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Laura M Wagner

Publications and source records attributed to Laura M Wagner.

5 recordsLinked to original sources

The role of the nurse in an ambulatory stroke and cognition clinic.

In this paper we described our approach to the development of the role of a nurse within a stroke and cognition ambulatory clinic at Baycrest. In developing this approach we integrated Baycrest's commitment to clients and family-focused care, our focus on interdisciplinary collaborative practice, the position of the post-rehabilitation clinic in the continuum of care, the clinical experience of the nurse and director, and the relevant scholarly literature. The role of the nurses in the stroke and cognition clinic includes assessment, interdisciplinary care planning, client/family support, and knowledge transfer.

Aftercare↗

Impact of a falls menu-driven incident-reporting system on documentation and quality improvement in nursing homes.

PURPOSE: Data from incident-reporting systems have been used successfully in disciplines other than health care to improve safety. This study tested the effect of a falls menu-driven incident-reporting system (MDIRS) on quality-improvement efforts in nursing homes. DESIGN AND METHODS: Following instrument development and testing, the intervention occurred over a 4-month period in three intervention nursing homes using the MDIRS matched with three homes using their existing narrative incident report to document falls. Data on fall incidents were collected from facility incident reports, and comparisons in incident-report documentation were made between the intervention and control groups. The minutes from quality-improvement meetings were examined to see how incident-report data were used for fall-prevention strategies. RESULTS: Almost one third of nursing home residents among the six facilities fell during the 4-month study period. Intervention nursing homes had significantly better documentation of fall characteristics on the incident reports than did the control nursing homes. Although only one nursing home fully implemented the MDIRS intervention, all three facilities identified strengths of the system. IMPLICATIONS: The MDIRS can have a significant impact in improving how nursing staff assess residents following a fall incident. Traditional narrative methods of documenting adverse incidents are time consuming and may not yield sufficient and accurate data. This model has the potential to enhance quality-improvement efforts and augment the current system of adverse incident reporting in nursing homes.

Accidental Falls↗

Use of a content analysis procedure for the development of a Falls Management Audit Tool.

The Falls Management Audit Tool (FMAT) was developed to assess the documentation of the falls management process in nursing homes. The multistep content analysis procedure was used to guide tool development and obtain reliability and validity of the FMAT. Established fall guidelines and national experts were used for item development. Trained gerontological nurse practitioners conducted chart audits in nursing home residents with a fall history. Adequate content validity (content validity index > .88) and interrater and intrarater reliability were established (kappas > .78) in the final version of the 57-item FMAT and pilot testing demonstrated feasibility. This study provided evidence that the FMAT is a reliable and valid tool, which can be used to assess the documentation of the falls management process and for measuring the effect of research or quality improvement interventions.

Accidental Falls↗

Reporting near-miss events in nursing homes.

Since the Institute of Medicine report To Err Is Human was published in 1999, improving patient safety has become a major initiative for nurses working in all care settings. Nursing homes are a fertile environment for both a high frequency of adverse events to occur and a high number of institutional barriers to reporting them. This article outlines the barriers to reporting adverse events in nursing homes and provides support for why reporting near-miss events can serve as a means of reducing these barriers. It also provides recommendations and specific strategies for how to implement near-miss reporting systems in nursing homes such as policy changes, supportive leadership, and educating nurses about near-miss events. Further nursing research in this evolving area of patient safety is warranted.

Humans↗