Thesis (M.S.) --University of Texas Graduate School of Biomedical Sciences at San Antonio, 2008. / Vita. Includes bibliographical references.

Thesis (M.S.)--University of Wisconsin, School of Nursing. / eContent provider-neutral record in process. Description based on print version record.

Primary nursing is a system of delivering nursing care when one nurse is responsible and accountable for the assessment of the patient's needs as well as the planning, implementing and evaluating of the nursing care throughout the patient's hospitalization. These activities are done in collaboration with the patient and other members of the health team. This system is a relatively recent development in the field of nursing. There has been little research done to either describe or evaluate primary nursing, particularly in the area of psychiatry. This study was an attempt to include both patients and nurses in such an evaluation. A validated and reliable questionnaire was developed by the author to obtain data related to patients' and nurses’ perceptions of the occurrence, importance and satisfaction of specific primary nursing behaviours. The questionnaire was administered to twenty-nine patients and their primary nurses during the last week of the patient's hospitalization. Nurses and patients reported that primary nursing behaviours related to discharge had a low occurrence rate. However, they attributed a high degree of importance to these same behaviours. Both groups reported a low occurrence and importance score for primary nursing behaviours related to family involvement with the primary nurse and the patient's treatment program. Both nurses and patients agreed on the occurrence and importance of most of the primary nursing behaviours. There was less agreement in the area of satisfaction. / Applied Science, Faculty of / Nursing, School of / Graduate

Yes / Background: Reducing emergency admissions to hospital has been a cornerstone of health care policy. There is little evidence of systematic interventions which achieved this aim across a population. We report the impact on unplanned admissions to hospital through a complex intervention over a 44 month period in Frome, Somerset. Aim: A population health complex intervention of an enhanced model of primary care and compassionate communities to improve population health and reduce emergency admissions to hospital Design: A cohort retrospective study of a complex intervention on all emergency admissions in Frome compared to Somerset from April 2013 to December 2017. Setting: Frome Medical Practice, Somerset Methods: Patients were identified using broad criteria including anyone with cause for concern. Patient centred goal setting and care planning combined with a compassionate community social approach was implemented broadly across the population of Frome. Results: There was a progressive reduction, by 7.9 cases per quarter (95% CI: 2.8, 13.1; p=0.006) in unplanned hospital admissions across the whole population of Frome, over the study period from April 2014 to December 2017. At the same time, there was sharp increase in the number of admissions per quarter, within the Somerset, with an increase in the number of unplanned admissions of 236 per quarter (95% CI: 152, 320; p<0.001). Conclusion: The complex intervention in Frome was associated with highly significant reductions in unplanned admissions to hospital with reduction of healthcare costs across the whole population of Frome

