Nurse-managed Program Research Articles

Effectiveness of Implementing an Integrated Care Management Program for Rabies Vaccination Patients

Objective: To analyze the effect of implementing a comprehensive nursing management program for rabies vaccination patients. Methods: 100 cases of rabies vaccination patients were selected as observation objects from January 2022 to December 2023, and after enrollment, they were grouped according to the different nursing management programs, with 50 cases in each group. The control group was only given routine nursing management, and the observation group was combined with comprehensive nursing management on the basis of routine nursing management. The completion rate of vaccination, the rate of adverse reactions, and the satisfaction rate were assessed, comparing the clinical effects of different nursing management programs. Results: The completion rate of the 5th shot of rabies vaccination in the observation group was 82.00% higher than 64.00% in the control group (χ2 = 4.1096, P < 0.05); the rate of adverse reaction of vaccination in the observation group was 4.00% lower than 18.00% in the control group (χ2 = 5.0051, P < 0.05); the vaccination satisfaction in the observation group was 98.00% higher than 86.00% in the control group (χ2 = 4.8913, P < 0.05). Conclusion: The application of comprehensive nursing management program can help rabies vaccination patients to improve the completion rate of vaccination and reduce the incidence of adverse reactions to vaccination, with clear effects.

Clinical Value and Safety Analysis of Adopting High-quality Nursing Management Program in Neonatal Care

Clinical Value and Safety Analysis of Adopting High-quality Nursing Management Program in Neonatal Care

The Effect of Nursing Management of Patients Undergoing Interventional Therapy for Liver Cancer Compared with Standard Care on Patient-Reported Outcomes.

To investigate the efficacy of individualized symptom management based on patients' self-reports during interventional therapy (IT) for liver cancer. Patients with liver cancer who recieved IT from April to August 2019 were assigned to either the intervention (n=70) or control group (n=70). The control group received routine nursing care and the intervention group received a nursing management program. The severity of specific symptoms, as measured by the Karnofsky Performance Scale (KPS), and satisfaction with nursing care, were analyzed. Compared to the control group, patients given individualized management experienced significantly less severe pain, nausea, anxiety, and fatigue (p < .05). The scores for KPS and satisfaction with care were both significantly improved in the intervention group than in the control group (p < .05). This high-quality nursing management program predicated on patients' self-reports is worthy of clinical application and popular adoption.

Empiric tuberculosis treatment in South African primary health care facilities - for whom, where, when and why: Implications for the development of tuberculosis diagnostic tests.

BackgroundThe extent and circumstances under which empiric tuberculosis (TB) treatment (treatment without microbiological confirmation at treatment initiation) is administered in primary health care settings in South Africa are not well described.MethodsWe used data from a pragmatic evaluation of Xpert MTB/RIF in which persons undergoing TB investigations by PHC nurses were followed for six months. Following Xpert or smear-microscopy at enrolment, investigations for tuberculosis were undertaken at the discretion of health care workers. We identified persons whose TB treatment was initiated empirically (no microbiological confirmation at time of treatment initiation at a primary health care facility) and describe pathways to treatment initiation.ResultsOf 4665 evaluable participants, 541 persons were initiated on treatment of whom 167 (31%) had negative sputum tests at enrolment. Amongst these 167, the median number of participant visits to health care providers prior to treatment initiation was 3 (interquartile range [IQR] 2–4). Chest radiography, sputum culture or hospital referral was done in 106/167 (63%). Reasons for TB treatment start were: 1) empiric (n = 82, 49%); 2) a positive laboratory test (n = 49, 29%); 3) referral and treatment start at a higher level of care (n = 28, 17%); and 4) indeterminable (n = 8, 5%). Empiric treatment accounted for 15% (82/541) of all TB treatment initiations and 1.7% (82/4665) of all persons undergoing TB investigations. Chest radiography findings compatible with TB (63/82 [77%]) were the basis for treatment initiation amongst the majority of empirically treated participants. Microbiological confirmation of TB was subsequently obtained for 11/82 (13%) empirically-treated participants. Median time to empiric treatment start was 3.9 weeks (IQR 1.4–11 weeks) after enrolment.ConclusionUncommon prescription of empiric TB treatment with reliance on chest radiography in a nurse-managed programme underscores the need for highly sensitive TB diagnostics suitable for point-of-care, and strong health systems to support TB diagnosis in this setting.

