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Biomedical subjects

K C Bloom

Publications and source records attributed to K C Bloom.

13 recordsLinked to original sources
PubMed1999

Performance evaluation and patient outcomes monitored by nurse practitioners and certified nurse-midwives in Florida.

In this descriptive survey study, four elements of performance evaluation of advanced practice nurses (APNs) currently in clinical practice were examined: evaluation frequency, evaluation responsibility, evaluation parameters, and monitored patient outcomes. Questionnaires were mailed to 2,093 APNs living in Florida and licensed by the Florida State Board of Nursing. Eight hundred twenty-two usable surveys were returned, for a 39% response rate. Of these respondents, 654 were in clinical practice as APNs, and comprised the final sample. The majority (56.9%) received formal annual evaluations, and most (75.9%) were evaluated primarily by physicians; only 17.5% reported peer evaluation. The most frequent evaluation parameters were appropriateness of care, patient satisfaction, patient outcomes, and patient volume. Patient outcomes fell into four categories: clinical endpoints, complications, compliance, and functional status. A need to increase the regularity, formality, and peer review elements of APN performance evaluation was concluded.

Adult↗
PubMed1994

Let the games begin.

Explore the source record for details and available documents.

Competitive Behavior↗
PubMedDate not supplied

Mentoring and job satisfaction. Perceptions of certified nurse-midwives.

The purpose of this study was to investigate the relationship between mentoring and job satisfaction among recently certified nurse-midwives. The Demographic Data Questionnaire, Job Satisfaction Survey, and Quality of Mentoring Tool were mailed to all first-year eligible members (N = 466) of the American College of Nurse-Midwives (ACNM). A total of 317 surveys (68%) were included in the analysis. Sixty-five percent (n = 208) have had a mentor. Twenty-six (8%) had participated in the ACNM Mentoring Program and 33 (10%) had participated in a student mentoring program other than the ACNM Mentoring Program. The most frequently identified qualities of the mentoring relationship were model, supporter, envisioner, and investor. Eighty-one percent (n = 249) reported that they were satisfied with their current job. There was no significant relationship between stated job satisfaction and participation in a mentoring relationship. A significant, but low, correlation was found between stated job satisfaction and the quality of the mentoring relationship (r = .16, P = .03) and between scores on the Job Satisfaction Survey and Quality of Mentoring Tool (r = .14, P = .04).

Adult↗
PubMedDate not supplied

Group B streptococcal (GBS) disease screening and treatment during pregnancy: nurse-midwives' consistency with 1996 CDC recommendations.

OBJECTIVE: In 1998, the screening and treatment practices of certified nurse-midwives (CNMs) for group B streptococcal (GBS) infection during pregnancy were studied and evaluated for their consistency with the 1996 perinatal GBS prevention guidelines of the Centers for Disease Control and Prevention (CDC). METHODOLOGY: Five hundred thirty-nine surveys were completed by CNMs attending the 1998 American College of Nurse-Midwives' Convention. Of these, 502 (94.7%) reported a practice policy for GBS prophylaxis. RESULTS: The Culture-Based Approach was used by 66.7% and the Obstetrical Risk Factor Approach by 28%. Most (69%) reported using multiple culture sites, most commonly the proximal vagina and anorectal area (33.2%), followed by the distal vagina and anorectal area (26.7%), and the anorectal area and proximal and distal vagina (7.1%). Most CNMs (92.5%) reported treating GBS intrapartally, with penicillin the most frequently reported antimicrobial (55.0%) used, and most (94.2%) reporting treatment through labor until birth. CONCLUSION: Overall, GBS prophylaxis practices among survey respondents comply with 1996 CDC recommendations; however, GBS screening practices show room for improvement and the need for continuing education that emphasizes the CDC guidelines, updates as they become available, and other new literature about the topic. In addition, heightened awareness among all perinatal providers is needed with respect to CDC guidelines, especially as they pertain to variations in culture sites, identification of risk categories, and the selection of appropriate antimicrobial treatment agents.

Centers for Disease Control and Prevention, U.S.↗
PubMedDate not supplied

Pregnancy wantedness in adolescents presenting for pregnancy testing.

PURPOSE: To explore and describe dimensions of pregnancy wantedness in adolescents who present for pregnancy testing. DESIGN: Descriptive survey. METHODS: Adolescents presenting for pregnancy testing at a multiservice teen center were invited to participate by completing the Pregnancy Importance Questionnaire while awaiting the results of their pregnancy test. Eighty-nine adolescents responded to questions concerning their desire for pregnancy, knowledge and access to birth control information and supplies, and expectations of how a pregnancy would change their lives. RESULTS: Approximately 7% wanted the pregnancy test to be positive, 60% wanted it to be negative, and 33% were not sure. There was a moderately low (1.97 out of 5) desire for pregnancy, a moderately high (3.11 out of 5) knowledge of and access to birth control, and moderately low (2.08 out of 5) expected changes with a pregnancy. There were no differences in these dimensions by age group (early, middle, and late adolescence). CLINICAL IMPLICATIONS: All clinicians working with adolescents should explore sexual risk-taking and pregnancy prevention measures among these clients. Appropriate counseling and follow-up is necessary for adolescents who present for pregnancy testing, whether the pregnancy test is positive or negative.

