducted in accordance with Arksey and O’Malley’s framework for scoping studies. Search strategies will be developed in cooperation with an experienced librarian, and adjusted to each individual database for example, CINAHL, PubMed, PsycINFO, ERIC and ERC. A preliminary search in CINAHL was conducted on the 17thof July 2019. Peer-reviewed published studies conducted with a qualitative, quantitative or mixed method design and focussing our objectives, will be eligible for inclusion. Included studies will be quality assessed in accordance with their study design. Data will be charted using a standardised extraction form. The qualitative data will be presented through a thematic analyses, and the quantitative data by descriptive numerical analysis. Lastly, nurse educators and nursing students will be consulted for validation of the findings from the scoping review.Ethics and disseminationUnder the Swedish Ethical Review Act (2003:460) this study does not need ethical clearance by a Regional Ethical Review Authority as it not includes any primary empirical data on biological material or sensitive information. The findings will be used to inform the design of a future study aiming to develop an, and subsequently evaluate it, educational intervention targeting teaching strategies focussing on nursing students’ critical thinking skills and abilities.

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Redfern, Oliver C., Peter Griffiths, Antonello Maruotti, Alejandra Recio Saucedo, and Gary B. Smith. "The association between nurse staffing levels and the timeliness of vital signs monitoring: a retrospective observational study in the UK." BMJ Open 9, no. 9 (September 2019): e032157. http://dx.doi.org/10.1136/bmjopen-2019-032157.

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ObjectivesOmissions and delays in delivering nursing care are widely reported consequences of staffing shortages, with potentially serious impacts on patients. However, studies so far have relied almost exclusively on nurse self-reporting. Monitoring vital signs is a key part of nursing work and electronic recording provides an opportunity to objectively measure delays in care. This study aimed to determine the association between registered nurse (RN) and nursing assistant (NA) staffing levels and adherence to a vital signs monitoring protocol.DesignRetrospective observational study.Setting32 medical and surgical wards in an acute general hospital in England.Participants538 238 nursing shifts taken over 30 982 ward days.Primary and secondary outcome measuresVital signs observations were scheduled according to a protocol based on the National Early Warning Score (NEWS). The primary outcome was the daily rate of missed vital signs (overdue by ≥67% of the expected time to next observation). The secondary outcome was the daily rate of late vital signs observations (overdue by ≥33%). We undertook subgroup analysis by stratifying observations into low, medium and high acuity using NEWS.ResultsLate and missed observations were frequent, particularly in high acuity patients (median=44%). Higher levels of RN staffing, measured in hours per patient per day (HPPD), were associated with a lower rate of missed observations in all (IRR 0.983, 95% CI 0.979 to 0.987) and high acuity patients (0.982, 95% CI 0.972 to 0.992). However, levels of NA staffing were only associated with the daily rate (0.954, CI 0.949 to 0.958) of all missed observations.ConclusionsAdherence to vital signs monitoring protocols is sensitive to levels of nurse and NA staffing, although high acuity observations appeared unaffected by levels of NAs. We demonstrate that objectively measured omissions in care are related to nurse staffing levels, although the absolute effects are small.Study registrationThe data and analyses presented here were part of the larger Missed Care study (ISRCTN registration: 17930973).

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Zhang, Juxia, Limei Yang, Xiaoying Wang, Jiao Dai, Wenjing Shan, and Jiancheng Wang. "Inpatient satisfaction with nursing care in a backward region: a cross-sectional study from northwestern China." BMJ Open 10, no. 9 (September 2020): e034196. http://dx.doi.org/10.1136/bmjopen-2019-034196.

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ObjectivesThe aim of the study was to examine the level of patient satisfaction with nursing care and identify the factors affecting satisfaction from the inpatient’s perspective in a backward region of China.DesignThis was a cross-sectional study.SettingThe study was conducted at a tertiary hospital located in northwest China.ParticipantsPatients admitted to the ward for at least 48 hours were chosen to participate in the survey.Primary outcome measureThe Newcastle Satisfaction with Nursing Care Scale was used. Data were collected from 219 patients.ResultsThe overall inpatient satisfaction with nursing care was 78.15±4.74. Patients were more satisfied with nurses who respected their privacy and treated them as individuals (67.7%). Patients were least satisfied with the type of information nurses gave them (11.7%) and with the sufficient awareness of their needs. Patients who were married, had a history of hospitalisation, surgery and were taken charge of by junior nurses had higher satisfaction.ConclusionsThe overall level of patient satisfaction was moderate. Patient-centred individualised care and providing sufficient information model of care are needed. There was a need for nurses to be aware of patients’ individualised care needs and to provide them with more information. This study may suggest/urge hospital administrators, policymakers and nurses to be more sensitive with patients’ married status, history of hospitalisation and surgery, the professional title of in charged nurses when care is provided. Ultimately to achieve better outcome of patients’ hospitalisation.

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Froggatt, Katherine, Ashley Best, Frances Bunn, Girvan Burnside, Joanna Coast, Lesley Dunleavy, Claire Goodman, et al. "A group intervention to improve quality of life for people with advanced dementia living in care homes: the Namaste feasibility cluster RCT." Health Technology Assessment 24, no. 6 (January 2020): 1–140. http://dx.doi.org/10.3310/hta24060.

