Biomedical subjects
Publications and source records attributed to M L Stricklin.
Patient response is a critical aspect of successful POC technology implementation. This article presents the results of a pilot POC patient satisfaction study conducted at four home health agencies. Variables impacting patient receptiveness and recommendations for patient education are discussed to help agencies develop individual POC training and education plans.
Home care agencies often fail to commit adequate resource time preparing nurses for POC technology. Successful implementations need to incorporate human issues in addition to the technical aspects for POC. This article discusses the experiences and perceptions of nurses who participated in a pilot POC training group. The pilot group and key elements of the training are presented. The results of a focus group present the major POC focus of importance for the nurses.
This article describes Home Talk and Healthy Talk, two practical applications of telephone technology developed at the VNA of Cleveland. Home Talk is a disease-specific monitoring system with preprogrammed automated questions that immediately score patient responses. If any responses fall out of the safety zone, the system calls the supervisor and a live intervention follows for assessment and appropriate action. Healthy Talk is a series of age-specific automated health screens used by nurses in community centers to engage clients to follow through with self-selected health goals. The use, cost-effectiveness, and impact on outcomes are also discussed.
Explore the source record for details and available documents.
Home- and community-based care are deeply rooted in the United States and worldwide. Public and private organizations have provided formal in-home and community health services for more than a century. Today they are an integral part of the care continuum, ranging from highly technical and professional services to simple forms of non-professional and voluntary support in homes. Because the roles and functions of community workers have expanded and diversified, organizations must successfully recruit, train and support workers with widely differing skills. In health care's new economic era, health has re-emerged as a community rather than individual concern. Non-traditional models of service delivery will be the cornerstone of community-based health care. Providers and policy-makers must find new ways to refocus from treating illness to achieving and maintaining health.
The growth of managed care has led to a greater emphasis on health promotion--disease prevention (HP/DP) as a primary component of health care delivery. New technology is simplifying the HP/DP process. One agency used a disease management monitoring system to track clients' general health status.
Older persons consume a disproportionate share of all medications dispensed in the United States. In particular, medications acting upon the central nervous system (CNS) have been overprescribed for elderly persons, both in and out of the institutional setting. Although researchers have studied drug use by elders who live in the community, little is known about the use of CNS medications by ill older persons who live at home. This descriptive study examined the use of CNS medications in a group of elderly persons (N = 141) admitted to a visiting nurse association for skilled care. Subjects resided in the community of a large midwestern city. Approximately half of the subjects used some type of CNS drug. Sedative/hypnotic and narcotic and opioid analgesics, two categories of medications with the potential for serious side effects, were most frequently prescribed. Nurses in community and institutional settings are in an ideal position to screen and monitor the use of CNS medications by homebound ill elders.
Individuals with cognitive impairment are at high risk for institutionalization; thus, they may benefit from the support provided by home health services. The authors studied a cohort of elderly persons admitted to a home health agency, after first assessing them for cognitive impairment. Comparisons were made between cognitively impaired and cognitively intact individuals. Significant differences in the volume and type of services used were found. Management issues for home health agencies are raised.
Home care providers rarely initiate research because of limited resources and the perception that research belongs to academic institutions. A survey of the affiliates of the Visiting Nurse Associations of America identified the types of research activities performed and the interest level of nurses in participating in research activities.
Explore the source record for details and available documents.
Who should be the judge of quality care--the consumer or healthcare professional? Traditionally, healthcare providers have decided what services consumers should receive and how consumers' needs should be met. Current trends in healthcare delivery are changing this one-sided practice. Throughout the United States, to determine what constitutes quality care, accrediting bodies, insurers, consumer groups, providers, and governments are collecting and analyzing data on standards for clinical practice, patient outcomes, and perceptions of those receiving healthcare.
A majority of nurses working in the community lack formal educational preparation to care for older adults. This study examined the perceived learning needs of Visiting Nurse Association (VNA) executives and agency staff nurses in Ohio related to continuing education in gerontology. Twenty-six executives and 478 staff nurses were asked to complete a gerontologic education survey; 17 executives and 344 staff nurses returned surveys. Findings suggest that few Ohio VNAs have focused on continuing education in gerontology. Indications exist that executives and staff nurses are not always in agreement regarding the importance of content needed for updating gerontological knowledge and skills. Educational and organizational strategies are offered to provide minimal standards for gerontologic professional practice in home care.
Since 1993, the Cleveland State University Department of Nursing and the Visiting Nurse Association of Cleveland have been involved in an innovative partnership known as Vision on 22nd Street. This partnership has produced a model to restructure the nursing curriculum and the practice setting in such a way that a seamless process, fully integrated within university and agency operations, prepares undergraduate nursing students for community-based practice. The groundwork supporting the model, the development of the curriculum, the preparation of participants, and the implementation of the model for program evaluation are the subject of this article.
Explore the source record for details and available documents.
To determine interobserver reliability of the Mental Health Patient Assessment Record, two independent observers, a visiting nurse and the investigator who was a constant second observer throughout the study, made home visit observations at two specified times: the initial assessment (time I), and approximately two months later (time II). The stratified random sample consisted of 26 discharged psychiatric patients who comprised approximately 75 percent of the new admissions to the agency during a four-week period. At time I, 26 visits were completed and values were obtained, using the Pearson product moment correlation for the scores on the MHPAR: 1) overall behavior, r = .96; 2) physical behavior, r = .91; 3) psychological behavior, r = .93; 4) social behavior, r = .83; and 5) medical behavior, r = .98. The sign test applied to total and category scores revealed that only one category, social behaviors, demonstrated a significant systematic bias of the constant second observer. Of the 26 patients observed at time I, 20 were visited at time II. The following values were obtained using the Pearson product moment correlation for MHPAR scores: 1) overall behavior, r = .98; 2) physical behavior, r = .91; 3) psychological behavior, r = .91; 4) social behavior, r = .94; and 5) medical behavior, r = .99. The sign test applied to total and category scores showed no systematic bias of the constant second observer.