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Biomedical subjects

V Schirm

Publications and source records attributed to V Schirm.

18 recordsLinked to original sources
PubMed2000

Using evidence-based practice for managing clinical outcomes in advanced practice nursing.

Preparation of advanced practice nurses to assume leadership positions for clinical decision making requires that traditional ways of solving clinical problems be augmented with information from relevant, research-derived evidence. In this article, the authors describe how one graduate program prepares advanced practice nurses to use the best scientific evidence with clinical expertise to influence patient outcomes. The assignments that students complete in their program provide examples of evidence-based practice that apply quality improvement principles and science-based nursing interventions to create best practices.

Education, Nursing, Graduate↗
PubMed2000

Caregiving in nursing homes. Views of licensed nurses and nursing assistants.

This investigation is a qualitative study of the views held by 36 licensed nurses (25 registered nurses and 11 licensed practical nurses) and 40 nursing assistants regarding caregiving in nursing homes. Because these care providers are most directly involved in the delivery of care, their views are important as determinants of quality of care. Study findings focus on the extent to which nurses and nursing assistants agree on what contributes to good care and how they perceive the work that each does. Also reported are their perceptions regarding factors that make care delivery easy or difficult. Results suggest that nurses and nursing assistants share selected perceptions about the division of labor in the nursing home. Also evident are areas of less agreement among these members of different status sets. A discussion of how these caregivers can work together as effective team members is presented.

Aged↗
PubMed1999

Understanding nursing home quality of care: incorporating caregivers' perceptions through structure, process, and outcome.

Nursing home quality of care has been influenced by the Omnibus Budget Reconciliation Act of 1987. This legislation mandated changes within the structure, process, and outcomes of care. These care elements are examined from the viewpoints of 32 licensed nurses and 40 nurse assistants. Accounts of good care, obtained through focus groups, are presented within the context of structure, process, and outcome to understand quality care. Implications about training nursing personnel are considered within the structure and the process of care and how these elements affect care outcomes.

Attitude of Health Personnel↗
PubMed1994

An exploratory study of associate degree nursing students' conceptual basis for caring practices.

Nursing educators, especially in associate degree nursing (ADN) programs, are confronted with the challenge of finding ways to include caring in practice. Recent studies provide guidance for incorporating caring behaviors into curricula, but little is known about students' definitions of care and what constitutes caring behaviors. The purposes of this exploratory study were to (1) describe students' definitions of caring and (2) determine how students know when they have cared for patients. ETHNOGRAPH was used to systematically group responses from a sample 117 first- and second-year nursing students from two programs. Students' descriptions of caring distinguished between meeting physical and psychosocial needs of patients, and depictions of actual caring behaviors. Students' responses to knowing when they cared for a patient fell in the categories of role performance, comfort, patient responses, and human needs gratification. Implications useful to educators in creating an environment where nursing students gain the skills necessary to further caring behaviors and practices are given.

Adolescent↗
PubMed1993

Cholesterol screening of older persons: focusing on health education.

Public education about cholesterol screening and evaluation has been strongly recommended by the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol (1988). For older persons, limited clinical evidence about benefits that may be derived from screening efforts poses particular challenges to education efforts by health care providers. Additionally, professional and lay information sources offer mixed messages about the purpose of cholesterol screenings. Studying a community hospital cholesterol-screening program provided a timely way to provide insight about the meaning of cholesterol evaluations for older persons. Findings from the program evaluation are discussed in light of the debate that continues about the benefits of cholesterol evaluation and treatment in older persons.

Aged↗
PubMed1993

Nursing personnel's perceptions of physical restraint use in long-term care.

The use of physical restraints as an accepted clinical intervention was dramatically changed by enactment of legislation in the United States. As a result, nursing personnel's notions of restraints as a therapeutic intervention were challenged. This study was initiated to obtain a better understanding of the underlying motivations for restraint use as a clinical intervention and to provide data helpful to nursing staff as they make the transition to restraint-free care. In the study, 124 long-term-care nursing personnel were surveyed regarding their perceptions of restraint use, and were asked whether or not they would recommend using restraints in selected clinical situations. Results of stepwise regression showed that 40% of the variation in the recommendation to use restraints can be explained by the type of nursing personnel (licensed nurse vs. nursing assistant), liability and treatment concerns related to restraint use, age of the nursing staff, and a belief that reducing restraints increases the need for psychoactive medications.

Attitude of Health Personnel↗
PubMed1992

Family-focused nursing care of hospitalized elderly.

