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PubMedDate not supplied

Reshaping a school health nursing service.

Faced with staff shortages and a recognition that the core health surveillance system in schools could not be sustained, school nurses in one area decided to pool their skills and target surveillance to children with identified needs. Following completion of a pilot programme in October 2002, the school health nursing service has been restructured and now operates in teams who manage a corporate caseload. The core programme includes a targeted health surveillance programme, a programme of health promotion and a referral system that were modelled on the pilot project.

Adolescent↗
PubMed2005

Data management and preliminary data analysis in the pilot phase of the HUPO Plasma Proteome Project.

The pilot phase of the HUPO Plasma Proteome Project (PPP) is an international collaboration to catalog the protein composition of human blood plasma and serum by analyzing standardized aliquots of reference serum and plasma specimens using a variety of experimental techniques. Data management for this project included collection, integration, analysis, and dissemination of findings from participating organizations world-wide. Accomplishing this task required a communication and coordination infrastructure specific enough to support meaningful integration of results from all participants, but flexible enough to react to changing requirements and new insights gained during the course of the project and to allow participants with varying informatics capabilities to contribute. Challenges included integrating heterogeneous data, reducing redundant information to minimal identification sets, and data annotation. Our data integration workflow assembles a minimal and representative set of protein identifications, which account for the contributed data. It accommodates incomplete concordance of results from different laboratories, ambiguity and redundancy in contributed identifications, and redundancy in the protein sequence databases. Recommendations of the PPP for future large-scale proteomics endeavors are described.

Algorithms↗
PubMed2004

The Overseas Service Veteran (OSV) At Home Pilot: how choice of care may affect use of nursing home beds and waiting lists.

In 1999 Veterans Affairs Canada (VAC) implemented the Overseas Service Veterans (OSV) At Home Pilot Project in response to the problem that a growing number of clients were on waiting lists for beds in long-term care facilities. The At Home pilot offered certain clients on waiting lists, who met nursing-level care and military-service requirements, access to home care and treatment services for which they had previously been ineligible. A review of the pilot showed that a large majority of clients preferred to remain at home, with support, rather than accept a long-term care placement, even when a bed became available. The pilot has helped reduce waiting times for nursing home beds and may have important implications for reducing costs and the demand for long-term care beds.

Canada↗
PubMed1998

A pilot study on improving oral care in long-term care settings. Part I: Oral health assessment.

Surveys of oral health in long-term care (LTC) settings have consistently documented low levels of health. In the complex LTC environment, programs to improve oral health have yet to be well defined. The purpose of this pilot project was to determine if a program of training for nursing assistants in combination with adjunctive aids to oral care could improve resident oral health indicators. This pilot study demonstrated improved oral health indexes among residents cared for by trained nursing assistants who had access to adjunctive oral care aids. Additional studies are needed to define the nature of oral caregiving in LTC settings as well as specific regimens which can assure continued oral health improvement in this environment.

Aged↗
PubMedDate not supplied

Chemotherapy standards for hospital in the home: how useful?

The process of developing practice standards is complex and resource intensive. The aim is to produce standards that meet the practicalities of clinical practice, are meaningful and achievable and that enhance the quality of patient care. This article details the process of developing chemotherapy standards for Hospital in the Home (HITH) and describes the results of a pilot project and the implications for nursing practice in this relatively new area of care delivery. Five Melbourne metropolitan Hospital in the Home (HITH) programs participated in the pilot process and evaluated the standards against their own programs. There was a wide variation in the skill sets nurses required depending on the structure of the HITH program. There were differences between programs in the nature of the interventions provided at home, documentation of treatments and points of contact for patients out of hours. Areas of concern identified by staff in the participating programs included the level of detail the standards required for assessment of the patients' home as an appropriate site to administer chemotherapy and the qualifications required by staff managing HITH chemotherapy patients.

Community Health Nursing↗
PubMed1998

[Four year's experience with quality assurance in anesthesiology in Hamburg].

