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Biomedical subjects

Mary Ann Anderson

Publications and source records attributed to Mary Ann Anderson.

14 recordsLinked to original sources
PubMed2005

Hospital readmission from home health care before and after prospective payment.

PURPOSE: To describe and compare clients who were readmitted to the hospital during an episode of home health care, before and after the inception of the prospective payment system (PPS). DESIGN: A longitudinal mixed design was used to replicate a study conducted 9 years previously (pre-PPS) in the same home care agency in the central part of the United States. METHODS: Seventy-six closed-case medical records from a not-for-profit hospital-affiliated home care agency were retrospectively reviewed and compared to pre-PPS data. The same data collection tool, the Hospital Readmission Inventory, was used for both pre- and post-PPS studies. Nurse administrators at the data collection agency were interviewed concerning comparative results. FINDINGS: Currently readmitted clients were sicker than were those in the previous research report, they were readmitted sooner for a different diagnosis, and they had less continuity of services. CONCLUSIONS: The home health care industry has undergone a dramatic change in payment for services, from fee-for-service to PPS. Of particular concern is the adverse patient outcome of an unplanned hospital readmission. Prior studies have characterized such patients in home health care, but no comparative reports were found in a literature search since the inception of PPS. Findings from this study indicated that an increased emphasis on cost containment and higher-risk clients appear to have changed patterns of care delivery.

Aged↗
PubMed2004

Realigning the communication paradigm in nursing case management.

Communication underlies all of case management (CM), and better comprehension of the processes of communication within the context of the CM role may facilitate positive patient and organizational outcomes, and assist providers and policy makers in designing effective CM systems. Thus, the purpose of this qualitative, pilot project was to explore dimensions of communication of the nurse case manager role within a hospital setting. The results describe a "hub and spoke" model of communications and suggest the utility of this familiar model for understanding the communication dynamics for those who work as nursing case managers in hospital settings. Findings suggest that nurse case managers are at various times both advocates and mediators--communications roles that may encompass somewhat contradictory demands and perspectives.

Adult↗
PubMed2004

The effectiveness of feminist pedagogy in empowering a community of learners.

The purpose of this study was to determine whether a pedagogy grounded in feminist ideals has the potential to empower students to make changes consistent with those ideals in their personal and professional lives. In Phase I, qualitative data were collected through e-mail questionnaires from students in two nursing schools, one in Canada and one in the United States. Findings were used to identify an appropriate tool to measure the empowering influence of feminist pedagogy. In Phase 2, a pretest-posttest design used Barrett's Power as Knowing Participation in Change Tool (PKPCT) to measure student empowerment. A clinical setting was added in a third baccalaureate nursing program. A total of 218 students participated in seven course offerings-four classroom and three clinical. One hundred one matched pairs were obtained, for an overall response rate of 46%. Repeated measures ANOVA revealed that overall empowerment scores, as measured by the PKPCT, and classroom empowerment (CE), as measured by the addition of a variable (i.e., the ability to contribute in class), increased significantly from pretest to posttest. Interaction between Sites 1 and 2 was also significant. Regression analysis indicated posttest CE scores added to pretest PKPCT and CE scores provided a strong model to predict overall empowerment scores, measured by the PKPCT at Time 2 (R2 = .703). Despite limitations related to loss of follow up and low response rates at one site, the results of this study supported both hypotheses: that empowerment would increase over the course of the class in which feminist pedagogical principles were used, and that classroom empowerment is likely to extend beyond the classroom to personal and work environments.

Analysis of Variance↗
PubMedDate not supplied

Disability law and nursing education: an update.

Over the past decade, the courts have been called upon to apply the provisions of the Americans With Disabilities Act and Section 504 of the Rehabilitation Act in several cases with implications for programs of nursing education. Courts have restricted who may be considered a qualified individual with disabilities. They have clarified the relative obligations of both students and educators in determining accommodations. Courts have been especially deferential to educational programs preparing health care professionals when program standards and pedagogical requirements are clearly articulated. However, accessibility and compliance with recommendations for accommodations are required at all sites where students are educated. Less clear are judicial interpretations related to making technology accessible and to the disclosure by programs of information about students' disabilities during licensing. These findings lead to several conclusions. First is the need for development of profession-wide standards of competencies and skills for nurses. Second is the need for dialogue about the potential for disability discrimination between nursing educators and state licensing bodies. Last is that faculty and administrators can proceed with some degree of confidence in protecting program practices that are based on sound pedagogical reasoning.

Architectural Accessibility↗
PubMedDate not supplied

Client characteristics and the cost of home care in the prospective payment system.

