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Biomedical subjects

V T Grando

Publications and source records attributed to V T Grando.

11 recordsLinked to original sources
PubMed2000

Initial field testing of an instrument to measure: observable indicators of nursing home care quality.

The "Observable Indicators of Nursing Home Care Quality" instrument was developed as a new measure of nursing home care quality. The instrument is based on a theoretical model of quality nursing home care grounded in data from provider and consumer focus groups. The instrument was piloted in 10 Missouri nursing homes. Subsequent versions were tested in 109 Missouri and 11 Icelandic nursing homes. Content validity was established using experts. Concurrent and known groups validity was evaluated using Minimum Data Set quality indicators, survey citations, and a process of care measure. Interrater and test-retest reliabilities were calculated as well as coefficient alpha. The "Observable Indicators of Nursing Home Care Quality" instrument is a new measure that can be used by researchers, and potentially by regulators, consumers, or providers, to observe and score specific indicators of quality care following a 20- to 30-minute inspection of a nursing home.

Focus Groups↗
PubMed2000

Light care residents in nursing homes: why they come, why they stay.

With the increasing numbers of frail elderly, why light-care nursing home (NH) residents enter and remain in NHs is important to understand. Light-care residents (n = 98) from 11 NHs and their nurses were interviewed using open-ended questionnaires. Residents' care requirements were estimated using Resource Use Groups, Version III (RUG-III). We found that residents entered and remain in NHs because of the inability to perform instrumental activities of daily living, the fear of injury, ambulation problems, health problems, the lack of daily assistance, and a recent hospitalization. Most residents and nurses did not know of other options. These problems could be managed in the community if appropriate systems were in place.

Activities of Daily Living↗
PubMed2000

Improving quality of care in nursing facilities. Gerontological clinical nurse specialist as research nurse consultant.

It is becoming increasingly common for nursing facilities to use Quality Indicators (QI) derived from Minimum Data Set (MDS) data for quality improvement initiatives within their facilities. It is not known how much support facilities need to effectively review QI reports, investigate problems areas, and implement practice changes to improve care. In Missouri, the University of Missouri-Columbia MDS and Nursing Home Quality Research Team has undertaken a Quality Improvement Intervention Study using a gerontological clinical nurse specialist (GCNS) to support quality improvement activities in nursing homes. Nursing facilities have responded positively to the availability of a GCNS to assist them in improving nursing facility care quality.

Aged↗
PubMed1999

Nursing home care quality: a multidimensional theoretical model integrating the views of consumers and providers.

This exploratory study was undertaken to discover the defining dimensions of nursing home care quality from the viewpoint of consumers of nursing home care. Eleven focus groups were conducted in five Missouri communities. The seven dimensions of the consumer multidimensional model of nursing home care quality are: staff, care, family involvement, communication, environment, home, and cost. The views of consumers and families are compared with the results of a previous study of providers of nursing home services. An integrated, multidimensional theoretical model is presented for testing and evaluation. An instrument based on the model is being tested to observe and score the dimensions of nursing home care quality.

Attitude of Health Personnel↗
PubMed1999

Minimum Data Set and Resident Assessment Instrument. Can using standardized assessment improve clinical practice and outcomes of care?

Regulating and standardizing the assessment of residents was envisioned by the 1986 Committee on Nursing Home Reform to have many advantages for facility management, government regulatory agencies, and clinical staff to evaluate changes in resident status and adjust the care plans accordingly. Standardized assessment data was viewed as a source of management information to be used to track case mix (i.e., acuity) of residents, allocate resources such as staff, and evaluate care quality. The Resident Assessment Instrument is a clinically relevant assessment process that can facilitate effective care planning, interventions, and quality improvement. It is a clinically complex process requiring care delivery systems developed by RNs to support the implementation of individualized care.

Aged↗
PubMed1998

Making do with fewer nurses in the United States, 1945-1965.

PURPOSE: To analyze the perceptions that nurses and hospital administrators had about the nursing shortage between 1945 and 1965 and the actions they took. Reasons nurses' wages remained low during this period of shortages and high demand were also examined to expand knowledge of nursing labor during a critical time in nursing history. METHOD: Historical analysis of primary and secondary sources generated between 1945 and 1965 including: (a) American Nurses' Association's (ANA) central files in Washington, DC; (b) ANA archives at the Mugar Memorial Library, Boston University; (c) official proceedings of the ANA's and American Hospital Association's (AHA) conventions; (d) nursing and hospital journals; (e) ANA and U.S. Government statistical documents and reports on the status of nursing labor; and (g) monographs on nursing, hospitals, the history of women's labor and the history of women in the 1940s, 1950s, and 1960s. FINDINGS: Hospital administrators and nurses disagreed on the causes of the nursing shortage and its remedies in the 20 years after World War II. Hospital managers believed the shortage occurred because many nurses left the work force to remain at home with their families. Nurses, however, identified low wages and deplorable working conditions as the cause. CONCLUSIONS: Hospital managers were successful at easing the shortage and controlling nursing costs by employing ancillary workers to replace RNs. Nurses took several different actions to deal with poor working conditions: initiating the ANA Economic Security Program, joining unions, and leaving hospital nursing.

History, 20th Century↗
PubMedDate not supplied

The ANA's Economic Security Program: the first 20 years.

This historical study is an analysis of the American Nurses Association's (ANA) Economic Security Program (ESP) from 1946 to 1966. Primary data sources include ANA Biennial Convention proceedings, ANA headquarters files, the ANA Collection at Mugar Memorial Library, and selected nursing journals. The findings indicate that although ANA took a bold step in initiating the ESP and collective bargaining, the ESP was minimally effective for several reason: nurses would not support collective bargaining, hospitals would not negotiate with nurses, ANA would not use coercive tactics, and hospitals were not included under existing labor laws. As a result, ANA resorted to an old tactic, education, to secure its economic goals.

American Nurses' Association↗
PubMedDate not supplied

Prevalence, incidence, management, and predictors of venous ulcers in the long-term-care population using the MDS.

OBJECTIVE: To describe the prevalence, incidence, management, and predictors of venous ulcers in residents of certified long-term-care facilities using the Minimum Data Set. DESIGN: Retrospective cohort study. SETTING AND PARTICIPANTS: 32,221 residents admitted to long-term-care facilities in Missouri between January 1, 1996, and October 30, 1998. MAIN OUTCOME MEASURES: Version 2.0 of the Minimum Data Set was utilized. Assessment items included selected measures from background information, disease diagnoses, physical functioning and structural problems, health conditions, oral/nutritional status, and skin condition. MAIN RESULTS: Venous ulcer prevalence on admission was 2.5%. The incidence of venous ulcer development for long-term-care residents admitted without an ulcer at 90, 180, 270, and 365 days after admission was 1.0%, 1.3%, 1.8%, and 2.2%, respectively. The most frequent skin treatments for residents with a venous ulcer were ulcer care, dressings, and ointments. Factors associated with venous ulcer development within a year of admission were diabetes mellitus, peripheral vascular disease, and edema. CONCLUSION: Venous ulcer prevalence and incidence are greater in the long-term-care population than in the community at-large. Residents with a venous ulcer are likely to have comorbid conditions such as diabetes mellitus, peripheral vascular disease, congestive heart failure, edema, wound infection, and pain. Based on these data, risk factors such as history of leg ulcers, recent edema, diabetes mellitus, congestive heart failure, or peripheral vascular disease should prompt clinicians to carefully plan care that will manage a resident's risk for venous ulcer development.

Activities of Daily Living↗