The Red Cross Rural Nursing Service: An Innovative Model of Public Health Nursing Delivery

Public Health nursing in the 1980s, together with the health care system in general, is facing complex social and professional issues, including professional autonomy, governmental relations, funding sources, cost containment, maintenance of standards, and aggregate versus individualiied foci of care. History can provide great insights into these recurrent issues, as exemplified by the Red Cross Rural Nursing Service. This historical review traces the origins and progress of the American Red Cross Rural Nursing Service through the first 10 years of its existence. Major emphasis is placed on the organizational development and evolution of the Service. The impact and early contributions of the Service to the development of public health nursing in the United States are still vital to contemporary and current social issues.     

Meeting the Health Care Needs of Migrant Farmworkers: The Experience of the Niagara County Migrant Clinic

The Niagara County Migrant and Rural Ministry Clinic (Migrant Clinic) in northwestern New York State is an example of how the health care needs of migrant farmworkers can be met with limited assistance and funding from federal, state, or local agencies. This article relates the history of the Migrant Clinic and describes how various sources of funding and personnel are utilized to operate the clinic. In addition, several case examples from the clinic are presented to illustrate how nurses and outreach workers are able to overcome some of the obstacles that migrant farmworkers face in obtaining health care services. By relating the experiences of this clinic, we hope to provide others who offer health care to migrant farmworkers with ideas about establishing and managing a clinic to serve this population.     

Nursing Futures: A Process to Promote Change in the Delivery of Care

In this era of healthcare reform, performing care using resources in an efficient manner is essential. “Nursing Futures,” a process used by a 24-bed general rehabilitation unit in a 530-bed facility, helped the unit to identify key components of care, determine opportunities for improvement, and create a new system for the delivery of care that maximized resources and improved customer satisfaction. A Nursing Futures Committee, composed of nursing staff from all levels and from all shifts, used a continuous quality improvement process to focus on the problems in care delivery and developed ways to solve these problems using the time and talents of registered nurses in the most effective way. The committee also identified expectations of staff by various customer groups; analyzed the delivery system and defined its shortcomings; developed the ideal patient care unit within financial and institutional constraints; and executed the plan, considering cost and evaluation of patient and staff satisfaction before and after the system was implemented. The new system provided consistency in patient care assignments by reorganizing the unit into two nursing teams and by creating a new nursing position, the patient care manager.     

Utilizing Innovative Technology to Improve Health Care

Staff expectations of leaders to recruit and retain nonexistent nursing personnel is an impossible task. In an effort to ease the burdens of an increasingly complex health care environment, caring, transformational nurse leaders can harness the power of innovative technology to improve health care. This article provides examples of several technological innovations as solutions to each of the Institute for Health Care Improvement’s Quintuple aims. Consideration is given to the importance of envisioning, inspiring, and supporting environments of curiosity, adaptation, and creativity necessary to advance the vision of sustainable, quality health care.     

Partnering Care Delivery and Research to Optimize Health

A close partnership between care delivery and research organizations has the potential to provide essential elements needed to optimize health and health care. This clinical leadership panel, held during the 14th Annual Health Maintenance Organization Research Network (HMORN) Conference, identifies the value, opportunities and challenges of those close partnerships between three HMORN care delivery and research organizations. The objectives of this plenary session were: (1) identify the important facets of partnership that bring value to care delivery and research, (2) pinpoint the critical alignments of care delivery and research that are needed to fulfill the promised value between clinical and research organizations, and (3) recognize the challenges that clinical and research organizations need to address.     

健康教育在儿童保健门诊的运用分析

目的对健康教育在儿童保健门诊的应用效果进行探讨和分析。方法选取我院2014年1月~2015年12月儿童保健门诊收治的56例儿童。随机分为对照组和观察组各28例。对照组实施常规护理,观察组在常规护理的基础上开展健康教育,比较两组儿童家属教育前后的心理状态变化、对护理的满意度、儿童的生长健康情况,并进行6个月随访,统计两组儿童的疾病发生率。结果观察组儿童的家长的SAS和MUIS评分在教育后明显下降,且观察组显著低于对照组,差异有统计学意义(P0.05)。观察组家长的满意度为100.00%,高于对照组的82.14%,差异有统计学意义(P0.05)。观察组的生长正常率为96.43%,显著高于对照组的50.00%,且体重异常、偏食和营养不足等发生率均显著低于对照组,差异有统计学意义(P0.05)。观察组常见病的发生率为7.14%,低于对照组的32.14%,差异有统计学意义(P0.05)。结论在儿童保健门诊中开展健康教育可以明显缓解家长的焦虑以及对疾病的不确定性,提高他们对护理工作的满意度,改善儿童的生长健康问题,促进其健康成长,减少常见病的发生率,效果显著,具有良好的临床应用价值。     

护理成本效益不合理阻碍护理事业的发展

目的 :阐明护理价值的增值和补偿对护理事业发展的作用 ,呼吁构建护理成本核算管理体系 ,对护理成本进行综合性研究 ,建立起适合我国国情的护理成本模式。方法 :从 1998年沿用至今的《深圳市医疗收费标准》2 0 0 0余项中提出护理收费项目共 5 4项、2 0 0 1年卫生部颁发的《全国医疗服务价格项目规范 (试行 )》数千项中提出护理收费共 5 8项进行对比 ,结合目前全国护理成本研究的现状进行分析。结果 :深圳市和全国医疗收费标准中的护理收费存在着明显的不合理 ,漏收费严重。护理工作几乎是一项未计酬的技术性服务 ,护理价值无法体现。结论 :护理收费不合理、价格背离价值 ,违背市场价值规律 ,严重阻碍了护理事业的发展 ,须引起权威人士的高度重视。