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Biomedical subjects

P Reiley

Publications and source records attributed to P Reiley.

16 recordsLinked to original sources
PubMed1996

Learning from patients: a discharge planning improvement project.

BACKGROUND: In 1991 Beth Israel Hospital (Boston) joined nine other hospitals in using the Picker/Commonwealth survey instrument to tap patients perceptions of their hospitalization experience. Beth Israel focused on one of the nine dimensions of the instrument-continuity and transition (discharge planning). FOUR WORK TEAMS: In 1992 four multidisciplinary work teams were formed-for cardiac surgical patients, stroke patients, patients on a medical unit, and patients on a medical and surgical unit. Each team conducted a patient/family discussion group, during which recently discharged patients and their families were asked about their preparation for discharge and asked for input on how to improve the process. INTERVENTIONS: Each work team developed interventions on the basis of information specific to their patients. The cardiac work team, for example, developed interdisciplinary practice guidelines for patient care management for the entire postoperative period; the guidelines include a patient education component on what patients and families can expect during hospitalization. OUTCOMES: Clinicians practice differently, inviting more patient feedback and other involvement in care, as a results of their involvement in the project. On the first annual patient survey, administered in 1994, only 6% of 1,179 randomly selected patients (versus 20% of the 100 patients first surveyed in 1993) indicated that they did not receive the information they needed to help themselves recover. CURRENT PROGRESS AND FUTURE DIRECTIONS: A standardized teaching packet containing material developed during the discharge planning improvement project is now distributed. In May 1995 the nursing department launched a patient and family learning center to better meet the health education needs of patients.

Aftercare↗
PubMed1996

Discharge planning: comparison of patients and nurses' perceptions of patients following hospital discharge.

Planning for hospital discharge is an important component of nursing. Results are presented of a study to determine how well primary nurses predict the functional ability of their patients following discharge and to assess whether patients and nurses agree about their patients' understanding of the post-discharge treatment plan. Comparing nurses' predictions with patients' reports of functional status 2 months following discharge, we found that nurses consistently underestimate the functional ability of their patients. Comparing nurses' perceptions of their patients' understanding of their post-discharge treatment plan with patients' reports about their understanding, significant differences were found between nurses' perceptions and patients' reports. Nurses' perceptions were that patients were much more knowledgeable than their patients reported. These preliminary data suggest that hospital discharge planning is an area for further investigation and intervention. Nurses should explore new paradigms for patient education as lengths of hospital stay decrease and care shifts from acute care to community care.

Activities of Daily Living↗
PubMed1995

Predicting in-hospital mortality. The importance of functional status information.

Monitoring risk-adjusted outcomes is the centerpiece of efforts to ensure health care quality. Because data collection is expensive, questions arise concerning what information is essential to adjust for risk. This investigation used retrospective analysis of existing, computerized clinical databases containing laboratory test results, information on chronic coexisting conditions, and nursing evaluations of functional status to predict in-hospital mortality. We studied persons admitted to one tertiary teaching hospital between 1987 and 1992 for cerebrovascular disease or pneumonia. Predictive models for each of the conditions were developed using logistic regression; the results were validated with split samples. We compared the predictive value of the nursing functional status assessments and the clinical laboratory data. For each study condition, the functional status data had as much prognostic information as the laboratory data. Specifically, a nurse's report that a patient required total assistance for bathing was the best single predictor of in-hospital mortality in the models for patients with either cerebrovascular disease or pneumonia. If hospitals admit patients with different levels of functional impairment, it is important to account for these differences before comparing outcomes across facilities. Assessments of functional status are a simple, inexpensive measure that may have considerable value.

Activities of Daily Living↗
PubMed1994

Use of a nursing intensity system as a measure of patient function.

The purpose of this study was to determine whether a nursing intensity system could be used as a valid and reliable measure of patient function (ability to perform activities of daily living). Eighty seven patients on the medical service were randomly selected for inclusion in the study. Functional status assessment was obtained by the Katz Index and compared with functional status data obtained from the nursing intensity system. Correlation between the two measures was high (r = .71, p < .001). The nursing intensity system was also found to have high internal consistency (alpha = .85). It was concluded that such systems have the potential to provide useful measures of function.

Activities of Daily Living↗
PubMed1994

Implementation of a collaborative quality assessment program.

The authors describe a collaborative quality assessment program between the department of anesthesia and critical care and the department of nursing. Data were collected on patient outcomes and were presented, through case reviews, at monthly quality assessment rounds. The program has been successful in stimulating important discussions between physicians and nurses about patient care.

Aged↗
PubMed1991

Implementation of a local area network for nursing management.

This paper describes the planning and implementation of a Local Area Network (LAN) for the nursing service of a 504-bed urban teaching hospital. The major goals of the network were: support for nurse executives, nurse managers, and the departmental assistants assigned to administrative offices; increased efficiency and effectiveness of the nursing administrative areas; and improved communication systems. Collaboration between the nursing service and the Computer Information Center (CIC) resulted in a network of over 70 workstations, spanning 11 buildings. The network provides access to multiple programs that support clinical, managerial, and research activities. Gateways provide access to the hospital's two mainframes.

Boston↗
PubMedDate not supplied

Predicting hospital length of stay in elderly patients with congestive heart failure.

The purpose of this study was to determine the variables, available at the time of hospital admission, that are associated with length of hospitalization. A second objective was to explore the extent to which patient functional status, an area of great concern to nursing, explains length of hospitalization. Severity of illness and functional status emerged as significant predictors of length of hospital stay.

Activities of Daily Living↗
PubMedDate not supplied

Implementing a local area network for nursing in a large teaching hospital.

The authors describe the assessment, planning, implementation, and benefits of a local area network (LAN) for the nursing service of a 504-bed urban teaching hospital. The major goals of the network were to increase the efficiency and effectiveness of the nursing administrative areas and improve communication systems. A network of more than 90 workstations, spanning 12 buildings, was installed. The network provides access to multiple programs that support clinical, managerial, and research activities. Gateways provide access to the hospital's two mainframe computers. Network benefits identified by nursing management include: improved communication and access to information; increased accuracy, efficiency and timeliness of data; and improved computer literacy.

Boston↗