Biomedical subjects

M T Lush

Publications and source records attributed to M T Lush.

5 recordsLinked to original sources

PubMed1998

Developing a nursing outcomes measurement tool.

In an era of rapidly shifting resources and changing models of care, healthcare providers must demonstrate quality and cost-effective patient care. Historically, quality of care has been described using administrative variables such as mortality, morbidity, length of stay, readmissions, and cost. Methods have not been readily available to define quality in terms of the effect of care delivery on the health of patients. Combined administrative and health-related databases are foundational to outcome infrastructures evolving with the electronic medical record. Nursing leaders in a large health maintenance organization sponsored the development of the Health Status Outcome Dimensions (HSOD) instrument. The HSOD instrument includes measures of functional status, knowledge, and engagement in healthcare and the patient and family psychosocial well-being. This article describes the processes used and the challenges faced in the development of the HSOD instrument. The current status of the HSOD instrument is described, as well as its planned future development.

California↗

PubMed1997

Developing a generic health status measure for use in a computer-based outcomes infrastructure.

This descriptive, correlational study was designed to determine the sensitivity of a generic health status instrument to patient population and to time. The study sample included adult patients undergoing total joint replacement (TJR), adult patients in acute congestive heart failure (CHF), and pediatric patients receiving chemotherapy (PediOnc). A 2 x 3 (population x time) ANOVA for TJR and CHF demonstrated a significant main effect of time (F = 8.0, p = .0006) and a significant interaction effect between time and population (F = 14.4, p < .0001) for functional status. In the PediOnc subsample (HSOD child version), the highest scores for all HSOD factors with the exception of functional status were at Time 3. There was also a significant main effect of time on health care involvement, on the caregiver factor, and the family factor. These results support the sensitivity of the HSOD to patient population and to time.

Adult↗

PubMed1997

Nurses use of health status data to plan for patient care: implications for the development of a computer-based outcomes infrastructure.

The purpose of this study was to examine the relationships between the patient's health status at hospital admission and the initial care planned by the nurse. Functional status, engagement in care, and psychosocial well-being were measured by the Health Status Outcome Dimensions(HSOD) instrument. The HSOD is the foundation for developing a computer-based infrastructure for the analysis of health related outcomes. The consecutive, convenience sample of 308 subjects was drawn from five acute clinical populations: pulmonary; cerebrovascular, cardiac; gastrointestinal; and infection. Logistic and multiple regression analyses were used to test the relationships between control (patient and setting) variables, health status, and the dependent variables of type of problem identified, number of problems identified, and the time required to implement interventions ordered for the patient. In seven of ten models, control variables of facility, age, and/or severity of illness contributed to a model at p < .01. In six of ten models, at least one health status measure significantly explained variation beyond the control variables, at p < .01. Study results support using data gathered during the course of care, to evaluate the process of that care. Further work is needed to understand the effects of setting and provider variables on the use of health status data in care planning. Computer-based outcomes infrastructures are essential to support the collection and analysis of health status over time.

Aged↗

PubMed1995

Developing an outcomes infrastructure for nursing. The Outcomes Taskforce.

An infrastructure to support the evaluation of patient care sensitive to the intervention of nursing personnel is being developed within a major health maintenance organization. In addition to traditional administrative measures of care, the database infrastructure will include measures of the patient's functional status, knowledge and engagement in care and psychosocial well-being. These measures are believed to be particularly sensitive to the independent intervention of the nurse. Reported here are the structures in place to monitor and support the reliability and validity of the administrative data elements; algorithm elements created to account for missing data; the model for the first generation of successful practice reports and the results of a study establishing the content validity of the clinical data elements.

Costs and Cost Analysis↗

PubMed1988

Dyspnea in the ventilator-assisted patient.

Our purpose in this study was to investigate the factors coincident with the occurrence of dyspnea in ventilator-assisted patients. Five alert and oriented patients with pulmonary disease that was restrictive, obstructive, or both, who were receiving mechanical ventilation, participated in this descriptive study. At 4-hour intervals and at complaint of dyspnea, patients quantified the severity of their dyspnea using the visual analogue and modified Borg scales. At each measurement of dyspnea, nurses observed concomitant physiologic and environmental variables. A moderate correlation (r = 0.51, p less than 0.001) was found between the number of events and activities occurring in the intensive care unit environment and the occurrence and severity of dyspnea. The visual analogue scale and modified Borg scale measures of dyspnea were highly correlated (r = 0.92, p less than 0.001) and may be useful tools for assessing dyspnea in patients undergoing mechanical ventilation.

Adult↗