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27 results on '"Bowers, Margaret T."'

2. Early Intervention for Steal Syndrome in Patients on Hemodialysis

Author

Kamel, Nada F., Bowers, Margaret T., Leonard, Christina, and Dillavou, Ellen D.

Subjects
Ischemia -- Care and treatment, Nursing care -- Methods, Hemodialysis -- Complications and side effects, Hemodialysis patients -- Care and treatment, Health
Abstract

Dialysis access-associated steal syndrome (DASS) is a serious, challenging complication related to diminished arterial blood flow to the hand. Patients may not be routinely assessed for this diagnosis, resulting in a delayed presentation with severe hand pain, nerve damage, and tissue loss. This pilot project examined the feasibility of implementing an assessment tool to routinely screen patients for steal syndrome. The tool was used for all patients in three participating dialysis centers. Positive patients had a streamlined referral to vascular surgery for assessment and possible treatment. This pilot project demonstrates that education and subsequent routine screening for DASS within the dialysis facility is feasible, and can be incorporated into the workflow for both the dialysis facility and the servicing vascular surgery office. Early recognition of DASS will prevent severe injuries and tissue loss. Key Words: Steal syndrome, dialysis access, dialysis access steal syndrome prevention, symptoms of steal syndrome, Steal Syndrome Assessment Tool., [NC/PD] 1.3 contact hours Dialysis-access-associated steal syndrome (DASS) is a serious complication that causes the hand in the hemodialysis access arm to become ischemic as the hemodialysis access reduces or [...]

Published
2023
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7. Implementing Electronic Tablet-Based Education of Acute Care Patients.

Author

Sawyer, Tenita, Nelson, Monica J, McKee, Vickie, Bowers, Margaret T, Meggitt, Corilin, Baxt, Sarah K, Washington, Delphine, Saladino, Louise, Lehman, E Philip, Brewer, Cheryl, Locke, Susan C, Abernethy, Amy, Gilliss, Catherine L, and Granger, Bradi B

Subjects
Health Services and Systems, Health Sciences, Clinical Research, Bioengineering, Cardiovascular, Heart Disease, 7.3 Management and decision making, Management of diseases and conditions, Quality Education, Heart Failure, Humans, Mobile Applications, Patient Education as Topic, Workflow, Nursing, Clinical sciences
Abstract

Poor education-related discharge preparedness for patients with heart failure is believed to be a major cause of avoidable rehospitalizations. Technology-based applications offer innovative educational approaches that may improve educational readiness for patients in both inpatient and outpatient settings; however, a number of challenges exist when implementing electronic devices in the clinical setting. Implementation challenges include processes for "on-boarding" staff, mediating risks of cross-contamination with patients' device use, and selling the value to staff and health system leaders to secure the investment in software, hardware, and system support infrastructure. Strategies to address these challenges are poorly described in the literature. The purpose of this article is to present a staff development program designed to overcome challenges in implementing an electronic, tablet-based education program for patients with heart failure.

Published
2016

16. Improving congestive heart failure care with a clinical decision unit

Author

Carpenter, Jo Ellen, Short, Nancy, Williams, Tracy E., Yandell, Ben, and Bowers, Margaret T.

Subjects
Hospitals -- Quality management, Decision making -- Methods -- Health aspects, Coronary care units -- Quality management, Congestive heart failure -- Care and treatment, Health
Abstract

* Evidence supporting the development of Clinical Decision Units (CDUs) to impact congestive heart failure readmission rates comes from several categories of the literature. * In this study, a pre-post design with comparison group was used to evaluate the impact of the CDU. * Early changes in clinical and financial outcome indicators are encouraging. * Nurse leaders seek ways to improve clinical outcomes while managing the current financially challenging environment. * Implementation of a CDU provides many opportunities for nurse leaders to positively impact clinical care and financial performance within their institutions., ACROSS THE NATION, hospitals are realizing the financial impact of altered Medicare reimbursement processes based on pay-for-performance programs called Value-Based Purchasing (VBP) and the Readmissions Reduction Program (RRP). These evolving [...]