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Background People with advanced dementia who live and die in nursing homes experience variable quality of life, care and dying. There is a need to identify appropriate, cost-effective interventions that facilitate high-quality end-of-life care provision. Objectives To establish the feasibility and acceptability to staff and family of conducting a cluster randomised controlled trial of the Namaste Care intervention for people with advanced dementia in nursing homes. Design The study had three phases: (1) realist review and (2) intervention refinement to inform the design of (3) a feasibility cluster randomised controlled trial with a process evaluation and economic analysis. Clusters (nursing homes) were randomised in a 3 : 1 ratio to intervention or control (usual care). The nature of the intervention meant that blinding was not possible. Setting Nursing homes in England providing care for people with dementia. Participants Residents with advanced dementia (assessed as having a Functional Assessment Staging Test score of 6 or 7), their informal carers and nursing home staff. Intervention Namaste Care is a complex group intervention that provides structured personalised care in a dedicated space, focusing on enhancements to the physical environment, comfort management and sensory engagement. Main outcome measures The two contender primary outcome measures were Comfort Assessment in Dying – End of Life Care in Dementia for quality of dying (dementia) and Quality of Life in Late Stage Dementia for quality of life. The secondary outcomes were as follows: person with dementia, sleep/activity (actigraphy), neuropsychiatric symptoms, agitation and pain; informal carers, satisfaction with care at the end of life; staff members, person-centred care assessment, satisfaction with care at the end of life and readiness for change; and other data – health economic outcomes, medication/service use and intervention activity. Results Phase 1 (realist review; 86 papers) identified that a key intervention component was the activities enabling the development of moments of connection. In phase 2, refinement of the intervention enabled the production of a user-friendly 16-page A4 booklet. In phase 3, eight nursing homes were recruited. Two homes withdrew before the intervention commenced; four intervention and two control homes completed the study. Residents with advanced dementia (n = 32) were recruited in intervention (n = 18) and control (n = 14) homes. Informal carers (total, n = 12: intervention, n = 5; control, n = 7) and 97 staff from eight sites (intervention, n = 75; control, n = 22) were recruited over a 6-month period. Recruitment is feasible. Completion rates of the primary outcome questionnaires were high at baseline (100%) and at 4 weeks (96.8%). The Quality of Life in Late Stage Dementia was more responsive to change over 24 weeks. Even where economic data were missing, these could be collected in a full trial. The intervention was acceptable; the dose varied depending on the staffing and physical environment of each care home. Staff and informal carers reported changes for the person with dementia in two ways: increased social engagement and greater calm. No adverse events related to the intervention were reported. Conclusions A subsequent definitive trial is feasible if there are amendments to the recruitment process, outcome measure choice and intervention specification. Future work In a full trial, consideration is needed of the appropriate outcome measure that is sensitive to different participant responses, and of clear implementation principles for this person-centred intervention in a nursing home context. Trial registration Current Controlled Trials ISRCTN14948133. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 24, No. 6. See the NIHR Journals Library website for further project information.

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Scott-Cawiezell, Jill, and Amy Vogelsmeier. "Nursing Home Safety: A Review of the Literature." Annual Review of Nursing Research 24, no. 1 (January 2006): 179–215. http://dx.doi.org/10.1891/0739-6686.24.1.179.

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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 monitored for a safe NH environment to occur. After a thorough review of both organizational and clinical NH literature, 30 organizational studies and 39 clinically based studies were reviewed. The review revealed that, organizationally, teamwork, communication, and leadership all were critical in resident and staff outcomes and clinically, assessment was an important missing process at critical points in the residents’ care for prevention and timely treatment of potentially dangerous conditions. The value of the registered nurse (RN) in this setting was clear in the many assessment issues noted and the lack of RN guidance for adherence to recognized practice guidelines. To explicate the role of the RN, first, better outcome measures must be developed that are nurse sensitive. A second clear agenda for NH research is the explication of the role of leadership, particularly nursing leadership, to create an environment where open and accurate communication can be accomplished among all of the diverse NH roles. This will help all members of the team to identify care improvement opportunities. Finally, a new frontier for the NH setting is the use of technology and the need to harness the information that has set in the NH system for years. Information mastery for staff and leadership is a necessary aspect of the organization that must be developed to provide sound information for strategic and focused change to occur.

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Herdman, Tracy Heather. "What nursing knowledge is needed to develop nursing practice?" Revista Eletrônica de Enfermagem 13, no. 2 (June 30, 2011): 159–64. http://dx.doi.org/10.5216/ree.v13i2.14773.

