15 results on '"Picone DM"'
Search Results
2. Measuring the dose of nursing intervention.
- Author
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Reed D, Titler MG, Dochterman JM, Shever LL, Kanak M, and Picone DM
- Abstract
PURPOSE. To increase awareness of the many issues involved in measuring the dose of nursing intervention in nursing interventions effectiveness research. METHODS. Identify critical issues in measurement of the dose of nursing intervention and discuss decisions regarding dosage measurement made in a study of the effectiveness of nursing interventions. FINDINGS. A single method can be applied to resolve two critical issues in intervention dosage measurement. CONCLUSIONS. Those conducting nursing interventions effectiveness research must think explicitly about how intervention dosage will be measured and reported so that dosage can be replicated in research and practice. PRACTICE IMPLICATIONS. Measuring and reporting the dose of nursing intervention in research is essential to the development of an evidence base adequate to support practice. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
3. Patterns of nursing intervention use across 6 days of acute care hospitalization for three older patient populations.
- Author
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Shever LL, Titler M, Dochterman J, Fei Q, and Picone DM
- Abstract
PURPOSE. The purpose was to (a) identify frequently used nursing interventions, and (b) describe patterns of interventions used for each of the three patient groups. METHODS. This secondary data analysis used data from an academic medical center where the Nursing Interventions Classification (NIC) was used to electronically document nursing care. Descriptive statistics describe the types, frequencies, and patterns of NIC interventions delivered to three older acute care populations. FINDINGS. Four NIC treatments were frequently used in all patient groups. There were also NIC treatments and patterns of treatments that were unique to each group. CONCLUSIONS AND IMPLICATIONS. Using standardized nursing language in electronic medical records (EMRs) enables data extraction and analysis. Data extracted from EMRs provides nurse administrators with a tool to guide decisions regarding nurse staffing, education, evaluation, and resource allocation. [ABSTRACT FROM AUTHOR]
- Published
- 2007
- Full Text
- View/download PDF
4. Nursing interventions and other factors associated with discharge disposition in older patients after hip fractures.
- Author
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Titler M, Dochterman J, Xie X, Kanak m, Fei Q, Picone DM, and Shever L
- Published
- 2006
5. Cost of hospital care for elderly at risk of falling.
- Author
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Titler M, Dochterman J, Picone DM, Everett L, Xie X, Kanak M, and Fei Q
- Abstract
The variables that relate to cost of hospital care for a large sample of elderly patients at risk for falling are examined. The chief predictors of cost of hospitalization were medical, pharmacy, and nursing interventions. Use of nursing interventions, on average, raised the median hospital cost less than use of medical or pharmacy interventions. Using a standardized nursing language with the hospital's information system can provide nurses with information that demonstrates the cost effectiveness of their interventions. [ABSTRACT FROM AUTHOR]
- Published
- 2005
6. Factors associated with falls during hospitalization in an older adult population.
- Author
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Titler MG, Shever LL, Kanak MF, Picone DM, and Qin R
- Subjects
- Aged, Humans, Risk Factors, Accidental Falls, Hospitalization
- Abstract
Background: Falls of hospitalized older adults are of concern for patients, family members, third-party payers, and caregivers. Falls are the most common safety incident among hospitalized patients with fall rates from 2.9-13 per 1,000 patient days. Little effectiveness research has been conducted on nursing interventions and other variables associated with falls of older adults during hospitalization., Purpose: The purpose of this exploratory outcomes effectiveness study was to examine variables associated with falls during hospitalization of older adults., Method: An effectiveness research model composed of patient characteristics, clinical conditions, nursing unit characteristics, medical, pharmacy, and nursing interventions was tested using generalized estimating equations (GEE) analysis. The sample consisted of 10,187 hospitalizations of 7,851 patients, aged 60 or older, admitted for acute care services over a 4-year period. Those included in the sample either had received the Nursing Interventions Classification (NIC) intervention of Fall Prevention (defined as "instituting special precautions with patient at risk for injury from falling" [Dochterman & Bulechek, 2004, p. 363]) or were at risk for falling as defined by a fall risk assessment scale. Data were obtained retrospectively from 9 clinical and administrative data repositories from 1 tertiary care hospital., Discussion: Variables that were positively associated with falls, after controlling for other variables in the model, included several medical and nursing treatments; several types of medications including antidepressants, benzodiazepines, antipsychotic, and psychotropic agents; and several types of nursing treatments including restraints and neurologic monitoring (at low use rates of < 2 times a day). Variables inversely associated with falls included registered nurse (RN) skill mix, pressure ulcer care, pain management, and tube care., Conclusions: The study demonstrates the importance of conducting interdisciplinary effectiveness research that includes nursing care. Most of the variables associated with falls were interventions (medical, pharmacy, and nursing). Dose of nursing treatments and RN skill mix were also associated with falls.
