Biomedical subjects

E W Bayley

Publications and source records attributed to E W Bayley.

At least 19 recordsLinked to original sources

PubMed1999

The LUNAR project: A description of the population of individuals who seek health care at emergency departments.

INTRODUCTION: Although little information exists about the consumers of emergency services and their illness behaviors, such information is essential for decision making by providers, administrators, and policy makers. The purpose of the LUNAR Project was to describe the population of individuals who seek health care at emergency departments. METHODS: After they attended a training course, 90 emergency nurses served as site coordinators in 89 emergency departments in 35 states. A standardized protocol was used to collect data retrospectively from 140 randomly selected patient records at each site. The final sample included 12,422 ED patients. RESULTS: Overall, 52% of the patient visits were for nonurgent care, 40% were for urgent care, and 8% were for emergent care. Most visits occurred between 10 AM and 8 PM and peaked at 6 PM. Children and younger adults were the largest consumers of services, primarily for nonurgent care. The most frequent reasons for visits were fever, chest pain, and abdominal pain, and the most common discharge diagnoses were middle ear infection, chest pain, and acute upper respiratory infection. DISCUSSION: The profile of ED patients showed a need for new types of services to provide nonurgent care and new interventions for preventing illnesses and injuries commonly treated in the emergency department.

Adolescent↗

PubMed1999

Perceptions of kidney transplant by persons with end stage renal disease.

This prospective, descriptive research study sought to identify factors that influence the pursuit of kidney transplant by persons with end stage renal disease (ESRD). Four research questions explored various areas about kidney transplants, including overall knowledge, reasons for wanting/not wanting a kidney transplant, sources of information, views of how one's life could change, and interest in receiving a transplant. A prospective, descriptive study was designed that used both quantitative and qualitative methods of data collection. A random sample of 115 persons from a total population of 450 individuals, currently undergoing treatment in 1 of 3 dialysis facilities in a mid-Atlantic state. was obtained. Two nurse interviewers used four instruments during a 1-hour, structured interview completed at the facility. The results show that: (a) two-thirds of the sample population underestimated the current success rate of transplantation; and (b) over half never discussed transplants with family members. Implications for health care providers are discussed in this article.

Adaptation, Psychological↗

PubMed1997

Preparing to change from acute to community-based care. Learning needs of hospital-based nurses.

OBJECTIVE: Increasingly, professional nurses will be required to function in practice settings other than acute care, yet little is known about how nurses perceive the skill sets required to practice in these nonacute care settings. This study explores nurses' perceptions and needs concerning the transition from acute to home care and community-based healthcare facilities. BACKGROUND: Because the healthcare reform environment of the 1990s mandates changes in the ways hospitals and hospital nurses care for patients, many nurses in acute care settings anticipate that their roles will include or perhaps shift completely to practice in the home and other community-based settings. How professional nurses perceive the skills required to practice in these nonacute care settings may well influence their willingness to accept work redesign initiatives and voluntary employment transitions that involve working outside the hospital setting. METHODS: Based on focus groups and the literature a three-part 56-item questionnaire was developed as the study instrument to assess skill needs and concerns related to functioning in the acute, home, and community-based setting. A total of 879 nurses representing various specialties in healthcare institutions in the Philadelphia and five-county surrounding areas participated. RESULTS: Test retest for the study instrument was 0.87 for a 2-week period, and alpha coefficients ranged from 0.90 to 0.94. Multivariate analyses revealed that proficiency on certain skill items in the acute care setting predicted feelings of proficiency in home and community-based settings. Based on regression and discriminant function analyses, top predictors and differentiators of proficiency in the nonacute care settings were wound care and dressing, knowledge of community resources, diabetic education, patient and family advocacy, communication with third-party payers, and neonatal care. CONCLUSIONS: Some nurses, such as those working in critical care, perceive themselves as being able to function proficiently in a wide variety of care settings-acute home, and community based. Furthermore, certain acute care skills were identified as top differentiators of proficiency in nonhospital settings, thus providing direction for nursing administrators and academic institutions. In addition, the tool developed for the study can serve as a self-assessment for individual nurses.

Adult↗

PubMed1994

A Delphi study on research priorities for trauma nursing.

OBJECTIVES: To identify and prioritize research questions of importance to trauma patient care and of interest to trauma nurses. METHOD: A three-round Delphi technique was used to solicit, identify, and prioritize problems for trauma nursing research. In round 1, experienced trauma nurses (N = 208) generated 513 problems, which were analyzed, categorized, and collapsed into 111 items for subsequent rounds. Round 2 participants rated each research question on a 1 to 7 scale on two criteria: impact on patient welfare and value for practicing nurses. Group median scores provided by 166 round 2 respondents and respondents' individual round 2 scores were indicated on the round 3 questionnaire. Subjects rated the questions again on the same criteria and indicated whether nurses, independently or in collaboration with other health professionals, should assume responsibility for that research. Median and mean scores and rank order were determined for each item. RESULTS: Respondents who completed all three rounds (n = 137) had a mean of 8.3 years of trauma experience. Nine research questions ranked within the top 20 on both criteria. The two research questions that ranked highest on both criteria were: What are the most effective nursing interventions in the prevention of pulmonary and circulatory complications in trauma patients? and What are the most effective methods for preventing aspiration in trauma patients during the postoperative phase? The third-ranked question regarding patient welfare was: What psychological and lifestyle changes result from traumatic injury? Regarding value for practicing nurses, What are the most effective educational methods to prepare and maintain proficiency in trauma care providers? ranked third. CONCLUSION: These research priorities provide impetus and direction for nursing and collaborative investigation in trauma care.

Adult↗

PubMed1990

Wound healing in the patient with burns.

The burn wound presents many unique challenges to the nurse who promotes optimal wound healing. Nursing care includes meticulous attention to the prevention of infection, wound cleansing and debridement, and application of topical antibacterial agents. Preparation of graft recipient sites, care of graft and donor sites, and use of various biologic and synthetic wound coverings are required. An interdisciplinary approach that provides for adequate nutrition, fosters physical function, and supports psychologic adjustment to altered self-concept is required for holistic healing of the burn wound.

Bandages↗

PubMed1987