There has been much speculation in the literature about the effect of the prospective payment system (PPS) on the home care industry but few reports of systematic investigation. Clearly, comprehension of client characteristics is essential for categorizing home care clients into the correct Home Health Resource Groups, for allocating resources appropriately, and for implementing necessary organizational changes to accommodate clients who require variations in the amount of resources predicted by the PPS. The purposes of this study were to compare the characteristics of home health clients that resulted in a financial gain or a financial loss for one agency under the PPS with those of the interim payment system. A secondary data analysis of 140 cases compiled by one not-for-profit hospital-affiliated home care organization was completed. Results suggested that client characteristics of the projected loss group had more recertifications on admission and at the end of the 60-day episode, a longer stay (3 weeks), and more visits, particularly from skilled nursing. Comprehension of client characteristics and the subsequent ability to adjust for the proper case mix will be crucial if home care agencies are to remain financially viable under the PPS. Replication of this project needs to be done using more variables and multiple sites.

Adult↗
PubMedDate not supplied

Nursing work life in acute care.

The purpose of this project was to explore how acute care nurses in a midwestern state rate the quality of their work life. A simple random sample of 1500 registered nurses was surveyed. Data were collected using Brooks' Quality of Nursing Worklife Survey (Brooks BA. Development of an Instrument to Measure Quality of Nursing Work Life [unpublished doctoral dissertation]. Chicago: University of Illinois at Chicago; 2001). Findings suggested that nursing workload was too heavy, and there was not enough time todo the job well. This study revealed that there remain ongoing and fundamental work life concerns for staff nurses that the profession has neither addressed nor resolved in any meaningful, long-term way.

Acute Disease↗
PubMedDate not supplied

Hospital readmission from a transitional care unit.

The purpose of this project was to characterize patients readmitted to the hospital during a stay in a transitional care unit (TCUT). Typically, readmitted patients were females, widowed, with 8 medical diagnoses, and taking 12 different medications. Readmission from the TCU occurred within 7 days as a result of a newly developed problem. Most patients did not return home after readmission from the TCU. Understanding high-risk patients' characteristics that lead to costly hospital readmission during a stay in the TCU can assist clinicians and healthcare providers to plan and implement timely and effective interventions, and help facility personnel in fiscal and resource management issues.

Aged↗
PubMedDate not supplied

Quality of life after participation in a rural phase II cardiac rehabilitation program.

The purpose of this study was to explore the effectiveness of a cardiac rehabilitation program (phase II) in improving participants' quality of life (QOL). Existing data collected previously by a not-for-profit rural community hospital using the SF-36 tool were analyzed. The secondary data consisted of precardiac and post-cardiac rehabilitation SF-36 scores for 121 phase II participants. All the 8 subscale post scores of the SF-36 were higher when compared to the pre-rehabilitation scores. In this non-controlled trial, results suggest that participation in rural cardiac rehabilitation programs may improve patients' perceptions of QOL and health.

Activities of Daily Living↗
PubMedDate not supplied

Evidenced-based factors in readmission of patients with heart failure.

The purpose of this project was to organize the variables associated with the hospital readmission of patients with heart failure (HF) into a usable framework to inform clinical practice and facilitate administrative decision making. An integrated, systematic review of the literature was used as the research approach. A content analysis of the sample (31 research reports from the years 1986-2004) yielded multiple factors associated with the hospital readmission of HF patients. Factors and their definitions were extracted, grouped into like categories, and eventually classified into 5 domains-demographic, physiologic, psychosocial, patient functioning, and resource utilization. The resulting framework has clinical, research, and administrative implications in the delivery of care to HF patients.

Activities of Daily Living↗
PubMedDate not supplied

Development of the Nursing Outcome (NOC) label: hyperactivity level.

TOPIC: Hyperactivity, a persistent, severe pattern of inattention or impulsivity, places children at risk for impaired functioning in many developmental areas. This behavior is characterized by short attention span, low frustration tolerance, impulsivity, distractibility, and increased physical activity. Responses from multiple sources in the child's environment must be monitored to manage childhood hyperactivity. PURPOSE: Success at school, in peer relationships, and parent-child interactions is frequently affected by hyperactivity. Using a focus group approach, a Nursing Outcomes Classification (NOC) label, definition, and indicators were developed for Hyperactivity Level. SOURCES: Review of the literature allowed for a content analysis approach and conceptualization of hyperactivity at several levels. CONCLUSION: Twenty three (23) measurable indicators were formulated and refined into conceptually and clinically coherent outcomes. Clinical relevance and utility were presented through a case study approach.

Adaptation, Psychological↗
PubMedDate not supplied

Defining quality of nursing work life.

As the largest single employee component of hospitals, nurses are critical to the functioning of the organization, and improving employee productivity continues to be a common theme in the health care literature. However, any increased productivity will be transitory if achieved at the expense of the quality of nurses' work life (QNWL), since improvement in the QNWL is prerequisite to improved productivity. The conceptual components of the concept of QNWL that differentiate QNWL from the concept job satisfaction are explored.

Attitude of Health Personnel↗