The effect of frontloading visits on patient outcomes

Frontloading, providing 60% of planned visits in the first 2 weeks of the home healthcare episode, was tested in two groups of patients: insulin-dependent patients with diabetes and patients with a primary diagnosis of heart failure. Frontloading was effective for patients with heart failure, decreasing rehospitalization by more than half (39.4-16%), with fewer visits (15.5 vs. 9.5) and equal clinical outcomes and patient satisfaction. There were no significant differences in outcomes for patients with diabetes.     

早期护理干预对高尿酸血症的影响

目的:通过科学正确的疾病预防知识的学习,使人们从根本上改变饮食结构及其生活方式,从而使其采取相应对策,以便降低高尿酸血症的血尿酸水平。方法:对符合标准的60例患者进行高尿酸血症知识认知程度的调查并进行分析。结果:经调查患者对高尿酸血症知识的认知程度由原先的25%增加到91.7%,可见早期护理干预对高尿酸血症的重要性。结论:通过对高尿酸血症患者的早期护理干预,即预防知识的教育,特别是减少含嘌呤食物的摄入量,并使其建立良好的生活方式,可有效减少高尿酸血症患者痛风的发病率和复发率。     

The effect of the clinical nurse specialist on patient outcomes

The review of the literature shows a beginning body of evidence to support the positive effects of CNSs on patient outcomes. The most commonly examined patient outcomes were length of stay, complications, use of health care services, cost, and mortality rates. The study done by the author shows that patients with TKR operations on units with CNSs had better patient outcomes than patients on units without CNSs. Patients on units with CNSs had an overall shorter TLOS and fewer complications than did patients on units without CNSs, which is consistent with the literature. Health care providers are making continuing efforts to decrease operating costs. Because of economic pressures on health care administrators, a need to examine various job positions exists. Decisions regarding which positions are retained or eliminated should be based on well-designed research data. The effect of CNSs on patient outcomes can mean improved quality of care and cost reduction. As more research is conducted to show the effectiveness of CNSs on patient outcomes, health care administrators and consumers may become more convinced that such a person is a valuable member to have on the health care team.     

The effect of nursing care planning systems on patient outcomes

Are written or standardized nursing care plans (NCP) as effective in enhancing the quality of patient care, and thus patient outcomes, as has been proposed for well over a decade? Data in this study did not validate the superiority of these two types of NCPs over another planning system. If the findings of this study are supported by further research, there will be scientific evidence upon which JCAH can base a reconsideration, and possible elimination, of their requirement for written/printed nursing diagnoses with corresponding nursing orders as part of nursing care planning systems.     

虚拟健康乐园生活方式干预效果研究

目的：研究虚拟健康乐园对生活方式的干预效果。方法：将60例有不良生活方式的人群分为干预组和对照组,每组30例,两组均在1个月内进行4次集中面授健康指导,之后干预组建立虚拟健康乐园干预5个月,对照组在5个月中每个月发放一次健康知识宣传材料。采用自陈式调查问卷进行评价,内容包括饮食、运动、吸烟和压力感,比较两组生活方式及压力感的干预效果。结果：干预组在饮食、运动方面干预前后的效果有统计学差异（P〈0．05）,与对照组比较差异有统计学意义（P〈0．05）,对照组在饮食、运动、吸烟、压力感方面干预前后的效果均无统计学差异（P〉0．05）。结论：虚拟健康乐园对不健康生活方式的干预效果明显。     

社区保健护理对高血压患者的影响

目的：探讨社区保健护理对原发性高血压患者病情的影响。方法：将120例原发性高血压病且无并发症的患者随机分为实验组和对照组60例,实验组采用药物治疗的同时进行社区保健护理（包括：集中授课、定期回访、举办高血压病联谊活动）;对照组仅采用药物治疗。观察两组患者1年后血压值和心脑血管并发症发生率的变化。结果：实验组患者的血压水平（收缩压和舒张压）与对照组相比明显下降（P〈0.01）,心脑血管并发症发生率显著降低（P〈0.05）。结论：提高高血压患者生存质量应从控制血压着手,进行社区保健护理是原发性高血压治疗的有效方法。     

The impact on patient health outcomes of interventions targeting the patient-physician relationship

