Ilsun Ko

Effects of nurse navigators on health outcomes of cancer patients.

Background: Care coordination has received increased attention in recent years because it critically affects patient safety and care quality across services and settings. Objective: The effectiveness of systematically developed nurse navigator interventions for newly diagnosed cancer patients was evaluated. Methods: Seventy-eight patients participated in a nonequivalent control group pretest-posttest design study. The study design spanned a 3-month period for all participants. Patient outcome measures included quality of life, satisfaction with care, and length of hospital stay. Results: Participants in the experimental program reported significant increases in several components of quality of life and with satisfaction with care and experienced fewer hospital stay days compared with the control group. Conclusion: This study provides evidence that standardized nurse navigator programs can improve patient outcomes in cancer care. Implications for Practice: Positive outcomes of the reduced length of stay and improved quality of life and patient satisfaction may help transform the cancer care delivery model toward more nurse-initiated cost-effective model.

Family planning practice and related factors of married women in Ethiopia

BACKGROUNDnThe family planning (FP) practice rate of Ethiopian women of reproductive age is lower than in most other sub-Saharan African countries.nnnAIMnTo examine the status of FP practice and identify intrapersonal, interpersonal and community factors associated with FP practice among married Ethiopian women in a rural area.nnnMETHODSnA cross-sectional survey was conducted with a convenient sample of 193 married women of reproductive age. A structured questionnaire, which was modified based on the Ethiopian Demographic Health Survey, was used. Multiple logistic regression analysis was conducted to identify factors associated with FP practice at three levels: intrapersonal, interpersonal and community.nnnRESULTSnAlmost 67% of women were currently using at least one FP method and most women obtained FP methods from the public health sector. Short-term methods such as pills and injections were most commonly used. FP practice was significantly associated with willingness to use long-term or permanent FP methods in future and spousal discussion about FP.nnnCONCLUSIONSnBoth intrapersonal and interpersonal factors were related to FP practice. Community factors, however, need to be further assessed using various methods to plan a comprehensive and more culturally acceptable community-based FP program. Caution is needed to generalize the findings because of the convenient sample, but community-based FP programs emphasizing long-term or permanent methods and male involvement in FP counseling would be successful strategies to increase FP practice.nnnIMPLICATIONS FOR NURSING PRACTICEnNurses and midwives need to be trained to provide knowledge and skills for long-term or permanent FP methods for service quality.

A unit-coordinator system: an effective method of reducing inappropriate hospital stays

BACKGROUNDnMany hospitals would benefit from a reduction in the length of inpatient hospital stays; in this regard, nursing approaches require complementation to ensure optimized nursing care. Such action is particularly important in general hospitals in Korea, where the ratio of patients to nurses is more than 10:1.nnnOBJECTIVESnThis study aimed to determine the effectiveness of a unit-coordinator system in complementing primary nursing in general hospitals as a means of reducing inappropriate hospital stays.nnnMETHODSnThe unit-coordinator system was implemented in seven wards in a hospital in Seoul for 8 weeks. The existing primary nursing system was maintained, and newly placed unit-coordinators organized the activities within each ward. The numbers of early admissions and early discharges were determined by assessing the electronic administrative records of the hospital. Further, the number of patients who had undergone check-ups and chemotherapy on the day of admission was confirmed from the daily reports of each ward. The effect of the unit-coordinator system on nurse satisfaction was assessed through direct interviews.nnnFINDINGSnEarly-discharge and early-admission numbers increased significantly after implementation of the unit-coordinator system. Early admission allowed check-ups and treatments to be performed on the day of admission. Thus, this system reduced the length of hospital stay by 1 day, and the total reduction of inappropriate hospital stays over the 8-week study period was 66 days. Further, the unit-coordinator system also increased nurse satisfaction.nnnCONCLUSIONnThe unit-coordinator system is an effective method of complementing primary nursing and reducing inappropriate hospital stays.