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Biomedical subjects

F Crosby

Publications and source records attributed to F Crosby.

At least 19 recordsLinked to original sources
PubMed1995

Readiness of nurses for electronic networking for quality assessment and improvement.

Quality assessment and improvement (QAI) is a rapidly evolving component of health care. Its operationalization in clinical practice can be greatly enhanced by information sharing, best practice networking, and communication of experiences and resources. Nurses play a key role in both QAI and information sharing in this endeavor. Electronic communication supports the rapid sharing of QAI-related information across agencies to link nurses with a common interest in continuously improving the quality of health care delivery. It offers the opportunity to diminish the barrier of distance, which is especially relevant for nurses in rural areas. Before electronic communication was established as an information-sharing mechanism, however, the readiness of nurses in both rural and urban/suburban settings was assessed. A convenience sample of nurses in western New York, who were surveyed via written questionnaire regarding electronic communication, most often described their comfort in using this medium as uncertain. This finding supports the need for preliminary preparation focusing upon the skills and experience needed to utilize the computer as a communication medium.

Attitude of Health Personnel↗
PubMed1994

In a changing world: database to keep the pace.

A database to manage health care information can be an especially useful tool for the CNS. Systematic management of information is important in the multifaceted role characteristic of the CNS's scope of practice. The CNS not only provides theoretically sound creative care to patients and serves as a role model to nursing staff, but also monitors and substantiates the quality and effectiveness of care delivered. To do this, the CNS participates in research activities and synthesizes and uses research findings. These aspects of professional practice require collection and analysis of information that could be facilitated by the use of a database. The purposes of this article are to introduce some basic concepts of database and its relevance and contribution to the CNS, discuss issues inherent in setting up a database, and provide guidelines for CNSs who are considering using a database in their clinical practice.

Databases, Factual↗
PubMed1991

Enhancing subject recruitment for nursing research.

Nursing research most often requires human subjects. Consequently, an essential component in planning and conducting research entails recruitment of subjects who knowledgeably consent to participate. A well-established theoretical base exists regarding sampling techniques and procedures for research methods. The operationalization of the theory into practical terms may be of interest to the clinical nurse specialist (CNS) who frequently assumes a leadership role to both conduct nursing research in practice settings and to advise other nurses interested in conducting research. The recruitment efforts in four different nursing studies were compared and contrasted in an effort to determine effective and efficient approaches to this issue. Sample populations included nurse practitioners, patients, nurse aides, and nurse educators. Methods of recruitment included direct contact, mail, and telephone contact. While the settings, purposes, and designs of the studies varied, some common elements regarding subject recruitment were suggested. The recruitment methods have been described, along with the implication in terms of practical application for conduct of nursing research by CNSs.

Communication↗
PubMed1991

Chemical impairment in colleagues: perceptions of Western New York nurses.

The purpose of this study was to determine nurses' perceptions about substance abuse in professional colleagues, opinions about strategies for dealing with substance abuse, and knowledge about resources available for dealing with the problem of chemical impairment. Subjects included a convenience sample of 161 nurses from Western New York. Data were gathered by a questionnaire that included "The Perceptions of Nursing Impairment Inventory" and items regarding respondents' background characteristics, suspicions about alcohol and drug abuse in nurse colleagues, and knowledge about and use of peer assistance services available through District I of the New York State Nurses Association. The major outcome of the study was identification of a knowledge deficit on the extent of the substance abuse problem in nursing, ability to recognize an impaired colleague, and awareness of services available. These data substantiate the need for implementing educational programs to increase nurses' basic knowledge of, and sensitivity to, the problem of chemical dependency.

Humans↗
PubMed1991

An information synthesis to evaluate nurse practitioner effectiveness.

An information synthesis was conducted at the Department of Veterans Affairs Medical Center, Buffalo, New York, to determine the extent to which nurse practitioner (NP) effectiveness had been established in the existing literature. Three hundred fifty documents were reviewed by experts and 102 documents were deleted from the analysis phase. Fifty-six documents referred to as the Better Studies contained the most relevant and valid findings and were compared with a model developed to represent NP effectiveness. NPs were found to effectively provide a wide range of health care services. They can function as independent health care providers as well as collaborative members of the health care team. NPs have been found to have a positive influence on patient-related outcomes. There should be continued use and support of NPs in health care delivery systems. Recommendations for additional study are presented.

Delivery of Health Care↗
PubMed1991

Needs of nurse educators & clinical nurses regarding quality assurance education.

A study was done to determine the needs and educational interest regarding quality assurance of nurses practicing in both academic and clinical settings in Western New York. A written survey questionnaire was developed and distributed to a convenience sample. Responses were received from 98 nurse educators (47% of those contacted) and from 148 clinical area nurses (42% of those contacted). Concepts about quality assurance were itemized and respondents indicated their level of interest in obtaining further information to increase their QA competencies about each. The topics of interest to both groups were similar and included standards of care, legal issues, documentation, techniques for implementation of QA in clinical practice, and measures of quality of care. Characteristics about a continuing education offering that would be desirable were specified.

Education, Nursing↗
PubMed1989

Research priorities for the care of the veteran patient.

The purpose of this project was to identify research priorities for the care of the veteran patient as identified by 367 various members of the Veterans Administration Nursing Service using the Delphi technique. A total of 1558 items were obtained and these were classified into categories from which 73 specific statements were written. Highest mean scores were obtained for items relating to interventions to decrease repeated admissions, care of the terminally ill, patient compliance, patient education, staffing, care planning, continuity post-hospitalization, quality nursing care, staff satisfaction, health promotion, and nursing intervention to assist patients and family in coping with illnesses.

