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Biomedical subjects

J L Brett

Publications and source records attributed to J L Brett.

11 recordsLinked to original sources
PubMed1997

Pro-ACT II: integrating utilization management, discharge planning, and nursing case management into the outcomes manager role.

Building on redesign efforts that created case management, clinical care technicians, support service hosts, and pharmacy technician roles, this redesign focused on integrating case management, utilization management, and discharge planning functions into a new outcomes manager role. The authors describe the process of developing and implementing the new role and outline specific actions that eliminated redundancy and inefficiency. Results of the evaluation of the project are reviewed, including full-time equivalent and salary savings and employee and physician satisfaction improvements.

Case Management↗
PubMed1991

The BACTEC TB system in the laboratory diagnosis of mycobacterial infection.

OBJECT: to compare the BACTEC TB system with our conventional multimedia system for the isolation of mycobacteria from clinical specimens. METHODS: specimens received over a two year period were cultured into BACTEC 12B vials and onto a variety of solid and liquid media routinely used by us for the isolation of mycobacteria. Cultures were observed regularly for bacterial growth, and examined for the presence of mycobacteria by acid fast microscopy. All results were recorded. At the end of the two year period the results for the two methods were compared. RESULTS: of the 4443 specimens cultured by both methods, 260 were positive for mycobacteria. Sensitivity and specificity were 88.31% and 99.35% respectively for the BACTEC, and 84.41% and 99.96% respectively for our routine multimedia system. Tuberculosis was confirmed by the BACTEC TB system in six patients who were otherwise culture negative. One of these patients had tuberculous meningitis. Three patients culture positive for M tuberculosis by our routine method, were negative by the BACTEC. Twenty-nine false positive cultures were detected, 27 by the BACTEC TB system alone. CONCLUSIONS: the BACTEC TB system is a rapid and sensitive system for the detection of mycobacteria in clinical specimens, and has proved to be a useful adjunct to our routine multimedia system. However, decreased specificity, particularly with lower respiratory tract specimens, means that positive results from these sites can be reported less confidently when they are detected by the BACTEC TB system alone. This negates some of the advantages of the BACTEC TB system for the detection of mycobacterial disease of the lungs.

Bacteriological Techniques↗
PubMed1991

Evaluating the cost impact of intravenous antibiotic dosing frequencies.

Cost differences between antibiotic dosing frequencies were studied at Robert Wood Johnson University Hospital. Developing a complete cost profile between antibiotic alternatives is difficult because of role separation within the hospital. To present a more complete profile, the study analyzed the incremental costs associated with the hospital pharmacy and nursing staffs regarding various dosing frequencies, including different iv admixture and administration methods. Results showed that administration of an antibiotic dose costs approximately $3.35 based on labor and material costs associated with admixture and administration. An average of 4.6 minutes/dose saves nurses up to 23 minutes for each patient who receives an antibiotic dosed once rather than six times daily over a 24-hour period. Costs of administration and admixture should be considered in comparisons of combination therapy with monotherapy when deciding between two therapeutically equivalent alternatives.

Anti-Bacterial Agents↗
PubMed1990

Implementing the ten-step monitoring and evaluation process in nursing practice.

Implementation of the ten-step monitoring and evaluation process as recommended by the Joint Commission leads to the development of a program that meets the requirements of the quality assurance standard. The Professional Practice Program at Robert Wood Johnson University Hospital (New Brunswick, New Jersey) demonstrates the application of this process within the Nursing Division. A conceptual model of nursing practice based on nursing diagnosis provides the framework for the program. Responsibility for the system belongs to the professional nursing staff through the election of unit-based representatives.

Academic Medical Centers↗
PubMedDate not supplied

An interview at Robert Wood Johnson University Hospital. ProACT model.

In its deliberations on the shortage of nurses, the Executive Board of NAON charged the Orthopaedic Nursing journal with bringing information to our readers concerning innovations in nursing care which have resulted partly in response to the current nursing crisis. This article presents an innovative care model implemented on an orthopaedic unit at Robert Wood Johnson University Hospital in New Brunswick, New Jersey. It describes not only the developed system but also the process that was used in implementing the design.

Clinical Protocols↗
PubMedDate not supplied

Organizational integrative mechanisms and adoption of innovations by nurses.

The relationship between organizational activities and structures that increase information flow (integrative mechanisms) and nurse adoption of innovations (research results) was studied using Rogers' theory of innovation diffusion. Analysis of variance demonstrated a significant interaction effect between level of integrative mechanism use, institution size, and nurse adoption of innovations. In small hospitals a higher level of integrative mechanism use was related to increased nurse innovation adoption; however, in large hospitals the opposite was found. Of the five categories of integrative mechanisms identified, only Research Conduct and Publication were significantly related to innovation adoption, and then only in small hospitals. In large hospitals, Conference and Presentation, Position and Committee, and Publication categories were demonstrated to be significantly, but negatively, related to innovation adoption among nurses.

Communication↗
PubMedDate not supplied

Use of nursing practice research findings.

Fourteen nursing research findings that meet the Conduct and Utilization of Research in Nursing (CURN) Project (1982) criteria for clinical use were identified from research journals and CURN publications. Data collected from 216 practicing nurses in small, medium, and large hospitals were analyzed to determine their awareness of, persuasion about, and use of the findings. The majority of nurses were aware of the average innovation, were persuaded about it, and used the average innovation at least sometimes. Use of the innovations had no relationship to hospital policies or procedures concerning the nursing research findings.

Attitude of Health Personnel↗