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Biomedical subjects

K H Bowles

Publications and source records attributed to K H Bowles.

9 recordsLinked to original sources

Application of the Omaha System in acute care.

Although effective as a standardized language for documentation in community and public health settings, the Omaha System has not been evaluated in acute care settings. The purpose of this study was to evaluate the utility of the Omaha System to code the terms used by nurses when documenting hospital care. The nursing documentation in 30 hospital records was content analyzed for signs and symptoms, patient problems, and nursing interventions, then coded into the categories of the Omaha System. Degree of match was evaluated using concept match scores, and utility was determined using empirical, operational, and pragmatic criteria. Study findings suggest several strengths (i.e., high reliability, coded 97% of the problems, easy to use) and some limitations (lack of mutual exclusivity among terms, lack of semantic clarity, the need for three new problems). This study has important implications in demonstrating the utility of the Omaha System for possible expansion into acute care to standardize communication between the hospital setting and home care.

Abstracting and Indexing↗

Patient problems and nurse interventions during acute care and discharge planning.

Standardization and computerization of medical documentation has provided a method to describe patient care by naming and linking patients' needs with nursing interventions. This study used a standardized nursing classification system to describe the types and frequency of problems experienced by elders hospitalized and discharged to home and the interventions used by staff nurses and advanced practice nurses (APNs) as they provided acute care and discharge planning for these cardiac patients. The patients' hospital records and the APN logs were content analyzed and then coded using the Problem Classification Scheme and Intervention Scheme of the Omaha System. Patients experienced an average of 8.6 problems that required a total of 7,000 interventions in all four Omaha System intervention categories. The results provided a description of the most frequent problems experienced by the patients linked with the most common nursing interventions. The nature, complexity, and prevalence of patient problems and the importance of communication across settings are evident. In addition, the study findings increase understanding of the contribution of nurses to the care of hospitalized elders as they make the transition from hospital to home.

Aged↗

How telehomecare affects patients.

The emergence of telemedicine as an acceptable mode of health care delivery creates opportunities and challenges for home care providers. As part of strategic planning and deployment of a telemedicine project, agencies must ask questions, such as, is this technology suitable for elderly clients? Can patients with multiple, chronic conditions benefit? Are caregivers willing to take on the responsibility of additional equipment in the home? Agencies must consider these and other issues when planning and evaluating a telemedicine project.

Community Health Nursing↗

Nursing intervention classification systems.

PURPOSE: To analyze the features, development, and research of the Omaha System, the Iowa Nursing Intervention Classification, and the Home Health Care Classification and provide a critical review of the unique components of each. ORGANIZING FRAMEWORK: Five elements: achievement of original purpose, language used, ease of computerizing format, clinical utility, and linkage of the Nursing Minimum Data set (NMDS) nursing care elements. CONCLUSIONS: Further testing and development of nursing classification systems should be done to determine the general value of nursing classification, the extent to which the original goals and purposes of classification are met, and to identify the unique features and contributions of each system. Further testing is important to determine the strengths, weaknesses, and applicability of the various systems for capturing the elements of the NMDS for different care settings, care givers, and patient populations. IMPLICATIONS: Nursing classification may eventually lead to naming and describing the work of nurses. Research findings will continue to provide information leading to a unified nursing language system that describes the practice of nursing in local, regional, national, and international health-care data sets used for research, clinical, education, policy, and administrative purposes.

Community Health Nursing↗

Patient problems and advanced practice nurse interventions during transitional care.

This study is a secondary analysis of patient records written by advanced practice nurses (APNs) as they provided discharge planning and 4 weeks of home follow-up to elderly patients hospitalized with common medical and surgical conditions. The purposes of this study were to examine the problems experienced by elders who were hospitalized and discharged to home, the interventions used by APNs as they cared for these patients, and the linkages between patient problems and APN interventions. Care logs written by the APNs to document the patient problems and nursing interventions were content analyzed and coded using the Problem Classification Scheme and Intervention Scheme of the Omaha System. The results provided a description of the 10 most frequent problems experienced by the patients linked with the APN's interventions. The study provides a description of the nature and complexity of patient problems as they transition from hospital to home and increases our understanding of the contribution of APNs to the care of elders.

Aged↗

The barriers and benefits of nursing information systems.

Nursing informatics is a growing field with many opportunities for nursing involvement. Because nurses are involved increasingly in the design, installation, and use of nursing information systems (NIS) it is important that they are aware of the barriers to and benefits of nursing information systems. This article describes the evolution of nursing information systems and the design goals for current systems. The lack of a unified nursing language and individual and organizational factors such as characteristics of the nurse, the unit, the administrative philosophy, and workload issues are discussed as barriers to NIS development. Increased nurse involvement, education, research, and recognition of the benefits of computerization are suggested to overcome the barriers. A review of the literature provides the reader with evidence of improved efficiency, patient safety and satisfaction, and ability to measure quality as benefits of NIS. Areas for further research are identified: outcomes measurement using NIS, decision support and expert systems, point-of-care documentation, interagency and interdisciplinary communication, and further work on individual and organizational factors.

Diffusion of Innovation↗