Nurse Management Program Based on Home Visits and Telephone Contacts Reduce Combined Clinical Outcomes in a Middle Income Country: Data from the Randomized Clinical Trial HELEN II

Nurse Management Program Based on Home Visits and Telephone Contacts Reduce Combined Clinical Outcomes in a Middle Income Country: Data from the Randomized Clinical Trial HELEN II

Evaluation of Clinical Outcomes One Year after Completion of Nurse Management Program Based on Home Visits and Telephone Contacts

Evaluation of Clinical Outcomes One Year after Completion of Nurse Management Program Based on Home Visits and Telephone Contacts

Referral to Telephonic Nurse Management Improves Outcomes in Women With Gestational Diabetes

Objective We sought to determine whether, among women with gestational diabetes mellitus, referral to a telephonic nurse management program was associated with lower risk of macrosomia and increased postpartum glucose testing. Study Design There was medical center–level variation in the percent of patients referred to a telephonic nurse management program at 12 Kaiser Permanente medical centers, allowing us to examine in a quasi-experimental design the associations between referral and outcomes. Results Compared with women from centers where the annual proportion of referral nurse management was 70% were less likely to have a macrosomic infant and more likely to have postpartum glucose testing (multiple-adjusted odds ratio, 0.75; 95% confidence interval, 0.57–0.98 and multiple-adjusted odds ratio, 22.96; 95% confidence interval, 2.56–3.42, respectively). Conclusion Receiving care at the centers with higher referral frequency to telephonic nurse management for gestational diabetes mellitus was associated with decreased risk of macrosomic infant and increased postpartum glucose testing.

Referral to telephonic nurse management improves outcomes in women with gestational diabetes

We sought to determine whether, among women with gestational diabetes mellitus, referral to a telephonic nurse management program was associated with lower risk of macrosomia and increased postpartum glucose testing. There was medical center-level variation in the percent of patients referred to a telephonic nurse management program at 12 Kaiser Permanente medical centers, allowing us to examine in a quasi-experimental design the associations between referral and outcomes. Compared with women from centers where the annual proportion of referral nurse management was <30%, women who delivered from centers with an annual referral proportion >70% were less likely to have a macrosomic infant and more likely to have postpartum glucose testing (multiple-adjusted odds ratio, 0.75; 95% confidence interval, 0.57-0.98 and multiple-adjusted odds ratio, 22.96; 95% confidence interval, 2.56-3.42, respectively). Receiving care at the centers with higher referral frequency to telephonic nurse management for gestational diabetes mellitus was associated with decreased risk of macrosomic infant and increased postpartum glucose testing.

The effect of nursing management development program on clinical competency in coronary care unit

Background: Nurses are the main members in nursing cares and nursing managers can improve their clinical competency by applying better leadership skills. This study carried out to determine the effect of nursing management program on clinical competency of nurses in a coronary care unit (CCU). Methods: A quasi-experimental study was carried out in two educational hospitals in Yazd- Iran. These hospitals were allocated randomly in case and control hospitals. 25 matched nurses were selected by convenience sampling from both case and control hospitals. The clinical competency of nurses was measured by related questioners consisted of two dimensions caring and care management behaviors by self-evaluation and head nurse evaluation in case and control groups. Then, the intervention was implemented in four stages including nurse's development, managers' development, adaptation and supervision period during four months in the case group. After intervention, clinical competency of nurses was measured in both groups. Results: The results showed that before intervention more than 80% of nurses in two groups was in the moderate clinical competency level and they were proficient based on Benner's skill acquisition model. After intervention, nurses' clinical competency improved to higher level in case group but it didn't change in control group (P<0.05). Conclusion: Creating necessary modifications in nursing environments through the management development program by head nurses may improve nurses' clinical competency.

Effects of a nurse-managed program on hepatitis A and B vaccine completion among homeless adults.