Published
2015

17. Tools for Economic Analysis of Patient Management Interventions in Heart Failure Cost-Effectiveness Model: A Web-based program designed to evaluate the cost-effectiveness of disease management programs in heart failure

Author

Reed, Shelby D., Neilson, Matthew P., Gardner, Matthew, Li, Yanhong, Briggs, Andrew H., Polsky, Daniel E., Graham, Felicia L., Bowers, Margaret T., Paul, Sara C., Granger, Bradi B., Schulman, Kevin A., Whellan, David J., Riegel, Barbara, and Levy, Wayne C.

Published
2015
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19. Discordance between patient-predicted and model-predicted life expectancy among ambulatory patients with heart failure

Author

Allen, Larry A., Yager, Jonathan E., Levy, Wayne C., Funk, Michele Jonsson, Tulsky, James A., Bowers, Margaret T., Dodson, Gwen C., Felker, G. Michael, and O'Connor, Christoper M.

Subjects
Heart diseases -- Care and treatment, Heart diseases -- Prognosis, Heart diseases -- Patient outcomes
Abstract

A study to evaluate the perception that ambulatory patients with cardiac disease associated with survival and compared this with previously available model data is conducted. Results reveal that active patients with cardiac problems had positive perceptions of their survival rates, which could affect decisions for future therapies and called for further study.

Published
2008

21. Testing new targets of therapy in advanced heart failure: the design and rationale of the Strategies for Tailoring Advanced heart failure Regimens in the outpatient setting: BRain natrIuretic peptide versus the clinical congesTion scorE (STARBRITE) trial

Author

Shah, Monica R., Claise, Karen A., Bowers, Margaret T., Bhapkar, Manjushri, Little, Julie, Nohria, Anju, Gaulden, Laura H., McKee, Vickie K., Cozart, Kara L., Mancinelli, Karen L., Daniels, Helen, Kinard, Tesca, Stevenson, Lynne W., Mancini, Donna M., O'Connor, Christopher M., and Califf, Robert M.

Subjects
Congestive heart failure -- Care and treatment, Diuretics -- Research, Ambulatory medical care -- Research, Natriuretic peptides -- Evaluation, Health
Published
2005

24. Introduction of the TEAM-HF Costing Tool: A User-Friendly Spreadsheet Program to Estimate Costs of Providing Patient-Centered Interventions

Author

Reed, Shelby D., Li, Yanhong, Kamble, Shital, Polsky, Daniel, Graham, Felicia L., Bowers, Margaret T., Samsa, Gregory P., Paul, Sara, Schulman, Kevin A., Whellan, David J., and Riegel, Barbara J.

Subjects
Heart Failure, User-Computer Interface, Models, Economic, Cost-Benefit Analysis, Patient-Centered Care, Humans, Health Care Costs, Article, Software, United States, Patient Care Management
Abstract

Patient-centered health care interventions, such as heart failure disease management programs, are under increasing pressure to demonstrate good value. Variability in costing methods and assumptions in economic evaluations of such interventions limit the comparability of cost estimates across studies. Valid cost estimation is critical to conducting economic evaluations and for program budgeting and reimbursement negotiations.Using sound economic principles, we developed the Tools for Economic Analysis of Patient Management Interventions in Heart Failure (TEAM-HF) Costing Tool, a spreadsheet program that can be used by researchers and health care managers to systematically generate cost estimates for economic evaluations and to inform budgetary decisions. The tool guides users on data collection and cost assignment for associated personnel, facilities, equipment, supplies, patient incentives, miscellaneous items, and start-up activities. The tool generates estimates of total program costs, cost per patient, and cost per week and presents results using both standardized and customized unit costs for side-by-side comparisons. Results from pilot testing indicated that the tool was well-formatted, easy to use, and followed a logical order. Cost estimates of a 12-week exercise training program in patients with heart failure were generated with the costing tool and were found to be consistent with estimates published in a recent study.The TEAM-HF Costing Tool could prove to be a valuable resource for researchers and health care managers to generate comprehensive cost estimates of patient-centered interventions in heart failure or other conditions for conducting high-quality economic evaluations and making well-informed health care management decisions.

Published
2011

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