PURPOSE: Since 1992 421,851 anaesthesias were documented by 39 institutes with a standard dataset issued by the German Society of Anaesthesiology and Intensive Care (DGAI). The project was run by the Association for Quality Assurance (EQS) in Hamburg. Some results of the evaluation of this datapool are presented questioning the feasibility of the project to support improvement processes within the participating institutions and which adjustments should be done considering these experiences. METHODS: Data from machine-readable protocols and documentation software representing all anaesthesia cases were recorded since 1992 in a pilot project and since 1994 compulsory with a standard dataset issued by the DGAI. Comparing statistics of these data was produced at the EQS project office. In the steering committee and in meetings of the project participants the contents, policy and results of the project office. In the steering committee and in meetings of the project were critically analysed and adjustments initiated whenever necessary. Validity of data and feasibility of the method used was also questioned on the background of comparable studies. RESULTS: With an incidence of 14.1% of all anaesthesias with special occurrences (AVB) the results are in the same range if compared with most other studies. However, documentation of data is not complete. This is assumed to be due to the large size of the dataset with 112 items and the additional workload associated with it. Nevertheless the participants mostly consider the project to be a very useful support for internal improvement projects. CONCLUSION: The project method used so far is not mature yet. The data set must be streamlined and rendered more concise, quality indicators should be defined and tested, and the availability of statistically proven limits of tolerance should be the immediate aims in the further development of the project.

Adult↗
PubMedDate not supplied

Training people with HIV disease for involvement in community planning process: Project LEAP. Learning Empowerment Advocacy, Participation.

Social and political pressure, as well as public health theory, mandate inclusion of PLWHIV in community planning and policy development processes. Barriers to PLWHIV participation may be cognitive, instrumental, and/or affective. The authors report on development, implementation, and initial evaluation of a pilot project testing a psychoeducational intervention to increase organizational participation by people with HIV. Organizational participation by individual increased from a mean of 0.5 organizations at entry to 2.3 at follow-up. Evaluation data indicate that increases in self-esteem, self-confidence, and specific knowledge, along with demystification of organizational operations, networking, and modeling by project staff contributed to the outcome.

Adult↗
PubMedDate not supplied

Incentivized digital outcomes collection.

The objective of this study was to assess the feasibility of digital patient satisfaction outcomes collection using the Internet and interactive voice response technology. Patients, health care providers, and industry sponsors were provided with incentives to participate. The participants included the practitioners and patients in medical and surgical practices who used Project Quality Card (patent pending) and the Practice Improvement Program. The study subjects were convenience samples of new and established patients seen between September 1999 and December 2000. There were 3 different pilot projects: QC1, QC2, and QC3. Patients were provided with a 20-minute prepaid phone card as an incentive for completing an interactive voice response call. Patients answered the 9-item visit rating questionnaire used to measure patient satisfaction. Patients responded on a 5-point scale, with 5 being excellent, and responses were totaled in the categories of patient access and physician attributes and in an overall score for the visit. A total of 998 patients from 77 physician offices participated. The activation responses, or percentage of patients using the Quality Cards, ranged from 12.8% in group 2 (QC2) to 26.6% in group 1 (QC1) to 34.8% in group 3 (QC3). This study demonstrates that incentivized digital outcomes collection can be successfully implemented in multisite community-based medical and surgical offices. The use of Project Quality Card (interactive voice response technology) and the Practice Improvement Program provides opportunities for user-friendly, benchmarked, real-time data collection. The percentage of patient activations is linked to provider participation in quality improvement programs. Patient participation is improved as the frequency of contact with a peer-directed database increases.

Data Collection↗
PubMedDate not supplied

A collaborative preceptor model for clinical teaching of beginning nursing students.

