The emergency room nurse and the psychiatric patient.
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Biomedical subjects
Publications and source records attributed to S L Jones.
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Although theories of the family and theories of family therapy have different origins and purposes, both provide the basis for a family focused nursing approach. Family theory is a practice theory with a focus on health while family therapy is a practice theory with a focus on pathology. Thus, the contributions of each are different. For nurses to adapt and apply the principles of the two theories correctly, they first must understand whether application of a basic theory with a focus on health or a practice theory with a focus on pathology is appropriate in the particular nursing situation. For example, if a husband is hospitalized, recovering from a myocardial infarction, a family focused nursing approach is mandatory in providing optimal nursing care. Assessment of the family situation will provide clues for the functional or dysfunctional state of the family and the appropriateness of utilizing family theory or family therapy principles. If the current state of family relationships is optimal, application of family theory principles than can be applied to guide health promotion on a family level is appropriate. Organizational and dynamic aspects of the family promoting the husband's recovery can be accentuated, supported, and emphasized in the nursing care. However, if the current state of family relationships is pathological, application of family therapy principles is appropriate. Here the goal of the nursing care is restoration of functional organizational patterns and interactive processes between family members.
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Sulfate transport by tobacco cells (var. Xanthi) cultured in liquid medium was investigated. Monophasic uptake was observed over a sulfate concentration range from 0.01 to 10 millimolar, and the K(m) was 20 micromolar. A time-dependent stimulation of transport was observed when cells were incubated in medium containing 0.5 millimolar Ca(2+). Calcium stimulation was dependent on the culture cycle and was maximal during the early exponential phase. It was not observed in sulfur-deficient cells with high transport rates and was relatively small in sulfate-loaded cells with low transport rates. A kinetic analysis showed that Ca(2+) increased the maximum rate of transport without affecting the K(m).
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Two-way television consultations between community hospital nurses and neonatologists at a nearby teaching hospital were conducted over a two- and one-half year period of time and were evaluated with respect to a baseline time period in which the television was not available. Screening for illness and prematurity in neonates occurred in a high risk population residing in a black, economically deprived, innercity area. Outcomes including transfer of sick babies from the community hospital to the large teaching hospital are analyzed in relation to prenatal maternal risk characteristics. Apgar scores, birth weight and gestational age. Evidence available suggests that television consultations facilitated formation of appropriate criteria for interhospital transfer and that routine clinical screening tests were performed more consistently following initiation of interhospital consultations.
Data from 1268 deliveries were analyzed and infant outcome was followed using the 2-way television link between a small community hospital and a university neonatal center. Scoring based on 36 prenatal risk characteristics found 26% of the mothers to be at high risk. This high-risk group accounted for 64% of the infant transfers and 67% of the neonatal deaths. Screening of obstetric patients using a prenatal risk score is advised.
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A closed-circuit television system is implemented between neonatal specialists at a large neonatal care hospital and nurses caring for infants in the newborn nursery in a small community hospital located in an inner city, predominantly black, economically deprived area. Data are systematically collected relating prenatal risk characteristics of mothers to outcome measures, including selected intrapartum maternal complications, neonatal morbidity and mortality, neonatal therapeutic interventions, and transfer of neonates from the small hospital to the larger hospital. To our knowledge, study of factors predicting transfer has received little attention in the literature. A log linear model is used to identify specific groups of prenatal risk characteristics capable of predicting maternal and neonatal outcomes.
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The utilization of the emergency room (E.R.) at a small community hospital located in a black inner-city area is investigated. Patients are classified according to a criterion for psychiatric intervention for the purpose of making staffing pattern recommendations. Psychiatric patients and non-psychiatric patients are classified by age, marital status, previous admissions to the E.R., time of arrival and time spent in the E.R., and circumstances of mode of arrival in the E.R. The criterion of psychiatric intervention is viewed as providing an additional dimension in the study of the emergency room, a hospital service which is providing increasing routine and non-routine medical care to the general population.
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Medical documentation of patient care by physical therapy has become a requirement for reimbursement of health services paid by federal and state programs or by other third-party payers. The medical record of physical therapy must satisfy several specific requirements of third-party payers before health services can be reimbursed. The fiscal intermediaries require a precise, written statement of the patient's physical problems, treatment goals and plan, and objective information on the patient's response to treatment. The criteria reflected for third-party payment must be satisfied and evident in succinct and accurate documentation in the medical record. Medical documentation must show evidence of a prescription, medical reason for treatment, a viable discharge plan, outcome of treatment, coordination of medical services, patient instruction, and discontinuance or adaptation of services when necessary. The requirements for third-party payment based on medical documentation are discussed.
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