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Trained Nurse (trained + nurse)
Selected AbstractsStandardized health check data from community-dwelling elderly people: the potential for comparing populations and estimating needHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 1 2000Peter Bath PhD Abstract The main aim of this study was to compare EASY-Care data obtained during nurse-administered annual health checks in two populations of older people. A secondary aim was to determine whether a standardized assessment system administered as part of routine practice by a trained nurse during the over-75 health check could generate useful information for comparing population health and functional status of community-dwelling-older people. One hundred and seventy-nine elderly people (aged 75 years and over) from the Woodstock ward, Belfast, having relatively high deprivation; and 238 elderly people from south Hampshire, ranging from affluent wards in New Forest to inner city wards, were assessed using the EASY-Care assessment system as part of their annual health check. There was a high response rate to the standardized assessment in both populations (75% and 79%). Compared to people in south Hampshire, the people in Belfast had higher relative risk of having fair/poor self-rated health, and lower relative risk of having good/sufficient accommodation and of having difficulty chewing. People in Belfast had a higher relative risk of being dependent for six of the seven IADL items and for continence of urine, bathing, grooming, use of the stairs and dressing among the ADL items. The results demonstrate the ability of data generated by assessment system to discriminate between populations of older people when used as part of routine practice. Differences in health and functional status may be associated with deprivation. Data collected during the annual health check about the health and functional status of older people could provide a useful adjunct to census and survey data to measure population needs and to support locality planning. [source] Kenosha County Falls Prevention Study: A Randomized, Controlled Trial of an Intermediate-Intensity, Community-Based Multifactorial Falls InterventionJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 4 2007Jane E. Mahoney MD OBJECTIVES: To decrease the rate of falls in high-risk community-dwelling older adults. DESIGN: Randomized, controlled trial. SETTING: Community-based. PARTICIPANTS: Three hundred forty-nine adults aged 65 and older with two falls in the previous year or one fall in the previous 2 years with injury or balance problems. INTERVENTION: Subjects received two in-home visits from a trained nurse or physical therapist who assessed falls risk factors using an algorithm. The intervention consisted of recommendations to the subject and their primary physician, referrals to physical therapy and other providers, 11 monthly telephone calls, and a balance exercise plan. Control subjects received a home safety assessment. MEASUREMENTS: The primary outcome was rate of falls per year in the community. Secondary outcomes included all-cause hospitalizations and nursing home admissions per year. RESULTS: There was no difference in rate of falls between the intervention and control groups (rate ratio (RR)=0.81, P=.27). Nursing home days were fewer in the intervention group (10.3 vs 20.5 days, P=.04). Intervention subjects with a Mini-Mental State Examination (MMSE) score of 27 or less had a lower rate of falls (RR=0.55; P=.05) and, if they lived with someone, had fewer hospitalizations (RR=0.44, P=.05), nursing home admissions (RR=0.15, P=.003), and nursing home days (7.5 vs 58.2, P=.008). CONCLUSION: This multifactorial intervention did not decrease falls in at-risk community-living adults but did decrease nursing home utilization. There was evidence of efficacy in the subgroup who had an MMSE score of 27 or less and lived with a caregiver, but validation is required. [source] Pre-operative information and patient-controlled analgesia: much ado about nothingANAESTHESIA, Issue 4 2004G. M. Chumbley Summary We examined whether pre-operative information benefited patients receiving patient-controlled analgesia (PCA) after major surgery. We investigated whether patients felt better informed about PCA and also whether pre-operative information altered the use of PCA, the adequacy of pain relief, worries about addiction and safety, and knowledge of side-effects. We investigated the effectiveness of information provided in two ways, namely by a patient-determined leaflet or an interview by a trained nurse from the pain team, compared with routine pre-operative information. We studied 225 patients, 75 in each group. Patients in the leaflet group were better informed about PCA, became familiar with using PCA more quickly and were less confused about PCA than the control group. However, there were no effects on pain relief, worries about addiction and safety, and knowledge of side effects. The pre-operative interview resulted