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Years ago, a nurse I admired was kidding me about graduate school. What was a nursing diagnosis (ND), and why did we need them? Wasn’t it enough to know that the infant had respiratory distress syndrome? Why add in this other layer of nonsense? Why spend my time thinking about theory and other ridiculous things that had no context in clinical practice? I hear similar comments from nurses today.What, then, is the knowledge of nursing practice? Nurses generally do not question the need for medicine to research disease and its treatment – yet many cite as irrelevant research done on human responses and treatment of those responses to achieve nurse-sensitive outcomes. When we neglect to teach, read or implement critical research on nursing knowledge and how it impacts patients – it becomes an afterthought, information that is “nice to know if you have time”. Is this what nursing is – a nice to have but not necessary field of practice? Why do nursing students and nurses in practice often feel they must implement physician orders and then, if they have time, “do some nursing”? I believe that this clinical reality occurs primarily because we do not, as a collective whole, really educate nurses, our peers or our patients about the discipline of nursing.Nursing curricula heavily emphasize pathophysiology and pharmacology – is this nursing? These disciplines provide important content for nursing practice. But do they define nursing? I believe they do not – nurses need to understand these related fields, but we need to focus on human responses. What is pain? How is it manifested across lifespan, setting, etiology, gender, or culture? How do we differentiate acute pain, chronic pain and impaired comfort? How does a particular medical condition impact the human response of pain or comfort? What makes pain associated with a bone fracture different from pain experienced with diabetic neuro-pathy? Do we really understand the concepts – or do we merely rush to provide pharmacologic treatment of a symptom we are observing? Is that medication the best intervention – or is it simply the easiest? What do we do for the patient who cannot tolerate the medicine, or does not want it? How does the etiology of the pain, the patient’s coping mechanisms and history, impact his pain response? If we do not understand how acute pain and chronic pain differ, or how impaired comfort and chronic pain differ, how do we know what we are really treating? How can we best achieve a positive patient outcome? I believe we cannot.Imagine a curriculum designed around core concepts of nursing knowledge. Rather than modules based on physician diagnosis (MD) on congestive heart failure or bone fractures, we could have modules on pain, risk for contamination, decreased cardiac output, or acute confusion. Rather than clustering content around medical diagnoses, we could use ND - concepts of importance to nursing practice – and cluster content around them, including related medical diagnoses, psychosocial, cultural and physiological responses, pharmacological treatments and desired outcomes.This would require many nurses to reframe their concepts of ND. Some recent literature implies that ND were developed for documenting nursing in the electronic health record (EHR). The truth is that ND were (and are) developed to provide language that describes the knowledge and practice of nursing. Just as medical diagnoses are used within medicine – not as a documentation tool, but as a tool for describing what is being treated in a concise, internationally understood language to drive intervention and outcome - if correctly developed as concepts that can be defined, studied, taught and implemented in practice, ND can describe what nurses know, drive what we do and what outcomes we achieve.I doubt that anyone would suggest that a physician should be allowed to create a medical diagnosis at a patient’s bedside and begin to use it clinically; yet some advocate for this practice in nursing. Simply construct a label and you have ND. But what does it mean? What do we know about this concept? How do I teach it, research it, measure it or share it with other disciplines and patients? How can we be so disinterested in understanding the core knowledge of our discipline? How can we allow what works best in a computer system to drive nursing practice, to mandate how we, as a discipline, develop the science beneath the labels?Are ND just documentation tools? Unfortunately, that is what they become when we neglect to teach the concepts – really understand these phenomena of nursing practice and the content underlying them. Nursing diagnoses were never meant to be simple terms that could be created at random to describe a condition. Nursing diagnosis labels should describe a concept (including health promotion concepts, not just “problems”) that is clearly and uniformly defined and supported by nursing research and practice literature, identified by signs/symptoms that can be obtained during nursing assessment, review of patient/family history, diagnostic tests and completion of various screening tools. The concepts should be well researched, well developed, and internationally disseminated.What would have to change to enable students to learn about nursing practice, how it supplements and interrelates with the practice of other health disciplines? We would have to teach nursing – the science of diagnosing and treating human responses to actual or potential health problems or life processes – and we would have to completely restructure, in most cases, how we practice nursing. Are you ready for such a challenge? I believe we must make these changes quickly, before we lose what it truly means to be a nurse.

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Kilpatrick, Kelley, Eric Nguemeleu Tchouaket, Maud-Christine Chouinard, Isabelle Savard, Naima Bouabdillah, Julie Houle, Geneviève St-Louis, Mira Jabbour, and Renee Atallah. "Identifying indicators sensitive to primary healthcare nurse practitioner practice: a review of systematic reviews protocol." BMJ Open 11, no. 1 (January 2021): e043213. http://dx.doi.org/10.1136/bmjopen-2020-043213.

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IntroductionPrimary healthcare nurse practitioners (PHCNPs) practice in a wide range of clinical settings and with diverse patient populations. Several systematic reviews have examined outcomes of PHCNP roles. However, there is a lack of consistency in the definitions used for the PHCNP role across the reviews. The identification of indicators sensitive to PHCNP practice from the perspective of patients, providers and the healthcare system will allow researchers, clinicians and decision-makers to understand how these providers contribute to outcomes of care.Methods and analysisA review of systematic reviews is proposed to describe the current state of knowledge about indicators sensitive to PHCNP practice using recognised role definitions. Outcomes of interest include any outcome indicator measuring the effectiveness of PHCNPs. We will limit our search to 2010 onwards to capture the most up-to-date trends. The following electronic databases will be searched: Allied and Complementary Medicine Database, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library Database of Systematic Reviews and Controlled Trials Register, Database of Abstracts of Reviews of Effects, EMBASE, Global Health, Health Economics Evaluation Database, Health Evidence, HealthStar, Health Systems Evidence, Joanna Briggs Institute, Medline, PDQ-Evidence, PubMed and Web of Science. The search strategies will be reviewed by an academic librarian. Reference lists of all relevant publications will be reviewed. Grey literature will be searched from 2010 onwards, and will include: CADTH Information Services, CADTH’s Grey Matters tool, OpenGrey, Organisation for Economic Co-operation and Development, ProQuest Dissertation and Theses and WHO. The PROSPERO International Prospective Register of Systematic Reviews will be searched to identify registered review protocols. The review protocol was developed using Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A narrative synthesis will be used to summarise study findings.Ethics and disseminationNo ethical approval is required for the study. The data used in the study will be abstracted from published systematic reviews. Dissemination strategies will include peer-reviewed publication, conference presentations and presentations to key stakeholders.PROSPERO registration numberCRD42020198182.

