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Biomedical subjects

M Maas

Publications and source records attributed to M Maas.

At least 55 records · Page 3Linked to original sources
PubMed1997

Outcomes for home and community nursing in integrated delivery systems.

In these tumultuous times in health care, nursing providers are under pressure to capture data that demonstrate the effectiveness of nursing interventions on client health. At the University of Iowa, researchers are attempting to develop a client outcome classification system that uses a standardized language across different health care settings to capture this vital information.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1997

Caregiving: concept analysis and outcomes.

More than ever before, caregiving has become a salient public policy issue. A number of recent and anticipated demographic, economic and social changes have occurred that make it imperative for researchers to critically examine the impact of caregiving on family caregivers' health, behavior, emotions, and social status. Researchers at the University of Iowa College of Nursing are working to classify standardized nursing-sensitive patient outcomes for use in language development, practice, research, and education to evaluate the effectiveness of nursing interventions and clinical nursing services. This article focuses on family caregiving and the analysis of caregiver role performance in both direct and indirect care, linking outcomes and indicators, to enable nurses to promote the health of caregivers.

Caregivers↗
PubMed1997

Assessing family and staff caregiver outcomes in Alzheimer disease research.

Outcomes and measurement issues related to caregivers for persons with Alzheimer disease and related disorders are examined. Assumptions regarding the dynamic linkages between resident, family, and staff outcomes are reviewed, and potential sources of stress inherent in family adaptation to the institutional setting, role transitions, and emotional responses that occur with placement are examined. Family and staff caregiver outcomes that flow logically from treatment goals, and what can be expected if sources of transitional and institutional stress are ameliorated through successful family and staff-related interventions, are discussed. Instruments developed to evaluate family perceptions of care and the caregiving role in institutional settings are described. The article concludes with an analysis of measurement approaches, general measurement issues, and those more specific to family and staff caregivers, as well as recommendations for further development in this area.

Alzheimer Disease↗
PubMed1996

Assessing quality of nursing home care: the foundation for improving resident outcomes.

Efforts to improve the quality of care and outcomes for nursing home residents are constantly of concern to state and federal regulators, nursing home providers, nursing home advocacy groups, and health policy researchers. The article describes a study that analyzed the quality indicators identified by the Health Care Financing Administration-sponsored Case Mix and Quality Demonstration Project using the Missouri nursing home Minimum Data Set database. The range of performance was considerable, and five of the indicators analyzed were risk adjusted to account for variation in resident acuity within facilities. Determining quality of care from assessment information that is routinely collected for nursing home residents has the potential to influence dramatically public policy decisions regarding reimbursement, recertification, and regulation and can play a vital role in improving resident outcomes.

Centers for Medicare and Medicaid Services, U.S.↗
PubMed1996

Evaluating physical functional outcomes: one category of the NOC system.

All professional health care disciplines are now being held accountable to demonstrate the outcomes they produce. It is imperative that nurses demonstrate the difference they make in patient care to justify the cost of professional nursing. Standardized language is needed to aggregate data and report information on nursing interventions and associated outcomes. The Nursing Outcomes Classification (NOC) system is the first comprehensive classification of nursing-sensitive patient outcomes. In this review, the development of this classification system with specific results related to physical functional status and implications of NOC for nursing practice are discussed.

Activities of Daily Living↗
PubMed1995

Use of standardized nursing diagnoses and interventions in long-term care.

1. Standardized language for patient assessment, nursing diagnoses and interventions provide a common language for professionals in long-term care. 2. A comprehensive Nursing Interventions Classification (NIC) was first published in 1992 by the Iowa Intervention Project and the North American Nursing Diagnosis Association offers a comprehensive list of nursing diagnoses. 3. Most frequently used nursing diagnoses were: Self Care Deficit: Bathing/Hygiene, Self Care Deficit: Dressing/Grooming, Impaired Physical Mobility, Altered Thought Process, and Potential for Injury.

Female↗
PubMed1995

What nursing diagnoses do nurses use in long term care?

The results of this survey validate that the NANDA nursing diagnoses classification is appropriate for use in long term care. Although ninety three percent of the current NANDA nursing diagnoses are used in practice, there remains a need for the development and testing of additional nursing diagnoses to describe patient problems encountered in long term care. Nurses in education and practice settings must work collaboratively to continue to identify, refine and validate the nursing diagnoses that are most appropriate for frail, older and/or chronically ill residents of long term care facilities.

Geriatric Nursing↗
PubMed1994

Long-term evaluation of Bennett's fracture. A comparison between open and closed reduction.

18 patients with Bennett's fracture were evaluated after a mean follow-up period of 10.7 years. Treatment consisted of closed reduction and K-wire fixation in seven cases and open reduction with osteosynthesis in 11 cases. Overall, symptoms were few and restricted mobility of the thumb could not be demonstrated. The strength of the affected hand was decreased in all patients regardless of the type of treatment. Osteoarthritis was found to correlate with the quality of reduction of the fracture, but had developed in almost all cases even after exact reduction. Exact reduction, either by the open or closed method, should be the aim of treatment of Bennett's fracture.

Adult↗
PubMed1993

Orgaran (Org 10172) or heparin for preventing venous thrombosis after elective surgery for malignant disease? A double-blind, randomised, multicentre comparison. ANZ-Organon Investigators' Group.

