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Biomedical subjects

R B Lovett

Publications and source records attributed to R B Lovett.

7 recordsLinked to original sources
PubMed1995

Validity and reliability of an oncology critical care patient acuity tool.

PURPOSE/OBJECTIVES: To test the reliability and validity of a patient acuity tool for use on a critical care oncology unit. DESIGN: Prototype classification system using therapeutic indicators to describe a patient's acuity. SETTING: Intensive care unit of a research and academic oncology hospital in the Southeastern United States. SAMPLE: Critical care nursing staff including management-level personnel at the research site. METHODS: An acuity tool for critical care was developed using the Johns Hopkins Oncology Center's patient classification system as a model. Content validity indexes were calculated based on ratings of nurse experts. interrater reliability was calculated based on two independent raters: a staff nurse and a patient care manager. MAIN RESEARCH VARIABLES: Appropriateness of language and categorization of therapeutic indicators developed for the tool. FINDINGS: The content validity index of the entire tool was 0.85; 24/25 indicators were retained. Reliability was r = 0.84. CONCLUSIONS: The tool is reliable and valid. IMPLICATIONS FOR NURSING PRACTICE: Acuity tools can be used to calculate unit productivity and assist with determination of staffing needs. In this age of healthcare reform, it is imperative that personpower needs in all care settings be accurately determined to provide cost-effective and safe care levels.

Critical Care↗
PubMed1993

Validity and reliability of a bone marrow transplant acuity tool.

The purpose of this project was to develop a valid and reliable patient-acuity tool for patients undergoing bone marrow transplant (BMT) as part of an overall patient-acuity system. A survey of other cancer centers and a review of the literature revealed no acuity tools that were designed for patients undergoing BMT. A four-level, nursing-diagnosis-based tool was developed with multiple indicators in each level, and its validity and reliability were studied. Content validity indexes (CVIs) were generated for each indicator by a panel of content experts. CVIs ranged from 0.4 to 1.0 with an overall CVI of 0.93 for the tool. Interrater reliability using two raters for 79 patients was high (r = 0.94, p < 0.001). Results of the study provide sufficient evidence of validity and reliability to warrant use of the tool, but further study is needed.

Bone Marrow Transplantation↗
PubMed1991

Validity and reliability of a pediatric hematology oncology patient acuity tool.

Appropriate use of nursing resources in the pediatric hematology and oncology inpatient settings demands a patient acuity system that is easy to use and accurate, and that objectively measures nursing care needs of a specialized patient population. Structured survey of 13 comprehensive cancer centers and a review of the literature show no valid and reliable acuity tools for this pediatric population. The purpose of this project was to study the validity and reliability of a newly developed pediatric hematology and oncology acuity system designed to quantify patient care needs. A new acuity tool for this pediatric population was developed based on the patient classification tool used at Johns Hopkins Hospital Oncology Center (JHHOC). The levels of care from the JHHOC tool were adopted, with therapeutic indicators modified to reflect nursing diagnoses relevant to the pediatric inpatient. Nursing care hours required for each level of care were also identified. Validity was studied using a content validity index (CVI). Experts from the pediatric unit where the tool would be used were asked whether each therapeutic indicator was assigned to the correct level of care (1 thru 5) based on patient care hours. CVIs for items ranged from .5 to 1.0; the overall CVI for the tool was .93. Interrater reliability was studied using two raters from the unit. Data were collected for 150 patient observations on a 12-bed pediatric hematology and oncology inpatient and short-stay outpatient unit. The resulting Pearson correlation coefficient was r = .97 (P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)

Humans↗
PubMed1989

Clinical practice evaluation in an oncology setting.

Clinical practice must be evaluated for efficiency and effectiveness using a logical, step-by-step methodology. Problem-solving models can serve as a guide to help clinicians systematically evaluate and answer the question, "Do nursing interventions make a difference?" Ultimately, this type of clinical practice evaluation will contribute to improving quality patient care as well as the efficiency of nurses' time.

Evaluation Studies as Topic↗
PubMed1985

Decentralization reduces nursing administration budget.

Faced with the need to decrease personnel costs, nursing administrators at Bayfront Medical Center analyzed the nursing department's organizational structure. The resulting change to a decentralized management structure, streamlining the management staff, is described. The radical, yet promising approach of eliminating evening and night shift nursing supervisors is discussed.

Administrative Personnel↗
PubMedDate not supplied

Validity and reliability of medical and surgical oncology patient acuity tools.

PURPOSE/OBJECTIVES: To develop valid and reliable medical and surgical acuity tools as part of an overall classification system for patients with cancer. SETTING: An acute care, tertiary, research, academic oncology hospital in the southeastern United States. SAMPLE: Clinical nursing experts in medical and surgical oncology; 125 patient observations for the surgical oncology acuity tool, and 75 patient observations for the medical oncology acuity tool. METHOD: The nursing division developed a medical oncology acuity tool and a surgical oncology acuity tool using the Johns Hopkins Oncology Patient Classification System as a model. They then studied the validity of developed tools using content validity indexes (CVIs). Two independent raters studied the interrater reliability of each tool. FINDINGS: CVIs for items on the surgical tool ranged from 0.57-1.0; the overall CVI for this tool was 0.86. CVIs for items on the medical tool ranged from 0.25-1.0. The overall CVI for this tool was 0.88. Pearson correlation coefficients were r = 0.95 (p < 0.001) for the surgical oncology acuity tool and r = 0.92 (p < 0.001) for the medical tool. Interrater reliability, tested continually for four years, was greater than 95%. CONCLUSIONS: The tools are reliable and valid. IMPLICATIONS FOR NURSING PRACTICE: Medical and surgical oncology acuity tools that are nursing diagnosis based, interface with nursing standards of care, are easy to use, and require no calculation provide reliable quantification of nursing work loads based on the care needs of patients with cancer. Supervisors use data from these tools to determine variable nursing hours per patient per day, establish productivity for units, make staffing and scheduling decisions, assign patients, work on budgets, and, ultimately, establish charges for nursing services. As the needs of medical and surgical oncology patients evolve, continued refinement of indicators and acuity levels will be needed. As other medical and surgical oncology tools are developed, further comparison will be warranted. Additional study would determine if the tools could be modified for these nursing uses in other cancer centers as well as in designated medical and surgical oncology units of other types of hospitals. Oncology acuity systems also could be established in the future as the basis for third-party reimbursement.

Cancer Care Facilities↗