Community Nursing Center Research Articles

Medication interventions for African-American adults: Practice-based evidence from two nurse-led clinics.

This study was conducted to describe and examine the impact of medication intervention practices among African-American clients in two nurse-led community nursing centers (CNCs). This study used a retrospective-descriptive design. Omaha System data from visits of 196 African-American adults living with chronic disease and having two or more CNC visits in which medication regimen was an identified problem and the main reason for the visit was analyzed. The sample had a mean age of 53.1 (6.67) and was primarily women (82%), uninsured, and with high school or less education. A total of 9,259 Medication regimen interventions were documented and implemented during 1,146 client CNC visits. A paired samples t test revealed statistically significant improvements in Knowledge (t=2.434, p<.01). Behavior (t=0.077, p=.94) and Status (t=1.489, p=.14) remained unchanged, although the ratings trended toward improvement for each. This study provides evidence that the nursing center model of care does improve the knowledge of medications among African-American clients. The study also demonstrated the Omaha System's utility to evaluate the impact of nursing interventions in community settings.

Ponkesdes Development into Community Nursing Center Based Health Promotion Model, Nursing Center and Behavioral Performance

Introduction: The vision of development in East Java is to realize a prosperous society and morals. In order to improve public health, as one of the measures to achieve this vision will require proximity access and improving the quality of health services in the community. Health cottage village (Ponkesdes) is a basic health services located in the village or villages that are part of the development of village midwife (Polindes). The aim of this study was to develop into a Community Nursing Center Ponkesdes based Health Promotion Model Theory, Nursing Center, and Performance Behavior nurse.Methods: The study design was an observational analytic consisting of two phases, namely the implementation of the exploratory and descriptive exploration causa effect. The population used in this study were nurses ponkesdes Tuban district that fit inclusion criteria as much as 20, with a sample of 20 respondents were determined using simple techniques saturated. The independent variable in this study is Nursing Center, Health Promotion and Behavior Model Performance dependent variable is the commitment and the action plan ponkesdes duty nurse. Instruments used in the collection of data in the form of questionnaires and data results focused discussion. Analysis of studies using the Partial Least Square.Results: This study showed a significant effect on Nursing Center nurse commitment Ponkesdes (t = 3.197). Health Promotion Model a significant effect on the commitment of nurses Ponkesdes (t = 2.185). Commitment nurses significantly influence nurses task Ponkesdes (t = 29.546).Discussion and Conclusions: Model development of community nursing center Ponkesdes be very relevant to be applied to programs that can improve the health and can be a solution for institutions of public health services.

Using ACHIS to Analyze Nursing Health Promotion Interventions for Vulnerable Populations in a Community Nursing Center: A Pilot Study

The purpose of the study was to describe the health promotion interventions of nurses serving a low-income urban population in an academic community nursing center (CNC) in Wisconsin. The Omaha System (OS) was used to code client problems and nursing interventions for 9,839 visits at the CNC. A dataset created by the Automated Community Health Information System (ACHIS), a computerized clinical information system, was used. A pilot testing was performed with the ACHIS data repository. Each intervention was linked to a nursing diagnosis coded with modifiers as either actual or potential problems or health promotion issues. The Lundeen's Comprehensive Community-based Primary Health Care Model (CCPHCM) which emphasizes primary prevention and health promotion activities served as the conceptual framework for this study. A total of 58,747 modifiers were documented for 58,747 nursing diagnoses where a total of 9,836 nursing interventions were provided to 9,839 community center visits at the CNC. Although a majority of the nursing diagnoses (61.8%) were coded as actual problems as might be expected for this vulnerable population, 38% of the client problems were documented as potential problems (20.6%) and health promotion issues (17.7%.) Health Teaching, Guidance and Counseling (38.9%) and Case Management (25.8%) were the most frequently coded interventions. This research adds to the understanding of the importance of nurses' interventions toward health promotion with the vulnerable population. This preliminary analysis suggests that the ACHIS provide a clinical information system for collecting, storing, processing, retrieving, and managing clinical data in a data repository. [Asian Nursing Research 2009;3(3):130-138].

The Midwest Nursing Centers Consortium Research Network: Translating Research Into Practice

Community nursing centers (CNCs) serve the health needs of culturally diverse populations that are often marginalized and likely to experience disparities in health. CNCs utilize innovative models of primary health care that blend traditional medical management with nursing case management and community-based health promotion strategies. This article describes the mission and activities of the Midwest Nursing Centers Consortium Research Network (MNCCRN), a practice-based research network (PBRN) funded by the Agency for Healthcare Research and Quality, and is one of only two federally funded nonphysician primary care PBRNs and the only PBRN in the United States comprising exclusively CNCs. The MNCCRN utilizes Advanced Practice Nurses to deliver primary health care with a particular emphasis on reducing health disparities. The MNCCRN has successfully established a multisite, multistate collaboration for community-based participatory research that will ultimately inform practice, education, and health policy.