This double-blind, randomised, multicentre trial in 513 patients having elective surgery for intra-abdominal or intrathoracic malignancy compared the efficacy and safety of venous thrombosis (VT) prophylaxis using 750 anti-factor Xa units of Orgaran (a mixture of low molecular weight heparinoids) given subcutaneously (sc) twice-daily with that of twice-daily injections of 5,000 units standard heparin. The main study endpoints were the development of postoperative VT detected by 125I-fibrinogen leg scanning, and the onset of clinically significant venous thromboembolism or bleeding. "Intent to treat" analysis showed a statistically non-significant trend towards less VT during Orgaran prophylaxis (10.4%) than after heparin (14.9%) and there was no difference in bleeding complications between the two study groups. Results remained similar if only patients who completed the intended course of therapy ("compliant patients") were analysed. Other trials have shown that Orgaran prevents VT after hip surgery and stroke. We now show it is also safe and effective in patients having major surgery for cancer.

Aged↗
PubMed1993

Disappearance of mesenteric lymphadenopathy with gluten-free diet in celiac sprue.

In an adult patient with untreated celiac sprue, mesenteric lymphadenopathy was detected by computerized tomography (CT). Although malignant lymphoma was suspected, the nodes disappeared after treatment with a gluten-free diet, as was documented by CT follow-up. This report demonstrates that mesenteric lymphadenopathy in celiac sprue might be benign. With the increased use of CT investigation, findings like these may be encountered more often.

Celiac Disease↗
PubMed1993

Preferences for decision-making autonomy.

Nurses' lack of autonomy has been identified as a leading cause of job dissatisfaction, but attempts to increase satisfaction by increasing autonomy have not always been successful. This survey of 356 randomly selected staff nurses and 130 head nurses from 16 hospitals extends previous work by identifying the preferred level of involvement in 21 patient care and 21 unit operation decisions. Staff nurses agreed on 60 percent of the decisions and, in general, preferred independent decision-making for patient care decisions and shared decision-making for unit operation. Head nurses indicated that staff nurses should have a higher level of autonomy than the staff nurses indicated for themselves.

Adult↗
PubMed1993

Gadolinium-DTPA enhanced magnetic resonance imaging of bone cysts in patients with rheumatoid arthritis.

OBJECTIVES: To examine the contents of intraosseous cysts in patients with rheumatoid arthritis (RA) through the signal intensity characteristics on gadolinium-DTPA (Gd-DTPA) enhanced magnetic resonance imaging. METHODS: The hand or foot joints of nine patients with the cystic form of RA (where the initial radiological abnormality consisted of intraosseous cysts without erosions) were imaged before and after intravenous administration of Gd-DTPA. A 0.6 unit, T1 weighted spin echo and T2* weighted gradient echo were used to obtain images in at least two perpendicular planes. RESULTS: Most cysts showed a low signal intensity on the non-enhanced T1 weighted (spin echo) images and a high signal intensity on the T2* weighted (gradient echo) images, consistent with a fluid content. No cyst showed an enhancement of signal intensity on the T1 weighted images after intravenous administration of Gd-DTPA, whereas synovium hyperplasia at the site of bony erosions did show an increased signal intensity after Gd-DTPA. Magnetic resonance imaging detected more cysts (as small as 2 mm) than plain films, and the cysts were located truly intraosseously. In six patients no other joint abnormalities were identified by magnetic resonance imaging; the three other patients also showed, after Gd-DTPA administration, an enhanced synovium at the site of bony erosions. CONCLUSIONS: It is suggested that intraosseous bone cysts in patients with RA do not contain hyperaemic synovial proliferation. The bone cysts in patients with the cystic form of RA may be the only joint abnormality.

Adult↗
PubMed1991

Nursing administration model for administrative practice.

The winds of change have swept in a new era for nursing. Complex decisions can be aided by a conceptual model for nursing administration practice. The authors discuss how the Iowa Model of Nursing Administration can be used by nurse administrators to solve administrative problems. Two practical examples are described.

Decision Making, Organizational↗
PubMed1990

Cystic rheumatoid arthritis: description of a nonerosive form.

In a study of patients with rheumatoid arthritis (RA), 9% (n = 70) were found to have a cystic form. At radiologic examination of these patients with cystic RA, the first abnormality seen consisted of periarticular intraosseous cysts without erosions. The cysts were distributed symmetrically, most often located at the proximal side of the joints and predominantly around the proximal interphalangeal, metacarpophalangeal, and wrist joints of the hands and the first interphalangeal and metatarsophalangeal joints of the feet. Computed tomographic scans showed the peripheral intraosseous location of the cysts. Magnetic resonance images showed that the cysts may contain fluid, inflamed synovia, or both. Cysts can be an important feature in the diagnosis of RA and a supplement to the criteria of the American Rheumatism Association. Osteoporosis, joint-space narrowing, and joint destruction occurred less frequently in patients with cystic RA than in patients with classic RA. Of the patients with cystic RA, 54% were male, and 50% were seronegative. This study is a supplement to and an enlargement on earlier descriptions of cyst predominance in RA.

Adolescent↗
PubMed1990

Adjunct executive appointment for faculty. An innovation in nursing collaboration.

The need for collaboration has never been greater. The healthcare delivery system faces unprecedented challenges arising from prospective payment, competition in the marketplace, higher patient acuity levels, and a shortage of professional nursing staff. The authors discuss a service-education collaboration model based on adjunct executive appointments of faculty members to healthcare organizations. The authors describe the model, a conceptual framework to guide its development, case studies of its implementation, and a summary of the benefits and risks associated with the initial implementation of the model.

Hospitals, Community↗