Biomedical subjects
Mary Fran Tracy
Publications and source records attributed to Mary Fran Tracy.
Regional use of complementary and alternative therapies by critical care nurses.
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Use of complementary and alternative therapies: a national survey of critical care nurses.
BACKGROUND: Demand for complementary and alternative therapies is increasing and is affecting all healthcare settings, including critical care. METHODS: A random sample of members of the American Association of Critical-Care Nurses was surveyed to determine the members' attitudes, knowledge, perspectives, and use of complementary and alternative therapies. RESULTS: Most of the 726 respondents were using one or more complementary and alternative therapies in practice. The most common therapies used were diet, exercise, relaxation techniques, and prayer. A majority of the nurses had some knowledge of more than half of the 28 therapies listed on the survey, and a majority desired additional training for 25 therapies. Respondents generally required more evidence judged as essential to use or recommend conventional therapy than to use or recommend complementary and alternative therapies. Nurses viewed complementary and alternative therapies positively overall, were open to use of the therapies, and perceived them as legitimate and beneficial to patients. Nurses judged the therapies helpful for treatment of a variety of symptoms. A majority of nurses desired an increase in the availability of the therapies for patients, patients' families, and nursing staff. Nurses' professional use of the therapies was related to having more knowledge of them, perceiving benefits of them, total number of therapies they recommended to patients, personal use, and affiliation with a mainstream religion. CONCLUSIONS: Educational programs that provide information about use of complementary and alternative therapies and the underlying evidence base most likely will increase the appropriate use of the therapies to achieve desired outcomes.
Comparison of health-related quality-of-life outcomes of men and women after coronary artery bypass surgery through 1 year: findings from the POST CABG Biobehavioral Study.
BACKGROUND: Women undergoing coronary artery bypass graft (CABG) surgery have a worse medical condition and fewer social and financial resources than men. Some studies have found that women recover less well than men after CABG, whereas others have found women's outcomes comparable to those of men. Past studies of health-related quality of life after CABG have too few women for adequate comparison with men and have not included patients whose data are not available at baseline (eg, emergency CABG), limiting generalizability. METHODS: A longitudinal study of symptoms and health-related quality of life was conducted among patients from four clinical centers enrolling both men (n = 405) and women (n = 269) in the Post CABG Biobehavioral Study in the United States and Canada. RESULTS: After 6 weeks from CABG (average 81 days), both men and women had less anxiety and symptoms related to depression than before surgery (P <.001). After 6 months (average 294 days), both men and women improved in physical and social functioning (P <.001). Although changes in scale scores were similar for men and women at each time point, women scored lower than men on these domains (P <.001, adjusted for baseline medical and sociodemographic differences) and had more symptoms related to depression through 1 year after CABG (P =.003). CONCLUSIONS: Both male and female patients improve in physical, social, and emotional functioning after CABG, and recovery over time is similar in men and women. However, women's health-related quality-of-life scale scores remained less favorable than men's through 1 year after surgery.
Nursing's role in complementary and alternative therapy use in critical care.
Critical care nurses can expect to encounter more patients using CAT and increasing opportunities and requests for CAT use in their critical care environments. This provides an opportunity for nurses' involvement to shape proactively how the use of these therapies will unfold in critical care. This can be accomplished in various ways. Actively ask patients and families about use of CAT. Initiate discussions with colleagues and peers about professional and personal use of therapies. Explore the knowledge and education needed to administer specific CAT. Engage in research regarding the use of CAT in critical care. Identify experts in the institution and surrounding community. Encourage critical care units and institutions to consider how CAT should be implemented across the institution. From a broader perspective, nurses may become part of professional political processes shaping patient accessibility to CAT and the use of CAT in the discipline, across disciplines, and in healthcare settings and public domains. It is crucial that nurses not relinquish their role as traditional providers of CAT in providing safe, effective, and holistic care at the bedside of critically ill patients.
Personal use of complementary and alternative therapies by critical care nurses.
Critical care settings are stressful to nurses, and exposure over time may contribute to stress-related symptoms and illnesses. Nurses' personal use of complementary and alternative therapies (CAT) may lessen the effects of stress and contribute to their overall well-being and health maintenance. A national survey of critical care nurses who are members of the American Association of Critical-Care Nurses revealed that a majority (96.4%) of critical care nurse respondents were using one or more CAT for personal use or had consulted a provider for CAT therapy. The most common therapies used were exercise, diet, massage, and prayer (or spiritual direction). Nurses' personal use of CAT was related to having knowledge of more types of CAT, use of more CAT in practice, a perception of benefits of greater numbers of CAT, more openness to use, more types of CAT recommended to patients, and a perception of more barriers to use in their institutional setting. Data support our model that links nurses' personal use to use in practice. Educational programs to promote nurses' knowledge and personal use of CAT could lead to an increase in appropriate use of CAT in professional practice and potential benefits to critical care patients and their families.
Nurse attitudes towards the use of complementary and alternative therapies in critical care.
BACKGROUND: There is increasing demand for complementary/alternative therapies (CAT) in critical care, however, critical care nurses' perspectives regarding CAT are unknown. OBJECTIVES: This study was conducted to determine critical care nurses' knowledge, attitudes, and use of CAT. SAMPLE/SETTING: A total of 348 critical care registered nurses working at least 40% in medical, surgical, cardiac, neurological, and pediatric ICUs at 2 tertiary-level hospitals in a large Midwestern city were surveyed. One hospital is a 926-bed private, urban hospital and the second is an 1868-bed academic-affiliated medical center. METHODS: A survey was distributed to all critical care nurses described above. RESULTS: The level of knowledge reported by 138 nurse respondents was greatest for diet, exercise, massage, prayer, and music therapy. Use of therapies was related to knowledge and training and consistent with beliefs of legitimacy and perceptions of beneficial effects. Despite barriers including lack of knowledge, time, and training, 88% of respondents were open or eager to use CAT, and 60% reported moderate or greater desire to use CAT. CONCLUSIONS: Critical care nurses are open to CAT use and many use them in their own practice. Because use was associated with knowledge, recommendations for future research include increasing the scientific base and enhancing knowledge to promote evidence-based incorporation of CAT in practice.
Clinical nurse specialist leadership in computerized provider order entry design.
PURPOSE: The purpose of this clinical project was to design and implement a computerized provider order entry system. BACKGROUND: Well-designed clinical computer systems can advance best practice and quality decision making, leading to improvements in patient and organizational outcomes. DESCRIPTION OF THE PROJECT: An Orders Design Group composed of clinical nurse specialists (CNSs), staff nurses, and information management personnel was formed. CNSs used competencies in the system sphere to lead the integration of the needs of patients, nurses, and organizations into new technologies. OUTCOME: CNSs facilitated implementation of a collaboratively designed interdisciplinary computerized order entry process. CONCLUSION: Evaluation of the design and implementation process demonstrated greater success with the order entry system under the leadership of CNSs than past initiatives where CNSs were not in leadership roles. IMPLICATIONS FOR NURSING PRACTICE: CNS competencies in designing and implementing innovative system-level solutions are key to clinical information systems design.