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991.
Julia Adler‐Milstein Ph.D. Jordan Everson M.P.P. Shoou‐Yih D. Lee Ph.D. 《Health services research》2015,50(6):1751-1771
Objective
To assess whether, 5 years into the HITECH programs, national data reflect a consistent relationship between EHR adoption and hospital outcomes across three important dimensions of hospital performance.Data Sources/Study Setting
Secondary data from the American Hospital Association and CMS (Hospital Compare and EHR Incentive Programs) for nonfederal, acute‐care hospitals (2009–2012).Study Design
We examined the relationship between EHR adoption and three hospital outcomes (process adherence, patient satisfaction, efficiency) using ordinary least squares models with hospital fixed effects. Time‐related effects were assessed through comparing the impact of EHR adoption pre (2008/2009) versus post (2010/2011) meaningful use and by meaningful use attestation cohort (2011, 2012, 2013, Never). We used a continuous measure of hospital EHR adoption based on the proportion of electronic functions implemented.Data Collection/Extraction Methods
We created a panel dataset with hospital‐year observations.Principal Findings
Higher levels of EHR adoption were associated with better performance on process adherence (0.147; p < .001) and patient satisfaction (0.118; p < .001), but not efficiency (0.01; p = .78). For all three outcomes, there was a stronger, positive relationship between EHR adoption and performance in 2010/2011 compared to 2008/2009. We found mixed results based on meaningful use attestation cohort.Conclusions
Performance gains associated with EHR adoption are apparent in more recent years. The large national investment in EHRs appears to be delivering more consistent benefits than indicated by earlier national studies. 相似文献992.
Disparities in Perinatal Quality Outcomes for Very Low Birth Weight Infants in Neonatal Intensive Care
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Eileen T Lake Douglas Staiger Jeffrey Horbar Michael J Kenny Thelma Patrick Jeannette A Rogowski 《Health services research》2015,50(2):374-397
ObjectiveTo determine if hospital-level disparities in very low birth weight (VLBW) infant outcomes are explained by poorer hospital nursing characteristics.ConclusionsPoorer nursing characteristics contribute to disparities in VLBW infant outcomes in two nurse-sensitive perinatal quality standards. Improvements in nursing have potential to improve the quality of care for seven out of ten black VLBW infants who are born in high-black hospitals in this country. 相似文献
993.
Regina Celia Fiorati Valeria Meirelles Carril Elui 《Revista latino-americana de enfermagem》2015,23(2):329-336
OBJECTIVE:
to analyze the socio-familial and community inclusion and social participation of people with disabilities, as well as their inclusion in occupations in daily life.METHOD:
qualitative study with data collected through open interviews concerning the participants'' life histories and systematic observation. The sample was composed of ten individuals with acquired or congenital disabilities living in the region covered by a Family Health Center. The social conception of disability was the theoretical framework used. Data were analyzed according to an interpretative reconstructive approach based on Habermas'' Theory of Communicative Action.RESULTS:
the results show that the socio-familial and community inclusion of the study participants is conditioned to the social determinants of health and present high levels of social inequality expressed by difficult access to PHC and rehabilitation services, work and income, education, culture, transportation and social participation.CONCLUSION:
there is a need to develop community-centered care programs in cooperation with PHC services aiming to cope with poverty and improve social inclusion. 相似文献994.
995.
Luz María Tejada-Tayabas Karla Lizbeth Partida-Ponce Luis Eduardo Hernández-Ibarra 《Revista latino-americana de enfermagem》2015,23(2):225-233
OBJECTIVE:
To examine, from the nursing perspective, the needs and challenges of coordinated hospital-home care for renal patients on hemodialysis.METHODS:
A qualitative analysis was conducted with an ethnographic approach in a hemodialysis unit in San Luis Potosi, Mexico. Semistructured interviews were conducted with nine nurses, selected by purposeful sampling. Structured content analysis was used.RESULTS:
Nurses recounted the needs and challenges involved in caring for renal patients. They also identified barriers that limit coordinated patient care in the hospital and the home, mainly the work overload at the hemodialysis unit and the lack of a systematic strategy for education and lifelong guidance to patients, their families and caregivers.CONCLUSIONS:
This study shows the importance and necessity of establishing a strategy that goes beyond conventional guidance provided to caregivers of renal patients, integrating them into the multidisciplinary group of health professionals that provide care for these patients in the hospital to establish coordinated hospital-home care that increases therapeutic adherence, treatment substitution effectiveness and patient quality of life. 相似文献996.
