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At least 775 records · Page 43Linked to original sources
PubMed1991

Audit of the effect of a nurse run asthma clinic on workload and patient morbidity in a general practice.

The aim of this study was to assess the effect of a nurse run asthma clinic on practice workload and the morbidity of patients in a four partner general practice. One hundred and fifteen asthmatic patients were studied and comparisons were made between the 12 months prior to the introduction of the clinic and the first 12 months after the clinic started. Morbidity was measured in terms of: the number of courses of oral steroids, the number of emergency salbutamol nebulizations, and the number of days lost from work or school. The number of consultations with the general practitioners were recorded. The repeat prescribing register was also monitored throughout the study to examine the effect of the clinic on prescribing in the practice. Consultations with general practitioners fell from a total of 818 to 414 during the study period (P less than 0.001). This was offset by 496 consultations with the nurse in the first 12 months of the clinic. As a result of attending the nurse clinic significant reductions (P less than 0.01) were found in the patients' requirements for courses of oral steroids, acute nebulizations and days lost from work or school. The results for the 46 children were similar to those for the 69 adults, confirming that the asthma clinic was effective for all ages. The clinic coincided with an increase in the number of patients receiving regular bronchodilator therapy and prophylactic medication. Eighty per cent of patients had their medication modified as a result of attending the clinic. The cost of prescribing remained remarkably stable.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1995

[Statistical study of workload at a birthing unit].

The work consists of a statistical study of the workload on a labour ward. This included a study of the admission/birth frequency and an investigation of the factors that influenced the process of admissions and the time spent on the ward. Also the relation between the number of midwives and women in labour present on the ward was investigated. It was found that the variation in the number of spontaneous admissions/births could be described reasonably well by a Poisson distribution. A simple statistical model was proposed to calculate the number of midwives necessary at any given birth frequency. For a specific choice of parameters the model fitted the actual distribution very well. The relative frequency of complications was highest for women with no previous births and smallest for women with one previous birth. The time spent on the labour ward depended significantly on the number of times the woman had given birth before and on whether the present delivery was complicated.

Delivery Rooms↗
PubMed1995

In-patient workload in medical specialties: 2. Profiles of individual diagnoses from linked statistics.

We analysed hospital use for 58 common clinical conditions in the medical specialties, using data from the two districts covered by the Oxford record linkage study 1968-1986. Episode rates, person rates, and ratios of multiple admissions per person were computed. In young adults, poisoning was the most common reason for admission. In older adults, the most common clinical conditions included atherosclerotic diseases and smoking-related lung diseases. Comparing the first and last time periods studied, admission rates increased by 10% or more in 37 of the 58 conditions, including 7 of the 10 conditions with the highest overall hospitalization rates. Conditions in which admissions increased by 10% or more included myocardial infarction, other ischaemic heart disease, chronic obstructive lung disease, asthma, pneumonia, diabetes, poisoning, dementia, prostate cancer and breast cancer among others. Workload declined by 10% or more in 13 conditions, including stroke, subarachnoid haemorrhage, hypertension, thyrotoxicosis, acquired hypothyroidism, and tuberculosis. Secular trends in hospital use are generally attributable either to changes in disease frequency in the population or to changes in clinic- or hospital-based technology and practice.

Adolescent↗
PubMed1995

Effects of workload on residents' sleep duration: objective documentation.

Sleep-wake cycles of 27 residents from the 800-bed Rambam hospital, which serves the northern part of Israel, were investigated by wrist-worn actigraphs. Fifteen subjects (aged 30.6 +/- 4.6) worked in wards with a "heavy" workload, and 12 (aged 35 +/- 2.6) in wards with a "light" load. There were significant differences among the residents in sleep duration. Residents working in the emergency room had the shortest sleep periods, and those working in "light" wards had the longest. There was no significant increase in sleep duration the day after the night "on call." Sleep duration was significantly negatively correlated with the number of new admissions, and with the subjective daily assessment of work load. It is concluded that residents working in wards with a heavy load suffer from chronic partial sleep deprivation, which should be taken into consideration in residents' work regulation.

Adult↗
PubMedDate not supplied

A computerized system to improve documentation and reporting of pharmacists' clinical interventions, cost savings, and workload activities.

