Introduction: Home health care is the fastest growing sector in the health care industry, with an... more Introduction: Home health care is the fastest growing sector in the health care industry, with an anticipated growth of 66 percent over the next 10 years and with over 7 million patients served each year. With the increasing acuteness of care provided in home health care and the increasing number of frail elderly that make up this patient population, it is important to identify risk factors that affect patient health and safety in this setting. Methods: A convenience sample of 1,561 home health aides, attendants, and personal care workers completed a risk assessment survey. Items addressed personal, patient, and home characteristics and health hazards. All activities had prior Institutional Review Board approval. Preliminary Results: Ninety-five percent of home health care workers (HHCWs) were female with an average of 8 years experience. The majority of clients were elderly, with a smaller percentage of adult (26 percent) and pediatric (7 percent) cases. HHCWs reported the followin...
Increasingly nursing will need to prove the cost effectiveness of alternative models of care. A c... more Increasingly nursing will need to prove the cost effectiveness of alternative models of care. A cost-effectiveness analysis, using a decision analysis format, compared a birthing center to a hospital for low-risk deliveries. Results indicate that a birth center is a cost-effective model of nursing care.
Although collaborative research across sites is essential to increase the statistical power and g... more Although collaborative research across sites is essential to increase the statistical power and generalizability of research findings, the need to undergo multiple institutional review board (IRB) reviews is a challenge. The purposes of this paper are to describe changes in the IRB submission process in 2 national multisite studies before and after the implementation of the Health Information Portability and Accountability Act (HIPAA) Privacy rule (2002 and 2008) and to discuss implications for policy and practice related to human subjects research. In the second study, there was a shorter mean approval time and reduced variability in the decision about the level of review, the mean number of pages per application doubled, and an increased proportion of IRBs required conflict of interest and data use agreements. Possible approaches to further enhance the efficiency and streamlining of the research review process are suggested.
Although there is increasing interest in the relationship between organizational constructs and h... more Although there is increasing interest in the relationship between organizational constructs and health services outcomes, information on the reliability and validity of the instruments measuring these constructs is sparse.
Background: Knowledge of how best to organize infection control programs to deliver effective car... more Background: Knowledge of how best to organize infection control programs to deliver effective care is not clear given contemporary contextual changes such as mandatory reporting of healthcare associated infections (HAI) and increased acuity of hospitalized patients. The objective of this study was to describe the structure and resources of infection control departments around the country and clinician compliance with the implementation of processes to prevent device-associated infections in intensive care units (ICUs). Methods: All non-governmental hospitals enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation included: 1) completing a web-based survey, and 2) joining our NHSN research group. Descriptive statistics and cross-tabulations were computed. The Centers for Disease Control and Prevention (CDC) compared facility characteristics and HAI rates by ICU type between respondents and non-respondents. Results: Of 3,374 eligible hospi...
Introduction: Home health care is the fastest growing sector in the health care industry, with an... more Introduction: Home health care is the fastest growing sector in the health care industry, with an anticipated growth of 66 percent over the next 10 years and with over 7 million patients served each year. With the increasing acuteness of care provided in home health care and the increasing number of frail elderly that make up this patient population, it is important to identify risk factors that affect patient health and safety in this setting. Methods: A convenience sample of 1,561 home health aides, attendants, and personal care workers completed a risk assessment survey. Items addressed personal, patient, and home characteristics and health hazards. All activities had prior Institutional Review Board approval. Preliminary Results: Ninety-five percent of home health care workers (HHCWs) were female with an average of 8 years experience. The majority of clients were elderly, with a smaller percentage of adult (26 percent) and pediatric (7 percent) cases. HHCWs reported the followin...
Increasingly nursing will need to prove the cost effectiveness of alternative models of care. A c... more Increasingly nursing will need to prove the cost effectiveness of alternative models of care. A cost-effectiveness analysis, using a decision analysis format, compared a birthing center to a hospital for low-risk deliveries. Results indicate that a birth center is a cost-effective model of nursing care.
Although collaborative research across sites is essential to increase the statistical power and g... more Although collaborative research across sites is essential to increase the statistical power and generalizability of research findings, the need to undergo multiple institutional review board (IRB) reviews is a challenge. The purposes of this paper are to describe changes in the IRB submission process in 2 national multisite studies before and after the implementation of the Health Information Portability and Accountability Act (HIPAA) Privacy rule (2002 and 2008) and to discuss implications for policy and practice related to human subjects research. In the second study, there was a shorter mean approval time and reduced variability in the decision about the level of review, the mean number of pages per application doubled, and an increased proportion of IRBs required conflict of interest and data use agreements. Possible approaches to further enhance the efficiency and streamlining of the research review process are suggested.
Although there is increasing interest in the relationship between organizational constructs and h... more Although there is increasing interest in the relationship between organizational constructs and health services outcomes, information on the reliability and validity of the instruments measuring these constructs is sparse.
Background: Knowledge of how best to organize infection control programs to deliver effective car... more Background: Knowledge of how best to organize infection control programs to deliver effective care is not clear given contemporary contextual changes such as mandatory reporting of healthcare associated infections (HAI) and increased acuity of hospitalized patients. The objective of this study was to describe the structure and resources of infection control departments around the country and clinician compliance with the implementation of processes to prevent device-associated infections in intensive care units (ICUs). Methods: All non-governmental hospitals enrolled in the National Healthcare Safety Network (NHSN) were eligible to participate. Participation included: 1) completing a web-based survey, and 2) joining our NHSN research group. Descriptive statistics and cross-tabulations were computed. The Centers for Disease Control and Prevention (CDC) compared facility characteristics and HAI rates by ICU type between respondents and non-respondents. Results: Of 3,374 eligible hospi...
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