PubMed Health⌕ Search

Biomedical subjects

J Bostrom

Publications and source records attributed to J Bostrom.

At least 19 recordsLinked to original sources
PubMed1997

Nursing wound care survey: sterile and nonsterile glove choice.

PURPOSE: The application of sterile and clean procedure to the practice of wound care nursing was examined. DESIGN: This prospective, descriptive study surveyed staff nurses regarding glove use. SUBJECTS AND SETTING: Seven hundred forty-three staff nurses from five health care agencies in the San Francisco Bay Area responded to the survey. INSTRUMENTS: A self-report wound care survey instrument was developed by Nursing Consortium for Research and Practice members from information adapted from the wound care literature. The questionnaire comprised 31 questions and required approximately 10 minutes to complete. METHODS: Nursing Consortium for Research and Practice members obtained approval from their respective institutional human subjects committees and distributed questionnaires among all nurses engaged in direct care. Some agency representatives personally handed the survey instruments to subjects, but most distributed them through their agencies personnel mailing systems. RESULTS: Seven hundred twenty-three (38%) of 1900 questionnaires were completed and returned to the five site coordinators. Differences were found between acute care and home health nurses. Acute care nurses were more likely than home care nurses to use sterile gloves in all wound care situations. CONCLUSION: Greater variation was found with regard to sterile technique in wound care practice than in previously reported studies. Although patient risk factors and wound type significantly influenced the choice of sterile or clean gloves, additional environmental and personal factors exerted considerable influence. These included health care setting, degree of professional education, and nurses' experiential background. Attempts to modify practice through policy change alone may not be sufficient to overcome resistance to change. Instead, it may be necessary for nurses to "unlearn" lessons from basic nursing education before they can adopt to new practices and clinical policies.

Adult↗
PubMed1996

Preventing skin breakdown: nursing practices, costs, and outcomes.

The aims of this study were to identify patients at risk for skin breakdown, to describe nursing interventions associated with the prevention of skin breakdown, and to analyze the cost of supplies used to prevent skin breakdown. An evaluation of nursing interventions used at three hospitals revealed that nurses used a variety of strategies for preventing skin breakdown. However, greater expenditures on prevention strategies did not improve outcomes and overuse of some items increased the incidence of skin breakdown. Protocol-based preventive nursing interventions are necessary to provide a cost-effective approach to the maintenance of skin integrity.

Adult↗
PubMed1996

Telephone follow-up after discharge from the hospital: does it make a difference?

Two systems of telephone follow-up of discharged patients were compared in this 3-month study. All medical and surgical patients on five nursing units of one acute care institution were included, yielding a sample of over 1,400 patients. One group of patients was called 2 to 3 days after discharge; another group received a brochure describing a nurse-run telephone service they could call. A third group of patients received no intervention. More than 90% of patients who were called had questions about self-care and recovery at home. Only nine patients initiated calls to the nurse telephone service. The three groups did not differ in patient satisfaction with health education or readmission rates within 30 days of discharge. This study suggests that patients have continued health education needs after discharge but are unlikely to actively seek needed information from a hospital-based telephone service.

Follow-Up Studies↗
PubMed1995

Outcomes assessment: at what cost?

Outcomes assessment has become a major focus for evaluating managed care, but little is known about the feasibility and costs of a comprehensive outcomes assessment program. In this pilot study, more than 200 patients who were scheduled for elective hospital admissions were assessed using the Short Form 36. This instrument was mailed to patients the week before admission and three months after discharge. Cost for each complete set of pre- and post surveys was more than $60. Data from the SF-36 suggests that diagnosis-specific instruments and survey timing are necessary, which would increase the cost of outcomes assessment.

California↗
PubMed1994

The cost-effectiveness of two intravenous additive systems.

The current health-care economic environment with increasing managed care and prospective payment system presents nurse administrators with the ongoing dilemma of providing optimal patient care while reducing or holding down the costs of that care. Evaluation of systems and processes used in the provision of care is key to containing expenditures. This study evaluates the cost-effectiveness of two intravenous (IV) additive systems, comparing the material, wastage, and labor costs and analyzing the effects of each system on nursing productivity. Results indicate that the higher material costs experienced with the implementation of the ADD-Vantage additive system (Abbott Laboratories, North Chicago, IL) are completely offset by the reduced labor expense. The introduction of a more efficient system also has a positive impact on nursing productivity demonstrated by the staff's use of their saved time in higher-level nursing functions.

Cost-Benefit Analysis↗
PubMed1994

Closing the gap between research and practice.