A major factor in delivering patient care is documenting activities by pharmacists. This documentation is not only essential to sustain existing programs but necessary to justify future growth of resources. A computerized documentation system for clinical interventions and workload activities was developed in a 340-bed university teaching hospital. With the expansion of its pharmaceutical care model, the department reworked its distribution process to allocate more pharmacist time for patient care. Manual documentation of these services, however, soon was identified as an obstacle. A software program was developed to alleviate the problems inherent with manual documentation. This "user-friendly" program tracks clinical recommendations and interventions by pharmacists, and calculates cost savings/avoidance. It also facilitates monthly and annual reporting for department managers.

Clinical Pharmacy Information Systems↗
PubMed1994

Organophosphate poisoning in a factory: relationship to workload and production volume.

In Singapore, all workers exposed to organophosphate compounds are required to undergo Statutory Medical Examinations. In this paper, the relationship between workload and worker exposure to these compounds is illustrated. In addition, the importance of performing detailed clinical examinations and baseline red blood cell acetylcholinesterase estimations for all organophosphate exposed workers is emphasised.

Acetylcholinesterase↗
PubMed1993

Study of workload of general medicine specialists working in the health insurance clinics.

This study was conducted at 4 of the H.I.O. polyclinics in Alex. with the objective of examining the change in visit rate per 1000 beneficiaries for general medicine specialty at H.I.O. clinics during a 4-year period (1985-1988) and to detect any trends that may have a bearing on the H.I.O. standards for supply of specialists. Data were collected from H.I.O. statistics department, H.I.O. regulations, and also through researcher's observation and specialists' interview. The collected data was used to describe the workload in terms of annual visit rate, actual number of working hours, the specialists' average production hours per day, the specialists' average idle time per day, the estimated number of required specialist working hours per day, and the specialists' recommended working hours per day. The results revealed a rising trend in the rate of use of general medicine specialist services and a definite shortage of supply of general medicine specialists was found in all clinics compared to H.I.O. standards. On the other hand, recommended supply based on specialist opinion was less than the H.I.O. standards but more than the current supply. Accordingly H.I.O. should re-estimate the specialist population standard and should seek the commitment of specialists to the revised standards.

Attitude of Health Personnel↗
PubMed1994

Tracking of reports and workload through the Quality Assurance Unit.

In summary, this documentation has aided the QA Unit in several ways. First, it has created a method for documenting and establishing the need for additional QA personnel as workload increases. Second, it serves as a tool for evaluating the individual performance of the QA Auditors. Third, it documents the individual reports as to when they were received and released by QA, forming a chain of custody for the reports.

Documentation↗
PubMed1994

Balancing workloads under GP attachment.

Alignment with a GP practice resulted in fluctuating workloads for health visitors Lynda Brooks, Caro Fickling and Caroline Walker. Here they describe how the introduction of a corporate caseload helped to restore balance.

Community Health Nursing↗
PubMedDate not supplied

An analysis of medical workload--evidence of patient to specialist mismatch.

The National Health Service has employed physicians since its inception, yet 46 years later there are few data on the day-to-day work done by physicians. This paper describes the case mix of general medicine in one region using data for general medical admissions to one specialty (respiratory medicine) as a working example. The pattern of general medical inpatient admissions is consistent across the 10 districts in the Mersey region: 26% have a respiratory diagnosis, 22% cardiac, and 15% gastrointestinal. For medical day cases, 60% are gastrointestinal. The average length of stay for particular conditions varies little between hospitals, and the average consultant 'cares' for 949 consultant inpatient episodes per year. In only half the Mersey districts is the respiratory consultant provision appropriate for the case mix admitted to the hospital. A simple algorithm applied to data collected routinely by regional health authorities can yield much information upon which to plan medical manpower. Applied to a specialty, it has identified mismatches between workload and consultant type. For respiratory medicine, at least six more respiratory physicians (a 30% increase) are needed to correct the underprovision in Mersey region.

Diagnosis-Related Groups↗
PubMedDate not supplied

Measuring nursing workload for case costing.

