Marlene R. Ventura

A patient satisfaction measure as a criterion to evaluate primary nursing.

The Risser Patient Satisfaction Scale was used to evaluate the effectiveness of implementing the key concepts of primary nursing. An experimental control design was used. Forty-six subjects from two units completed the questionnaire. Estimates of reliability and homogeneity are reported. There is reason to question the discriminant validity of the subscales. No significant differences were obtained between the units on any of the subscales or total scale score. A number of explanations are offered for interpreting the measuring of the nonsignificance of the differences. Work need to continue on revising existing patient satisfaction measures or developing new ones. Other criteria with theoretical importance should be used in conjunction with satisfaction measures in assessing the effects of primary nursing.

The relationship between knowledge about acquired immunodeficiency syndrome and the implementation of universal precautions by registered nurses.

The relationship between the level of knowledge of registered nurses [RNs] concerning acquired immunodeficiency syndrome [AIDS]-related issues and the practical observance of universal precautions was studied. It was hypothesized that the more knowledge a nurse has concerning AIDS the more likely he or she is to implement universal precautions. All registered nurses who have direct patient contact (N = 400) and are employed at a Northeastern teaching medical center, were provided a packet of three questionnaires and encouraged to participate. Two hundred thirteen (53%) RNs returned completed questionnaires Subgroups were examined for trends relating such parameters as age and the amount of AIDS knowledge, using analysis of variance. The major hypothesis was tested by correlating the scores for AIDS knowledge and the implementation score. Results indicated no relationship between knowledge and the implementation of universal precautions (r = −0.12). When evaluating scores according to work areas, those subjects with higher knowledge scores had lower practice scores. Other demographic variables showed no influence on either knowledge or implementation scores as measured by this study Further study is needed to understand what factors will motivate RNs to implement universal precautions.

Promoting research-based nursing: the nurse administrator's role.

As the practice of research increasingly becomes a part of the nursing profession, nurses must develop their ability to evaluate and incorporate the findings gained through the research process. This article reports the results of a survey aimed at determining problem areas existing among nursing staffs in understanding, accepting, and incorporating research findings. The report will help nursing administrators identify specific factors that inhibit the use of research findings and improve the conditions for incorporating research in their facilities.

Enhancing subject recruitment for nursing research.

NURSING RESEARCH MOST often requires human subjects. Consequently, an essential component in planning and conducting research entails recruitment of subjects who knowledgeably consent to participate. A well-established theoretical base exists regarding sampling techniques and procedures for research methods. The operationalization of the theory into practical terms may be of interest to the clinical nurse specialist (CNS) who frequently assumes a leadership role to both conduct nursing research in practice settings and to advise other nurses interested in conducting research. The recruitment efforts in four different nursing studies were compared and contrasted in an effort to determine effective and efficient approaches to this issue. Sample populations included nurse practitioners, patients, nurse aides, and nurse educators. Methods of recruitment included direct contact, mail, and telephone contact. While the settings, purposes, and designs of the studies varied, some common elements regarding subject recruitment were suggested. The recruitment methods have been described, along with the implication in terms of practical application for conduct of nursing research by CNSs.

Correlation between the quality patient care scale and the Phaneuf audit

There has been a sustained interest in the assessment of quality of health care delivery in the United States of America. This has been manifested by accelerated efforts for the development, maintenance and improvement of quality assurance programs. At the same time, there is an increasing need for the development of reliable and valid instruments to accomplish this objective (Lindeman, 1975). Donabedian (1966) described a framework for evaluation that includes structure, process and outcome. To date in nursing, most of the emphasis has focused on the assessment of the process of nursing care. Process approaches measure those nursing care activities performed by nursing personnel on behalf of patients and families. This definition is further refined by the addition of a qualifier to differentiate between evaluating concurrent and retrospective process. Concurrent evaluation focuses on review of nursing care while it is in progress and while the patient is still in the hospital. This approach is exemplified by such instruments as the Quality Patient Care Scale (QualPacs) (Wandelt and Ager, 1974), Veterans Administration Nursing Care Quality Evaluation Scale (VA-NCQE) (Veterans Administration Department of Medicine and Surgery, 1969) and RUSH-Medicus Methology for Monitoring Quality of Nursing Care (Jelinek, Haussmann, Hegyvary and Newman, 1974; Haussmann, Hegyvary and Newman, 1976; Haussmann and Hegyvary, 1977). In concurrent review, the evaluation is completed during a patient’s hospitalization, using not only the patient’s clinical records, but also a patient interview (if appropriate) and direct observation. Supporters of this approach say that although concurrent review of nursing care is more costly, this approach provides more information sooner and enables improvement of care for the specific patient for whom the changes in care are indicated (Trussell and Strand, 1978).