in no benefits. Our findings indicate that the detailed provision of pre-operative information failed to improve patients' experiences of PCA. [source] Finnegan neonatal abstinence scoring system: normal values for first 3 days and weeks 5,6 in non-addicted infantsADDICTION, Issue 3 2010Urs Zimmermann-Baer ABSTRACT Objective The neonatal abstinence scoring system proposed by Finnegan is used widely in neonatal units to initiate and to guide therapy in babies of opiate-dependent mothers. The purpose of this study was to assess the variability of the scores in newborns and infants not exposed to opiates during the first 3 days of life and during 3 consecutive days in weeks 5 or 6. Patients and methods Healthy neonates born after 34 completed weeks of gestation, whose parents denied opiate consumption and gave informed consent, were included in this observational study. Infants with signs or symptoms of disease or with feeding problems were excluded. A modified scoring system was used every 8 hours during 72 hours by trained nurses; 102 neonates were observed for the first 3 days of life and 26 neonates in weeks 5,6. A meconium sample and a urine sample at weeks 5,6 were stored from all infants to be analysed for drugs when the baby scored high. Given a non-Gaussian distribution the scores were represented as percentiles. Results During the first 3 days of life median scores remained stable at 2 but the variability increased, with the 95th percentile rising from 5.5 on day 1 to 7 on day 2. At weeks 5,6 median values were higher during daytime (50th percentile = 5, 95th percentile = 8) than night-time (50th percentile = 2, 95th percentile = 6, P = 0.02). Conclusion Scores increase from days 1,3 to weeks 5,6 and show day,night cycles with 5,6 weeks. Values above 8 can be considered pathological. This data may help to raise suspicion of narcotic withdrawal and to guide therapy. [source] Economic crisis and challenges for the Greek healthcare system: the emergent role of nursing managementJOURNAL OF NURSING MANAGEMENT, Issue 5 2010VENETIA NOTARA MSc notara v., koupidis s.a., vaga e. & grammatikopoulos i.a. (2010) Journal of Nursing Management18, 501,504 Economic crisis and challenges for the Greek healthcare system: the emergent role of nursing management Background, Despite several reform efforts, the Greek health care system still faces problems related to misdistribution of trained health staff and finance between geographical areas. Aim, The objectives of the present study were to describe the current situation of the delivery of the healthcare service in Greece, to explore the basic implications of the economic crisis from a nursing management perspective and to examine future practices opening a debate in policy developments. Key issue, The principal finding of this study was the serious shortage of trained nurses, the imbalances in nursing personnel, an excess of doctors and the complete absence of a Primary Healthcare System in civil areas provided by general doctors. Conclusion, It is important that health care policy makers become aware and seriously consider rearranging the Health Care System to become more effective and efficient for the population (client). Special attention should be paid to strengthening areas such as primary health care, public health and health promotion in the direction of minimizing the demand of hospital services. Implications for nursing management, Any implementation of major health care reforms should consider seriously the role of the nursing management which formulates the substantial link between the health services and the patient. [source] Training subspecialty nurses in developing countries: Methods, outcome, and costPEDIATRIC BLOOD & CANCER, Issue 2 2003Judith A. Wilimas MD Abstract Background As infections are controlled in developing countries, other pediatric subspeciality programs such as oncology become increasingly important. A major impediment to the development of such programs is a lack of trained nurses. Therefore, education of pediatric subspecialty nurses becomes a priority. Procedure We describe three models we have used for education of pediatric oncology nurses: a short series of classes or lectures with additional training of key nurses, an expanded 12 week series of classes at centers combining didactic and clinical instruction and a regional residential school offering regular 12 week courses in theory and clinical practice. Results Cost analysis showed that the cost per nurse trained was, respectively, $3,700; $4,350; and $5,500. Early effectiveness indicators show that retention rates are high, home institutions are satisfied, and nurses trained shared their knowledge with other nurses and improved nursing practices. Conclusions Programs to teach subspecialty nursing in developing countries are effective and can improve medical care. Such programs should be based on past experience and evaluated as to cost and effectiveness. Med Pediatr Oncol 2003;41:136,140. © 2003 Wiley-Liss, Inc. [source] | ||||||||||