Hepatitis B virus (HBV) infection constitutes a major health problem for homeless persons. Ability to complete an HBV vaccination series is complicated by the need to prioritize competing needs, such as addiction issues, safe places to sleep, and food, over health concerns. The objectives of this study were to evaluate the effectiveness of a nurse-case-managed intervention compared with that of two standard programs on completion of the combined hepatitis A virus (HAV) and HBV vaccine series among homeless adults and to assess sociodemographic factors and risk behaviors related to the vaccine completion. A randomized, three-group, prospective, quasi-experimental design was conducted with 865 homeless adults residing in homeless shelters, drug rehabilitation sites, and outdoor areas in the Skid Row area of Los Angeles. The programs included (a) nurse-case-managed sessions plus targeted hepatitis education, incentives, and tracking (NCMIT); (b) standard targeted hepatitis education plus incentives and tracking (SIT); and (c) standard targeted hepatitis education and incentives only (SI). Sixty-eight percent of the NCMIT participants completed the three-series vaccine at 6 months, compared with 61% of SIT participants and 54% of SI participants. NCMIT participants had almost 2 times greater odds of completing vaccination than those of participants in the SI program. Completers were more likely to be older, to be female, to report fair or poor health, and not to have participated in a self-help drug treatment program. Newly homeless White adults were significantly less likely than were African Americans to complete the vaccine series. The use of vaccination programs incorporating nurse case management and tracking is critical in supporting adherence to completion of a 6-month HAV/HBV vaccine. The finding that White homeless persons were the least likely to complete the vaccine series suggests that programs tailored to address their unique cultural issues are needed.

Innovation in nurse executive development: Computer simulation

The Johnson and Johnson Nurse Executive Fellowship is a competitive nurse management program that is held each year during June. In conjunction with the University of Pennsylvania Wharton School and the Leonard Davis Institute of Health Economics, the 3-week program “provides senior nurse executives with business and management knowledge that is crucial to their leadership at a time of significant challenges for both the nursing profession and the future of health care.” 1

Innovation in nurse executive developmentComputer simulation

The Johnson and Johnson Nurse Executive Fellowship is a competitive nurse management program that is held each year during June. In conjunction with the University of Pennsylvania Wharton School and the Leonard Davis Institute of Health Economics, the 3-week program “provides senior nurse executives with business and management knowledge that is crucial to their leadership at a time of significant challenges for both the nursing profession and the future of health care.” 1 Johnson and Johnson. Available at: www.jnj.com/community/contributions/programs/The_Wharton_Fellows_Program_in_Management_for_Nurse_Executives.htm.Cited July 13, 2004.. Google Scholar

A programme for children with nocturnal enuresis

AIM: To describe and evaluate the implementation, effects and outcomes of a nurse-managed nocturnal enuresis treatment programme. METHOD: The research design comprised three data sources: focus group interviews with six public health nurses providing the nocturnal enuresis treatment programme, case notes of a convenience sample of 30 children who had completed the treatment programme and interviews with seven children who had completed the programme. RESULTS: The study showed a success rate of 87 per cent (n = 26). Success was defined as maintaining nocturnal continence for 14 consecutive nights. Key aspects in the programme's success and delivery included the child taking responsibility for the programme instead of the parent, the nature of the nurse-child interaction and the nurses' flexibility in adapting the programme for each child. CONCLUSION: The children had experienced low self-esteem as a result of nocturnal enuresis, but success on the programme dramatically improved their self-esteem and ability to socialise with other children. The study affirmed the value of the nurse as the facilitator of this programme. The study has contributed to the knowledge base on the management of nocturnal enuresis in a community-based nurse-managed programme.

A community-based approach to sexual assault.

The community-based Athens-Clarke County Sexual Assault Nurse Examiners (ACC-SANE) program was developed to respond to the needs of sexual assault victims. Although this type of SANE model allows for a strong nurse-managed program, there are frustrations and pitfalls that differ from most hospital-based programs. At this time, the majority (71%) of SANE programs are based in hospitals, and few (15%) function in outpatient/community facilities. In the ACC-SANE program, many community agencies interact to provide a seamless approach to postassault health care, counseling, and criminal prosecution. SANE nurses are well equipped to provide forensic examinations in a caring, out-of-hospital environment. The program is housed in a remodeled cottage that rests on property owned by the Athens-Clarke County government and that is adjacent to the local police department. ACC-SANE is governed by a nonprofit board of directors. This management model has allowed the original organizing groups to remain active in the development of the program. As these agencies continue in the governance of the program, they remain committed to the success of ACC-SANE. The impact of program growth and published program guidelines is examined.