It is important for nurse executives to understand the consequences of different methods of measuring nursing costs in determining total patient care costs. Nursing is the largest component of a case cost and the study reported in this article examined the impact of using different nursing workload measurement systems in developing case costs and how they relate to nurse executives. The considerable consequences of these findings for case costing are discussed.

Costs and Cost Analysis↗
PubMed1994

Practice nurses: characteristics, workload and training needs.

AIM: This study set out to identify the present and future training needs of practice nurses in South West Thames Regional Health Authority and to examine these needs within the nurses' current and changing workloads and social, educational and occupational profiles. METHOD: A questionnaire was sent to 899 practice staff identified by family health services authority records whose salaries were in part reimbursed and in whose job title the word nurse appeared. The questionnaire enquired about personal and practice demography, tasks and activities currently undertaken, perceived role development and training requirements, and preferred organization of training. RESULTS: A total of 620 completed questionnaires were returned (69%). Nurses' work involved treatments, immunizations investigations, administration, first contact with patients, support to the general practitioner and health promotion. The areas of role development selected most commonly by nurses were counselling skills (60%) and health promotion (54%); in terms of training the most popular areas were communication skills (62%) and the theory and practice of health promotion (48%). Fewer than one third of the nurses who were engaged in health checks for elderly people or the provision of diabetes care, asthma care or advice about the human immunodeficiency virus (HIV) and the acquired immune deficiency syndrome (AIDS) held an appropriate qualification. CONCLUSION: Practice nurses in the region were engaged in a wide range of activities for which many have had little formal training; the majority wished to develop their role and undertake further training. If practice nurses are to play a key part in the development of primary care services they must be adequately prepared for their clinical and health promotion role.

Education, Nursing, Continuing↗
PubMed1993

Why measure workload?

There have been calls for the objective measurement of nurses' workload since the 1920s. As demands on nurses' time grow, this is becoming increasingly important to ensure cost-effective care.

Humans↗
PubMed1995

Promoting measure of nursing care workload through computerization.

In order to obtain a global approach of the patient centered activity and relative costs, we propose to add to the DRG a care workload evaluation. Such an application was developed and integrated to the automated medical record implemented in each medical department of the hospital. The "Soins Infirmiers Individualisés à la Personne Soignée" (SIIPS) indicator was chosen to estimate nursing acuity. Implementation of the application in ten departments and first results permit to demonstrate the system feasability and the fiability of this indicator. These conclusions conducted us to propose the extension of this experimentation to all the clinical departments of the hospital before the end of 1995.

Diagnosis-Related Groups↗
PubMed1996

Analysis of labor and delivery workload.

An inexpensive method of determining the staffing requirements for a labor and delivery unit is described. Data were collected hourly by an independent observer to determine the workload by hour of day in this unit. By matching RN staffing with the pattern of activity, implementing cost training and developing guidelines to respond to volume changes, the cost per delivery has increased only 16% since 1988.

Cost Control↗
PubMedDate not supplied

Validity and reliability of nursing workload measurement systems: review of validity and reliability theory.

Nursing workload measurement systems (WMSs) are used in inpatient and outpatient settings for staffing, scheduling, and budgeting. The nurse administrator can use WMS data to make wise decisions in these key areas providing the data are reliable and valid. Unfortunately, in most institutions, attention to issues of reliability and validity occurs only at system implementation and then the systems are left unattended. This article provides an overview of validity and reliability as it relates to WMSs. Part Two of this article will demonstrate how validity and reliability theory can be operationalized in an ongoing program for maintaining WMS reliability and validity.

Humans↗
PubMedDate not supplied

Workload measurement and psychiatric mental health nursing: mathematical and philosophical difficulties.

There are difficulties with implementing workload measurements instruments and patient classification systems in psychiatric settings. These instruments are designed at a ratio level of measurement. This would be valid only if nursing practice existed at a similar level. The nurse-client relationship is considered to be the essence of psychiatric nursing and this phenomena is described as ordinal level phenomena. In psychiatric nursing, it is essential to consider the nurse as well as the client, and to assess the current phase of the relationship. There is a need to balance the economic pressure for justification by numbers with the realization that many aspects of nursing practice are not measurable as reducible phenomena nor exist at a ratio level.

Humans↗