Improving home care. A survey on physician and nurse communication

Home health care is growing, and phone calls between physicians and home care nurses are essential to successful home care patient management. This preliminary study analyzed several aspects of the physician and home health nurse telephone communication, including effectiveness, time expenditure, percentage of calls resolved by physicians, and documentation of phone contacts between 90 medical/surgical physicians and six home health nurses in Cleveland, Ohio. The phone conversations involved 154 patient contacts during a 3-month period. Overall, we found 75% of the home calls were effective. Eighty-five percent of calls required 15 minutes or less for completion, 47% of nurse-generated calls were resolved by physicians, and 26% of calls were documented in the patient's medical record. Our results illuminated several aspects of home care communication amenable to improvement.     

Home care aide retention: building team spirit to avoid employee walkouts

While home care agencies work to increase productivity and decrease costs, it is easy to lose sight of the value of employees. Because home care aides are seldom in the office, their value to the organization may get overlooked. In this article, one home care agency shares ways to build team spirit among the home care aides and empower them to be better employees. The result has been increased productivity, improved morale, and a more stable workforce.     

A critique of multiculturalism in heath care: the challenge for nurse education

This paper is concerned with the way in which discussions of the health status of people from minority ethnic groups and the delivery of health care to such groups has been constructed, in the nursing literature in particular, within a culturalist framework which has many serious drawbacks. The paper reviews the argument for a 'multicultural' approach to health care and also discusses some of the main implications of this analysis for the education of health professionals. It suggests that health workers and those responsible for the education of such workers, need to reassess learning needs in the light of a critique of the effects of an analysis based on 'cultural pluralism' and 'ethnic sensitivity'. The paper suggests ways in which the nursing curriculum must be broadened to take into account the limitations of a culturalist approach and to debate the interplay of racism and other structures of inequality and their influence on health and on a service delivery.     

A missed opportunity: master's education for certified nurse practitioners

Many nurse practitioners were prepared in nondegree certificate programs and lack academic credentials desired in today's marketplace. The history of nurse practitioner education is reviewed, and a master's completion program for certified nurse practitioners is presented.     

Implementing nurse sensitive outcomes into care planning at a long-term care facility

This article describes one long-term care facility's efforts to implement standardized language in the care planning process. Federal regulations for long-term care mandate the use of a uniform comprehensive assessment tool. Eighteen Resident Assessment Protocols (RAPs) are identified for data collection. Computer databases were revised for care planning. Appropriate North American Nursing Diagnosis Association (NANDA) diagnoses were linked to each RAP. Nursing-Sensitive Outcomes (NOCs) were linked to each NANDA as goals. Nursing Interventions Classifications (NICs) were linked to NANDA diagnosis and NOC outcomes as approaches. The databases are illustrated, and frequently used NANDAs and NOCs are identified.     

A primary care nurse clinic

A nurse-driven clinic that uses a client-centered approach evolved from an independent ambulatory care program. The clinic operates 4 to 5 hours per day and provides patient counseling, health care maintenance, primary care, patient education, and therapeutic care.     

Distinctiveness effects in children's long-term retention.

In 3 experiments, kindergarten and second-grade children's retention was examined in the context of 2 distinctiveness manipulations, namely, the von Restorff and bizarre imagery paradigms. Specifically, children learned lists of pictures (Experiments la and lb) or interactive images (Experiment 2) and were asked to recall them 3 weeks later. In Experiments la and lb, distinctiveness was manipulated perceptually (changing colors) and conceptually (changing categories or switching to a numeral), whereas in Experiment 2, distinctiveness concerned the interaction (common or bizarre) between the referents. The results showed that (a) older children retained more information than younger children, (b) younger but not older children failed to benefit from numerically distinct information, and (c) distinctiveness in other domains facilitated children's retention. These results highlight the importance of distinctive information in children's retention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Improving neglected influenza vaccination among healthcare workers in long-term care

OBJECTIVE: To increase utilization of influenza vaccination among long-term-care health workers. DESIGN: Before-after intervention study. SETTING: A 300-bed life-care community served by 195 staff employees. INTERVENTION: An educational intervention followed by a Vaccination Fair. MEASUREMENTS: Percent receiving vaccination. A post-intervention survey was used to define staff attitudes towards vaccination. RESULTS: Use of influenza vaccination among staff increased from 8% the previous year to 46% during a Vaccination Fair and to 54% during a similar Fair the next year. CONCLUSIONS: Organized institutional efforts to promote immunization among health-care workers, such as a Vaccination Fair, improves compliance among health-care workers.     