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Ananth, P. Vijai, and Surendra Kumar Bouddh. "Intensive care unit prophylaxis and its outcome in a rural tertiary care hospital: an observational study." International Journal of Basic & Clinical Pharmacology 7, no. 9 (August 23, 2018): 1742. http://dx.doi.org/10.18203/2319-2003.ijbcp20183482.

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Background: Intensive Care Unit is used to treat patients closer to their beds, in order to observe them more as distinct people to almost all the critically-ill patients.Methods: One hundred admitted patients in the ICU, 25 each sets of the patients observed their prophylactic management to prevent stress ulcer, pressure ulcer, UTI and chest infection, observations noted for the 7 days, directly by seeing and by cross-checked patient’s case-sheets.Results: There were 2 (8%) patients developed stress ulcer, 1 (4%) Catheter associated bacteriuria, 2 (8%) patients grade II pressure ulcer, and 5 (20%) patient’s done endotracheal intubation. All these 5 (20%) report of sputum culture found Ps. Aeruginosa, Klebsiella sensitive for Ceftriaxone + Sulbactum. The standard nursing care done by the on duty nursing staffs, i.e., no one given Ryle’s tube feeding for the stress ulcer cases, advised soft, palatable, non-spicy oral diet, Pressure ulcer’s 8% patients shifted on the air-bed mattress, ulcer’s cleaned with normal water soaked soft-napkin and applied sterile pad compressed dressing locally. For the ventilator in-situ patient’s, endotracheal tube cleaned 8-12 times within 12 hours. The Inbuilt Ventilator tube cleaned, and its filter changed and kept ready by the following standard aseptic precaution before using the ventilator. The chest physiotherapy was done by the chest medicine specialist of the all 5 ventilated patients. Prophylactic medication provided, i.e., Injection Pantoprazole 40mg once daily, Injection Ciprofloxacin 400mg twice daily, and Injection Inj. Ceftriaxone + Sulbactum gm 12 hourly interval administered daily.Conclusions: From this study, we can conclude that Gentamicin is more nephrotoxic and causes greater fall in creatinine clearance although the dose of Gentamicin administered is much lower compared to Amikacin.

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Ersek, Mary, Nayak Polissar, Anna Du Pen, Anita Jablonski, Keela Herr, and Moni B. Neradilek. "Addressing methodological challenges in implementing the nursing home pain management algorithm randomized controlled trial." Clinical Trials 9, no. 5 (August 9, 2012): 634–44. http://dx.doi.org/10.1177/1740774512454243.

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Background Unrelieved pain among nursing home (NH) residents is a well-documented problem. Attempts have been made to enhance pain management for older adults, including those in NHs. Several evidence-based clinical guidelines have been published to assist providers in assessing and managing acute and chronic pain in older adults. Despite the proliferation and dissemination of these practice guidelines, research has shown that intensive systems-level implementation strategies are necessary to change clinical practice and patient outcomes within a health-care setting. One promising approach is the embedding of guidelines into explicit protocols and algorithms to enhance decision making. Purpose The goal of the article is to describe several issues that arose in the design and conduct of a study that compared the effectiveness of pain management algorithms coupled with a comprehensive adoption program versus the effectiveness of education alone in improving evidence-based pain assessment and management practices, decreasing pain and depressive symptoms, and enhancing mobility among NH residents. Methods The study used a cluster-randomized controlled trial (RCT) design in which the individual NH was the unit of randomization. The Roger’s Diffusion of Innovations theory provided the framework for the intervention. Outcome measures were surrogate-reported usual pain, self-reported usual and worst pain, and self-reported pain-related interference with activities, depression, and mobility. Results The final sample consisted of 485 NH residents from 27 NHs. The investigators were able to use a staggered enrollment strategy to recruit and retain facilities. The adaptive randomization procedures were successful in balancing intervention and control sites on key NH characteristics. Several strategies were successfully implemented to enhance the adoption of the algorithm. Limitations/Lessons The investigators encountered several methodological challenges that were inherent to both the design and implementation of the study. The most problematic issue concerned the measurement of outcomes in persons with moderate to severe cognitive impairment. It was difficult to identify valid, reliable, and sensitive outcome measures that could be applied to all NH residents regardless of the ability to self-report. Another challenge was the inability to incorporate advances in implementation science into the ongoing study Conclusions Methodological challenges are inevitable in the conduct of an RCT. The need to optimize internal validity by adhering to the study protocol is compromised by the emergent logistical issues that arise during the course of the study.

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Martins, Lina, Gillian Down, Birgitte Dissing Andersen, Lene Feldskov Nielsen, Anne Steen Hansen, Nana Overgaard Herschend, and Zenia Størling. "The Ostomy Skin Tool 2.0: a new instrument for assessing peristomal skin changes." British Journal of Nursing 31, no. 8 (April 21, 2022): 442–50. http://dx.doi.org/10.12968/bjon.2022.31.8.442.