Over the past 3-4 decades, numerous studies have been published evaluating interventions targeted at healthcare providers, at patients, or at both patients and healthcare providers, which are designed to, in some fashion, improve the provider-patient relationship and thereby enhance patient health outcomes. This article synthesizes findings from 14 literature reviews of relevant studies published between 1991 and 2007. Findings indicate that interventions aimed at physicians and other providers have consistently produced positive effects on provider communication behaviors and interpersonal skills. However, only moderately positive effects on patient satisfaction, and limited impact on patient healthcare behaviors such as compliance, appointment adherence, and resource use were found. Effects on primary medical outcomes were minimal although some positive effects on secondary medical outcomes such as quality of life were obtained. Patient-targeted interventions also showed consistently positive effects on patient-physician communication in addition to enhanced patient participation in decision making. Effects on patient primary medical outcomes were limited, and weak effects on patient satisfaction were obtained. Characteristics of studies and training programs that may have influenced outcomes are discussed, as are practical impediments to promoting better physician-patient communication in clinical practice.     

护理干预对肺结核患者服药依从性的影响

目的:探讨护理干预对提高肺结核患者服药依从性的影响。方法:将100例肺结核患者按其住院顺序随机分为实验組和对照组各50例。对照组患者给予一般的药物治疗+常规护理,实验组患者则在此基础上给予个体化的全程健康教育护理干预。于患者出院后3个月,通过门诊随访或电话随访形式,分别对两组患者进行服药依从行为调查。结果:护理干预前两组患者服药依从性比较无统计学意义(P0.05),护理干预后两组比较有统计学意义(P0.05)。结论:护理干预能更好地提高肺结核患者的服药依从性。     

The effect of three positioning methods on patient outcomes after cardiac catheterization

Title.  The effect of three positioning methods on patient outcomes after cardiac catheterization.
Aim.  This paper is a report of a study to investigate the effect of three positioning protocols on back pain, heart rate, blood pressure and vascular complications after cardiac catheterization.
Background.  After cardiac catheterization, bed rest is prescribed in order to minimize vascular complications, but this often leads to back pain and other complications, such as hemodynamic instability.
Methods.  A three-group quasi-experimental design was used in this study, which was conducted in 2006. A convenience sample of 105 patients was randomly assigned to either the control or the two experimental groups (A and B). The control group received routine care. Group B was treated only with modified positioning and group A with modified positioning and a pillow under their body. Back pain, heart rate, arterial blood pressure, haematoma formation and bleeding were measured at regular time intervals.
Findings.  The control group experienced higher levels of pain after 3, 6, 8 hours and the morning after catheterization. The level of pain in group B was also higher than in group A at 3 hours after the procedure. Mean heart rate and blood pressure were lower in the experimental groups compared with the control group at 6 and 8 hours after catheterization. No statistically significant difference between the three groups regarding the amounts of overall bleeding and overall haematoma formation was observed.
Conclusion.  Changing position in bed and using a supportive pillow during the early hours after cardiac catheterization can effectively minimize pain and hemodynamic instability without increasing vascular complications.     

Teaching video effect on renal transplant patient outcomes

A study was undertaken to test the effect of a teaching video on renal transplant recipient outcomes. A quasi-experimental, pretest/posttest design was used. Fifty-nine adults undergoing renal transplantation were studied. Subjects were randomly assigned to either an experimental group, which received discharge preparatory teaching with the use of a teaching video, or to a control group, which received standard teaching. Subjects in the experimental group had significantly greater improvements in knowledge scores postteaching. No other differences were seen. Findings suggest the use of a teaching video can be a useful adjunct to educational programs designed for renal transplant patients and their families.     

家庭护理干预对出院肾病综合征患儿的影响

目的:探讨对出院后肾病综合征患儿实施家庭护理干预的效果.方法:将68例患儿随机分为干预组和对照组各34例.对照组给予常规护理,干预组在此基础上进行护理干预.1年后比较两组患儿疾病的复发率及遵医率.结果:干预组患儿肾病复发率较低,自我遵医能力较高,两组比较差异均有统计学意义(P＜0.05).结论:对肾病综合征患儿在出院后进行家庭护理干预能明显降低疾病的复发率,增强其遵医率.     

Supporting patient choice: an intervention to promote independent dialysis therapies

Independent dialysis therapies are as effective as in-center therapies but cost only about half as much. This project incorporated a patient focus group to better understand patient perceptions and possible barriers related to choosing independent dialysis therapies. Focus group findings included hardship related to loss of kidney function, the need for support from healthcare professionals, the need for educational materials and recruitment strategies focused on the benefits of independent dialysis, the need for peer support to encourage choice of independent dialysis modality, and support for technical issues. Themes identified by the focus group were used to create two new education tools and a nurse-delivered education program for patients with CKD. Future evaluation will determine whether these efforts lead to an increase in selection of independent dialysis therapies.     