Adolescent↗
PubMedDate not supplied

Assisting the unprepared woman during labor.

Many women cannot or do not take classes to prepare themselves for the birth experience. Labor room nurses can use several prepared childbirth concepts to teach these women coping techniques in the course of labor, resulting in an increase in their comfort level and, possibly, a decrease in the amount of analgesia and/or anesthesia required. Suggestions are also made regarding the role of a significant other as a labor partner for the unprepared woman.

Adult↗
PubMedDate not supplied

Perceived relationship with the father of the baby and maternal attachment in adolescents.

OBJECTIVE: To examine the perceived relationship with the father of the baby and maternal attachment in pregnant adolescents. DESIGN: Exploratory, longitudinal, using a convenience sample. SETTING: Four antepartum clinics for low-income women. PATIENTS/PARTICIPANTS: Seventy-nine adolescents, ages 12-19 years, < 20 weeks gestation; follow-up assessments at 20-29 weeks (n = 64), 30-40 weeks (n = 54), and within 1 week after birth (n = 47). Chi-square analysis showed no differences in demographic characteristics or major variables of those who completed the study and those who dropped out (p > or = .89). MAIN OUTCOME MEASURES: An investigator-developed Father of the Baby Scale, Cranley's Maternal-Fetal Attachment Scale, and Avant's Maternal Attachment Assessment Strategy. RESULTS: A close and satisfying relationship with the father of the baby was positively correlated with some aspects of maternal-fetal attachment (r = .24 to .33, p < .05) and maternal-infant attachment (r = .38, p < .05). CONCLUSIONS: The findings of this study lend tentative support to Rubin's theory of maternal identity formation. A close and satisfying relationship with the father of the baby has a positive influence on maternal attachment behaviors. Additional research related to the adolescent's relationship with the father of the baby is needed. Fathers of the babies of adolescent mothers should be included, where appropriate, in ongoing care of the mother and infant.

Adolescent↗
PubMedDate not supplied

Postadoptive reactions of the relinquishing mother: a review.

OBJECTIVE: To review the literature addressing the process of relinquishment as it relates to the birth mother. DATA SOURCES: Computerized searches in CINAHL; Article 1 st, PsycFIRST, and SocioAbs databases, using the keywords adoption and relinquishment; and ancestral bibliographies. STUDY SELECTION: Articles from indexed journals in the English language relevant to the keywords were evaluated. No studies were located before 1978. Studies that sampled only an adolescent population were excluded. Twelve studies met the inclusion criteria and were included in the analysis. DATA EXTRACTION: Data were extracted and information was organized under the following headings: grief reaction, long-term effects, efforts to resolve, and influences on the relinquishment experience. DATA SYNTHESIS: A grief reaction unique to the relinquishing mother was identified. Although this reaction consists of features characteristic of the normal grief reaction, these features persist and often lead to chronic, unresolved grief. CONCLUSIONS: The relinquishing mother is at risk for long-term physical, psychologic, and social repercussions. Although interventions have been proposed, little is known about their effectiveness in preventing or alleviating these repercussions.

Adoption↗
PubMedDate not supplied

The development of attachment behaviors in pregnant adolescents.

The development of attachment behaviors over time in a group of pregnant adolescents, ages 12 to 19, was investigated with Rubin's theoretical framework. Seventy-nine low-income pregnant adolescents enrolled in the study in their first trimester. Follow-up data were collected in the second and third trimesters (n = 64 and 54, respectively) and after delivery (n = 47). Multivariate analysis, using profile analysis, indicated that maternal attachment in adolescents begins in pregnancy and increases over time, especially after quickening. Age-related differences were noted in the development of maternal-fetal attachment behaviors related to giving of self. Results showed a positive relationship between attachment in the third trimester and demonstration of affectionate behaviors toward the infant after birth. These findings are consistent with the theoretical framework.

Adolescent↗
PubMedDate not supplied

The efficacy of individualized computerized testing in nursing education.

This study examined the effects of an individualized computerized testing system for baccalaureate nursing students enrolled in health assessment and obstetrics/women's health during a 3-year period. One hundred twenty-seven students participated in the study. The testing software, Pedagogue, was used to generate the computer tests, and the students took all quizzes on-line. The mean scores on computer tests in both courses were as good as, or better than, previous scores on paper-pencil forms of the tests (P < .05).

Analysis of Variance↗