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Background: Peristomal skin complications (PSCs) are frequently reported postoperative complications. PSCs can present visibly or as symptoms such as pain, itching or burning sensations. Aim: To develop a new tool that can capture a range of sensation symptoms together with visible complications and an objective assessment of discolouration in the peristomal area. Method: Consensus from qualitative interviews with health professionals and people with an ostomy, and input from expert panels, formed the basis of a patient-reported outcome (PRO) questionnaire. A decision tree model was used to define a combined score including PRO and objectively assessed discolouration area. Findings: Six elements were included in the PRO questionnaire and four health states representing different severity levels of the peristomal skin were defined. Conclusion: The Ostomy Skin Tool 2.0 is a sensitive tool that can be used to follow changes in the peristomal skin on a regular basis and thereby help prevent severe PSCs.

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Bettencourt, Amanda P., Linda H. Aiken, Douglas Sloane, and Matthew McHugh. "T4 Nursing Matters! Better Nurse Staffing and Work Environments Associated with Lower Burn Patient Mortality." Journal of Burn Care & Research 41, Supplement_1 (March 2020): S3. http://dx.doi.org/10.1093/jbcr/iraa024.003.

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Abstract Introduction The complexity of modern burn care requires an integrated team of clinicians working together to achieve the best possible outcome for each survivor. Nurses are central to many aspects of a burn survivor’s care including physiologic monitoring, fluid resuscitation, pain management, infection prevention, complex wound care, and rehabilitation. Previous research suggests that hospital nursing resources such as staffing, education, and the quality of the work environment relate to overall patient mortality, but the relationship between those resources and burn mortality has not been previously examined. Due to their unique and complex care needs, burn patients are likely highly sensitive to nursing resources. Methods This study examined whether patient-to-nurse ratios, nurse education, and features of the clinical work environment are associated with burn patient in-hospital mortality. A multivariable regression model using a linked, cross-sectional claims database of 14,064 adult (>18 yrs.) burn patients admitted to 653 hospitals was employed. Mortality was risk-adjusted for age, burn size, the presence of mechanical ventilation, co-morbidities, and hospital characteristics such as burn patient volume, technological capabilities, and teaching status. Nursing resources were independently reported by 29,586 bedside nurses working in the study hospitals. The work environment was assessed using the National Quality Forum-endorsed Practice Environment Scale. Nursing resources differ in the high vs. low-volume hospitals, so the final model includes an interaction term for each nursing resource and hospital burn patient volume. Results In the risk-adjusted main-effects model, the patient’s age, burn size, presence of mechanical ventilation, comorbidities, and hospital burn patient volume were all significantly associated with in-hospital mortality. The full model including interaction terms suggests that in high burn patient volume hospitals (>100 patients / yr.) each additional patient added to a nurse’s workload is associated with 30% higher odds of mortality (p< 0.05, 95% CI [1.02, 1.94]), and improvements in the nurse work environment are associated with 28% lower odds of mortality (p< 0.05, 95%CI [0.07, 0.99]). Conclusions Nurse staffing and the nurse work environment significantly relate to burn patient mortality in high-volume burn hospitals where the most complex burn patients often receive care. Applicability of Research to Practice Nursing resources are critical to the survival of the most complex burn patients, and are a significant, yet previously unmeasured variable in the evaluation of burn outcomes. To promote optimal recovery for burn survivors, attention to nurse staffing and the work environment is warranted. Future evaluations of burn patient outcomes should account for hospital nursing resources.

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Utz, Sharon Williams. "Nursing-Sensitive Outcomes." Family & Community Health 29, no. 2 (April 2006): 158. http://dx.doi.org/10.1097/00003727-200604000-00011.

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ELLER, LUCILLE S. "Guided Imagery Interventions for Symptom Management." Annual Review of Nursing Research 17, no. 1 (January 1999): 57–84. http://dx.doi.org/10.1891/0739-6686.17.1.57.

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For the past several decades, papers in the nursing literature have advocated the use of cognitive interventions in clinical practice. Increasing consumer use of complementary therapies, a cost-driven health care system, and the need for evidence-based practice all lend urgency to the validation of the efficacy of these interventions. This review focuses specifically on guided imagery intervention studies identified in the nursing, medical and psychological literature published between 1966 and 1998. Included were 46 studies of the use of guided imagery for management of psychological and physiological symptoms. There is preliminary evidence for the effectiveness of guided imagery in the management of stress, anxiety and depression, and for the reduction of blood pressure, pain and the side effects of chemotherapy. Overall, results of this review demonstrated a need for systematic, well-designed studies, which explore several unanswered questions regarding the use of guided imagery. These include the effects of different imagery language, symptoms for which guided imagery is effective, appropriate and sensitive outcome measures, method of delivery of the intervention and optimum dose and duration of the intervention, and individual factors that influence its effectiveness.

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Heslop, Liza. "Outcome detection using hospital activity data: Implications for development of nursing-sensitive quality monitoring and reporting in Australia (Commentary on Schreuders et al., Int. J. Nurs. Stud. 51 (3) (2014) 470–478)." International Journal of Nursing Studies 52, no. 1 (January 2015): 487–90. http://dx.doi.org/10.1016/j.ijnurstu.2014.04.007.

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Cardoso, Ana Filipa, Paulo Queirós, António Salgueiro Amaral, Carlos Fontes-Ribeiro, Amorim Rosa, Rui Cruz, Matilde Agostinho Neto, Helena Felizardo, and Souraya Sidani. "Validation of the Therapeutic Self-Care Scale-European Portuguese Version in Primary Care Type 2 Diabetes Adults." International Journal of Environmental Research and Public Health 19, no. 7 (March 22, 2022): 3750. http://dx.doi.org/10.3390/ijerph19073750.