- Published
- 2011
- Full Text
- View/download PDF
7. Predictors of medication errors among elderly hospitalized patients.
- Author
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Picone DM, Titler MG, Dochterman J, Shever L, Kim T, Abramowitz P, Kanak M, and Qin R
- Subjects
- Age Factors, Aged, Comorbidity, Drug Utilization, Hospitals, Teaching organization & administration, Hospitals, Teaching statistics & numerical data, Humans, Medication Errors classification, Nursing Staff, Hospital organization & administration, Personnel Staffing and Scheduling organization & administration, Polypharmacy, Retrospective Studies, Severity of Illness Index, Sex Factors, Socioeconomic Factors, Hospital Administration statistics & numerical data, Medication Errors statistics & numerical data, Quality Assurance, Health Care organization & administration
- Abstract
Medication errors are a serious safety concern and most errors are preventable. A retrospective study design was employed to describe medication errors experienced during 10187 hospitalizations of elderly patients admitted to a Midwest teaching hospital between July 1, 1998 and December 31, 2001 and to determine the factors predictive of medication errors. The model considered patient characteristics, clinical conditions, interventions, and nursing unit characteristics. The dependent variable, medication error, was measured using a voluntary incident reporting system. There were 861 medication errors; 96% may have been preventable. Most errors were omissions errors (48.8%) and the source was administration (54%) or transcription errors (38%). Variables associated with a medication error included unique number of medications (polypharmacy), patient gender and race, RN staffing changes, medical and nursing interventions, and specific pharmacological agents. Further validation of this explanatory model and focused interventions may help decrease the incidence of medication errors.
- Published
- 2008
- Full Text
- View/download PDF
8. The effects of hospitalization on multiple units.
- Author
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Kanak MF, Titler M, Shever L, Fei Q, Dochterman J, and Picone DM
- Subjects
- Academic Medical Centers, Aged, Efficiency, Organizational, Female, Hospital Costs, Humans, Length of Stay, Linear Models, Logistic Models, Male, Midwestern United States, Multivariate Analysis, Nursing Administration Research, Nursing Evaluation Research, Outcome Assessment, Health Care, Patient Care Planning organization & administration, Patient Discharge standards, Patient Education as Topic, Continuity of Patient Care organization & administration, Hospital Units organization & administration, Nurse's Role, Patient Transfer organization & administration, Quality Indicators, Health Care organization & administration
- Abstract
Patients are often cared for on multiple units during the course of a hospitalization. This study used general linear modeling and logistic regression analyses to demonstrate the effect of hospitalization on multiple units upon selected nursing treatments, resource use, and clinical outcomes. Primary medical diagnosis, comorbid medical conditions, and severity of illness were controlled for in the analyses. A significant association was found between hospitalizations on multiple units and selected nursing treatments, resource use, and all clinical outcomes except for mortality. Nurses play a central role in coordinating the care that patients receive across inpatient units and are positioned to develop and implement strategies to mediate the negative impacts associated with patients moving across multiple units.
