Thesis (M.H.A.)--University of Michigan, 1957.

Thesis (M.S.)--University of Michigan, 1985.

Thesis (M.H.A.)--University of Michigan, 1957.

Thesis (M. Heal. Sc.)--University of Canterbury, 2009. / "January 2009." Typescript (photocopy). Some forms in the appendix in Japanese. Abstract in English and Japanese. Includes bibliographical references (p. 94-100). Also available via the World Wide Web.

Thesis (M.S.)--University of Michigan, 1985.

D.Cur. (Intensive General Nursing) / Critical care nursing is cost-effective quality nursing to the critical ill patient. This nursing is inftuenced by certain expectations as well as the professional-ethical authorisation. The aim ofthis study is to describe and explore the expectations and the professional-ethical authorisation of the functions of the critical care nurse to enable the formulation ofguidelines for the scope of practice for the critical care nurse within South African context. Phase I was to determine the expectations of the critical care nurse, the nursing service managers and the doctors with regard to the functions of the critical care nurse. A focus group interview was held with a group of experts in the field of critical care. The results were used to compile a questionnaire. This questionnaire was sent to the critical care nurses, the nursing service managers and the doctors in South Africa for completion. From these results the functions of the critical care nurse were determined. Phase 2 is to analyse the expectations (Phase 1) according to the professional-ethical authorisation of the critical care nurse. Firstly, literature was explored and described to determine the professional ethicalauthorisation regarding the accountability ofthe critical care nurse. Secondly, the functions were analysed according to the professional-ethical authorisation. The analysis showed that except for prescribing medication, altering medication dosages and drawing blood samples from the critical ill patient, the critical care nurse is practicing within her professional-ethical authorisation. Phase 3 was to formulate guidelines for the scope of practice for the critical care nurse within a South African context. Through usage of the data (Phase I and 2) the scope of practice was formulated. Guidelines were formulated for the practise, education and research regarding the limitations of the professional-ethical authorization and the implementation of the scope of practice for the critical care nurse.

M.Cur. / The neonate has the right to quality nursing care and the Neonatal Intensive nursing care practitioner is personally and professionally-ethically liable for quality nursing care. The process of quality improvement is a structured, planned and purposeful action where standards are set and the nursing care is evaluated after which remedial steps are taken to improve quality nursing care. In this study the focus is on the first step in the quality improvement cycle; the setting of standards. The central theoretical statement is as follows: standards for Neonatal Intensive nursing care facilitate quality nursing care in the Neonatal Intensive Care unit. The purpose of the study is to describe and formulate standards for Neonatal Intensive nursing care which can be utilised as an accreditation instrument for institutional self evaluation to improve quality nursing care. The aim of the study is justified by means of a descriptive, explorative, contextual research design. Standards for Neonatal Intensive nursing care were developed and validated by utilising a threephase research method. In phase one subjects for standards were identified by a panel of six experts. They were chosen according to their academic qualifications and nursing experience. The identification was done by means of a critical debate, after which a preliminary conceptual framework was formulated. During the second phase a comprehensive literature control was undertaken to refine the preliminary conceptual framework. The final conceptual framework, that was formulated during phase two, served as a basis for the description and formulation of standards. The standards were divided as unit management standards and clinical nursing care standards. During the third phase a final validation of the standards occured by means of a consencus debate between the experts that were used in the first phase. An accreditation instrument was developed to be utilised for institusional self evaluation in order to facilitate quality nursing care. The standards comply with content validity within the context of a Neonatal Intensive Care unit in a private hospital in Gauteng. It is recommended that the standards are validated nationally in the Neonatal Intensive Care practice in order to be implemented after inservice training to the different role players. The following hypotheses is set for testing: standards for Neonatal Intensive nursing care improve quality nursing care in the Neonatal Intensive Care unit.

No description available.

Long-term outcomes for patients admitted to intensive care units (ICUs) are recognised to be of increasing importance. Published studies indicate that ICU survivors have significant physical impairment, impaired quality of life, and excess mortality during the post-ICU period. The period of excess mortality has been variously estimated as lasting from one to 16 years after ICU discharge. Remarkably little information about long-term mortality and healthcare resource use exists for critical care populations, and outcomes relative to a non-ICU control population are unknown. The aims of the studies presented in the thesis were (i) to describe long-term (five year) mortality and identify factors associated with mortality for patients admitted to ICUs in Scotland (ICU admission cohort) and those surviving to be discharged from hospital alive (ICU survivor cohort); (ii) to compare mortality rates with control populations after adjustment for relevant confounders; (iii) to evaluate the extent of, and factors associated with, long-term (five year) major healthcare resource use of survivors of critical illness (ICU survivor cohort); and (iv)to compare major healthcare resource use with a control hospital inpatient population. I undertook a detailed systematic review of the international literature relating to healthcare resource use in ICU survivors to inform the design of the part of the study relating to resource use. This revealed a paucity of high quality studies but led to recommendations for improving the conduct and reporting of future research in this field. Using both retrospective cohort and matched cohort study designs, I analysed data relating to all patients admitted to Scottish ICUs in 2005 from the Scottish Intensive Care Society Audit Group (SICSAG) database. Two cohorts were defined: an ICU admission cohort, representing all ICU admissions, and a subcohort of those who survived to hospital discharge (ICU survivor cohort). Matched control cohorts of non-ICU hospital inpatients were selected from national datasets. The main outcomes were five-year mortality and major healthcare resource use obtained from linkage to national datasets. Major healthcare use was measured by number of hospital readmissions, number of days spent in hospital and hospital costs during the five years after hospital discharge. Five year mortality was 53% in the ICU cohort compared with 27% for the matched control hospital cohort and 16% for an age/sex-standardised general population. Among hospital survivors, ICU patients had higher five year mortality after adjustment for confounders (HR 1.3, 95%CI 1.2 to 1.4, p<0.001). Age, comorbidity, ICU admission diagnosis and deprivation quintile were independently associated with five-year mortality. The ICU diagnosis with greatest five year mortality (relative to self-poisoning) was variceal bleeding (HR 3.9, 95%CI 2.2 to 6.7, p<0.001). The readmission rate for the 5259 ICU patients surviving to hospital discharge declined from 1.7 readmissions per person in the first year to 0.9 in the fifth year of follow-up. Overall, ICU survivors spent a mean of 29 days in hospital over the five year follow up period, at a cost of £14593 per person. Previous number of admissions was the factor most strongly associated with resource use. ICU patients had a significant increased rate of hospital admission compared with the control cohort throughout the five year follow up period (admission rate ratio 1.21 (95%CI 1.14 to 1.29, p<0.001)). In the programme of work presented in this thesis, I have systematically reviewed evidence for resource use following critical illness, and have demonstrated that ICU patients are more likely to die compared with other hospital inpatients over a five-year horizon, even when only hospital survivor cohorts are considered. Furthermore, I have demonstrated that ICU survivors utilise a significant amount of excess acute hospital resource, which is relevant to health service planning and economic evaluations.

published_or_final_version / Nursing Studies / Master / Master of Nursing