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Self-care is an important nursing-sensitive outcome. Reliable and valid measures are needed for therapeutic self-care assessment that may inform the development and evaluation of individualized nursing interventions co-created with type 2 diabetes mellitus (T2DM) adults. The therapeutic self-care scale European Portuguese version (TSCS-EPV) is a validated generic measure that may be used to assess self-care in T2DM adults. Aim: To examine the psychometric properties of the TSCS-EP version in T2DM adults, in primary health care. Methods: A cross-sectional pilot study in a convenience sample of 80 adults with T2DM from two primary health care centers in Portugal was conducted. Individuals completed the Portuguese version of the TSC scale. Results: A three-factor solution emerged from the principal component analysis: “Recognizing and managing signs and symptoms”; “Managing changes in health condition” and “Managing medication”, explaining 75% of the total variance. Total scale Cronbach’s alpha was 0.884 and for the three factors ranged from 0.808 to 0.954. Conclusion: the therapeutic self-care scale European Portuguese version is a promising scale for assessing therapeutic self-care abilities in adults with T2DM in primary care settings. More consistent results on its validity and reliability are needed for it to be used in the country.

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Stone, Patricia W. "Nursing shortage and nursing sensitive outcomes." Applied Nursing Research 15, no. 2 (May 2002): 115–16. http://dx.doi.org/10.1053/apnr.2002.33417.

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Waters, Teresa M., Cameron M. Kaplan, Ilana Graetz, Mary M. Price, Laura A. Stevens, and Barbara L. McAneny. "Patient-Centered Medical Homes in Community Oncology Practices: Changes in Spending and Care Quality Associated With the COME HOME Experience." Journal of Oncology Practice 15, no. 1 (January 2019): e56-e64. http://dx.doi.org/10.1200/jop.18.00479.

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PURPOSE: We examined whether the Community Oncology Medical Home (COME HOME) program, a medical home program implemented in seven community oncology practices, was associated with changes in spending and care quality. PATIENTS AND METHODS: We compared outcomes from elderly fee-for-service Medicare beneficiaries diagnosed between 2011 and 2015 with breast, lung, colorectal, thyroid, or pancreatic cancer, lymphoma, or melanoma and served by COME HOME practices before and after program implementation versus similar beneficiaries served by other geographically proximate oncologists. Difference-in-differences analysis compared changes in outcomes for COME HOME patients versus concurrent controls. Propensity score matching and regression methods were adjusted for clinical and sociodemographic differences. Our primary outcome was 6-month medical spending per beneficiary. Secondary outcomes included 6-month out-of-pocket spending, inpatient and ambulatory care–sensitive hospitalizations, readmissions, length of stay, and emergency department and evaluation and management visits. RESULTS: Before COME HOME, 6-month medical spending was $2,975 higher for the study group compared with controls (95% CI, $1,635 to $4,315; P < .001) and increasing at a similar rate. After intervention, this difference was reduced to $318 (95% CI, −$1,105 to $1,741; P = .661), a significant change of −$2,657 (95% CI, −$4,631 to −$683; P = .008) or 8.1% savings relative to 6-month average spending ($32,866). COME HOME was also associated with significantly reduced (10.2 %) emergency department visits per 1,000 patients per 6-month period ( P = .024). There were no statistically significant differences in other outcomes. CONCLUSION: COME HOME was associated with reduced Medicare spending and improved emergency department use. The patient-centered medical home model holds promise for oncology practices, but improvements were not uniform.

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Maliszewski, Genevieve, Meredith Dreyer Gillette, Chris Brown, and John D. Cowden. "Parental Feeding Style and Pediatric Obesity in Latino Families." Hispanic Health Care International 15, no. 2 (May 16, 2017): 65–70. http://dx.doi.org/10.1177/1540415317707739.

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Introduction: Pediatric obesity has become an epidemic in the United States. Previous research has shown that parenting factors related to feeding style affect child weight and that Latino families are especially at risk for pediatric obesity. The goal of the current study was to evaluate the relationship between parental feeding style and child body mass index (BMI) in Latino families. Method: Latino parents of children between the ages of 2 and 8 ( N = 124) completed a survey on parental feeding styles, acculturation, and demographics. The outcome variable was child BMI. Results: Among respondents, 89% were mothers, 72% were overweight or obese, and 40% reported an indulgent feeding style. Children had a mean age of 59 months ( SD = 23.8) and a mean BMI z score of 0.77 ( SD = 1.14). A demanding parental feeding style was associated with lower child BMI z score, r = −.179, p < .05, and higher acculturation level, r = .213, p < .05. Conclusions: Findings from the current study can be used to inform health care practitioners of the need to use culturally sensitive interventions that consider parents’ feeding behaviors. Future research is warranted in the area of ethnic variations of parenting and how these affect feeding and obesity in this highly vulnerable population.

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Lyons, Ann M., Katherine A. Sward, Vikrant G. Deshmukh, Marjorie A. Pett, Gary W. Donaldson, and Jim Turnbull. "Impact of computerized provider order entry (CPOE) on length of stay and mortality." Journal of the American Medical Informatics Association 24, no. 2 (July 8, 2016): 303–9. http://dx.doi.org/10.1093/jamia/ocw091.