With decreased clinical and faculty resources, monitoring students in the clinical area for safety and progress can be difficult. The authors discuss a project that used preceptors for selected beginning students to address issues related to high student-to-faculty ratios, individualized teaching, role modeling, and increased faculty time for scholarship. Based on student evaluation of the pilot project, the authors recommend using nurse preceptors for teaching beginning nursing students.

Cooperative Behavior↗
PubMed1999

A clinical project to evaluate reuse of a CAPD disconnect system minicap as a safe, effective practice.

The current health care environment is being driven by approaches to health care services that focus on quality and at the same time cost-effectiveness. With this in mind, a clinical project was designed to investigate the possibility of reusing the disconnect minicap as a safe, effective clinical practice. During a two-phase project, continuous ambulatory peritoneal dialysis (CAPD) disconnect caps were purposely touch contaminated and cultured before and after povodine iodine was instilled in the minicap. During the second phase of the project a simulated peritoneal effluent system was constructed and fluid cultures obtained. The specimen analyses demonstrated negative reports of the minicap after dwelling in povidine iodine and fluids after reuse of the minicap. The pilot project opens an area of research for nephrology nurses that could potentially lead to cost savings in the provision of care for patients with chronic renal failure.

Anti-Infective Agents, Local↗
PubMed1998

G7: a framework for international cooperation in medical informatics.

The world's major economic powers, the G7, have initiated a collaborative International research and demonstration program to exploit the benefits of information and communications technology for society. The Global Healthcare Applications Project (GHAP) is investigating a variety of informatics applications in disease specific domains, telemedicine, and multilingual textual and image database systems. This paper summarizes the nine GHAP sub-projects undertaken to date, with emphasis on those in which the U.S. is a participant. The growing use of smart card technology, especially in Europe, is adding new impetus for similar medical and health experiments in the U.S. A pilot project now underway in several Western states is described.

Computer Communication Networks↗
PubMed1991

Identification of nontraditional dental hygienists and their educational degrees. A strategy for baccalaureate program recruitment.

A pilot project was conducted to increase student applicant interest in a degree-completion program. Since applicants reported a preference for employment in nontraditional settings, and questioned whether further education was needed, a strategy was developed to identify dental hygienists in Michigan who were so employed, and to establish their educational levels. Through telephone interviews, nontraditional dental hygienists were asked to identify additional professionals that were known within the nontraditional network. Nontraditional employment was defined as any setting other than a private dental office, with job responsibilities not confined to patient care; dental hygiene educators were excluded. The interviews were conducted by one graduate student, one day a week, for 15 weeks. The interviewer generated a list of 44 Michigan dental hygienists employed in nontraditional job settings as defined in this study. In terms of educational levels, 23% had certificate/associate degrees (n = 10) as their highest degrees, 41% had bachelor's degrees (n = 18), and 36% had master's degrees (n = 16). Non-patient care was the job description for 93% of the nontraditional settings (n = 41). The implied need for baccalaureate and/or graduate education for nontraditional employment has positively affected recruitment for the degree-completion program. The relationship that has been established with the network of nontraditional dental hygienists has also improved recruitment efforts and enhanced the curriculum. This project suggests that the definition of nontraditional dental hygiene employment should not be limited to settings which involve patient care. Similar projects should be initiated in other states to improve interest in baccalaureate education.

Dental Hygienists↗
PubMed1993

Promoting the health promoting school.

The Health of the Nation strategy commits the government to establishing a national network of health-promoting schools. Alysoun Moon describes an independent pilot project in Wandsworth, south London which is pioneering the concept in ten selected primary schools.

Child↗
PubMed1995

Te mahi niho hauora ki Ratana Pa: the dental health project at Ratana Pa.

