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Biomedical subjects

Joanna Bokovoy

Publications and source records attributed to Joanna Bokovoy.

6 recordsLinked to original sources
PubMed2005

Understanding discharge instructions after vascular surgery: an observational study.

Patient education is a dynamic ongoing process that occurs from admission to discharge. Vascular surgery is an intensive procedure that causes stress to patient and family members. High stress levels in patients are a barrier to learning. There is a large body of knowledge available on patient education. However, research is lacking on patient retention of discharge instructions after vascular surgery. This study describes patient responses to 4 questions that were asked 3 days after in-hospital teaching was completed by a registered nurse regarding either femoral-popliteal bypass surgery or abdominal aortic aneurysm repair surgery.

Adult↗
PubMed2004

Work flow analysis: eliminating non-value-added work.

OBJECTIVE: To evaluate the impact of implemented work environment changes on nursing and support staff roles. BACKGROUND: In 1999, the authors identified key drivers of unnecessary work associated with the day-to-day delivery of patient care in their institution and implemented changes based on their results. METHODS: Both quantitative and qualitative methods were used. Work sampling and focus groups were used to evaluate work flow. Activity categories were identified and clearly defined by advanced practice nurses. All compiled data were subsequently synthesized and cross-checked with the information acquired through independent, multidisciplinary validation studies. RESULTS: There were significant changes (P <.0001) noted in overall distribution of observed activities for nurses and all support staff. CONCLUSIONS: The significant changes noted in overall distribution of observed activities reflect the important adjustments made in both job descriptions and the environment to eliminate key drivers of unnecessary work in the delivery of patient care.

Attitude of Health Personnel↗
PubMed2003

Results of an inner-city school-based asthma and allergy screening pilot study: a combined approach using written questionnaires and step testing.

BACKGROUND: A questionnaire alone may not be an adequate screening tool for asthma. OBJECTIVE: To determine whether an asthma questionnaire used in combination with an exercise step test is better than a questionnaire alone in screening for asthma in children and to evaluate the validity of a rhinitis questionnaire in determining atopy. METHODS: The International Study of Asthma and Allergies in Childhood (ISAAC) asthma core questionnaire was used to screen for asthma in 307 inner-city first through third graders. All children who had scores consistent with a diagnosis of asthma underwent step testing, as did a subset of children who had negative overall scores. All children who had inconsistent asthma scores and step test results underwent methacholine challenge testing. The same 307 children underwent rhinitis screening and children who had one or more positive responses on the ISAAC rhinitis questionnaire underwent skin testing as did a subset of children who had all negative responses. RESULTS: Three hundred of 307 asthma and rhinitis questionnaires were returned. Twenty-eight children (9%) had global asthma scores that were considered to be positive (5 or above). Twenty-four of these children underwent step testing as did 34 randomly selected children who had negative global asthma scores. Thirty-one (91%) of the 34 children who had negative global asthma scores had negative step tests. Similarly, 20 of 24 children (83%) of the children who had positive global asthma scores had negative step tests. Only 4 children who had positive global asthma scores were step test-positive or had reversible airway obstruction at baseline. Using a positive methacholine challenge as the gold standard for establishing bronchial hyperresponsiveness, the global asthma score derived from the eight-item ISAAC asthma questionnaire yielded a sensitivity of 64%, a specificity of 11%, a positive predictive value of 47%, and a negative predictive value of 20%. Comparing the six-item ISAAC rhinitis questionnaire results to the gold standard, skin test reactivity, the questionnaire yielded a sensitivity of 76%, a specificity of 21%, a positive predictive value of 56%, and a negative predictive value of 40%. CONCLUSIONS: Step testing was not useful as a screening tool for asthma. In addition, the ISAAC asthma questionnaire may not be a good asthma screening tool for inner-city pediatric populations, especially if the form is self-administered. Investigators should first validate both the ISAAC asthma and rhinitis screening questionnaires in the particular population to be studied before widespread asthma and allergy screening efforts are initiated using these tools.

Asthma↗
PubMedDate not supplied

Dance of the call bells: using ethnography to evaluate patient satisfaction with quality of care.

Ethnographic methods can provide insights into patients' perceptions of quality of care. We used ethnographic methods to examine problems related to answering patient call lights on one inpatient unit in the hospital. Communication through call bells consisted of 3 interrelated components. These included answering the call bell, communicating the patient's request, and following through with the request. Results of this study provided a deeper understanding of the nuances of power and control embedded within the issue of patient-caregiver communication and empowered unit staff to find solutions to the call bell problem.

Anthropology, Cultural↗
PubMedDate not supplied

Research on the frontlines of healthcare: a cooperative learning approach.

BACKGROUND: Evidence-based practice is a common goal in hospitals, but learning about research so that the practice can be done is often challenging for clinicians. OBJECTIVES: The aims of this study were to (a) develop a process that supports organizational and staff development while conducting research and (b) conduct a research study in the emergency department (ED) to examine patient population, satisfaction, and waiting room issues. METHODS: A multidisciplinary team of clinicians and scientists was assembled to learn and do research while evaluating the ED waiting room of a Level I trauma center. A cooperative learning method approach was used to teach research concepts as the study was designed and implemented. RESULTS: The team demonstrated their knowledge and understanding of research concepts by being involved actively in the creation and implementation of the preintervention study. Using information from photographs, observations, and a questionnaire, the team identified the following key dissatisfaction areas: (a) atmosphere (including comfort with environment, neatness and cleanliness, and noise), (b) telephones, (c) parking and thoroughfare, (d) professional behavior and staff presence (including personal attention), (e) security, and (f) triage and confidentiality. DISCUSSION: The model of working in partnership with researchers and using cooperative, collaborative research is an effective way to evaluate and address issues related to quality of care while learning about the research concepts needed to put evidence into practice.

Cross-Sectional Studies↗