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Biomedical subjects

Joanne R Duffy

Publications and source records attributed to Joanne R Duffy.

9 recordsLinked to original sources
PubMed2005

Improvement in the outcome indicator of readmission of patients with heart failure: a case analysis.

This article describes the process used by one performance improvement committee to analyze comprehensive assessment data, including OASIS data, and relate it to nursing activities described in the clinical nursing notes. The end goal was to improve, or decrease, the hospital readmission rate of their patients with heart failure. The fit between patient characteristics and the plan of care described and delivered in two groups was evaluated. Differences in patient characteristics and nursing documentation of outcomes provided the data for remediation and for testing of a new intervention.

Aged↗
PubMed2005

Critically appraising quantitative research.

Critical appraisal of quantitative research is a skill that is necessary for adequate evidence-based practice. This paper describes critical appraisal and offers a process for its implementation. Four categories of quantitative studies are reviewed and associated links to relevant critical appraisal frameworks are provided. The implications for students, nursing faculty members, and practicing nurses are discussed.

Curriculum↗
PubMed2002

The clinical leadership role of the CNS in the identification of nursing-sensitive and multidisciplinary quality indicator sets.

Within a team-oriented approach to healthcare, the demonstration of quality is challenging. Multidisciplinary quality indicators ideally represent all pertinent stakeholders and are preferred when evaluating the quality of care for specific patient populations. Recently, however, nursing-sensitive indicators have been developed that reflect the unique contribution of nursing to patient outcomes. Because nursing-sensitive quality indicators reflect nursings' accountability for patient care, they must also be considered when identifying indicators sets. Controversy exists concerning the appropriate definition, number, and approach to indicator identification. Many organizations are attempting to measure everything to ensure that all appropriate indicators are represented. To incorporate both nursing-sensitive and multidisciplinary quality indicators, a phased organization-wide approach is advocated. Through clinical leadership skills combined with the advanced practice roles of consultant, educator, and researcher, the clinical nurse specialist can facilitate the inclusion of relevant indicators, preserve both multidisciplinary and nursing-sensitive approaches, and maintain efficiency during the process. The clinical nurse specialist, with clinical expertise and advanced education has a unique leadership role in the identification of the resultant critical indicator matrix.

Humans↗
PubMed2002

Nosocomial infections: important acute care nursing-sensitive outcomes indicators.

Clinical and cost burdens related to nosocomial infections continue to plague the US healthcare system. Vulnerable populations, such as the elderly and the immunocompromised are especially at risk. Current evidence suggests that because hospital stays are shorter, nosocomial infection rates per 1000 patients have actually increased. Nosocomial infections, specifically bacteremias, have been targeted by the American Nurses Association as outcomes that can be affected by nursing in acute care settings. Nursing staffing and practices recently have been linked to the incidence of nosocomial infections. Participation in national databases and benchmarking techniques can provide data-based evidence that nursing practice influences nosocomial infections. Advanced practice nurses are key to ensuring that evidence-based practice environments, in which data drive decision-making, can flourish so that nurses can identify and implement practices that can reduce the rates of nosocomial infections.

Bacteremia↗
PubMedDate not supplied

Nonpharmacological strategies for improving heart failure outcomes in the community: a systematic review.

The purpose of this systematic review was to synthesize current evidence regarding nonpharmacological approaches to heart failure (HF) management. Following a literature search, identified studies were coded using the Heart Failure Study Assessment Scale (HFSAS) developed by the authors. Results included high-quality ratings, a predominance of multidisciplinary disease management studies, decreased readmission rates, and some improvement in quality of life. Implications for practice, leadership, education, and research are described.

Ambulatory Care↗
PubMedDate not supplied

New blood test to measure heart attack risk: C-reactive protein.

In 2003, the American Heart Association and the Centers for Disease Control and Prevention issued a scientific statement that suggested the use of high-sensitivity C-reactive protein, a recognized marker of inflammation, as an optional myocardial infarction risk factor measurement (Circulation. 2003;107:499-511). Compared with earlier guidelines, the statement suggested a more aggressive approach for identifying patients at risk of cardiovascular events. The increased interest in and the mounting evidence of the role of inflammation in the development of acute coronary syndrome was a major impetus for this. This article focuses on the use of high-sensitivity C-reactive protein as a nonlipid cardiovascular event risk marker and the implications for practice, education, and research.

Biomarkers↗
PubMedDate not supplied

Development and testing of a caring-based intervention for older adults with heart failure.

The clinical and cost burdens of heart failure (HF) continue to rise, creating an immediate need for cost-effective interventions geared toward improving health outcomes. This article describes the development and testing of a caring-based nursing intervention for older adults with advanced HF who have been recently discharged from acute care. The developmental process and components of the intervention are presented. A methodology for testing the intervention is also introduced. Through a phased development process including research, this intervention can be refined and used to guide clinicians, administrators, and policymakers in the provision of high-quality care to older adults with HF.

Aged↗
PubMedDate not supplied

The Quality-Caring Model: blending dual paradigms.

Evidence supports associations between professional nursing and quality health outcomes. Yet, what specifically accounts for those linkages remains buried in the daily practice of nursing. The Quality-Caring Model exposes and demonstrates the value of nursing within the evidence-based practice milieu of modern health care. It favors a process, or way of being, that challenges modernist conventions and highlights the power of relationships. By reaffirming the nature of nursing's work as relationship-centered, the blended model describes the 2 dominant relationships that comprise professional encounters. Relationships characterized by caring are theorized to influence positive outcomes for patients/families, health care providers, and health care systems. Model components are clarified, assumptions described, and propositions stated. Conceptual-theoretical linkages in the model are identified and ties to empirical indicators provide the logical consistency necessary for validation. Clinical practice and research applications of the model are offered. The Quality-Caring Model helps to translate the hidden work of nursing into objective terms that can be tested. Scientifically demonstrating its worth will advance professional nursing while simultaneously improving the quality of health care.

Empathy↗