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Objective: To examine changes in patient outcome variables, length of stay (LOS), and mortality after implementation of computerized provider order entry (CPOE). Materials and Methods: A 5-year retrospective pre-post study evaluated 66 186 patients and 104 153 admissions (49 683 pre-CPOE, 54 470 post-CPOE) at an academic medical center. Generalized linear mixed statistical tests controlled for 17 potential confounders with 2 models per outcome. Results: After controlling for covariates, CPOE remained a significant statistical predictor of decreased LOS and mortality. LOS decreased by 0.90 days, P < .0001. Mortality decrease varied by model: 1 death per 1000 admissions (pre = 0.006, post = 0.0005, P < .001) or 3 deaths (pre = 0.008, post = 0.005, P < .01). Mortality and LOS decreased in medical and surgical units but increased in intensive care units. Discussion: This study examined CPOE at multiple levels. Given the inability to randomize CPOE assignment, these results may only be applicable to the local setting. Temporal trends found in this study suggest that hospital-wide implementations may have impacted nursing staff and new residents. Differences in the results were noted at the patient care unit and room levels. These differences may partly explain the mixed results from previous studies. Conclusion: Controlling for confounders, CPOE implementation remained a statistically significant predictor of LOS and mortality at this site. Mortality appears to be a sensitive outcome indicator with regard to hospital-wide implementations and should be further studied.

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Mandal, Suprakash, Puneet Misra, Gautam Sharma, Rajesh Sagar, Shashi Kant, SN Dwivedi, R. Lakshmy, and Kiran Goswami. "Effect of Structured Yoga Program on Stress and Professional Quality of Life Among Nursing Staff in a Tertiary Care Hospital of Delhi—A Small Scale Phase-II Trial." Journal of Evidence-Based Integrative Medicine 26 (January 1, 2021): 2515690X2199199. http://dx.doi.org/10.1177/2515690x21991998.

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Background. Nursing staff suffer from various level of stress and burnout. We aimed to assess the effect of 12 weeks of structured yoga on stress and the professional quality of life among nursing staff. Design and method. An open-label, phase-II randomized clinical trial was undertaken considering a sample size of convenience was done. In service nursing staff were randomized (1:1) to intervention group and wait-list control group. Primary outcome was perceived stress which was measured by Perceived Stress Scale (PSS). Secondary measures were professional quality measured by Professional Quality of Life (ProQOL) scale, blood pressure, serum cortisol, and high-sensitive C-reactive protein. Both the per-protocol and intention to treat analysis was done. Results. Total 113 participants were allocated to intervention group (n = 58, mean = 35 years, SD = 7.9 years) and wait-list control group (n = 55, mean = 32.5 years, SD = 6.8 years). After 12 weeks, 19 participants of intervention group and 32 participants of wait-list control group were included in the per-protocol analysis. Follow-up mean PSS score was 15.4 (95% CI 12.6-18.2, SD 5.8) in intervention group, 20.7 (95% CI 19.7-21.7, SD 2.8) in wait-list control group (p-value < 0.0001). The other parameters didn’t differ between the groups and from baseline to end line too. Conclusions and relevance. The finding showed supervised structured yoga may be efficacious to reduce stress. Studies with larger sample size are needed to confirm the findings. Trial registration. It was approved by the Institute Ethics Committee (Reference no: IECPG-543/20.12.2017, RT-57/31.01.2018) and was registered prospectively in the Clinical Trial Registry of India prospectively (No. CTRI/2018/02/012206).

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Maas, Meridean L., Marion Johnson, and Sue Moorhead. "Classifying Nursing-Sensitive Patient Outcomes." Image: the Journal of Nursing Scholarship 28, no. 4 (December 1996): 295–302. http://dx.doi.org/10.1111/j.1547-5069.1996.tb00377.x.

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Page, Cecilia Anne Kennedy. "Nursing-Sensitive Innovations Influencing Outcomes." Nursing Clinics of North America 49, no. 1 (March 2014): xi—xii. http://dx.doi.org/10.1016/j.cnur.2013.12.001.

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Potempa, Kathleen, Susan Butterworth, Marna Flaherty-Robb, Margaret Calarco, Deanna Marriott, Bidisha Ghosh, Amanda Gabarda, et al. "The Impact of Nurse Health-Coaching Strategies on Cognitive—Behavioral Outcomes in Older Adults." International Journal of Environmental Research and Public Health 20, no. 1 (December 27, 2022): 416. http://dx.doi.org/10.3390/ijerph20010416.

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The practice of nurse health coaching (NHC) draws from the art and science of nursing, behavioral sciences, and evidence-based health-coaching methods. This secondary analysis of the audio-recorded natural language of participants during NHC sessions of our recent 8-week RCT evaluates improvement over time in cognitive–behavioral outcomes: change talk, resiliency, self-efficacy/independent agency, insight and pattern recognition, and building towards sustainability. We developed a measurement tool for coding, Indicators of Health Behavior Change (IHBC), that was designed to allow trained health-coach experts to assess the presence and frequency of the indicators in the natural language content of participants. We used a two-step method for randomly selecting the 20 min audio-recorded session that was analyzed at each time point. Fifty-six participants had high-quality audio recordings of the NHC sessions. Twelve participants were placed in the social determinants of health (SDH) group based on the following: low income (<USD 20,000/year), early-onset hypertension, and social disadvantages. Our analyses significantly improved change talk and the other four factors over time. Our factor analyses indicated two distinct factors at each measurement point of the study, demonstrating the stability of the outcome measures over time. Our newly developed measurement tool, IHBC, proved stable in structure over time and sensitive to change. This NHC program shows promise in improving cognitive–behavioral indicators associated with health behavior change in both non-SDH and SDH individuals.