The purposes of this research were to gain an understanding of how nurses in acute care settings involve families of elderly patients in planning and giving care, and to determine the extent of that involvement in nursing documentation. Data were obtained from patient records and interviews with nurses. Evaluated were characteristics of elderly patients and families, documentation of family involvement in care, and nurses' descriptions of family care. A comparison of data sources indicated that nurses verbalized far more inclusion of families in care than the written records documented. Results of this research support the importance of clarifying and promoting acute care-nurses' involvement of family members who are central to the care of increasing numbers of elderly persons.

Aged↗
PubMed1991

Nurse empathy to caregivers of chronically ill elders.

1. Findings showed that differences exist with regard to the amount of strain family caregivers experience and how caregivers perceive the nurses' empathy. 2. Caregivers to older persons requiring more health care services experienced more objective strain (ie, lack of time or more physical demands) than caregivers to persons who required less health care services. 3. Caregivers in isolated environments viewed nurses as more empathic compared with caregivers residing in areas where there was opportunity for more interaction with others.

Adult↗
PubMed1989

Functionally impaired elderly: their need for home nursing care.

An understanding of care requirements of functionally impaired elderly living in the community is especially important to community health nurses (CHNs), if they are to maximize services to elderly care recipients and their lay caregivers. This study is a report of the functional status of 53 elderly care recipients who were receiving care by informal and formal caregivers. Findings on the functional abilities of elderly in this study are compared with findings from studies of nursing home and community residing elderly. Implications for nursing practice relative to assessments and interventions for functionally impaired elderly are given. Results of the research point to the need for additional investigations to determine home-care needs of growing numbers of of frail elderly.

Activities of Daily Living↗
PubMed1989

Managing aggressive elderly in long-term care.

1. Patients in long-term care perceived themselves to have more control over their socialization activities than over physical activities of daily living. 2. Patient's perceived control over physical activities was related to their degree of functional ability. However, functionally independent patients perceived themselves to have little control over eating and bathing. 3. Perceived control was not found to be a significant factor influencing aggressive behavior in this study. It is recommended that patients' mental status be included as a variable in future studies. 4. Nurses in long-term care need to institute nursing interventions that encourage patients' choices in basic activities of daily living.

Activities of Daily Living↗
PubMed1989

Program planning for long-term care: meeting the demand for nursing services.

The recruitment of nurses who are key to the delivery of quality long-term care is clearly an important issue. Nursing homes are admitting elderly persons who, in the recent past, would have been cared for in the acute care hospital. Nurses must care for ventilator dependent persons and others whose lives are supported by high technology. At the same time, nursing skill and expertise is essential to maintenance of functioning in elderly residents who are dependent in routine activities of daily living. The reimbursement rates of third-party payers contribute to the inability of nursing homes to be competitive with acute care facilities in the recruitment of qualified nurses. As demonstrated through implementation of the nurse refresher course and development of the in-house nursing program, long-term-care facilities can be creative in their endeavors to overcome obstacles associated with nurse recruitment. Implementation of an education program emphasizes the necessity of having capable and caring nurses prepared for long-term care. Development of a mechanism such as an in-house nursing agency enables better compensation to nurses. Consequently, care to elderly in nursing homes is recognized as important, and nurses are better valued for services that are indispensable.

Education, Nursing, Continuing↗
PubMed1989

Shared care by formal and informal caregivers for community residing elderly.

This investigation is a descriptive survey of 53 functionally impaired elderly who were receiving care from an informal caregiver as well as from professional nurses. The eventual outcome of care for the 53 subjects in terms of whether they continued to receive home care or entered a nursing home is also presented. Implications regarding the need for nursing assessments and interventions relative to functional abilities of elderly at home are presented.

Aged↗
PubMedDate not supplied

Medication counseling for the elderly: effects on knowledge and compliance after hospital discharge.

The findings from the instruments used in this study and the additional qualitative data of the personal interviews provide information helpful to the nurse's understanding of medication knowledge and compliance patterns in older persons. Investigations that study older persons over time are needed to identify how behaviors change. Such studies would also be helpful in identifying self-care behaviors learned over extended periods of time. It may also be helpful to investigate knowledge and compliance behaviors in the home setting, where the environment may be more conducive to learning. With the patient assuming more and more responsibility for self-care, it is imperative that professionals explore all opportunities to assist patients in acquiring the skills essential to promoting their own well-being.

Aged↗