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Biomedical subjects

Thomas A Mackey

Publications and source records attributed to Thomas A Mackey.

11 recordsLinked to original sources
PubMed2005

Quality improvement and changes in diabetic patient outcomes in an academic nurse practitioner primary care practice.

PURPOSE: To examine a set of system interventions in the management of patients with diabetes and the outcomes of their care. DATA SOURCES: Preintervention and postintervention data collected from electronic medical records. CONCLUSIONS: The sample size was smaller than expected, contributing to a lack of statistical significance from preintervention to postintervention in the patient outcome measures. The systems-level variables that were under the direct control of the clinic staff (e.g., pneumococcal vaccine given) showed great improvement. In the preintervention period, the percentage of "yes" responses to the system-level variables ranged from 8 to 24 and jumped to 16 to 95 after the intervention. IMPLICATIONS FOR PRACTICE: Unequivocally, this project demonstrated that systems-level changes result in improved care being provided to patients; however, these had minimal impact on the patient outcome variables. Promoting change in patient behavior is difficult, which may have contributed to the lack of significance in this area, while the variables under the direct control of the clinic staff were more easily changed.

Diabetes Mellitus↗
PubMed2003

Occupational health nurses' educational needs: what do they want?

Educational preferences, impediments to obtaining an education, and the needs of occupational health nurses are not well understood. The purposes of this regional study were to determine the graduate and continuing educational preferences, impediments, and needs of occupational health nurses in the states of Texas, New Mexico, Arkansas, Louisiana, and Oklahoma. Questionnaires (1,172) were mailed to all occupational health nurses identified by the respective state boards of nursing (N = 5). Results from 256 (response rate of 21.8%) returned questionnaires show 43.8% were interested in obtaining a graduate degree in occupational health nursing while only 48.8% of employers encourage them to obtain a higher degree. Only 33.2% reported the company for which they work provides rewards for obtaining an advanced degree or certification as an occupational health nurse. The two greatest impediments to obtaining a graduate degree as an occupational health nurse were a long distance from campus (56.3%) and lack of money (37.9%).

Adult↗
PubMedDate not supplied

National consensus on data elements for nurse managed health centers.

This report presents a summary of the findings from the National Network for Nurse Managed Health Centers Data Consensus Conference. Nationally, nurse-managed health centers are increasingly offering communities another option for access to high-quality primary care. The lack of agreed upon, standardized data elements for these centers has limited the ability to present clear information about their contributions as well as to inform policy related to their support and development. Fifty-three national invitees came to consensus in Washington, DC on the critical data elements for a national database for nurse-managed health centers. This database includes both clinical and financial/business practices elements. Consensus was not reached around some clinical areas. These areas are briefly discussed as well as the plans for next stages of data collection.

Community Health Centers↗
PubMedDate not supplied

Evaluation of training designed to prevent and manage patient violence.

This study was designed to determine whether the test responses of mental health care workers (n = 118) showed significant improvement after attending a training session about managing violence. Four variables (knowledge, attitude, self-efficacy, and behavioral intention) were measured before and after staff attended a training program that consisted of two commercial programs: the Nonviolent Crisis Intervention (CPI) and Handle with Care. The Nonviolent Crisis Intervention is designed to teach staff how to prevent and control disruptive behavior of clients. "Handle with Care" is a combination of lecture and demonstration of self-defense skills and restraining methods for staff who work with potentially assaultive patients. The research team used a one group, pretest/posttest study design for the evaluation. The study location was an acute care psychiatric hospital located in the southwestern United States. Hospital staff completed a pretest, participated in a 12-hour intervention, and completed a posttest immediately after the intervention. The evaluation of staff responses demonstrated improvements in posttest scores that were significant for knowledge, attitude, self-efficacy, and behavioral intention to use the training techniques. More research is needed regarding evaluation of programs that train mental health care workers to prevent and manage patient violence. Such research can help us develop more effective programs.

Adolescent↗
PubMedDate not supplied

A global survey of occupational health competencies and curriculum.

The World Health Organization has identified a worldwide shortage of occupational health professionals, but evidence suggests that the work and education of these professionals vary across countries. This survey examined the professional development of occupational physicians, occupational nurses, industrial hygienists, and ergonomists in terms of practice competencies and academic curriculum. Of 89 countries that received the survey, 48 (54%) responded. Important differences in competencies and curricula were identified for all groups. More competencies were identified more frequently in developed countries. Academic programs existed more often in developed countries, but curriculum contents varied. The study provides a concrete reference point for discussion and development of competencies and curriculum.

Competency-Based Education↗
PubMedDate not supplied

Quality indicators for academic nursing primary care centers.

ANCs, by definition, deliver more than clinical services to patients and communities. The unique identifier that separates ANCs from other primary care/ambulatory care centers is the educational service they offer to students and other faculty in the school of nursing to which they belong. Therefore, measuring the quality of an ANC must include a measurement of the educational properties that it possesses in addition to the usual quality measurements by such organizations as AAAHC, JCAHO, CHAP, and AAACN. Unless these properties are included and measured by an ANC, it becomes difficult to justify the existence of such a clinic within a school of nursing. ANCs are encouraged to develop quality evaluation programs aimed at evaluating the educational aspects as well as the administrative and clinical aspects of their operations.

Academic Medical Centers↗
PubMedDate not supplied

Outsourcing issues for nurse practitioner practices.

Nurse practitioner managed practices face multiple business and clinical processes. While most practice managers are prepared as clinicians, they are not well prepared to deal with the daily multiple business infrastructure issues they face. To provide for increased efficiency and effectiveness, nurse practitioner practices should consider outsourcing context business functions.

Competitive Bidding↗
PubMedDate not supplied

Using FTE and RVU performance measures to assess financial viability of academic nurse-managed centers.

Financial performance measures are essential to improve the fiscal management of academic nurse-managed centers (ANMCs). Measures are compared among six ANMCs in a consortium and against an external, self-sustainable, profitable ANMC and national data for family practice physicians. Performance measures help identify a center's strengths and weaknesses facilitating the development of strategies aimed at a variety of targets (business practices related to revenue and costs) to improve financial viability. Using a variety of financial performance measures to inform decision making will aid ANMCs in keeping their doors open for business.

Academic Medical Centers↗