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Biomedical subjects

M T Nolan

Publications and source records attributed to M T Nolan.

28 records · Page 2Linked to original sources
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Advance directive decision making among medical inpatients.

Per the Patient Self-Determination Act of 1991, hospitals are required to ascertain whether patients have an advance directive (AD). At this point, factors prompting patients to issue ADs have not been studied. The purpose of this study was to describe patients' understanding of ADs as well as the process patients used to arrive at their decisions to implement an AD. A stratified random sample of 26 patients from two intensive care units, one general medical unit, one general cardiac unit, and one acquired immunodeficiency unit were selected for participation. Patients were asked a series of open-ended questions to determine their knowledge and understanding of ADs. The constant comparative method was used to review the transcripts. It was found that only 31 per cent of patients had issued an AD, and 20% had learned of ADs for the first time during their hospitalization. Response analysis showed four phases of AD decision making: evaluation of illness, establishment of priorities, consideration of implications of the directives, and selection or rejection of directives. In conclusion, patients continue to have limited understanding of ADs and their implications. Continued investigation will elucidate the best strategies to educate patients about this topic.

Advance Directives↗
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Editing a nursing practice book.

Publishing a nursing practice book can be an exciting challenge for the critical care nurse who identifies a gap in the literature. This article provides information on how to produce an edited book from the starting point to successful publication. Identifying a book idea, selecting chapter authors, finding a publisher, writing a prospectus, the editing process, production, and marketing the book are discussed. Examples drawn from the authors' experiences in editing a transplantation nursing book are provided, as well as comments from other book editors.

Books↗
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Family planning.

Explore the source record for details and available documents.

Abortion, Legal↗
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A comparative evaluation of two educational strategies to promote publication by nurses.

BACKGROUND: Two group educational strategies to promote publication by nurses at The Johns Hopkins Hospital were evaluated and found to result in similar success rates. METHOD: Eighteen nurses, divided into two groups, attended three monthly sessions for instruction, guidance, and encouragement on writing and publishing. One group received additional guidance and encouragement during quarterly meetings for 1 year. Data were collected on participants' characteristics and publication success rates. RESULTS: Both groups achieved similar publication success rates. CONCLUSION: A group education program to promote publication by novice nurse authors achieved positive outcomes and used resources more cost-effectively than the traditional method of individual instruction and guidance. Two factors having positive effects on publication success were: a) having a clear topic for publication at the outset of the educational program, and b) holding a positive perception of the value placed on publication within one's practice environment. The authors suggest alternative educational and other strategies to encourage nurses to share their clinical knowledge through publication.

Curriculum↗
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Preparing nurses for the acute care case manager role: educational needs identified by existing case managers.

BACKGROUND: There is little in the literature about how best to prepare nurses for case manager roles. METHOD: Twenty acute care case managers were asked to identify skills and knowledge that would be of value to nurses new to case manager roles. RESULTS: Community resources, discharge planning, and third party reimbursement were the top three educational needs identified by all case managers. Baccalaureate prepared case managers identified clinical issues to be of value, such as family coping, patient education, quality of life, and social support, while master's prepared nurses identified only system-related issues. CONCLUSION: Educational programs preparing baccalaureate prepared case managers could focus on both clinical and system issues, while programs preparing master's educated case managers could focus primarily on managing system issues. Staff development professionals may also call on experts inside and outside the institution to assist in teaching about health care finance and reimbursement issues.

Acute Disease↗
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Perceived stress and coping strategies among families of cardiac transplant candidates during the organ waiting period.

OBJECTIVE: To explore and describe perceived stress and coping strategies among families of candidates for cardiac transplant during the organ waiting period. DESIGN: This descriptive, multiinstitutional study was guided by the T-Double ABCX Model of Family Adjustment and Adaptation (McCubbin & Thompson, 1987). SETTING: Five tertiary care centers with transplant programs in three Southeastern cities. SUBJECTS: Thirty-eight family members of patients on the active list for cardiac transplantation, including 35 women and three men with a mean age of 44 years (SD = 13.17). Subjects had a family member on the waiting list for a mean of 6.5 months. INSTRUMENTS: Family members completed the following three instruments: (1) Family Inventory of Life Events and Changes (FILE), (2) Family Crisis Oriented Personal Scale (FCOPES), and (3) Family Perception of the Transplant Experience Scale (FPTES). RESULTS: Stress: 53% and 47% of respondents indicated that they were experiencing moderate and low degrees of stress, respectively. Coping: Family members used more coping mechanisms than normative subjects in the literature. Coping strategies used in order of decreasing frequency: (1) knowing our family has the strength to solve our problems, (2) facing problems head-on, and (3) seeking support from friends. Appraisal: Mean score of 32.13 reflects subjects' positive perception of the pretransplant experience. The three statements with which the subjects most strongly agreed: (1) heart illness has changed roles of family members, (2) family member will survive the transplant operation; and (3) this is an experience that could bring out the family's strengths. CONCLUSIONS: An increase in the number of coping strategies used with low to moderate stress levels suggests the effectiveness of coping strategies in mediating stress. The preference for active rather than passive coping strategies may be reflective of the selection criteria for transplant candidates or nursing interventions during this period to minimize stress and promote family coping.

Adaptation, Psychological↗
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Perceived stress and coping strategies among candidates for heart transplantation during the organ waiting period.

The effectiveness of the transplantation team in diffusing stress during the pretransplantation period is increasingly important the longer the patient remains on the transplant waiting list. This study describes the stressors and coping strategies of heart transplant candidates during the waiting period. Thirty-nine candidates on the active list for heart transplantation from four mid-East Coast transplantation centers participated. With a possible stress score of 0 to 243, the mean score for this sample was a low 72.84 (standard deviation = 37.47). The three most common stressors were (1) requiring a heart transplant, (2) having terminal heart disease, and (3) worrying family members. The three most common coping strategies were (1) thinking positively, (2) using humor, and (3) trying to keep life as normal as possible. The finding of low stress levels was surprising but may reflect the presence of hope or the patient's desire to spare family members worry--a concern commonly cited by patients. Another explanation is that patients desiring to be perceived as ideal transplant recipients may have underreported their stress. This suggests that the transplantation team should support positive coping strategies when possible and that both patient and family coping should be closely monitored throughout the waiting period.

Adaptation, Psychological↗
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Scanner technology for data-based decision making.

Scanner systems offer several benefits to nurse executives. Clinical, educational, and administrative data can guide the nurse executive's decisions providing greater control over patient care outcomes. Information from large patient care data sets provides a powerful tool for persuading executives in other departments. Additionally, the nurse executive who can eliminate the need for personnel to conduct time consuming and costly manual data entry, may be able to justify financial support for continued development of the nursing department's information system and technological training for the staff. In this way, scanner technology meets the immediate need for information and serves as an entry to more advanced communications systems.

Electronic Data Processing↗