Wellness for a Lifetime: Improving Lifestyle Behaviors of Low-Income, Ethnically Diverse Populations

Eight community nursing centers (CNCs) belonging to the Midwest Nursing Centers Consortium, a practice-based research network, implemented a community-based, multidimensional strategy to promote behavior changes among high-risk, ethnically diverse, low-income adults. The purposes of this study were

Surveillance as a Nursing Intervention: Use in Community Nursing Centers

The purpose of this multisite retrospective descriptive study was to describe the nature of surveillance as a nursing intervention within 3 urban community nursing centers (CNCs). Secondary analysis of clinical data was conducted for clients seen in 1995. The CNCs used the Automated Community Health Information System (Lundeen & Friedbacher, 1994), a relational database. Nursing diagnoses and interventions were described according to the Omaha Classification System (Martin & Scheet, 1992b). The sample included 1,506 unduplicated clients who received care during 5,248 encounters and was characterized by more adults 20 years and older (56.1%), women (71.0%), and African Americans (77.2%). The age range of the clients was infancy to 95 years (M= 29.90 years). Surveillance was a significant nursing intervention making up 27.1% of all interventions (7,557 of 27,898), and 68.5% of the clients received surveillance. There was a significant relation between the provision of surveillance and age range, χ² (5, N = 1,427) = 211.96, p _ .001, V = .385, and gender, χ² (1, N = 1,501) = 17.90, p _.001, φ = .109. Clients who were 40 years and older and who were women were more likely to receive surveillance. Surveillance was provided most often for the diagnoses of circulation and nutrition. Health promotion and disease prevention diagnoses were more likely to prompt surveillance. The provision of surveillance was linked to age and developmental risk factors.

Developing a Community Nursing Center

With the move to community-based nursing education, schools of nursing are seeking ways to implement high-quality clinical experiences for undergraduate and graduate students in partnership with the community. The author presents ten tips for the development of a community nursing center that accomplishes this goal.

Advanced practice community health nursing in community nursing centers: a holistic approach to the community as client.

Community nursing centers are unique arenas for advanced practice community health nursing. These innovative nurse-managed delivery models are grounded in a holistic approach to the community-as-client. They provide the public with direct access to a range of advanced practice professional nursing services that are not otherwise available. Community Nursing Centers are collaborative with other health professions and organizations. They aim to meet the assessed needs of underserved populations using extant resources to achieve optimal health for all members of the community. This article discusses the underlying conceptual basis for development of community nursing centers and provides a case study example.

Population-Based Research: The Foundation for Development, Management, and Evaluation of a Community Nursing Center

The use of population level data is central to developing and managing community-focused programs that promote and protect the health of the public and to evaluating the outcomes of these efforts. Community nursing centers provide a focus to examine the use of population level data in the development of programs for community health practice and research. While health-related data may be analyzed at the level of individuals, families, populations, or communities, for effective community programs the use of population level data is essential. The conceptual relationship of these different levels of data to the organizational process is explored.

An Alternative Paradigm for Promoting Health in Communities: The Lundeen Community Nursing Center Model

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Community Nursing Centers???Issues for Managed Care

Community nursing centers (CNCs) can contribute significantly to the effectiveness and efficiency of managed care networks. The Silver Spring CNC is one example of a community nursing center that has demonstrated the ability to positively affect both the process and outcome of care for users from an urban community in Milwaukee. The CNCs must develop mechanisms to document both the process and outcomes of nursing practice and place these data squarely in the public policy arena if the full potential of these innovative practice organizations is to be realized.

Foot Care: An innovative Nursing Service in a Community Nursing Center

In this article we describe how providing regular foot care for the residents of public housing at an on-site nursing clinic has become a vital part of the clinic's services for the elderly and disabled residents. Good foot care contributes significantly to the health and well-being of elderly and at-risk groups of clients. With relatively little extra education for the nursing staff and for minimal cost, foot care can become an integral part of nursing services provided in many different types of community health settings. A framework for initiating and implementing a foot care program is highlighted.

Using nursing diagnoses to explain utilization in a Community Nursing Center.

The purpose of this study was to examine the usefulness of nursing diagnoses, based on the Omaha System framework, in explaining utilization of primary health care services in a Community Nursing Center (CNC). Utilization was defined as the number of client visits at the CNC. Data were obtained from a total of 331 client records where the Omaha System taxonomy was used in the documentation of nursing diagnoses with each nurse/client encounter. Hierarchic regression analysis was conducted to examine predictors of utilization. Nursing diagnoses were significant predictors of utilization at the CNC above and beyond client demographics. These findings suggest that nursing diagnoses data may be useful in explaining clients' use of CNCs.

Dollars and sense in health reform: interdisciplinary practice and community nursing centers.

Historically, community nursing centers (CNCs) provided care to underserved populations, and today they are reemerging to provide accessible, nurse-managed care in urban and rural settings. The quality and cost-effectiveness of care provided by advanced practice nurses in a managed-care environment is described using the Neuman Systems Model. Significant documentation from the literature underscores the value of nurse-managed care, but supports the need for interdisciplinary practice. CNC primary and preventive care in a "center without walls" is described and promoted for accessible, cost-effective and quality care in the context of health care reform.

Community Nursing Centers Gaining Ground as Solution to Health Issues

Community Nursing Centers Gaining Ground as Solution to Health Issues

Establishing a Profitable Outpatient Community Nursing Center

In 1983, the newly implemented prospective payment system reduced the length of hospital stays, thereby curtailing many of the services that patients traditionally received. The Division of Nursing at Memorial Medical Center of Long Beach, California identified many patient needs that were no longer being addressed during the inhospital stay and began looking for a way for nurses to meet these needs on an outpatient basis. The result was the formation of Memorial Medical Center's Community Nursing Center.

Meeting the health care needs of older adults through a community nursing center.

1Assistant Professor, School of Nursing, University of Texas Health, Science Center at Houston 2Chief Nurse, Harris County Health Department, Houston, Texas