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Carey, Niamh, Marie Harte, Claire Gorry, and Laura McCullagh. "OP136 Provision Of A Chimeric Antigen Receptor T-Cell Program: A Rapid Review." International Journal of Technology Assessment in Health Care 35, S1 (2019): 31. http://dx.doi.org/10.1017/s0266462319001648.

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IntroductionThe recent European Medicines Agency (EMA) approval of chimeric antigen receptor (CAR) T-cell therapies, axicabtagene ciloleucel and tisagenlecleucel, means the imminent arrival of health technology assessment (HTA) submissions to HTA agencies. HTA requires identification of all resources and organizational impacts pertaining to an intervention. Rapid review is a form of knowledge synthesis that abbreviates certain methodological aspects of systematic reviews to produce information in a timelier manner. Considering the time-sensitive nature of CAR T-cell HTAs, the aim of this research was to conduct a rapid review to identify the institutional requirements for the provision of a CAR T-cell program.MethodsA Rapid Review protocol was developed and registered in PROSPERO. Electronic databases, EMBASE and MEDLINE, and grey literature were searched. All study designs published in English after the year 2000 were included. Studies pertained to the use of CAR T-cells in adult and pediatric patients with solid and hematological malignancies. No restrictions were placed on the comparators or study setting. Primary outcomes were organized into two categories: (i) resource use, (ii) processes relating to implementation of CAR T-cell programs. Secondary outcomes included associated costs of implementation and barriers to successful implementation. Screening, review, and extraction of relevant data was conducted by a single reviewer. Extracted data included publication details, population and setting, study characteristics, outcomes and outcome measures, and strengths and limitations of research. Data was synthesized by means of thematic analysis.ResultsResults indicate that the provision of a CAR T-cell program in Ireland will require the establishment of bespoke infrastructural support. This includes additional outpatient facilities, ICU resources, and nursing capacity. Close relationships will need to be formed between hematology, ICU and neurology.ConclusionsThe findings of this Rapid Review will inform the assessment of organizational impacts associated with the introduction of a CAR T-cell program, ensuring a robust HTA assessment.

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Yang, Ke-Ping A., Lillian M. Simms, and Jeo-Chen T. Yin. "Nursing-Sensitive Patient Care Outcomes in Taiwanese Nursing Homes." Image: the Journal of Nursing Scholarship 30, no. 3 (September 1998): 290. http://dx.doi.org/10.1111/j.1547-5069.1998.tb01309.x.

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Sasso, Loredana, Annamaria Bagnasco, and Roger Watson. "Competence-sensitive outcomes." Journal of Advanced Nursing 73, no. 5 (February 18, 2016): 1002–3. http://dx.doi.org/10.1111/jan.12941.

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Johnson, Sarah, and Elizabeth Schenk. "A Proposal: Nurse-Sensitive Environmental Indicators." Annual Review of Nursing Research 38, no. 1 (December 23, 2019): 265–74. http://dx.doi.org/10.1891/0739-6686.38.265.

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Healthcare contributes significant pollution to the natural environment. Nurses are obligated by professional commitment, to avoid causing harm in their care processes and decisions, including environmental harm. Nurse awareness of healthcare-generated pollution is growing but nurses may lack an understanding of how nursing contributes specifically to this pollution and what nurses can do within their scope and span to address it. This chapter introduces the concept “Nurse-Sensitive Environmental Indicators” as a proposal to identify, measure, and reduce the unintended harm of nursing practice that contributes to healthcare-generated pollution. It discusses the environmental problem, environmental health, and healthcare. The chapter explains what environmental stewardship has to do with nursing and describes nurse sensitive indicators. As has been the case with other quality outcomes measures, identifying agreed-upon environmental outcomes measures may give the nursing profession tools to measure and then address environmental impacts arising from nursing practice.

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Coleman, Elizabeth Ann, Sharon K. Coon, Kimberly Lockhart, Robert L. Kennedy, Robert Montgomery, Nevada Copeland, Paula McNatt, Shelia Savell, and Carol Stewart. "Effect of Certification in Oncology Nursing on Nursing-Sensitive Outcomes." JONA: The Journal of Nursing Administration 40, Supplement (October 2010): S35—S42. http://dx.doi.org/10.1097/nna.0b013e3181f37f9f.

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Coleman, Elizabeth Ann, Sharon K. Coon, Kimberly Lockhart, Robert L. Kennedy, Robert Montgomery, Nevada Copeland, Paula McNatt, Shelia Savell, and Carol Stewart. "Effect of Certification in Oncology Nursing on Nursing-Sensitive Outcomes." Clinical Journal of Oncology Nursing 13, no. 2 (January 1, 2009): 165–72. http://dx.doi.org/10.1188/09.cjon.165-172.

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Whitman, Gayle R. "Nursing-Sensitive Outcomes in Cardiac Surgery Patients." Journal of Cardiovascular Nursing 19, no. 5 (September 2004): 293–98. http://dx.doi.org/10.1097/00005082-200409000-00003.

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Journal articles on the topic 'Nursing sensitive outcome'

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