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Biomedical subjects

M D Naylor

Publications and source records attributed to M D Naylor.

8 recordsLinked to original sources

Content analysis of pre- and post- discharge topics taught to hospitalized elderly by gerontological clinical nurse specialists.

THE PURPOSE OF this study was to analyze the content of topics taught to hospitalized elderly during hospitalization and after discharge by gerontological clinical nurse specialists (CNSs). Content analysis of the topics taught by two CNSs for 20 elderly subjects resulted in the identification of four major categories of patient information needs: management of the health problem that resulted in the current admission, need for and availability of post-discharge health and other support services, preparation for and care after diagnostic or surgical procedures, and health promotion and prevention of future health problems.

Aged

Measuring the effectiveness of nursing practice.

This article examines the importance of outcomes as indicators of quality of care. The appropriateness of selected traditional and emerging outcomes in measuring the effectiveness of nursing interventions is addressed.

Activities of Daily Living

Comprehensive discharge planning for the elderly.

Discharge planning for the elderly can potentially reduce patient length of hospital stay, prevent rehospitalization, enhance patient outcomes and lessen the burden of care on the families. While increased numbers of elderly are being discharged earlier, there are few data on the process and effects of discharge planning protocols developed specifically for this population. The proposed study will attempt to answer the following questions regarding hospitalized elderly with selected DRG classifications: Are there significant differences between elderly patients who receive the hospital's general discharge planning procedure used for all categories of patients and elderly who receive the hospital's general discharge planning procedure plus a comprehensive discharge planning protocol specific to the elderly and implemented by a gerontological nurse specialist in: (1) Patient Outcomes (length of initial hospitalization; post-discharge morbidity; post-discharge health services; functional status; mental status; satisfaction with care; self-esteem; patient's perception of health status; and stress level); (2) Family Related Outcomes (primary care giver's functional status; mental status; care giving demands; stress level and family functioning); (3) Cost of Care Outcomes (charges for initial hospitalization, rehospitalizations, post-discharge health services; family related costs; and gerontological nurse specialist costs). The study design is a randomized clinical trial with a total of 280 elderly (2 groups of 140). The control group will receive routine discharge planning; the treatment group will receive routine discharge planning plus an elder-specific comprehensive discharge planning protocol. Data analysis will include frequency distributions and summary statistics. For each of the research questions, multivariate analysis of variance or chi-square statistics will be used.

Aged

A clinical teaching project: examination of a clinical teaching model.

This project, started in 1985 by Dr Infante, is based on theory of the use of the clinical laboratory in nursing education. It fully recognizes the complementary roles of nursing education and nursing service by having practitioners participate as preceptors, role models, and mentors. Six clinical agencies participated in this innovative clinical teaching project with the goal of improving the effectiveness and efficiency of nursing education and nursing practice. It is hypothesized that the synchronization of clinical laboratory experiences with instruction in nursing theory and science and a closer collaboration among faculty, students, and nurse practitioners will give students an appropriate balance of academic and clinical practice perspectives and skills to prepare them effectively to meet the complex health care needs of patients. The subjects were 173 undergraduate baccalaureate nursing students enrolled in an upper-division generic program. For the purpose of testing Infante's clinical model, the students were randomly assigned to a control or experimental group for two successive incoming classes of nursing students. Each student's academic and clinical progression was monitored. Data were gathered using grade point average, a standardized test for nursing knowledge (Mosby Assesstest; Mosby, St Louis), college laboratory practicum, and simulated testing for clinical application skills.2+ Data were analyzed using independent t tests. The findings indicate that the students in the experimental group, who used the experimental clinical model, achieved higher grade point averages, higher scores on the Mosby Assesstest, and higher college laboratory practicum scores than the students in the control group. The findings support the need for further investigation of innovative clinical teaching models.

Clinical Competence

Institutional yield on research: a case study.

This University of Pennsylvania School of Nursing study on the early discharge of very low birthweight infants led to a care model that saves over $18,000 per infant. The benefits to the institution as a whole, however, have been far greater. They include enhanced faculty and student recruitment as well as $700,000 in indirect cost recovery.

Cost-Benefit Analysis

Comprehensive discharge planning for hospitalized elderly: a pilot study.

The purpose of this randomized clinical trial was to examine the effects of a comprehensive discharge planning protocol implemented by a gerontological nurse specialist as compared to the hospital's general discharge planning procedure. There were no statistically significant differences between groups in length of initial patient hospitalization or in rates of posthospital infections. A statistically significant difference was found when groups were compared on the number of subjects rehospitalized during the study period. The findings of this pilot study reinforce the need for continued study of the impact of comprehensive discharge planning for hospitalized elderly.

Activities of Daily Living