O propósito deste estudo foi desenvolver um software-protótipo, que possibilite aos enfermeiros atender ao planejamento da assistência de enfermagem, prescrição de intervenções de enfermagem e toda sua documentação de forma informatizada.A equipe multiprofissional envolvida no desenvolvimento deste software-protótipo foi constituída pela pesquisadora, um analista de sistema e um programador. A metodologia utilizada fundamentou-se no ciclo de vida de desenvolvimento de sistema, baseando-se no conceito de prototipação. Sedimentou-se em duas fases: a fase de definição e a de desenvolvimento. A fase de definição iniciou-se com a etapa de planejamento, seguido pela definição e análise dos requisitos necessários para sua construção e culminou com a produção da especificação de requisitos do software. A fase de desenvolvimento traduziu o conjunto de requisitos em um modelo informatizado, estruturado em 10 módulos, referentes ao processo de sistematização da assistência de enfermagem. Os módulos denominados: Ficha de Identificação, Dados Clínicos, Internações, Informações adicionais e Entrevista armazenam dados relativos às necessidades humanas básicas e abrangem: o índice de massa corpórea, situação clínica, resumo de admissão, internações anteriores e os dados para identificação do paciente. O módulo para Coleta de Dados foi desenhado para cadastrar informações diferenciadas sobre os sinais e sintomas e gerar, automaticamente, o módulo Lista de Problemas. Este viabiliza a elaboração da prescrição de enfermagem específica para cada paciente por meio da utilização de uma base de dados previamente estabelecida pelo sistema. Para propiciar maior comodidade e agilidade nas atividades de documentação, o módulo sobre Sinais Vitais permite transformar, eletronicamente, os valores atribuídos à pressão arterial, pulso, respiração e temperatura em gráficos individualizados. O ambiente Balanço Hidroeletrolítico permite implementar, automaticamente, o balanço parcial e total oferecendo aos enfermeiros simplicidade na execução desta tarefa, bem como realizar seu acompanhamento posterior. A avaliação deste recurso inovador na performance da Sistematização da Assistência de Enfermagem nos diferentes estágios do seu processo será objeto de um estudo posterior. / The purpose of this study is to develop a software-prototype to help the nurses to plan the nursing care, to make nursing interventions and all documentation in a computerized way. The multi- professional team is involved in the development of this software-prototype and constituted by the researcher, a system analyst and a programmer. The methodology is based in the life cycle of system development, basing on the prototype concept. It is following up into two phases: the definition and the development one. The definition phase began with the planning stage, following for the definition and analysis of the requirements for the construction and it culminated with the specification of the software requirements.The development phase translated the group of requirements in a computerized model, structured in 10 modules, regarding the process of nursing care system. The Identification, Clinical Data, Interview and additional Information modules store data related to the basic human needs and they include: the index of corporal mass, clinical situation, admission summary, and the patient's identification. The Data Collection module was design to register information related to the signs and symptoms and to generate, automatically, the List of Problems module. This makes possible the elaboration of the nursing prescription of each patient using the data base established previously by the system. To make better the documentation activities, the Vital Signs module allows to transform, electronically, the values attributed to the blood pressure, pulse, breathing and temperature in individualized graphs.The fluid and electrolyte metabolism balance module allows to implement, automatically, the partial and total response helping the nurses in the execution of this task, as well as to accomplish the subsequent attendance. The evaluation of this innovative resource in the performance of Nursing Care System will be object of a subsequent study.

O propósito deste estudo foi desenvolver um software-protótipo, que possibilite aos enfermeiros atender ao planejamento da assistência de enfermagem, prescrição de intervenções de enfermagem e toda sua documentação de forma informatizada.A equipe multiprofissional envolvida no desenvolvimento deste software-protótipo foi constituída pela pesquisadora, um analista de sistema e um programador. A metodologia utilizada fundamentou-se no ciclo de vida de desenvolvimento de sistema, baseando-se no conceito de prototipação. Sedimentou-se em duas fases: a fase de definição e a de desenvolvimento. A fase de definição iniciou-se com a etapa de planejamento, seguido pela definição e análise dos requisitos necessários para sua construção e culminou com a produção da especificação de requisitos do software. A fase de desenvolvimento traduziu o conjunto de requisitos em um modelo informatizado, estruturado em 10 módulos, referentes ao processo de sistematização da assistência de enfermagem. Os módulos denominados: Ficha de Identificação, Dados Clínicos, Internações, Informações adicionais e Entrevista armazenam dados relativos às necessidades humanas básicas e abrangem: o índice de massa corpórea, situação clínica, resumo de admissão, internações anteriores e os dados para identificação do paciente. O módulo para Coleta de Dados foi desenhado para cadastrar informações diferenciadas sobre os sinais e sintomas e gerar, automaticamente, o módulo Lista de Problemas. Este viabiliza a elaboração da prescrição de enfermagem específica para cada paciente por meio da utilização de uma base de dados previamente estabelecida pelo sistema. Para propiciar maior comodidade e agilidade nas atividades de documentação, o módulo sobre Sinais Vitais permite transformar, eletronicamente, os valores atribuídos à pressão arterial, pulso, respiração e temperatura em gráficos individualizados. O ambiente Balanço Hidroeletrolítico permite implementar, automaticamente, o balanço parcial e total oferecendo aos enfermeiros simplicidade na execução desta tarefa, bem como realizar seu acompanhamento posterior. A avaliação deste recurso inovador na performance da Sistematização da Assistência de Enfermagem nos diferentes estágios do seu processo será objeto de um estudo posterior. / The purpose of this study is to develop a software-prototype to help the nurses to plan the nursing care, to make nursing interventions and all documentation in a computerized way. The multi- professional team is involved in the development of this software-prototype and constituted by the researcher, a system analyst and a programmer. The methodology is based in the life cycle of system development, basing on the prototype concept. It is following up into two phases: the definition and the development one. The definition phase began with the planning stage, following for the definition and analysis of the requirements for the construction and it culminated with the specification of the software requirements.The development phase translated the group of requirements in a computerized model, structured in 10 modules, regarding the process of nursing care system. The Identification, Clinical Data, Interview and additional Information modules store data related to the basic human needs and they include: the index of corporal mass, clinical situation, admission summary, and the patient's identification. The Data Collection module was design to register information related to the signs and symptoms and to generate, automatically, the List of Problems module. This makes possible the elaboration of the nursing prescription of each patient using the data base established previously by the system. To make better the documentation activities, the Vital Signs module allows to transform, electronically, the values attributed to the blood pressure, pulse, breathing and temperature in individualized graphs.The fluid and electrolyte metabolism balance module allows to implement, automatically, the partial and total response helping the nurses in the execution of this task, as well as to accomplish the subsequent attendance. The evaluation of this innovative resource in the performance of Nursing Care System will be object of a subsequent study.