Following the success of a dental health project provided for Maori communities along the Wanganui River by the Royal New Zealand Dental Corps, the people of Ratana Pa, 20 km south of Wanganui, requested a similar service. Funding for a pilot project was provided by the Central Regional Health Authority through Good Health Wanganui. The project was a joint venture between the Health Committee of Ratana Pa and Dental Health of Good Health Wanganui. The dental health of the people at Ratana Pa was generally poor, featuring a high rate of decay and serious periodontal disease. Severe halitosis was common. As a result of poor oral health, many patients, especially young women, were whakama, a state of embarrassment and shame that caused them to keep their teeth hidden. An increase in self-esteem and greater interest in dental health occurred after treatment. A second treatment phase began in March 1995. This community-driven Maori health initiative, in partnership with a Regional Health Authority, fulfils obligations under the Treaty of Waitangi.

Adult↗
PubMed2005

Costs of a home-based rehabilitation program for older adults after lower limb orthopedic surgery: a pilot study.

Little is known about the cost of home-based rehabilitation programs in Quebec, Canada. The objective of this pilot project was to test a cost estimation methodology in the context of rehabilitation services delivered at home and to provide preliminary data on the costs for lower limb orthopedic surgery patients. This pilot study examined a short-term home care program for adults, aged 65 and over who returned home after lower limb surgery and required rehabilitation services. Efficacy was determined as the functional autonomy changes between admission and discharge from home rehabilitation program, as measured by the functional autonomy measurement system (SMAF). Costs of professionals, including direct and indirect time related to the intervention, were also determined in order to document cost-effectiveness of the program. Eighteen subjects were recruited. From those, 14 had complete data available for the analysis. The result shows that costs related to the combined natural improvement and the effect of the home-based rehabilitation program were CAN dollars 419 per unit of change of functional autonomy. The results of this pilot study confirm the feasibility of the cost estimation methodology for a home-based rehabilitation program.

Aged↗
PubMed1994

Mandibular premolar differentiation.

The authors present a method for differentiating between human mandibular premolars: P1 inf and P2 inf. The material with which the method was developed consisted of 260 stone casts. On these, both premolars were present and were intact on at least one side. The study models represented 131 girls and 129 boys, mean age 14.6 yr. In a comprehensive pilot project, a whole range of macromorphologic criteria was tested that, in various combinations, could be expected to be usable for differentiation between P1 inf and P2 inf. On the basis of the pilot study, the total variation was reduced to four criteria-combinations, called types, which, in summary, can be characterized as the following: type 1: flattening of the mesiolingual part of the crown, no lingual lobe; type 2: at least one lingual lobe; type 3: lingual part of the crown symmetrically curved, no lingual lobe; type 4: other characteristics. After definition of the types, their occurrence on P1 inf and P2 inf was definitively registered. Observations were made with a stereomicroscope; 131 premolar pairs from the right side and 129 from the left were registered. Statistical tests showed that there was no significant difference in the distribution of types between variants from the right and left sides, or between girls and boys. These data were therefore pooled for P1 inf and P2 inf, respectively. A subsequent test revealed, as expected, a highly significant difference in the distribution of the four types among 1. and 2. premolar.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2003

"Where does the damp come from?" Investigations into the indoor environment and respiratory health in Boston public housing.

The self-reported prevalence of asthma increased by 75% from 1980 to 1994, a trend found to be significant and evident in every region of the country. The increase has been most marked in children 0-14 years of age, and there is evidence that, as with lead poisoning, inner-city and urban populations are most at risk. Attention has turned to the role of indoor environment risk factors, especially in homes and schools. Such factors include moisture and mold growth, pest infestation, dust mites, the building envelope, heating systems, inadequate ventilation, NO2, and environmental tobacco smoke. The Healthy Public Housing Initiative (HPHI) is a Boston-based community-centered research and intervention project designed to engage Boston Housing Authority residents in a collaborative process to improve respiratory health, quality of life, building conditions, and building maintenance in public housing. This article summarizes the significant research findings from four pilot studies in housing developments that lay the foundation for the larger HPHI asthma-related environmental intervention study. The research design for the pilot projects is informed by principles of community-collaborative research. The strengths of this model of research to our work are also discussed.

Adolescent↗