Currently, a 10- to 15-year gap exists between discovery of potential innovations and implementation of these innovations into nursing practice. The Retrieval and Application of Research in Nursing (RARIN) project is helping to reduce this gap in one western hospital. The goal of RARIN is to improve the quality of nursing care by facilitating the transfer of new and clinically relevant nursing information to current practice. This is accomplished by providing nurses with both the tools and training for rapid retrieval of scientific information. Their work areas have been electronically linked with local, national, and international scientific information systems.

California↗
PubMed1994

The impact of continuity of nursing care personnel on patient satisfaction.

Although continuity in nursing care is valued highly by nurses, there is little research that demonstrates its value to patients. In this study, the relationship of nursing care continuity to patient satisfaction was examined. Overall patient satisfaction was not related to continuity of nursing care, but nursing continuity on specific shifts was related to satisfaction with discrete aspects of care, such as involvement of patients and families in care.

Age Factors↗
PubMed1994

Predictors of nurses' involvement in research activities.

Practicing nurses who have special expertise concerning clinical problems generally have minimal involvement in clinical nursing research. As a step toward increasing their research participation and, therefore, the relevancy of clinical studies, this study surveyed 1,217 nurses employed at nine health care agencies concerning their research attitudes, work environment, and research involvement. Descriptive statistics indicated that nurses value nursing research and want more time for research-related activities. Discriminant function analysis revealed that prior research instruction, awareness of support for research, and positive attitudes toward research were predictive of nurses' participation in research activities.

Adult↗
PubMed1994

Managing pain in a diverse medical-surgical patient population.

A joint research and quality assurance task force was established to evaluate pain management practices. Medical and surgical patients and their nurses were surveyed about patient pain during the hospitalization and a plan for pain assessment and management was developed.

Adult↗
PubMed1993

Incorporating nursing assistive personnel into a nursing professional practice model.

A pilot project evaluated the effect of incorporating nursing assistive personnel (NAP) into the existing nursing professional practice model at a tertiary care university medical center. A plan to use permanent, unit-based NAP was developed, implemented, and evaluated. Among the findings were a redistribution of selected nursing activities and conditions enhancing the integration of NAP to fulfill nonprofessional tasks and thus support the work of the registered nurse.

Academic Medical Centers↗
PubMed1993

The proliferation of health care contracts at a tertiary care hospital: organizational and financial impacts.

The impact of negotiation and management of numerous health insurance contracts on one tertiary care hospital's organization and costs is explored. Contract-related activities have proliferated within the organization, requiring extensive labor time and costs. Information exchange is the most time-consuming activity, suggesting that systems are needed both to facilitate transmission of information among hospital personnel, insurers, physicians, and review organizations and to reduce the variation among contracts.

Contract Services↗
PubMed1992

Staff nurse knowledge and perceptions about prevention of pressure sores.

A survey of 245 staff nurses from multiple health care settings revealed that nurses had a good knowledge of risk factors for skin breakdown. However, a variety of environmental and clinical factors were cited as impediments to their ability to maintain patient skin integrity. Development of nursing interventions that are effective and also practically feasible in a particular care setting are needed.

Adult↗
PubMed1992

Early determinants of required nursing care hours in the acute care setting.

This study was conducted to evaluate how patients' requirements for nursing care are related to physician and nurse practice and hospital and patient characteristics. Data available in the first 24 hours of hospitalization were collected for more than 5,000 patients admitted to a 600-bed tertiary care hospital and discharged in one of 20 DRGs. Average daily nursing care hours and total nursing care hours were best predicted by the amounts of specific types of nursing care required on the first day of hospitalization.

Diagnosis-Related Groups↗
PubMedDate not supplied

Data collection as an educational process.

Data collection, an experiential method for learning about the research process, may affect the attitudes and future research involvement of nurse data collectors. This study describes the effects of the data collection experience on nurses' perceptions of nursing research and the research environment and on their plans for research involvement. Implications of using the data collection experience as an educational process about research are included.

Adult↗
PubMedDate not supplied

Relationship of direct nursing care hours to DRG and severity of illness.

Great variation in nursing resource use is documented within DRGs. Much of this variation may be explained by patient severity of illness. Variance in nursing resource use within DRGs can be reduced by using a severity of illness instrument to score patients.

Costs and Cost Analysis↗
PubMedDate not supplied

Research utilization: making the link to practice.

One goal of nursing staff development educators is to update staff practice through the application of nursing research findings. A multi-site study was conducted to determine what factors are related to a nurse's use of research findings. The study suggests that staff involvement in research-related activities such as data collection is the best predictor of use of research findings in the clinical setting. This finding was used to design strategies for facilitating the transfer of research findings to practice.

Clinical Nursing Research↗