The study evaluated the cost-effectiveness of community based Nurse Case Management (NCM) utilizing existing hospital information systems data. Program outcomes of intensive NCM were compared with those of existing hospital programs for a group at high risk for readmission. Thirty-one elderly patients were assigned to one of three groups. A retrospective pretest-posttest design was used and multivariate analyses were performed. Outcomes were measured at six month intervals before and after NCM. The intensive NCM group had a higher length of stay and inpatient costs than the other two groups. Direct costs of NCM were estimated at $1.55 per active case per day. The study found that cost-effectiveness of NCM cannot be determined accurately unless health risk assessments are quantified, NCM is clearly translated into categories of intervention, and direct costs of NCM are measured consistently. These factors must be integrated into routine hospital information system reports.

Dissatisfaction with medical information is a common problem among patients. There is also evidence that patients lack information that physicians believe they have given to the patient. The aims of this study were to 1) survey patients' subjective need for, and satisfaction with, the information that they received during their hospital stay 2) develop and evaluate systematic routines for giving information to the patients and also communication and collaboration between the medical and nursing staff concerning the satisfaction of the patients' need for information. The study was an intervention project and the research perspective was organizational psychology. Survey study. The patients experienced a considerable need for medical information, especially about the examination results and prognosis. The patients' need for information regarding prognosis was the least satisfied. Intervention 1. A general improvement of the information to the patients occurred when the systematic routines were established. The patients' subjective need for information was unchanged throughout two years. Their satisfaction with information, after an initial improvement, did not increase throughout these two years. There was low correlation between the patients' and their physicians' estimations concerning the patients' need for information on diagnosis, prognosis and examination results. Likewise, concerning the adequacy of that information. Intervention 2. Communication and collaboration between the medical and nursing staff included a system for assessment and solution of the patients' information problems. Problem-solving took place at a multidisciplinary team conference (MTC). Medical problems were better elucidated than the patients' psychological problems. After training of registered nurses (RN) as conference chairpersons, the patients need for information was better understood. The staff reported 42 information problems after training compared to two before. For half of the information problems decisions were discussed on steps to be taken in order to satisfy the patients' need for information. A year after the system for assessment and solution of information problems was established, the patients were more satisfied with information about examinations and their results and on information about medication (p&lt; 0.05). Further, new norms for the patients' need for information were established and a change was initiated. The results are discussed with regard to how and why patients' shall have information, by whom and to whom information shall be given, when and where information shall be given and which content it shall have. / <p>S. 1-56: sammanfattning, s. 57-137: 4 uppsatser</p> / digitalisering@umu

Thesis (M.S.)--University of Michigan, 1988.

Thesis (M.S.)--University of Michigan, 1989.