PubMed Health⌕ Search

Biomedical subjects

Ruth Wetta-Hall

Publications and source records attributed to Ruth Wetta-Hall.

11 recordsLinked to original sources
PubMed2006

Influence of semi-recumbent position on intra-abdominal pressure as measured by bladder pressure.

BACKGROUND: Intra-abdominal pressure (IAP) obtained by bladder pressure measurement is used to detect impending abdominal compartment syndrome (ACS), but, while it is recommended to use a supine position, the literature describes IAP measurement in varying positions. This study evaluated the impact of body position at differing head-of-bed (HOB) elevations on bladder pressure when planned to be used as a surrogate IAP measurement. MATERIALS AND METHODS: Forty-five trauma patients admitted to a surgical intensive care unit underwent bladder pressure measurements at 0, 15, 30, 45 degrees HOB position and 30 degrees HOB position plus 15 degrees of reverse Trendelenburg tilt; these measurements were performed in counterbalanced fashion and assessed by built-in angle indicators on the bed rails of each bed. Study participants were connected to an IAP monitoring kit via their indwelling Foley catheter. RESULTS: A total of 675 bladder pressure measurements were obtained with 135 measurements at each of five HOB elevations (0 degrees , 15 degrees , 30 degrees , 45 degrees , 30 degrees +15 degrees tilt). Statistically significant differences occurred between all HOB elevations. Statistically significance differences also occurred at different BMI statuses. CONCLUSIONS: Elevating HOB significantly increases bladder pressure measurement. Bladder pressure measurements in nonsupine positions may not provide valid interpretation for IAP, and more so in cases of increased body mass index.

Abdomen↗
PubMed2005

Stigma and safe havens: a medical sociological perspective on African-American female epilepsy patients.

PURPOSE: Very little is known about the attitudes and behaviors of minorities with epilepsy. This pilot study explored access to health care, help-seeking behaviors, and adherence to treatment among African-American females with epilepsy. METHODS: Ethnographic interviews were conducted with 10 African-American female adults. RESULTS: Findings indicate four major obstacles to care: limited financial resources, lack of knowledge about epilepsy among African-Americans, poor patient-provider communication, and lack of social support. Social support impacted individuals seeking surgery, and also affected purchasing medication, adherence to medical treatment, and needed transportation. Lack of knowledge and misinformation about epilepsy in the African-American community and poor communication with physicians contribute to the social stigma felt by these patients. CONCLUSIONS: The behavioral epidemiology of epilepsy among African-Americans is lacking. This disease exacerbates health disparities for this population. These findings point to a need for a safe haven for these individuals.

Adult↗
PubMed2005

Quantitative evaluation of "Can It Happen in Kansas: Response to Terrorism and Emerging Infections".

PURPOSE: This study describes the evaluation of a 2-year plan to train 10 percent of Kansas' multidisciplinary health professionals for response to terrorism and emerging infections. This project was part of a national effort covering 19 states funded by the Health Resources and Services Administration in 2003. METHODS: The initial training occurred in six 2-day workshops. A terrorism preparedness questionnaire was developed to assess Health Resources and Services Administration terrorism response competencies/learning objectives. These were measured before, after, and 3 months after training in a hybrid cross-sectional and cohort follow-up design. RESULTS: Health professionals' mean scores significantly improved on all four Health Resources and Services Administration terrorism self-reported competencies from pretest to posttest. Three months posttraining, health professionals' mean scores decreased slightly but remained significantly higher than their pretest scores. CONCLUSIONS: This project prepared healthcare professionals to respond to the medical consequences of terrorism. The integration of core competencies into the evaluation plan allowed for trainees to evaluate their confidence and abilities. The evaluation plan and curriculum may serve as useful tools for preparation of healthcare workers nationwide, with the potential to rebuild the public health infrastructure to assume preparedness responsibilities.

Adult↗
PubMed2005

Help on the line: telephone-triage use, outcomes, and satisfaction within an uninsured population.

Telephone triage programs have been shown to be cost-effective and favorably utilized by insured populations. However, there are 45 million Americans who are uninsured and who do not have access to telephone nursing. A telephone triage service was piloted for local uninsured residents. Within the 17-month trial period, 320 calls were received, representing 207 clients. This study reports on the results of the telephone survey with a cross-sectional sample of uninsured triage patrons (N = 80). One half reported they would have sought other medical care if the telephone triage service had not been available. Most callers (98%) believed that their health care concern was understood. Moreover, 98% agreed with the advice given, and 90% reported following up on the advice given. Overall satisfaction by the uninsured population with the telephone-based nurse triage service was positive and appears to be an effective and acceptable tool by those uninsured individuals who utilized its services.

Adult↗
PubMed2004

Kansas office-based nurses' evaluation of patient tobacco cessation activities.