程序化产前健康教育对初产妇分娩结局的影响

目的探讨产前制定程序化健康教育对初产妇分娩结局的影响。方法选取行产前检查并自愿接受分娩计划及相应的健康教育120例初产妇为观察组,同期随机选取常规产前检查及健康教育120例初产妇为对照组,对两组孕妇分娩方式、会阴侧切、阴道助产、产后2小时出血量进行对比。结果观察组剖宫产率明显低于对照组,差异有统计学意义(P0.05)。结论对初产妇程序化健康教育可提高自然分娩率,降低剖宫产率,提高产科质量。     

系统性红斑狼疮患者心理健康分析及护理干预

目的：调查SLE患者的心理状况。制定相应的护理干预措施,改善SLE患者的心理健康状况,方法：68例SLE患者分别于入院1周内、2周后、4周后（或出院前）填写症状自评量表（SCL-90）及自制的SLE患者心理影响因素量表。结果：SLE患者入院时与中国常模相比,SCL-90阳性数目、阳性均分及各种因子均高于中国常模,经护理干预后,SLE患者SCL-90阳性数目、阳性均分几个因子都有明显下降。结论：SLE患者心理健康状况普遍较差,在药物治疗的同时应加强心理护理。     

健康干预对脑卒中患者生存质量的影响

目的：探讨健康干预对脑卒中患者的生存质量的影响。方法以112例脑卒中患者为研究对象,通过健康教育、康复训练、心理支持、社会支持等进行健康干预。在干预前与干预后3个月、6个月、12个月分别对患者的生存质量进行测量,并统计分析比较。结果两组患者总健康状况、总生存质量、心理领域、生理领域干预前与干预后3个月、6个月、12个月比较差异具有统计学意义（P＜0．001）,且总健康状况、生理及心理领域在干预后之间比较,差异也具有统计学意义（P＜0．01）。社会关系、环境领域干预前与干预后比较,差异无统计学意义（P＜0．05）。结论脑卒中患者的健康教育、康复训练、心理和社会支持影响患者的生存质量。加强对患者的健康干预,可以提高患者的存在质量。     

Effects of New Zealand's health reengineering on nursing and patient outcomes

BACKGROUND: In 1993, New Zealand (NZ) implemented policies aimed at controlling costs in the country's public health care system through market competition, generic management, and managerialism. The cost control focus was similar to reengineering efforts implemented by other countries struggling with escalating health care costs, particularly the United States. OBJECTIVE: The study's purpose was to examine the effects hospital reengineering may have on adverse patient outcomes and the nursing workforce. RESEARCH DESIGN: The study was a retrospective, longitudinal analysis of administrative data. Relationships between adverse outcome rates and nursing workforce characteristics were examined using autoregression analysis. SUBJECTS: All medical and surgical discharges from NZ's public hospitals (n = 3.3 million inpatient discharges) from 1989 through 2000 and survey data from the corresponding nursing workforce (n = 65,221 nurse responses) from 1993 through 2000 were examined. MEASURES: Measures included the frequency of 11 nurse sensitive patient outcomes, average length of stay, and mortality along with the number of nursing full time equivalents (FTEs), hours worked, and skill mix. RESULTS: After 1993, nursing FTEs and hours decreased 36% and skill mix increased 18%. Average length of stay decreased approximately 20%. Adverse clinical outcome rates increased substantially. Mortality decreased among medical patients and remained stable among surgical patients. The relationship between changes in nursing and adverse outcomes rates over time were consistently statistically significant. CONCLUSIONS: In the chaotic environment created in NZ by reengineering policy, patient care quality declined as nursing FTEs and hours decreased. The study provides insight into the role organizational change plays in patient outcomes, the unintended consequences of health care reengineering and market approaches in health care, and nursing's unique contribution to quality of care.     

护士行为干预对住院病人健康教育效果的影响

目的通过对护士行为进行干预，提高住院病人健康教育的效果。方法自行设计调查表，对实施行为干预前后、住院3d以上病人的一般资料、健康教育效果等进行调查，所得数据进行统计学处理。结果经统计学分析，实施护士行为干预前后病人健康知识知晓值的比较有统计学意义（P〈0．05），病人的入院宣教知识、辅助检查相关知识、心理卫生的有关知识的知晓值都得到了显著的提高。结论对护士的健康教育技巧、方式等行为进行干预，能有效地提高临床病人健康教育的效果。