Letícia Becker Vieira Ivis Emília de Oliveira Souza Florence Romijn Tocantins Florentina Pina-Roche 《Revista latino-americana de enfermagem》2015,23(5):865-873
Objective:
to analyze the possibilities of help/support through the mapping and acknowledgement of the social network of women who denounce experiences of violence at a Police Precinct for Women.Method:
qualitative study based on the theoretical-methodological framework of Lia Sanicola''s Social Network, through interviews with 19 women.Results:
the analysis of the network maps evidenced that the primary social network was more present than the secondary on and, despite consisting of significant relations, it demonstrates limitations. The women access the secondary network occasionally in the violence problem and/or its repercussions in their life and health. The discrete presence of the health network in the composition of the social network was revealed and, when mentioned, the relation between the health professional and the woman was characterized as fragile.Conclusion:
the importance of the social network relates to the creation of spaces of help/support for the women beyond the moment of the aggression, which accompany them throughout their process of emancipation from an experience annulled by violence, considering that each woman acts and makes decisions in the relational context when she is ready for it. 相似文献997.
998.
Pain,health perception and sleep: impact on the quality of life of
firefighters/rescue professionals
Rafael Silva Marconato Maria Ines Monteiro 《Revista latino-americana de enfermagem》2015,23(6):991-999
Objective:
to evaluate the quality of life of firefighters and rescue professionals, and characterize their socio-demographic, health, work and lifestyle profile.Methods:
cross-sectional study that used a socio-demographic, lifestyle, health, work data questionnaire and the WHOQOL-BREF quality of life aspects, in Fire Department bases, Civil Air Patrol Group of the Military Police and Rescue Group of Emergency Services.Results:
ninety professionals participated in this study - 71 firefighters, 9 nurses, 7 doctors and 3 flight crew members. The average age of the group was 36.4 ± 7.8 years; they worked about 63.7 hours per week; 20.2% reported pain in the last week and 72.7% had body mass index above 25 kg/m2. The average of the WHOQOL-BREF domains was: physical (74.6), psychological (75.2), social (76.5) and environmental (58.7). Significant association was found (Mann-Whitney test and Spearman correlation) between the WHOQOL-BREF domains and pain in the past six months, in the last week, health perception, job satisfaction, hours of sleep, domestic tasks and study.Conclusion:
the main factors related to quality of life were presence of pain, health perception, sleep and domestic activity. 相似文献999.
Karina de Oliveira Azzolin Dayanna Machado Lemos Amália de Fátima Lucena Eneida Rejane Rabelo-Silva 《Revista latino-americana de enfermagem》2015,23(1):44-50
OBJECTIVE:
to assess patient knowledge of heart failure by home-based measurement of two NOC Nursing Outcomes over a six-month period and correlate mean outcome indicator scores with mean scores of a heart failure Knowledge Questionnaire.METHODS:
in this before-and-after study, patients with heart failure received four home visits over a six-month period after hospital discharge. At each home visit, nursing interventions were implemented, NOC outcomes were assessed, and the Knowledge Questionnaire was administered.RESULTS:
overall, 23 patients received home visits. Mean indicator scores for the outcome Knowledge: Medication were 2.27±0.14 at home visit 1 and 3.55±0.16 at home visit 4 (P<0.001); and, for the outcome Knowledge: Treatment Regimen, 2.33±0.13 at home visit 1 and 3.59±0.14 at home visit 4 (P<0.001). The correlation between the Knowledge Questionnaire and the Nursing Outcomes Classification scores was strong at home visit 1 (r=0.7, P<0.01), but weak and non significant at visit 4.CONCLUSION:
the results show improved patient knowledge of heart failure and a strong correlation between Nursing Outcomes Classification indicator scores and Knowledge Questionnaire scores. The NOC Nursing Outcomes proved effective as knowledge assessment measures when compared with the validated instrument. 相似文献1000.
Marcos Barragan da Silva Miriam de Abreu Almeida Bruna Paulsen Panato Ana Paula de Oliveira Siqueira Mariana Palma da Silva Letícia Reisderfer 《Revista latino-americana de enfermagem》2015,23(1):51-58