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Of critical importance to the financial viability of any home health agency are its productivity standards for staff. The authors discuss the results of a study that analyzed staff time spent in direct patient care, documentation of that care, travel, and other activities, and how the resulting data influenced agency operations.  相似文献   

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"Government's influence on professional practice, quality healthcare, and agency administration increases with each passing year. Federal, state, and local laws and regulations impact the day-to-day operations...." Therefore, it is important for professional nurses to understand both legislative and regulatory processes, identify resources, and take action when necessary (, p. 675).  相似文献   

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Pediculosis continues to be a widespread problem for both the public and health care professionals, including home health nurses. Dealing with this problem is complicated by a number of factors, including questions concerning the efficacy and safety of the medications used and the level of knowledge of about this condition. Because pediculosis often is considered more as an embarrassing annoyance than a serious threat, it has a relatively low priority on the list of contemporary health care concerns. This article addresses several practical questions concerning the character and treatment of pediculosis that are of special concern to home health nurses.  相似文献   

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OBJECTIVE: To assess prevalence and risk factors for medication under- and overadherence in a two-week period following hospital discharge in adults > or = 65 years. DESIGN: Prospective, cohort study. SETTING: Three home healthcare agencies in Madison, Wisconsin, and surrounding vicinity. PARTICIPANTS: One hundred forty-seven older participants taking three or more medications who were hospitalized for medical illness, received home nursing after discharge, and completed the two-week interview. MEASUREMENTS: The main outcome measures were having at least one medication with less than 70% adherence (underadherence) and having at least one medication with more than 120% adherence (overadherence) based on pill counts. RESULTS: Forty-five (30.6%) participants were underadherent and 27 (18.4%) participants were overadherent with at least one medication> In a multivariate model, underadherence was predicted by poor cognition (OR 2.5; 95% CI 1.02 to 6.10) and higher medication use (OR 1.16; 95% CI 1.03 to 1.31, for each 1-unit increase in number of medications). Both poor cognition and low education were significantly associated with overadherence in univariate analysis; however, neither variable was significant once included in the multivariate model. CONCLUSIONS: Under- and overadherence to medications is common after hospital discharge. Poor cognition and a greater number of medications were associated with underadherence. Poor and lower education were markers for overadherence; however, further study is needed to determined whether these are independent predictors. Patients who have impaired cognition or are taking a greater number of medications after hospitalization may benefit from targeted interventions to monitor and improve medication compliance.  相似文献   

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Forty-five Australian faculties and schools of nursing were surveyed by questionnaire to gain information about the health education component of undergraduate and postgraduate programs, and about current research activity relating to the educational role of nurses. Response rate achieved was 69%. Almost all institutions indicated involvement in preparing nursing students for an educational role, yet only five respondents described research activity relating to this. Most preparation was provided in an integrated context rather than in separate course units and the length of time allocated varied substantially. Responses to questions about content and clinical experiences were often omitted or were very general, with those involved in providing separate courses being much more likely to supply detailed or specific information. It is hypothesised that in general nurses are graduating from Australian colleges and universities inadequately prepared for the health educator role.  相似文献   

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The research focusing on pain in Hispanic/Latino populations suggests that their cultural values and beliefs of stoicism, fatalism, the importance of family, spirituality, and folk healing have an impact on their pain experience. Based on research findings this article suggests strategies nurses can use to assess and suggest pain management interventions for patients of Hispanic/Latino culture.  相似文献   

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A consultation was held to seek children's views on how to make better children's nurses to influence a new curriculum. In one-to-one sessions, ten hospitalised children were asked to complete body outlines of 'good' and 'not so good' nurses. Based on this the children were asked about how good children's nurses could be made. They agreed that although children's nurses are special people with some innate characteristics, they also needed education to make them good at nursing children. The children were able to identify three areas of learning that could help to make a good children's nurse. The researchers categorised these as: attitudinal and professional persona; Cognitive and psychomotor learning; experiential learning. The consultation highlighted methodological issues in consulting children about curriculum development, as well as drawing our attention to how children are represented in the children's nursing curriculum. Child nurse lecturers should work in collaboration with clinical colleagues and, more importantly, children to develop teaching and learning in children's nursing.  相似文献   

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OBJECTIVE: To assess incidence, healthcare consequences, and identify risk factors for adverse drug events (ADEs) in elderly patients receiving home health services during the month following hospital discharge. METHOD: This was a prospective cohort study of three home health agencies in Madison, Wisconsin, and its surrounding area. The sample consisted of 256 participants aged > or =65 years who were hospitalized for medical illness, received home nursing after discharge, and completed the one-month interview. The main outcome measure was self-reported ADEs (possible, probable, or definite) during the month following hospital discharge. RESULTS: Incidence of ADEs was 20%. Fifty-two participants (20.3%) reported 64 ADEs: 23 possible, 37 probable, and four definite. The most common ADEs involved the gastrointestinal tract (31.3%) and the central nervous system (31.3%). Of 53 ADEs reported to providers, 59% of the drugs were discontinued or altered. One ADE resulted in hospitalization. In logistic regression, female gender (OR = 2.26; 95% CI 1.06 to 4.77) and the interaction between number of new medications and cognition were significantly associated with ADEs. The risk of an event increased with the number of new medications at discharge; however, risk was elevated primarily for participants with lower cognition. CONCLUSIONS: ADEs were common during the month following hospital discharge, were more frequent in women, and often resulted in medication changes. Individuals at particular risk were those with lower cognition who were discharged with several new medications.  相似文献   

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