- Published
- 2008
- Full Text
- View/download PDF
9. The effect of high nursing surveillance on hospital cost.
- Author
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Shever LL, Titler MG, Kerr P, Qin R, Kim T, and Picone DM
- Subjects
- Aged, Cost-Benefit Analysis, Direct Service Costs, Female, Humans, Male, Middle Aged, Midwestern United States, Models, Econometric, Risk Assessment, Accidental Falls prevention & control, Hospital Costs, Hospitalization economics, Nursing Assessment economics, Nursing Staff, Hospital economics, Population Surveillance
- Abstract
Purpose: The purpose of this study was to determine the cost of one nursing treatment, surveillance, for older, hospitalized adults at risk for falling., Design: An observational study using information from data repositories at one Midwestern tertiary hospital. The inclusion criteria included patients age>60 years, admitted to the hospital between July 1, 1998 and June 31, 2002, at risk for falls or received the nursing treatment of fall prevention., Methods: Data came from clinical and administrative data repositories that included Nursing Interventions Classification (NIC). The nursing treatment of interest was surveillance and total hospital cost associated with surveillance was the dependent variable. Propensity-score analysis and generalized estimating equations (GEE) were used as methods to analyze the data. Independent variables related to patient characteristics, clinical conditions, nurse staffing, medical treatments, pharmaceutical treatments, and other nursing treatments were controlled for statistically., Findings: The total median cost per hospitalization was $9,274 for this sample. The median cost was different (p=0.050) for patients who received high versus low surveillance. High surveillance delivery cost $191 more per hospitalization than did low surveillance delivery., Conclusion: Propensity scores were applied to determine the cost of surveillance among hospitalized adults at risk for falls in this observational study. The findings show the effect of high surveillance delivery on total hospital cost compared to low surveillance delivery and provides an example of a useful method of determining cost of nursing care rather than including it in the room rate. More studies are needed to determine the effects of nursing treatments on cost and other patient outcomes in order for nurses to provide cost-effective care. Propensity scores were a useful method for determining the effect of nursing surveillance on hospital cost in this observational study., Clinical Relevance: The results of this study along with possible clinical benefits would indicate that frequent nursing surveillance is important and might support the need for additional nursing staff to deliver frequent surveillance.
- Published
- 2008
- Full Text
- View/download PDF
10. Cost of care for seniors hospitalized for hip fracture and related procedures.
- Author
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Titler M, Dochterman J, Kim T, Kanak M, Shever L, Picone DM, Everett L, and Budreau G
- Subjects
- Aged, Analysis of Variance, Arthroplasty, Replacement, Hip nursing, Clinical Competence, Comorbidity, Cost of Illness, Cost-Benefit Analysis, Diagnosis-Related Groups economics, Direct Service Costs statistics & numerical data, Female, Hip Fractures epidemiology, Hip Fractures therapy, Hospital Charges statistics & numerical data, Humans, Length of Stay economics, Linear Models, Male, Models, Econometric, Nurse's Role, Nursing Administration Research, Nursing Staff, Hospital economics, Nursing Staff, Hospital supply & distribution, Personnel Staffing and Scheduling economics, Retrospective Studies, Workload economics, Arthroplasty, Replacement, Hip economics, Hip Fractures economics, Hospital Costs statistics & numerical data, Hospitalization economics
- Abstract
Hospitalization and treatment for hip fracture and elective hip replacement surgery are increasing as the number of elderly increases and with new surgical breakthroughs. Little research has been conducted on the interventions and other variables that impact cost of care; no research has been published that includes the impact of nursing care on hospital cost. To explain the cost of hospital care that includes nursing interventions for an older patient population hospitalized for a hip fracture and/or related procedure. An effectiveness research model composed of patient characteristics, clinical conditions, nursing unit characteristics, medical, pharmacy, and nursing interventions related to the outcome of hospital cost was tested using GEE analysis. The analysis included 195 variables systematically reduced to 71 that were then examined in a sample of 568 hospitalizations (n = 523 patients, > or = 60 years old) admitted for treatment of a hip fracture or elective hip procedure over a 4-year period. Data were obtained retrospectively from nine clinical and administrative data repositories from one tertiary care hospital. The best predictors of increased hospital cost were the nursing intervention of Tube Care, the level of RN staffing below the unit's average, total number of medical procedures, total number of different medications, and low levels of the nursing intervention of Surgical Preparation. More RN hours per patient day and some nursing interventions were associated with reduced cost. The study demonstrates the importance of conducting effectiveness research in nursing. Some nursing interventions were associated with increased cost and some with decreased cost, but when compared with medical and pharmacy interventions, fewer nursing interventions were associated with increased cost. Inadequate RN staffing raised cost whereas increased RN staffing was associated with lower costs.
