Biomedical subjects

Vivienne Smith

Publications and source records attributed to Vivienne Smith.

4 recordsLinked to original sources

PubMed2006

Usefulness of aortic root dimension in persons > or = 65 years of age in predicting heart failure, stroke, cardiovascular mortality, all-cause mortality and acute myocardial infarction (from the Cardiovascular Health Study).

Echocardiographic measures of left ventricular (LV) function and structure as well as left atrial size have been reported to predict adverse cardiovascular disease (CVD) outcomes. Although anatomic changes of the aortic root are likely to reflect effects of hypertension and atherosclerosis, few data are available on the predictive value of aortic root dimension (ARD) for outcome in free-living populations. The purpose of this investigation was to determine whether in a cohort of patients aged > or = 65 years ARD was associated with traditional coronary heart disease (CHD) risk factors and with 10-year incident CVD outcomes. In the National Heart, Lung, and Blood Institute-sponsored Cardiovascular Health Study, 3,933 free-living black and white men and women > or = 65 years of age without prevalent CVD had 2-dimensional directed M-mode echocardiographic measurements of ARD as part of a comprehensive evaluation. ARD was associated with age and gender (greater in men) but not race. ARD was also positively associated with diastolic blood pressure, LV hypertrophy, major electrocardiographic abnormalities, and other echocardiographic measures, including LV mass, ventricular septal and posterior wall thickness, and LV dimension. After adjustment for other known risk factors, high ARD was associated with an increased risk for incident congestive heart failure (CHF) in men (hazard ratio for upper compared with all other quintiles 1.47, p = 0.014), stroke in men and women (hazard ratio 1.39 per cm, p = 0.015), CVD mortality in men and women (hazard ratio 1.48 per cm, p = 0.007), and total mortality in men and women taking antihypertensive medications (hazard ratio 1.46 per cm, p = 0.007), but not with incident myocardial infarction (MI) (hazard ratio 0.89, p = 0.39). In conclusion, in a cohort of patients aged > or = 65 years without clinical CVD at baseline, ARD was associated with several CHD risk factors and measures of subclinical disease and was predictive of incident CHF, stroke, CVD mortality, and all-cause mortality, but not of incident MI.

Age Factors↗

PubMed2003

Charge nurse leadership development and evaluation.

OBJECTIVE: To describe the development and evaluation of a permanent charge nurse role and report outcomes of this leadership model over 4 years. BACKGROUND: A permanent charge nurse role was developed to improve continuity of care and develop emerging nurse leaders. An evaluation model was constructed to measure program outcomes. Kouzes and Posner's Leadership Model served as the theoretical framework. METHODS: The permanent charge nurse role was developed, training planned, and the evaluation framework established. Measurements included two survey instruments, an investigator-developed End-of-Shift Report, and institutional patient satisfaction data. Survey instruments included Kouzes and Posner's Leadership Practice Inventory (LPI), concurrently measuring self (charge) and other (staff) perceptions of charge leadership. The McClosky Mueller Satisfaction Scale (MMSS) measured charge and staff nurse job satisfaction. Data were collected at baseline, post-implementation, and additional time periods. RESULTS: Charge RNs reported significantly more favorable perceptions of leadership abilities than staff. The Shift Report successfully tracked both system and charge management issues. Patient satisfaction data did not yield data due to vendor changes. Job satisfaction results showed charge nurses reported higher satisfaction with schedule, praise and recognition, control and responsibility, than staff nurses. CONCLUSIONS: Using data to evaluate charge nurse leadership guides continued program improvements.

Attitude of Health Personnel↗

PubMed2002

Successful interdisciplinary documentation through nursing interventions classification.

Automated documentation systems enable health care professionals to develop dynamic, interdisciplinary care plans. Use of a standardized nomenclature provides a common framework and language for the communication of the plan, and also can support data collection to determine best clinical practices. A comprehensive patient care record will link the interdisciplinary care plan to clinical charting and the documentation of outcomes. This article reviews efforts to improve interdisciplinary communication by computerizing the documentation system, using the Nursing Interventions Classification (NIC).

Benchmarking↗

PubMedDate not supplied

Evaluating the impact of computerized clinical documentation.

A computerized system for care planning and documentation of patient care was initiated at a western teaching hospital, using the framework of Nursing Interventions Classification and Nursing Outcomes Classification standardized languages. The software integrates care planning and documentation, and includes both order entry as well as a charting application. Prior to initiating the project, a study was conducted to evaluate staff attitude toward computerization, time needed for documentation, and comprehensiveness of charting entries. Data from staff surveys, observations, and chart audits conducted pre- and post-computer project implementation demonstrated that the staff attitudes toward computers were less positive, the time required for charting was unchanged, and there were improvements in how completely the nurses documented charting elements.

Adult↗