Effectiveness of Health Promotion Interventions

The purpose of the study was to determine whether patients who participated in an intervention program would improve exercise and foot-care habits, reduce smoking, and would, in turn, have fewer PVD-related illnesses than patients not exposed to the intervention. Eighty-six patients with ankle/ brachial pressure indices of less than 1.0 on one or both legs were randomly assigned to a study (N=42) or control (N=44) group. All patients were assessed on a variety of health-related and activity behaviors prior to and again 26 weeks after enrollment in the study. Study patients who participated in the intervention worked with professionals on selecting programs designed to modify and improve their smoking, exercise, and/ or foot-care habits. At the end of 26 weeks, chi-square analysis showed no significant differences between study and control groups on change in smoking and foot care, although the results were in the anticipated direction. Study patients who chose to increase their exercise showed greater increase than control patients in frequency (p = .001), distance (p = .007), and length (p = .002) of walks. Although behaviors were modified, especially in the area of exercise, it was felt that longer interventions on a larger sample size are needed.

Study priorities identified by nurses in mental health settings

The policy of establishing priorities for research is not new (Abdellah, 197Oa, 6, c; American Nurses’ Assodiation, 1976, 1980; Gortner et al., 1976). However, it has received added attention in recent years (Lindeman, 1975; Oberst, 1978). In a project supported by funds from the Health Services Research and Development Service, Veterans Administration, Washington, DC, the Delphi Technique was used to identify areas for systematic study in the care of the veteran patient as perceived by members of the Veterans Administration Nursing Service (Ventura and Waligora-Serafin, 1979, in press). The purpose of this paper is to identify only that portion of the larger study that dealt with priorities for research as perceived by nurses working in mental health settings. The outcome of such an endeavor would be: (1) the identification of priority statements that could assist in the determination of a relevant scope of research by mental health nurses; (2) the assignment of a degree of importance to identified priority areas; (3) the ability of Nursing Service administrators to promote and enhance the utilization of research that has implications for nursing practice; (4) the opportunity for more intensive research; (5) the opportunity to link researchers with nurses working in the clinical area.

In a changing world: database to keep the pace.

A database to manage health care information can be an especially useful tool for the CNS. Systematic management of information is important in the multifaceted role characteristic of the CNSs scope of practice. The CNS not only provides theoretically sound creative care to patients and serves as a role model to nursing staff, but also monitors and substantiates the quality and effectiveness of care delivered. To do this, the CNS participates in research activities and synthesizes and uses research findings. These aspects of professional practice require collection and analysis of information that could be facilitated by the use of a database. The purposes of this article are to introduce some basic concepts of database and its relevance and contribution to the CNS, discuss issues inherent in setting up a database, and provide guidelines for CNSs who are considering using a database in their clinical practice.

Long-Term Care Nurses Identify Educational Needs Regarding Quality Assessment and Improvement

An increasing demand is being placed on nurses who are practicing in long-term care settings to conduct and/or participate in quality assessment and improvement (QAI) activities. A local survey of directors of nursing in long-term care indicated both personal interest and interest on the part of their staff nurses to attend continuing education (CE) programs regarding quality of care to increase their competencies in this area. Specific interest areas and recommendations for an educational offering regarding quality assessment and improvement for long-term care nurses are described.

Internal psychometric characteristics of the quality patient care scale.

This study sought to clarify the subdimensions of the domain of quality nursing care as measured by the Quality Patient Care Scale. The care received by 269 surgical patients over a predetermined period was assessed by nonparticipant nurse observers using the methodology. The instrument contains six subscales. The data analyses showed them to be internally homogeneous and capable of providing reliable measurements. The unrotated first factor for each subscale is strong and items correlate with it and with the respective subscale totals. However, in the Psychosocial Individual, Physical, and General areas, enough clustering of items within subscales emerged to support the contention that there are several conceptually discrete, yet interdependent, sources of variation in each subdomain. The factor analyses identified the clustering of items, but, in the present exploratory mode of research, the ability to understand the apparent complexity of subdomains is limited. Future researchers should elaborate these complexities to determine if they represent consistent and discrete sources of variance that can be replicated and used to provide more accurate assessments. The subscales moderately intercorrelated, and evidenced discriminant validity.