Interference effects in young children's long-term retention.

Classical interference effects were examined in preschool and kindergarten children's paired-associate recall (Experiment 1) and free recall (Experiment 2). Children in the control conditions learned a single picture list, whereas children in the experimental conditions learned 2 picture lists in succession. After 24 hr, children recalled items from the one list they had learned (control conditions), items from only List 1 (retroactive interference conditions), or items from both lists (modified free-recall conditions). Analyses based on the trace-integrity framework indicated that (a) children were susceptible to interference, (b) the locus of interference effects was at storage, (c) both younger (preschool) and older (kindergarten) children experienced similar amounts of interference, and (d) variations in trace strength generally did not modulate the magnitude of interference effects. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health care policy and long-term care.

Discusses changes in the age structure of the nation, the locus of care, the nature of disease, and the cost of care as factors that have led to recent proposed revisions in health-care policy. The need for increased future involvement of a rehabilitation philosophy as a response to the current crisis in policy is examined. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrated care management: aligning medical call centers and nurse triage services

Successful integrated delivery systems must aggressively design new approaches to managing patient care. Implementing a comprehensive care management model to coordinate patient care across the continuum is essential to improving patient care and reducing costs. The practice of telephone nursing and the need for experienced registered nurses to staff medical call centers, nurse triage centers, and outbound telemanagement is expanding as the penetration of full-risk capitated managed care contracts are signed. As health systems design their new care delivery approaches and care management models, medical call centers will be an integral approach to managing demand for services, chronic illnesses, and prevention strategies.     

Expanding retrieval practice promotes short-term retention, but equally spaced retrieval enhances long-term retention.

Expanding retrieval practice (T. K. Landauer & R. A. Bjork, 1978) is regarded as a superior technique for promoting long-term retention relative to equally spaced retrieval practice. In Experiments 1 and 2, the authors found that expanding retrieval practice of vocabulary word pairs produced short-term benefits 10 min after learning, conceptually replicating Landauer and Bjork's results. However, equally spaced retrieval produced superior retention 2 days later. This pattern occurred both with and without feedback after test trials. In Experiment 3, the 1st test occurred immediately or after a brief delay, and repeated tests were expanding or equally spaced. Delaying the first test improved long-term retention, regardless of how the repeated tests were spaced. The important factor for promoting long-term retention is delaying initial retrieval to make it more difficult, as is done in equally spaced retrieval but not in expanding retrieval. Expanding the interval between repeated tests had little effect on long-term retention in 3 experiments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Geropsychology in long-term care settings.

Discusses services trained psychologists can offer in long-term care settings for the aged, including individual assessment, psychotherapy, staff training, program consultation, and development. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Osteoarthritis. A continuing challenge

Despite reports of successful cryopreservation of primary human hepatocytes, existing methods do not produce sufficient recovery of viable cells to meet the needs of basic research or clinical trials of hepatocellular transplantation. We now describe a protocol for efficient cryopreservation of primary human hepatocytes using University of Wisconsin (UW) solution, fetal bovine serum, and dimethyl sulfoxide (DMSO). This method provides > 90% viability of differentiated, primary human hepatocytes 8 mo after cryopreservation as measured by trypan blue exclusion, preserves hepatocyte morphology, liver-specific gene expression (alpha 1 antitrypsin), and replication. The effectiveness of UW solution as a cryopreservative agent suggests that metabolic as well as ultrastructural factors may be important in the effective cryopreservation of primary human hepatocytes. The present method represents an effective protocol for cryopreserving differentiated primary human hepatocytes for research. This method may allow characterization and banking of human hepatocytes for clinical applications, including hepatocellular transplantation and hepatic assist devices.     

The effects of item familiarization on the long-term retention of paired-associate lists.

Investigated the effects of prior item familiarization on the acquisition and retention of paired-associate lists. Ss were 32 undergraduates in 8 experimental and 2 control groups. The critical items were trigrams which were paired with paralogs in the paired-associate task. There were 20 trials of learning, and recall was tested after 1 wk. The experimental treatments formed a 2 * 2 * 2 factorial design. Familiarization was either (a) for stimulus or response terms, (b) relevant or irrelevant to the learning task, or (c) at a frequency of 10 or 40 exposures/item. Control groups were given no preliminary training. Performance on the early learning trials was facilitated by response but not by stimulus familiarization. Both relevant and irrelevant response familiarization increased long-term retention losses, whereas stimulus familiarization had no reliable effect on recall. It is concluded that response familiarization is a source of both facilitation and interference. (French summary) (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)