PubMed Health⌕ Search

Biomedical subjects

M L McClure

Publications and source records attributed to M L McClure.

At least 19 recordsLinked to original sources
PubMed2001

Going forward into the 21st century. Stewart Conference endpaper.

The issues addressed in these brief remarks represent some of the most serious problems that we will need to solve if we hope to deliver the kind of health care that is needed in the new century. What a challenge! In approaching this task we will have to be so much more creative than we have ever been. As our colleague, Joann Disch (2000), suggested in a recent column, we will need to learn that creativity is often a matter of asking the right questions. Her prime example was a good one and one that I would leave you with today. "...the major transformation that occurred in Nomadic societies (was) when the question changed from, 'How do we get to the water?" to, "How do we get the water to come to us?" (p. 311). On all these major issues, it will take a great deal of thoughtful deliberation and hard work for us to "get the water to come to us." I do believe that we can manage this, however, and I also believe that nurses will need to exert more leadership in this effort. But nurses will also need to step up to the plate and take a more active role than we have been willing to take in the past. That may well prove to be the most difficult test for our profession, simply being generous enough with our time and talents, remembering that the trick is not to have all the right answers but rather to ask the right questions. Carpe diem! Seize the day!

Delivery of Health Care↗
PubMed2000

Engaging staff nurses in evidence-based research to identify nursing practice problems and solutions.

This article illustrates how one academic health science center in a large metropolitan area sought to improve the quality of patient care by soliciting the input of their nursing staff in devising an action plan for change. The research model incorporated both survey and focus group methods used by nursing leaders in administration and practice to identify and prioritize nursing research and clinical needs in their organization. The goal was to establish consensus among clinicians and researchers about significant issues in the institution requiring in-depth attention. A second objective was to design a survey instrument that is easy to complete and could be distributed, collected, and analyzed easily, thereby providing empirical data to the clinicians in a timely manner and in a simple format. This expedited process enabled specific action plans to be developed around the identified problems. Moreover, the process promoted interest in advancing nursing research and evidence-based practice among the clinicians and administrators.

Adult↗
PubMed1999

The effects of dietary patterns on quality of life: a substudy of the Dietary Approaches to Stop Hypertension trial.

Few studies have examined the effects of dietary changes, particularly modifications of whole dietary patterns, on quality of life. The Dietary Approaches to Stop Hypertension (DASH) trial compared the effects of 3 dietary patterns on blood pressure. In this substudy, we examined the effect of these diets on health-related quality of life. All DASH participants ate a control diet for 3 weeks and then were randomly assigned to continue the control diet, to a fruits and vegetables diet or to a combination diet for 8 weeks. The combination diet emphasized fruits, vegetables, and low-fat dairy products. It included whole grains, poultry, fish, and nuts, and was reduced in fats, red meat, sweets, and sugar-containing beverages. The control diet was similar to typical American intake; the fruits and vegetables diet was rich in fruits and vegetables but was otherwise similar to the control diet. Both the fruits and vegetables diet (P < .001) and the combination diet (P < .001) significantly lowered blood pressure. At the Duke University Medical Center, Durham, NC, site, participants completed the Medical Outcomes Study Short Form-36 questionnaire to assess their health-related quality of life at baseline and at the end of the dietary intervention. Eighty-three participants completed the questionnaires at both time points. In general, health-related quality of life improved in all treatment groups except for the control group in perceptions of change in health, which diminished. In the combination diet group all the subscales were improved or unchanged compared with baseline values. However, only the change in health score improved significantly (P < .05) as compared with that of the control diet group. When all the subscales were summed into a total score, the control diet was associated with mean improvement of 4.0%, the fruits and vegetables diet with 5.0%, and the combination diet with 5.9% from baseline. These data suggest that the fruits and vegetables diet and particularly the combination diet cannot only lower blood pressure, but may also improve the perception of health-related quality of life.

Adult↗
PubMed1991

Military nursing and diagnosis-related groups: using the past to benefit our future.

To contain the escalating cost of health care, a prospective payment system is being introduced into the military. The authors propose a proactive approach to this change in health care financing by evaluating the experiences of nurses to a similar change in the civilian sector. These approaches are presented as nine interrelated lessons: responding optimistically; shifting into a business mode; valuing clinical nursing experts; understanding the implications for documentation; moving to decentralized management; changing outpatient care delivery; considering the effects on job satisfaction; evaluating the relationship between costs and nursing resource consumption; and basing nursing practice in science.

Diagnosis-Related Groups↗
PubMed1990

New York University Medical Center's Cooperative Care Unit: patient education and family participation during hospitalization--the first ten years.

The New York University Medical Center Cooperative Care (CC) program is a model of a delivery system of acute inpatient hospital care characterized by a live-in family member or friend acting as a "care partner". It has an emphasis on education in order to encourage full patient and family involvement in care during the acute hospitalization, thereby preparing both parties for management at home after discharge. The education-intensive experience of CC provides an alternative to traditional inpatient hospital care with the expected outcome of CC being to increase patient and family knowledge and satisfaction, adherence to the medical regimen, and appropriate self-management. The functioning ability of the patient-care partner team should be improved on discharge, which may result in decreased subsequent utilization of high cost healthcare resources such as rehospitalization. This paper describes the structure of the CC form of inpatient care, the types of patients appropriate for such care, and the experience of its first ten years of operation, with its implications as a replicable model for other institutions.

Academic Medical Centers↗
PubMed1984

Managing the professional nurse. Part I. The organizational theories.

How do employment organizations outside the hospital field deal with issues such as staff productivity, motivation, burnout, and high turnover? In Part I of this two-part article, the author presents an overview of modern management theory and practice, drawn from the literature on organizational behavior. She shows how nursing administrators can use this scholarly foundation to better understand the organizing principles and problems of their departments. In Part II (to be published in March 1984), the author applies these classic and relevant theories to the specific challenges that face the manager of professional nurses.

Administrative Personnel↗
PubMed1984

Managing the professional nurse. Part II. Applying management theory to the challenges.

In Part I of this article, the author reviewed the ideas of some of the major administrative thinkers over the past 30 years. Having set the stage with an overview of current thinking in the general area of management theory, the author here examines some of the specific challenges involved in managing the professional nurse. Often, these problems are unique and the management theorists offer only limited help. In other instances, management theory is directly relevant. The author addresses the following four broad categories that are unique to the profession of nursing: nursing as a female profession, professionalism and the lack of it, stress and burnout, and expectancy congruence.

Administrative Personnel↗