Biomedical subjects

B J Hays

Publications and source records attributed to B J Hays.

23 records · Page 2Linked to original sources

PubMedDate not supplied

Care paths. A new approach to high-risk maternal-child home visitation.

Care paths for the maternal and infant populations are used to define immediate and long-term outcomes related to care received in the home. This article describes a care path developed by public health nurses for intervention with an at-risk maternal-child population in a city/county health department. A public health nursing care management model provided the framework for developing this care path to foster cost-effective use of limited resources. It is crucial that public health nurses articulate clearly the services provided in the home both for those who may seek service and for policy makers who determine funding structure. The project demonstrated that care paths for home visitation involving high-risk prenatal clients are useful tools that streamline documentation, foster consistency and continuity of care, facilitate quality improvement efforts, and provide outcome data.

Adolescent↗

PubMedDate not supplied

Public health nursing data. Building the knowledge base for high-risk prenatal clients.

PURPOSE: To examine and compare referral reason, clinical pathway variance, and intensity of need for care for high-risk prenatal clients of public health nurses. DESIGN: A prospective, descriptive design was used for this pilot study. METHODS: Reasons for referral to the high-risk prenatal home visitation program, variances from a prenatal clinical pathway, and intensity of need for care scores obtained using the Community Health Intensity Rating Scale (CHIRS) were collected at 28 weeks and 38 weeks of gestation from the clinical records of 20 high-risk prenatal clients (age range 16-43 years) visited by five expert public health nurses in one midplains public health nursing department. RESULTS: Findings indicated that the three sources of clinical data provided congruent but not identical data, with each contributing elements needed to specify public health nurses interventions for high-risk prenatal clients. CLINICAL IMPLICATIONS: Collaborative clinical research studies such as this one are useful in advancing evidenced-based practice in clinical agencies. The congruence between the clinical path variance and the intensity of need for care scores reaffirms the importance of the domain of health behavior intervention as a major aspect of public health nurses practice.

Adolescent↗

PubMedDate not supplied

Patterns of health resource utilization, costs, and intensity of need for primary care clients receiving public health nursing case management.

Case management has been promoted as a managed care strategy that improves quality of care and contains costs. Health resource utilization patterns and associated costs were examined for a generalized primary care population receiving a public health nursing model of case management intervention during a 30-week period. Subjects were referred by providers practicing in an academic health science center and included two client subsamples: chronically ill adults and younger families requiring health maintenance. Health resource utilization patterns and associated costs were examined in relation to intensity of need for care levels as determined by the Community Health Intensity Rating Scale. Results of this pilot study suggest that during public health nursing case management intervention, health resource utilization patterns changed from the preintervention period. Total health resource utilization costs were correlated with care needs related to health management behavior of the chronically ill.

Adult↗

PubMedDate not supplied

Nursing care requirements and resource consumption in home health care.

Nursing care requirements provide the rationale for nursing practice. Two representations of nursing care requirements are nursing intensity and nursing diagnoses. In the present study, these two indicators each significantly explained variation in nursing resource consumption in home health care. Further study is needed to refine a measure of nursing intensity that has construct validity and a base in nursing theory. In addition, techniques are needed for grouping and weighting the various nursing diagnoses to reflect their contribution in explaining the amount of care provided to patients.

Health Resources↗

PubMedDate not supplied

Nursing intensity as a predictor of resource consumption in public health nursing.

The community Health Intensity Rating Scale (CHIRS) has been found to explain variations in resource consumption by home health care clients. The purposes of this study were to determine the amount of variance in nursing resource consumption among public health nursing (PHN) clients explained by CHIRS and to assess whether the four CHIRS domains accurately represent its underlying structure. The sample included 133 PHN clients from three programs: frail older adult, high-risk prenatal, and high-risk infant. CHIRS total score significantly predicted variation in nursing resource consumption in two of the three PHN programs when a composite measure of resource consumption, referred to as nursing effort, was used as the criterion variable. A principal components factor analysis of CHIRS produced a three-factor solution, two of which were reliable enough for use as subscales. A contextual/behavioral subscale and a physiological subscale increased the variance in nursing resource consumption explained in two of the three PHN programs.

Adolescent↗