Clinical Nursing Research↗
PubMed1989

Nurse practitioner perceptions of facilitators and constraints to practice.

The purpose of this study was to identify and explain conditions that served to constrain and/or facilitate the practice of Veterans Administration (VA) nurse practitioners (NPs). A 60% stratified random sample of all full-time VA NPs was surveyed. The sample represented NPs from the four hospital complexity levels and six geographic regions. A 92% response rate was obtained for a sample of 257 NPs. On the whole, VA NPs appeared to experience more facilitation than constraint. Areas that seemed to be especially positive for VA NPs were related to the direct delivery of care, and areas that interfered with their practice were related to administrative issues. NP practice is facilitated if there is a feeling of status, opportunity for professional growth, and NP personal satisfaction. Status can be influenced by independence in practice, support from top nurse administrators, and enough clerical support. Professional growth can be enhanced by providing opportunities for continuing education, research, physician back-up, and medical center committee membership. Personal satisfaction may be promoted through job security, independence in practice, fringe benefits, continuity of caseload, and opportunity for promotion. Throughout the analyses, independence repeatedly surfaced as an important criterion in the facilitation of NP practice.

Delivery of Health Care↗
PubMed1987

Future research recommendations for establishing NP effectiveness.

An information synthesis was conducted to examine nurse practitioner effectiveness as substantiated in existing literature. After an extensive computerized and manual search of the literature, 248 documents judged by staff to be relevant to the topic were reviewed by a content-area expert (N = 11 members), and a methodology expert (N = 8 members). Experts had been chosen on the basis of multiple nominations from an extensive national survey of professional nurses in leadership positions. Upon completing the respective reviews, experts identified key areas in support of NP effectiveness that had not been established or clarified in existing literature. A summary and discussion of the experts' recommendations for future studies in support of nurse practitioner effectiveness are presented.

Costs and Cost Analysis↗
PubMed1976

Parenteral nutrition in the septic patient: nitrogen balance, limiting plasma amino acids, and calorie to nitrogen ratios.

A series of eight septic patients was provided varying levels of beef fibrin protein hydrolysate by central vein in the presence of adequate calories for evaluation of nitrogen retention under septic conditions. The mean nitrogen intake to achieve nitrogen equilibrium was 240 mg/kg of body wt per day. This represents a 40% increase over that required to produce nitrogen equilibrium in normal adults. The mean caloric intake of these patients was 43.3 kcal/kg of body wt per day. The calorie to nitrogen ratio based on the above intake was calculated to be 180:1. In order to utilize effectively calorie to nitrogen ratios in the nutritional care of patients, it is suggested that ratios be standardized using daily total coloric expenditures. Correcting the mean measured resting calorie expenditures of these patients for minimal daily activity, a caloric to nitrogen ratio of 138:1 was obtained. The plasma amino acid ratios in these septic patients confirm the finding that valine and phenylalnine are limiting amino acids in a beef fibrin hydrolysate at infusion levels below 240 mg of N/kg of body wt per day. Analysis of the urinary excretion of total nitrogen, urea, and amino acids in two patients suggests that 30 to 50% of the infused peptides of a beef fibrin hydrolysate are lost in the urine in these septic patients.

Abscess↗
PubMedDate not supplied

Factors limiting evaluation of health care programs for the homeless.

The problem of homelessness and the need for health care by homeless people does not seem to be subsiding. All indications are that current legislation to implement dramatic welfare reform will eventually increase the number of homeless persons. Evaluation to guide, monitor, and select the most effective approaches in the provision of health care will remain a key element in health care delivery. Although barriers regarding evaluation of homeless health care have been reported by previous researchers as similar, the results in this study document findings elicited from administrators in the field. The administrators have the expertise to address some of the more common barriers and reduce them. Ways to approach this endeavor and to support staff in participating in and successfully integrating evaluation activities into health care provision will require attention of funding agencies, program administrators, and inclusion of staff and clients in planning. As the era of managed care becomes the focus of how health care is delivered, evaluation of existing programs will be essential to their survival. The descriptive information obtained in this exploratory study provides useful instruction for considering issues that need to be addressed in planning and implementing evaluation of health care to homeless persons.

Administrative Personnel↗
PubMedDate not supplied

Long-term care nurses identify educational needs regarding quality assessment and improvement.

An increasing demand is being placed on nurses who are practicing in long-term care settings to conduct and/or participate in quality assessment and improvement (QAI) activities. A local survey of directors of nursing in long-term care indicated both personal interest and interest on the part of their staff nurses to attend continuing education (CE) programs regarding quality of care to increase their competencies in this area. Specific interest areas and recommendations for an educational offering regarding quality assessment and improvement for long-term care nurses are described.

Cost Control↗
PubMedDate not supplied

An experience in designing patient education materials.

This article describes the authors' experience in designing four booklets for patient education. Design considerations, readability estimates, layout preparation, content validity, and printing considerations are discussed.

Consumer Behavior↗
PubMedDate not supplied

Combining work and home.

The health consequences for women of combining work outside the home with domestic responsibilities are reviewed. The chapter evaluates role stress as a function of multiple roles and concludes that such juggling promotes women's health by offering increased variety of functions performed as well as increased emotional buffering. The chapter also concludes that women's working outside the home has a positive effect likewise on children and spouses.

Female↗