- Published
- 2007
- Full Text
- View/download PDF
11. Casemix--not guilty?
- Author
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McCaughan BC and Picone DM
- Subjects
- Australia, Hospitalization trends, Humans, Diagnosis-Related Groups economics, Hospitals, Public statistics & numerical data
- Published
- 1997
12. Devolved clinical management and casemix.
- Author
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McCaughan BC and Picone DM
- Subjects
- Australia, Humans, Patient Care Team, Product Line Management, Social Responsibility, Diagnosis-Related Groups, Health Resources statistics & numerical data, Hospital Restructuring trends
- Abstract
Devolved clinical management aims at greater medical and nursing involvement in the management of health resources and focuses on achieving measurable improvements in patient care through better use of resources. It permits the major drivers of the health care system (doctors), in collaboration with the major direct care providers (nurses), to be not only effective at allocating resources but also effective resource users. Casemix is a classification of patient care episodes based principally on resource use and can assist in the process of managing health services. We discuss the relationship between devolved clinical management and casemix systems. Health care organisations must move towards devolved clinical management, with a greater focus on the patient and a greater emphasis on accountability among all clinical disciplines.
- Published
- 1994
- Full Text
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13. Simplified counter-immunoelectrophoresis (CIEP) with a commercially produced antigen on cellulose acetate membrane for the diagnosis of hydatidosis.
- Author
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Mansueto S, Migneco G, Tripi S, and Picone DM
- Subjects
- Antigens, Counterimmunoelectrophoresis methods, Humans, Echinococcosis diagnosis
- Published
- 1980
- Full Text
- View/download PDF
14. A sero-epidemiological survey of asymptomatic cases of Boutonneuse fever in western Sicily.
- Author
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Mansueto S, Vitale G, Miceli MD, Tringali G, Quartararo P, Picone DM, and Occhino C
- Subjects
- Antibodies, Bacterial analysis, Boutonneuse Fever immunology, Fluorescent Antibody Technique, Humans, Rickettsia immunology, Sicily, Boutonneuse Fever epidemiology, Rickettsiaceae Infections epidemiology
- Abstract
963 sera from contacts, persons from various localities, and blood donors were examined with a commercially produced kit for micro-immunofluorescence for the presence of antibodies to Rickettsia conorii. 10.6% of sera were serologically positive. The higher rates of positivity were observed in sera of contacts (19%) and persons from Mussomeli (20%) and Ustica (18.4%), the lower rates in blood donors from Palermo (3.5%). These results support the view that there is an occupational risk factor related to a rural environment.
- Published
- 1984
- Full Text
- View/download PDF
15. [Further observations on the use of counterimmunoelectrophoresis (CIEP) on cellulose acetate membrane (Cellogel) in the diagnosis of visceral leishmaniasis (author's transl)].
- Author
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Mansueto S, Miceli MD, La Cascia C, and Picone DM
- Subjects
- Animals, Dogs, Humans, Counterimmunoelectrophoresis instrumentation, Counterimmunoelectrophoresis methods, Dog Diseases diagnosis, Immunoelectrophoresis methods, Leishmaniasis, Visceral diagnosis, Leishmaniasis, Visceral veterinary
- Abstract
Technique of counterimmunoelectrophoresis (CIEP) on cellulose acetate membrane (Cellogel) is described for diagnosis of (human and canine) visceral leishmaniasis (VL). Various lots of antigen were grossly obtained from the liquid phase (10, 20 and 30 tubes respectively) of cultures of Leishmania donovani by repeated freezing and thawing. Sera from patients (and, in a few cases, dogs) with confirmed VL, other parasitic and non-parastic diseases (especially blood disorders and hepatosplenomegaly) and from blood donors were tested. Positive results were obtained in 91-93% (according to various lots) of the patients with VL. All sera from infected dogs gave positive results. No precipitin lines were detected in the control sera. Antigens from 30 (or 20 tubes) showed better results with regard to the evidence of the precipitin lines. Clarity of the precipitin bands appears to be in relation to: 1. the protein concentration of the antigens; 2. the antibody levels of the sera. CIEP on cellulose acetate membrane combine the features of good sensitivity, specificity and speed of performance and appear available for use also in epidemiological research.
- Published
- 1980
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