PubMed · 7373584
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1980. Training district nurses.. https://pubmed.ncbi.nlm.nih.gov/7373584/
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The reliability, validity, and sensitivity of the Medical Outcome Study Short Form (SF-36) and the Quality of Life Profile: Senior Version (QOLPSV) for measuring outcomes of home care nursing were evaluated. Data were collected from 50 clients receiving home care nursing services. Twenty-two registered nurses and six registered practical nurses collected client and nursing data on each home visit. Client baseline and outcome measures were collected by two independent evaluators at admission and discharge from the home care service. Internal consistency reliability ranged from.76 to.94 for the eight subscales of the SF-36. Internal consistency reliability ranged from.47 to.82 for the nine subscales of the QOLPSV. The subscales of both instruments had minimal problems with missing responses. The SF-36 was found to be more sensitive than the QOLPSV to change over time. In addition, the subscales of the SF-36 were found to be more sensitive than the subscales of the QOLPSV to several of the nursing variables, such as intensity of the client's nursing condition and skill mix.
This paper outlines the detail of the case study method used in a project commissioned by the English National Board for Nursing, Midwifery and Health Visiting (ENB) to investigate the changing educational needs of community nurses with regard to needs assessment and quality of care in the context of the NHS and Community Care Act, 1990. It explains the methodological procedures and analytic processes which led to integration of data across the whole study, focusing on the role of a prior theoretical framework in case study design. Recently qualified practitioners (health visitors and district nurses) were observed during a regular shift (N=134 visits), concentrating on their practice of assessing needs, and on liaison and collaboration within teams and across sectors. They were interviewed after the observation period (N=33 practitioners), to determine the extent of formality they attached to each assessment, and elicit information about aspects which may be embedded in everyday practice as well as those recorded for explicit requirements.The preliminary analysis resulted in the modification of a model for assessing service quality, and identified various points where a 'policy-practice gap' might arise between policies and practice in both the health service and education. The practicalities of operationalising a multiple case study design into research are highlighted, and the mechanism for 'generalising to theory' illustrated.
The Balanced Budget Act of 1997 (BBA 97) contains the most dramatic changes to the Medicare program since its genesis nearly 35 years ago. To remain financially viable under the cost-cutting measures mandated in this Act, hospitals, home health agencies, skilled nursing facilities, and their employees must have a working knowledge of its contents. In addition, the patients served by these health care providers must have well documented and positive health outcomes, and they must be satisfied with the care and service they receive. Nevertheless, merely understanding the changes mandated by BBA 97 is not sufficient for success; clinicians also must develop innovative solutions to the hurdles the Act erects and quickly integrate them into daily practice. Issues of payment and reimbursement have everything to do with the delivery of today's patient care, regardless of the setting where it is delivered. BBA 97 offers special opportunities to wound, ostomy, and continence care clinicians.