Publications

Abstract

Delirium or acute confusion increase the likelihood of physical restraint use and subsequent harmful physical and psychological effects. Assessment for delirium is presented as a conceptual framework to guide researchers, administrators, and clinicians in developing strategies to decrease the use of physical restraint and to support quality of life for hospitalized older adults.

Abstract

Attitudes about drug use, including nicotine and alcohol, shape the caregiving potential of the nurse/client relationship. Sometimes these attitudes enhance care provision; often the attitudes close doors to ways of working together. The author presents an overview of drug use, including healthcare providers' perspectives of the problem. Areas of positive interaction that can benefit patients and family are highlighted, and content essential to the client's overall wellbeing is presented for incorporation into nursing approaches.

Abstract

This study found that costs of implementing projects aimed at improving nurse recruitment and retention vary substantially. At 37 hospitals the costs ranged from a mean of $1,029 per bed for shared governance to $8,399 per bed for computer projects. For a typical 30-bed unit implementing a non-computer project, an average of 1,800 hours of personnel time was devoted to implementation. In most cases, hospitals found that the projects took more resources than expected to get off the ground. The benefit/cost results indicate that the potential annual savings in hospital operation costs associated with reduced length of stay were approximately $3,015 for each $1,000 of one-shot implementation costs spent per bed.

Abstract

OBJECTIVE - To determine to what extent nurse practitioner (NP) practice patterns of diabetes care are consistent with standards of care suggested by the American Diabetes Association (ADA). RESEARCH DESIGN AND METHODS - A descriptive study was conducted to examine practice patterns. A convenience sample of 78 charts was audited, representing a proportionate number of charts for each of the six masters-prepared, certified NPs employed in an ambulatory primary-care center. RESULTS - Practice patterns related to diabetes care revealed a discrepancy between established standards of care and the degree to which care was documented. All six NPs acknowledged that they became clinically competent to care for patients with diabetes on the job. CONCLUSIONS - Results of this small study suggest that NPs are not consistently following standards of care suggested by the ADA.

Abstract

This article discusses opportunities for nurse practitioner and community health nurse partnerships in patient care. Financial incentives in a restructured health delivery system will increase access to community-based care. The authors argue that case management will be greatly enhanced by clinical partnerships and a direct reimbursement of nurse practitioner and primary care providers.

Abstract

The relative impact of various nursing care delivery models and management interventions on nurse satisfaction was assessed in 37 New Jersey hospitals. Nurses ranked pay as the most important factor, followed by autonomy and professional status. Changes in scores between pilot and comparison units were significantly different for satisfaction with interactions and task requirements. Change in satisfaction with interaction was significant for all initiatives in aggregate, as well as for each of the five types of initiatives separately. The change in satisfaction with task requirements was significant for all initiatives taken as a group and for those units that implemented reorganization, computer, and education initiatives. Even among nurses who eventually liked the new environment there was a period of initial dissatisfaction.

Abstract

The 1976-1980 National Health and Nutrition Examination Survey revealed that an estimated 34 million adults (26%) between the ages of 20 and 75 are obese. The health implications of obesity are well known and contribute to the increased morbidity and early mortality in those who are affected. As a result, obesity has become a public health concern that has been targeted as a national health objective in Healthy People 2000. The overall health objective, related to the problem of overweight in adults, is to reduce the prevalence from 26% to < 20%.

Abstract

Worldwide, squamous cell cervical cancer and intraepithelial lesions (SIL) are a major source of morbidity and mortality. Compared to women in general, women with human immunodeficiency syndromes (HIV) are at higher risk of developing SIL. With the HIV epidemic escalating among women, prevalence, morbidity, and mortality related to SIL are likely to increase unless adequate prevention and detection programs are mounted. Consequently, this article provides background information for the design of such programs, focusing on selected biochemical risk factors and natural history of SIL in women infected with HIV (HIV+) and women in general (HIV-). Current screening policies are described, and implications for nursing research and policy are discussed.