In this study, we examined the tobacco cessation efforts of nurses working in primary care settings. A 43-item questionnaire was mailed to 1,036 office-based nurses located throughout Kansas. With a response rate of 50.1%, 415 questionnaires were available for analysis. Although 89% of respondents encountered patients who smoked on a daily or weekly basis, only 51% reported documenting their patients' tobacco use, and 38% assessed patients' readiness to quit. Two thirds (66%) of nurses believed that tobacco management was part of their role but only 35% provided cessation advice, 23% recommended nicotine replacement therapy, and 14% provided coping techniques. Nurses cited barriers such as perceiving patients as disinterested or unmotivated to quit (65%) and having little time (55%), skills (32%), or knowledge (25%). Most (91%) agreed that they needed additional tobacco control education. Nurses who were advanced registered nurse practitioners or clinical nurse specialists were more likely to feel confident about their smoking cessation counseling skills compared to nurses with less education (66.7 vs. 31.2%, p =.010). Office-based nurses identified specific barriers that could be addressed through professional education about tobacco management.

Adaptation, Psychological↗
PubMed2004

Community case management: a strategy to improve access to medical care in uninsured populations.

Case management is a rapidly growing strategy to help vulnerable populations access the health care they need in a fragmented U.S. service delivery system. A number of lessons can be learned from the successes and challenges of a developing, hospital-based, community-focused case management group in Sedgwick County, Kansas. The Community Case Management program has a case management team based at each of four hospitals. Each team has a social worker and a nurse, whose main goal is to help the uninsured find a primary health care home. This dynamic combination has several benefits. Each team member brings a vital skill set in helping the clients change behavior and access the care and support they need. Also, the nurse-social worker team concept creates a synergy in which team members support each other and create the best solution to their clients' needs.

Case Management↗
PubMedDate not supplied

Assessment of patient and provider satisfaction scales for project access.

OBJECTIVE: This study examined the underlying variables that contribute to patient and provider satisfaction with Project Access, a physician-driven program that connects low-income, uninsured adults (aged 18-64) to denoted specialty care and hospital services. SUBJECTS AND METHODS: Of the 550 physicians and 1400 patients participating per year, 125 physicians and 164 patients completed and returned the 14- and 15-item satisfaction questionnaires, respectively. The data from both surveys were factor analyzed. RESULTS: Patient satisfaction data factored into 4 dimensions: respect from program implementation staff, respect from pre-Project Access enrollment staff, practical health-related issues, and the level of understanding of Project Access guidelines and expectations. Provider satisfaction data factored into 3 dimensions: external services available to patients, receiving recognition and respect, and the administration of Project Access. CONCLUSIONS: Patients' feelings of respect seemed to be closely associated with their satisfaction with Project Access, in addition to the helpfulness of the program. Providers also considered respect and recognition an important factor contributing to their satisfaction, in addition to ease of administrative duties and services available to patients.

Adolescent↗
PubMedDate not supplied

Strategies for community-based organization capacity building: planning on a shoestring budget.

Community-based organizations often capacity build to successfully enable themselves to be adaptable and responsive to constantly changing environments. However, community-based organizations are stretched for time, staffing, and funding, and the added obligation of regularly performing management planning tools, such as strategic planning, needs assessments, program evaluations, or market demand forecasting, strain limited resources. Through case studies, this article illustrates how collaborations between universities and community-based organizations can result in the development of successful management planning tools through the use of geographic information systems and secondary resources. Such collaborations produced maximization of production and effectiveness in an environment characterized by limited resources.

Community Health Services↗
PubMedDate not supplied

Preparing for burn disasters: evaluation of a continuing education training course for pre-hospital and hospital professionals in Kansas.

"Preparing for Burn Disasters: A Training Course for Pre-Hospital and Hospital Professionals in Kansas," a continuing education program designed to provide licensed health care practitioners a training opportunity for multiple burn victim incidents, emphasized the challenges that the community-wide multidisciplinary team faces when responding to burn disasters. A pre-post survey design was used to assess changes in participants' knowledge and self-rated ability, confidence, and competence to perform in a burn disaster before and after training. Participants (N = 383) were predominantly female (71.1%), 40 years or older (57.7%), nurses (52.2%), were employed in a pre-hospital care setting (38%), and had worked in healthcare for 10 years or fewer (53.6%). The percentage of correct responses pre- vs post-test increased between 30% and 65% on two-thirds of the knowledge items. On the basis of paired-samples t-test analysis, statistically significant increases in participants' overall self-ratings of ability and confidence in burn management were observed in every content area. Most participants (64%) felt competent or highly competent to manage multiple burn casualties after the training program, and most participants (58%) indicated that they intended to incorporate the newly acquired knowledge into their daily practice within 2 weeks. Evaluation results demonstrate that a successful program was designed and implemented. The curriculum and teaching methods achieved desired goals for improved knowledge, which appear to have been translated to enhanced abilities, confidence and competence in burn assessment and treatment modalities.

Adult↗