Julie Lamoureux

Laparoscopic ventral hernia repair with primary closure versus no primary closure of the defect: potential benefits of the robotic technology

Some authors recommend primary closure of the defect before placement of the mesh. The purpose of this study is to compare laparoscopic ventral hernia repair (LVHR) without primary closure of the defect (NPCD) versus LVHR with primary closure of the defect (PCD).

Measuring perceptions of shared governance in clinical practice: psychometric testing of the RN-focused Index of Professional Governance (IPNG)

Shared governance is considered an innovative management process model that includes shared decision-making between all members of the healthcare workforce and focuses on nurses’ control over their practice and accountability of care. One specific tool that measures shared governance perceptions of nurses is the RN-focused Index of Professional Governance (IPNG). The objective of this study was to assess reliability and add to the validity of the IPNG by further establishing the construct validity and correlating the scale scores to measures of satisfaction obtained from the National Database of Nursing Quality Indicators (or NDNQI) survey. There were 76 respondents representing six units in one hospital. We reported high reliability for each one of the six subscale scores as well as for the total score (Cronbach alphas of 0.94 and higher). Construct validity was supported by the invariance of the scores across age groups along with schooling and experience levels. Concurrent validity was supported by a correlation of the IPNG score with job enjoyment (r = 0.437, p = 0.002) and the desire to recommend the hospital as a place of employment (r = 0.442, p = 0.001). The IPNG should also be tested in other healthcare professionals as its scoring ability can compare management, units and departments.

Association between Severity of Anemia and 30-Day Readmission Rate: Archival Data of 847 Patients with Acute Decompensated Heart Failure

Hospitals today are facing adjustments to reimbursements from excessive readmission rates. One of the most common and expensive causes of readmissions is exacerbation of a heart failure condition. The objective of this paper was to determine if there was an association between the presence of anemia in patients with acute decompensated heart failure and their readmission rate. Using archival data of 4 hospitals in the Miami area, a sample of 847 inpatients with a diagnostic related group (DRG) of HF at discharge was considered. There was a significant association between low hemoglobin values and a high rate of readmissions at 14 days and at 30 days in subjects with normal sodium and creatinine values. For subjects with low sodium and high creatinine values, a higher readmission rate was seen in men with low hemoglobin but not in women. These results support a prospective effort to measure the impact of anemia and its treatment on readmission rates.