Lipid management in a private cardiology practice (the Midwest Heart Experience)

Emerging evidence that lowering cholesterol levels reduces the incidence of coronary heart disease led Midwest Heart Specialists to establish a lipid clinic in 1985. The physician-directed, nurse-managed program was developed to improve patient adherence to National Cholesterol Education Program (NCEP) guidelines and provide high-quality preventive services while preserving productivity for the busy interventional cardiologist who was the medical director of the program. From 1996 to 1997, Midwest Heart Specialists was one of 140 medical practices to participate in a national Quality Assurance Program (QAP). The purpose of the project was to evaluate the degree of treatment of hyperlipidemia in patients with coronary heart disease. Although the overall physician practice results were significantly better than the national averages, the lipid-clinic results were dramatically more impressive: 100% of the lipid-clinic patients were on lipid-lowering therapy and 97% of the patients had a low-density lipoprotein (LDL)-cholesterol level documented on the chart. Of these, 71% met their LDL goal, as compared with only 11% nationally. The results of the QAP within the physician practice stimulated the development of a new practice-wide lipid-management system. This new systematic approach to lipid management has improved overall lipid outcomes dramatically. The success of the Cholesterol Management Program has enhanced the reputation of the practice in the community, tied high-risk patients and their families to the practice, and improved the marketability of a full complement of cardiovascular services via Midwest Heart Specialists.

A nurse-managed weight reduction programme for obstructive sleep apnoea syndrome.

This longitudinal, clinical intervention study was designed to investigate whether pulmonary departments can set up a cost-effective weight and lifestyle programme as primary treatment of obstructive sleep apnoea syndrome (OSAS). A weight reduction programme (1 year) in a pulmonary department for outpatients in Helsinki University Central Hospital. A total of 24 (23 men) moderately obese (body mass index [BMI], 30-40 kg m(-2)) patients with newly diagnosed OSAS. Interventions. The first 6 weeks consisted of a very low-calorie diet (VLCD, 500 kcal day(-1)) and thereafter normal food low in calories. There were altogether 12 group meetings for behavioural management. Daytime somnolence, BMI and oxygen desaturation index of 4% (ODI4) were measured prior to the programme, at the end of the VLCD phase and at 1 year. The programme was easy to administer without any serious side-effects. At 1 year, patients had lost a mean of 33% of their overweight (mean weight at baseline 110 kg, after 99 kg) and their ODI4 indexes improved significantly (P < 0.005). There was no correlation between the amount of weight loss and improvement in ODI4 indexes. The cost per patient was about half the cost of treatment with nCPAP (nasal continuous positive airway pressure) for 1 year at our hospital. A nurse-managed programme with VLCD and behavioural management is safe and effective on an outpatient basis. Weight loss should be encouraged in OSAS in patients with moderate overweight. The amount of weight loss needed for improvement of OSAS is unique to each individual.

Fine-tuning nurse management education through formative evaluation

This paper briefly describes a unique nursing management program, Education for First-Level Nursing Management (EFFLNM), which combines the advantages of a short, compressed course with those of an extended-time course. Three six-month cycles of this program were funded by the U.S. Public Health Service. Each cycle consisted of 13 days of workshops, three 90-minute teleconferences and telephone coaching by project staff members. Formative evaluation data from end-of-day and end-of-workshop assessments were used to monitor and improve lesson content and teaching methods both within and across cycles. This paper also describes an on-going evaluation process that made it possible to adapt content to a mature, experienced audience's needs.

Obstetric and gynecologic abdominal wound infections: A comprehensive nurse-managed program

Obstetric and gynecologic abdominal wound infections: A comprehensive nurse-managed program

This NIS could integrate a nursing management program and complement DRGs as well

This NIS could integrate a nursing management program and complement DRGs as well

How to develop a complete nursing management program.

How to develop a complete nursing management program.