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PubMedDate not supplied

Nursing-sensitive outcomes data collection in acute care and long-term-care settings.

BACKGROUND: Most administrative databases do not contain good information about nursing-sensitive outcomes. OBJECTIVES: To determine (a) the reliability of the instruments measuring nursing-sensitive outcomes, (b) whether the outcome measures are sensitive to changes in patients' health, and (c) whether the outcome measures are associated with nursing interventions. METHODS: The sample consisted of 890 patients from acute care hospitals and long-term-care facilities. A repeated measures design was used. Functional status was assessed on admission and discharge using Minimum Data Set 2.0 items. Symptom (pain, nausea, dyspnea, fatigue) frequency and severity were assessed with 4-point and 11-point numeric scales, respectively. Therapeutic self-care was assessed on discharge from acute care. Nursing interventions were assessed by documentation review. RESULTS: The outcome measures demonstrated very good interrater reliability with weighted Kappa ranging from .64 to .93. The internal consistency reliability was high for functional status and therapeutic self-care. The outcome tools were sensitive to change in patient condition. Select nursing interventions were related to functional status, therapeutic self-care, and symptom outcomes. DISCUSSION: The findings suggest that nurses are able to collect data on nursing-sensitive patient outcomes in a reliable and valid way.

Aged↗
PubMed1993

Collecting data to evaluate the effect of health policies on vulnerable populations.

Public health policies often have disproportionate effects on the poor and other vulnerable groups. Standard survey techniques are often difficult to apply to these vulnerable populations, and many data bases systematically omit such individuals. The purpose of this paper is to review our experience in collecting primary survey data from public hospital, mentally ill, HIV-infected, and non-English-speaking patients. Important issues in conducting research on these populations include proper selection of subjects and comparison groups and difficulties involved in recruitment and enrollment of subjects. Maintaining longitudinal data on these populations is difficult and often requires tracking, secondary contacts, home visits and community outreach, and the use of organizations, institutions, and networks. Investigators must also pay careful attention to ethical issues involved in conducting research on vulnerable populations.

Data Collection↗
PubMed2004

Analysing and interpreting routinely collected data on sharps injuries in assessing preventative actions.

BACKGROUND: Sharps injuries (SI) occur frequently in hospitals and are a risk for exposure to bloodborne pathogens. During the 1990s, the safety service of a university general hospital introduced, in collaboration with the occupational health service, specific measures to reduce the number of SI. AIM: The aim of this study was to assess the occurrence and evolution of SI during this period and to evaluate the effectiveness of the preventative measures taken, making use of routinely collected data. METHOD: In a retrospective study, we analysed the number of SI recorded from 1990 to 1997. The study population was all employees at risk of SI. Because the introduction of intensive preventative measures dates from 1996, an effect on the incidence of SI can be expected from 1996. To assess this effect, mean incidence rates for 1990-1995 and for 1996-1997 were compared. RESULTS: In the study period, a total of 4230 SI were recorded. The global SI incidence rate decreased from 33.4 SI per 100 occupied beds per year in 1990-1995 to 30.1 in 1996-1997 (P < 0.01). In the same period, among nurses a decrease in incidence rate from 17.2 to 12.7 SI per 100 person-years was noted (P < 0.0001) and for the hotel service from 4.8 to 3.7 (not significant). CONCLUSION: Although this study has various restraints, these results suggest that intensive preventative actions, in combination with technological advances, may have contributed to a drop of 67 SI cases per year.

Humans↗
PubMed1990

DataVoice: a microcomputer-based general purpose voice-controlled data-collection system.

An integrated system of hardware and software has been developed to combine the input of coordinate data from a digitizing pad with voice input for object identification or classification. The menu and voice-controlled software generates a sequential ASCII file which contains an object identification section and a data section. Rules for data entry and analysis programs have been developed for several applications. These are being tested and include general stereological analyses, bone, kidney and skin histomorphometry, boundary analyses, neuron classification and malignancy grading.

Artificial Intelligence↗
PubMed2006

Strategies for data collection and calibration with a pinhole-geometry SAXS instrument on a synchrotron beamline.

Undulator X-ray sources on third-generation synchrotrons have pushed small-angle X-ray scattering (SAXS) to the forefront of techniques in nanoscience and technology. With higher X-ray fluxes and improved focusing, it is usually the scattered intensity detector that places the most serious limitations on the overall capabilities of the instrument. Incorporating relatively simple components like point detectors, scattering standards, masking filters and in-line sample visualization into the flight tube of a pinhole-geometry SAXS camera can do much to mitigate these limitations. How these enhancements can be incorporated into routine data collection is demonstrated on the ChemMatCARS SAXS instrument, which utilizes pinhole geometry with an undulator insertion device at sector 15 of the Advanced Photon Source. In addition, with an X-ray energy range of 6-32 keV (2.0-0.4 A) and an energy resolution of 10(-4) DeltaE/E, this instrument can measure anomalous SAXS over a wide variety of atom species, with reliable normalization of scattered data.

Calibration↗
PubMed1998

Statistical design of REACT (Rapid Early Action for Coronary Treatment), a multisite community trial with continual data collection.

Unusual problems in statistical design were faced by Rapid Early Action for Coronary Treatment (REACT), a multisite trial testing a community intervention to reduce the delay between onset of symptoms of acute myocardial infarction (MI) and patients' arrival at a hospital emergency department. In 20 pair-matched U.S. communities, hospital staff members recorded delay time throughout a 4-month baseline period and the subsequent 18-month intervention period, during which one randomly selected community of each pair received a campaign of public and professional education. To exploit the continual nature of its data-collection protocol, REACT estimated the trend of delay time separately in each community by linear regression, adjusting for age, sex, and history of MI, and compared the ten adjusted slopes from intervention communities with those from control communities by a paired t-test. Power calculations based on the analytical model showed that with K=600-800 cases per community, REACT would have 80% power to demonstrate a differential reduction of 30 min in mean delay time between intervention and control communities, as well as effects on a variety of secondary outcomes. Sensitivity analysis confirmed that the number of communities was optimal within constraints of funding and that the detectable effect depended weakly on the effectiveness of matching but strongly on K, helping the investigators set operational priorities. The methodologic strategy developed for REACT should prove useful in the design of similar trials in the future.

Emergencies↗
PubMed1997

Joint data collection system saves hospital system $3.6 million.

Knee and hip joint replacement costs at HealthEast in St. Paul, MN, were 33% too high, according to national benchmark data. However, before managers could lower costs, they had to gather their data. After a drawn-out manual compilation, healthEast piloted an automated system for tracking joint replacement data. That software is now available nationwide. By collecting the data, measuring cost and utilization, HealthEast has lowered its total knee and hip replacement costs by $3.6 million.

Cost Control↗
PubMed2005

Creating a bridge between data collection and program planning: a technical assistance model to maximize the use of HIV/AIDS surveillance and service utilization data for planning purposes.

Over time, improvements in HIV/AIDS surveillance and service utilization data have increased their usefulness for planning programs, targeting resources, and otherwise informing HIV/AIDS policy. However, community planning groups, service providers, and health department staff often have difficulty in interpreting and applying the wide array of data now available. We describe the development of the Bridging Model, a technical assistance model for overcoming barriers to the use of data for program planning. Through the use of an iterative feedback loop in the model, HIV/AIDS data products constantly are evolving to better inform the decision-making tasks of their multiple users. Implementation of this model has led to improved data quality and data products and to a greater willingness and ability among stakeholders to use the data for planning purposes.

Data Collection↗