Contributing to a positive outcome

Achieving a successful patient outcome depends on contributions from a range of health professionals. Each discipline shares values, responsibilities and a vision for what the service should achieve.     

Managing relapse as a positive opportunity for change.

During the process of lifestyle changes, there is a high incidence of relapse during the first three months. There are frequently negative feelings experienced by both the nurse practitioner and the client. This paper presents information concerning relapses, conceptualizing relapse as a positive experience, and strategies to support clients who encounter relapse in their efforts to maintain positive health habits.     

Organizational change toward a nursing agenda. A framework from the Strengthening Hospital Nursing Program

Although nursing is central to most efforts aimed at changing U.S. hospitals and care delivery systems, little is known within the profession about initiating or participating in large system--total hospital--change. Using data from the national Strengthening Hospital Nursing Program, a program supported by the Robert Wood Johnson Foundation and The Pew Charitable Trusts, the authors explore what organizational factors are relevant for hospital change that is systemic, ambitious, and favorable to a nursing agenda.     

Patient satisfaction as a positive nursing outcome

The purpose of this cross-sectional survey was to assess patient satisfaction and analyze its relationship to nurse staffing levels in 34 inpatient wards at 4 Finnish university hospitals. The patients were satisfied with their care in general. However, the proportion of registered nurses (RNs), the patient-to-RN ratio, and the RNs' working years were highly related to patient satisfaction. Eight patients per RN was the cut-off point for patient satisfaction.     

Convenient care clinics: Making a positive change in health care

Abstract
Purpose: To discuss the impact of retail health clinics, also known as convenient care clinics (CCC), on the changing landscape of health care in the United States.
Data sources: Selected articles from the scientific literature and data from the industry literature.
Conclusions: The concept of the CCC has been well-received by the public, and nurse practitioners (NPs) have been intimately involved in the development and expansion of these clinics. The professional association of CCCs has been instrumental in promoting operational standards for CCCs to insure a high quality of service. Some resistance to the concept from physicians remains but the convenience for consumers appears to drive the high levels of satisfaction reported.
Implications for practice: Collaboration among all healthcare providers is essential to expand access to care for everyone. NPs are crucial to the operation of CCCs and provide care that is well-received by consumers.     

How a multidisciplinary team improved a process to attain positive patient outcome

A case study approach will be used to demonstrate the effectiveness of a continuous quality improvement team designed to explore the process of preoperative medical record completeness. The goal of this team was to improve essential chart components (e.g., electrocardiography, history and physical examination) required 48 hours before the date of surgery in an effort to facilitate optimum patient management and timely flow of patients to the operating room. When the 48-hour compliance rule is followed, the nurse reviewer has sufficient time to review all patient data and notify attending physicians or designees of any abnormalities. In essence, improving component compliance provides better quality care because patients are able to be assessed before surgery with enough time to solve any problems.     

A positive change for a healthier life: Weight reduction strategies for obese people

People who are obese have increased risk of a range of conditions, and also often suffer socially and psychologically. To successfully reduce their weight, they need to make lifelong changes in their eating and exercise habits.     

Mayo Medical Center Brain Injury Outpatient Program: treatment procedures and early outcome data.

The rehabilitation of persons with brain injuries has proved challenging; community reintegration is often unsuccessful. Herein we describe our intensive group-oriented outpatient treatment program for persons with brain injury and report outcome data for the graduates of the program thus far. This interdisciplinary program emphasizes the development of cognitive skills, compensation techniques, social skills, emotional adjustment, leisure skills, physical fitness, and health maintenance. Although goals are individually determined, independent living and employment are goals for most participants in the program. Before initial participation, all candidates undergo an extensive 2-day assessment. Typically, a patient remains in the program for approximately 6 months. The specific group treatment approaches used in the program are discussed. Outcome data are assessed with use of the Portland Adaptability Inventory and goal attainment scaling, as well as comparisons of preprogram and postprogram employment status and level of independent living. Our initial results support the conclusion that this comprehensive and integrated treatment program is efficacious in rehabilitating persons with mild to moderate sequelae of brain injury.     

Mental Health Nurse Incentive Program: contributing to positive client outcomes

Mental health conditions are likely to affect almost half of the population at some stage in their lives. Despite the magnitude and potentially serious consequences of mental illness and disorders, access to services is a significant problem. In 2007, the Mental Health Nurse Incentive Program (MHNIP) was implemented to improve access to mental health care in Australia. Mental health nurses are engaged under the MHNIP to work with general practitioners, psychiatrists, and other mental health professionals to treat clients experiencing a mental health condition. This paper presents findings from a qualitative exploration of nurses working under the MHNIP in Australia. In-depth interviews were conducted with 10 nurses currently working under the MHNIP to gain an understanding of their roles and their perceptions of the effectiveness of this new programme. Data were analysed using NVivo. Four major themes emerged: developing the role, a holistic approach, working collaboratively, and benefits to clients. The findings suggest that mental health nurses have the potential to make a significant contribution to enhancing access to, and the quality of, mental health care through flexible and innovative approaches.     

Nursing intervention studies require outcome measures that are sensitive to change: Part One.

In selecting an outcome measure for a study evaluating a nursing intervention, the criterion of sensitivity to change should predominate. Researchers commonly justify their choice of outcome measures for experiments based on such psychometric criteria as high internal consistency reliability and patterns of correlations reflecting convergent and discriminant validity. Although such criteria are appropriate for measures to assess individual differences, they are insufficient when the measures will be used for intervention studies. Researchers may need to develop new measures that are tailored for experimental studies if existing measures are valid mainly for the assessment of individual differences. In this first portion of a two-part article, three of seven factors to consider in selecting an outcome measure for an intervention study are outlined and recommendations for application of principles of reliability and validity in the context of sensitivity to change are given.