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Biomedical subjects

D A Peters

Publications and source records attributed to D A Peters.

At least 19 recordsLinked to original sources
PubMed1999

Quantifying client need for care in the community: a strategy for managed care.

The Community Health Intensity Rate Scale (CHIRS) is a tool that provides an index of a client's need for care. Emphasis in healthcare has shifted from episodes of illness to covered lives and managed care. CHIRS contains all the elements for holistically determining the intensity of a client's need for care and the environmental, psychosocial, and health behaviors of the client. The CHIRS has been utilized with a variety of community health populations. Each application of CHIRS provided feedback to the researchers for use in revising CHIRS. This article reports the findings of a study which tested the validity and reliability of the refined version of CHIRS. The validity and reliability needed further refinement at the indicator level. The study produced a more practical tool for determining intensity of need for clients in the community.

Attitude of Health Personnel↗
PubMed1997

Stability of ursodiol 25 mg/mL in an extemporaneously prepared oral liquid.

The stability of ursodiol in an extemporaneously formulated oral liquid was studied. A suspension was prepared by combining the contents of commercially available 300-mg capsules of ursodiol with glycerin, Ora-Plus (Paddock Laboratories), and orange syrup. A second formulation was prepared by combining ursodiol capsules with sterile water for irrigation. The final concentration of ursodiol in each formulation was 25 mg/mL. Six samples of each preparation were stored in 4-oz amber plastic prescription bottles protected from light. Three were stored at 22-23 degrees C and three were refrigerated at 2-6 degrees C. Immediately after preparation and at 7, 15, 30, 45, and 60 days, samples were obtained and frozen until assay by high-performance liquid chromatography. On day 60 the mean percentage of the initial ursodiol concentration remaining was 108.4% for the suspension stored at room temperature and 103.3% for the refrigerated suspension. The ursodiolin-water formulation was not analyzed because of rapid settling of ursodiol. Ursodiol 25 mg/mL in an oral liquid prepared extemporaneously from capsules and sweetened vehicle was stable for 60 days when stored in amber plastic bottles at 22-23 and 2-6 degrees C. Addition of ursodiol powder to water without a suspending agent resulted in a liquid formulation with a high variability in content uniformity.

Cholagogues and Choleretics↗
PubMed1996

Preliminary development of the School Health Intensity Rating Scale.

Nursing consultants from the states included in the Mountain Plains Regional Resource Center, U.S. Dept. of Education, identified the need for a scale to classify student health status. The classification would allow schools to determine the level of needed student health services. This identified need led to the development of the School Health Intensity Rating Scale (SHIRS) degree in partnership with Donna A. Peters. RN, PhD. FAAN, developer of the Community Health Intensity Rating Scale (CHIRS). The consultants and school nurses participating in the project piloted the scale and a scale research project is now in progress.

Adolescent↗
PubMed1995

Determining intensity of need of high-risk maternal and infant clients.

Sound funding decisions by policymakers require data that relate health care services to both client need and client outcome. However, client need for care is not easy to express quantitatively, particularly in the realm of preventive and health promotion services. Application of the Community Health Intensity Rating Scale (CHIRS) with high-risk infants and prenatal clients revealed that differences in intensity of need, particularly in contextual and behavioral domains, helped to explain variation in amount of care received. The CHIRS holds promise of providing the language and measurement with which to articulate client need as the basis for cost-effective multidisciplinary care.

Child Health Services↗
PubMed1995

Outcomes: the mainstay of a framework for quality care.

To move toward quality care, it is important to understand all relevant terminologies and concepts. A conceptual framework is useful for organizing all the relevant practice components, such as professional standards, protocols, critical paths, and care plans. The article presents a framework for quality care that focuses on outcomes and defines and incorporates all the other essential elements that are used to reflect quality.

Health Planning Guidelines↗
PubMed1992

A new look for quality in home care.

The management of quality is being transformed in healthcare. Continuous improvement is a cornerstone to this new look at quality. However, no continuous quality program will succeed without incorporating the values and wants of the consumer of care and the end point they want to reach. This article presents an overview of the values to consider and the way to define outcomes.

Attitude of Health Personnel↗
PubMed1991

Measuring quality: inspection or opportunity?

This article has attempted to provide a different way of looking at the quality of health care and its measurement. How well quality is measured is based on beliefs about health, the provider-client relationship, and the health care system. In the end, quality really depends on the human spirit itself and how individuals treat themselves and others. Without a personal commitment to quality and respect for one's self and others, there is no means to achieve quality. There never will be sufficient financial resources, organizational artifice, or measurable standards to safeguard quality any other way. Each of us must care enough to make this happen--for ourselves, for our patients, and for our profession.

Attitude of Health Personnel↗
PubMed1990

Maternal stress increases fetal brain and neonatal cerebral cortex 5-hydroxytryptamine synthesis in rats: a possible mechanism by which stress influences brain development.

Previous studies have shown that maternal stress modifies 5-hydroxytryptamine (5-HT) receptor binding in several brain regions of the adult offspring and alters the intensity of the behavioral responses to 5-HT receptor agonists. We now report that the same stress, crowding combined with daily saline injections during the final week of pregnancy, elevates maternal plasma free tryptophan level without significantly affecting total tryptophan. The increased maternal plasma tryptophan was associated with significantly increased fetal brain levels of tryptophan, 5-HT and 5-hydroxyindoleacetic acid. These increases were maintained after birth until at least postnatal day 10. Since 5-HT is recognised as having a role in the control of neuron development during the perinatal period, we suggest that the stress-induced increase in fetal brain 5-HT synthesis may play a part in the mechanisms by which prenatal stress alters adult behavior.

Animals↗
PubMed1989

A concept of nursing discharge.

The timing is opportune for this expansion of hospital nurses' practice into the home. First, more home health agencies are aligning themselves with hospitals, making cooperative arrangements easier. Second, in response to the nursing shortage crisis, institutions are developing share governance models that offer nurses more autonomy and control over their schedules, affording them the opportunities to accommodate home visits into their day. If these visits are reimbursable through a third party payer, the nurse and the home health agency could receive payment if the hospital nurse either had a direct contract with the agency or belonged to a temporary staffing agency (registry) from which the home health agency could request services. If, however, the hospital nurse is unable to follow the patient into the home, that nurse could make a referral to a home health agency. For example, the hospital nurse would communicate the patient's treatment plan to the home health agency, request any necessary ancillary services (e.g., physical therapy or home health aides), and provide any education and training necessary for the community health nurse to provide hands-on care to patients with complex or high-technology needs. The home health agency could also employ special high-technology nurses for these types of cases. The use of this alternative, however, reduces the continuity of care aspect of the nursing discharge concept. The concept of nursing discharge solves several problems. It facilitates continuity of care and provides a definition for home health care that identifies the need both to service acutely ill patients and facilitate basic community health concepts.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