Omaha Research Articles

Construction of clinical nursing pathway for patients with laparoscopic cholecystectomy surgery based on Omaha System

Objective To construct clinical nursing pathway for patients with laparoscopic cholecystectomy surgery in acute cholecystitis stage, and to provide standardized nursing service. Methods With case record and literature review as theoretical basis, Omaha System as frame, clinical nursing pathway with patient centered was developed through analysis of main nursing problem and intervention. Results Omaha System oriented clinical nursing pathway was constructed in different stages of Laparoscopic cholecystectomy surgery with acute calculous cholecystitis. Conclusions Combined standardized nursing language and nursing process, clinical nursing pathway based on Omaha system provide practicability nursing plan in different stage regarding time as the coordinate axle. It contains assessment, problem, intervention and outcome evaluation indexed, which is beneficial to improve nursing quality. Key words: Laparoscopic cholecystectomy surgery; Clinical nursing pathway; Omaha system

Application of Omaha system to the unstable angina pectoris patient nursing of vital energy deficiency and blood stasis

Objective Nursing intervention evaluation is conducted to the unstable angina pectoris patient nursing of vital energy deficiency and blood stasis through Omaha system to make a complete clinical nursing system so as to improve the nursing quality. Methods A total of 74 patients were randomly divided into observation group and control group in accordance with diagnosis standard, 37 cases of each group.The patients of control group had nursing according to the Chinese traditional medical nursing scheme of vital energy deficiency and blood stasis patients of chest obstruction and cardiac pain disease issued by Beijing Traditional Chinese Medicine Administration, and Omaha system was applied to the patients of observation group for nursing.In addition, SAQ (Seattle angina questionnaire) score and Omaha system outcome evaluation form Likert 5 score digital measurement were applied 3 weeks before and after admission to and discharge from hospital to have evaluation for the patients. Results SAQ score and Omaha system outcome evaluation form Likert 5 score digital measurement score of patients in observation group were superior to control group. The difference had statistical significance(P<0.05). Conclusion Omaha question classification system model has operability on the nursing of unstable angina pectoris patients of vital energy deficiency and blood stasis, which can further improve nursing quality, promote the evaluation of clinical nursing and implementation of integral nursing. Key words: Omaha system; Unstable angina pectoris; Nursing

Effects of Omaha system on transitional care in discharged patients with colon carcinoma

Objective To explore the effects of Omaha system on transitional care in discharged patients with colon carcinoma. Methods Patients with colon carcinoma who accepted surgical treatment in Tangshan Gongren Hospital of Hebei Province were selected as subjects. A total of 62 patients were chosen as control group with routine transitional nursing education from January 2012 to December 2013. Besides, a total of 63 patients were chosen as observation group with Omaha system nursing education based on intervention in control group from January 2014 to December 2015. The improvement of nursing outcomes and general self-efficacy in Omaha problem system was compared between two groups. Results The scores of problem recognition from four domains including physiology, social psychology, health-related behaviors and environments of patients in observation group were (1.21±0.20) , (2.14±0.30) , (1.23±0.72) , (2.15±0.34) better than those in control group with significant differences (t=4.635, 2.695, 3.896, 14.632; P<0.01) 6 months after intervention. The score of the cancer self efficacy scale was (35.12±5.22) in observation group and (21.27±8.27) in control group with a significant difference (t=8.652, P<0.01) . Conclusions Transitional care for discharged patients with colon carcinoma based on Omaha system can nicely help nurses understand the nursing needs of discharged patients and provide corresponding education and guidance according to problems so as to help patients, family members and community solve the problems that they encounter during rehabilitation course, and to improve the quality of life of them. Key words: Colonic neoplasms; Omaha system; Transitional care

Application of nursing case management mode framed by Omaha system in patients with hepatocirrhosis complicated with gastrointestinal bleeding

Objective To explore the application of nursing case management mode framed by Omaha system in patients with hepatocirrhosis complicated with gastrointestinal bleeding, so as to provide evidence-based basis for clinical nursing. Methods A total of 72 hepatocirrhosis complicated with gastrointestinal bleeding patients were collected from July 2014 to July 2016 in our hospital. All the patients were randomized divided into observation group (36 cases) and experimental group (36 cases). The patients of observation group were given case management mode framed by Omaha system, while the patients of control group were given conventional case management model. Analysis and evaluation of scores were implemented before and after the nursing intervention in observation group. The quality of life, hospitalization days and number of hospitalizations after discharge were compared between two groups. Results The nursing problems of observation group during hospitalization were mainly distributed in the environment, social psychology, physiology and health related behaviors. After nursing intervention, there were significant differences in all nursing outcomes for nursing problems (t=12.470, 10.720, 17.520, 7.600, 7.549, 12.146, 16.857, 5.607, 14.683, 7.085, 11.66, 11.024, 12.723; P<0.05) . After intervention in observation group, the activity of daily living was (19.18±5.67), social activity (13.96±3.89), depression symptom (11.69±3.97), anxiety symptom (9.34±2.88), and survival quality (54.17±5.45), which were less than (27.21±3.84) , (18.53±3.58) , (17.64±2.75) , (15.72±2.93) , (79.10±8.63) (t=7.036, 5.187, 7.392, 9.317, 14.654; P<0.05). After intervention, the length of hospitalization was (8.7±3.9) d, the cost (5 419.5±2 539.2)Yuan and the revisit times (0.4±0.2), which were less than (10.8±3.4)d, (7 312.4±4 280.1)Yuan and (0.7±0.3) of control group (t=2.435, 2.282, 4.992; P<0.05). Conclusions Compared with conventional methods, the case management framed by Omaha system can effectively improve the quality of life, reduce hospitalization days, hospitalization cost and number of re-hospitalizations after discharge. Key words: Liver cirrhosis; Omaha system; Case management; Gastrointestinal bleeding

Urban Villages and Local Identities: Germans from Russia, Omaha Indians, and Vietnamese in Lincoln, Nebraska

Urban Villages and Local Identities: Germans from Russia, Omaha Indians, and Vietnamese in Lincoln, Nebraska

Application of continuing nursing based on Omaha system in postoperative rehabilitation of patients with hypertensive cerebral hemorrhage

Objective To explore the application effect of continuing nursing based on Omaha system in postoperative rehabilitation of patients with hypertensive cerebral hemorrhage. Methods A total of 37 patients with hypertensive cerebral hemorrhage in neurosurgery department of the First Hospital of Jiaxing from July 2015 to February 2016 were recruited as the intervention group, while 34 patients with hypertensive cerebral hemorrhage from November 2014 to June 2015 were selected as the control group. Patients in the control group received postoperative general nursing for patients with hypertensive cerebral heorrhage. Patients in the intervention group received continuing nursing based on Omaha system beside general nursing which lasted 8 weeks until after discharge. Patients′ behavior, cognition and status were compared between two groups to evaluate the nursing effects. Results Omaha system contains four aspects including environment, psychology and society, physiology and health-related behavior. Nursing problems found in the intervention group were related to previous four aspects. A total of 21 problems were sorted out. The scores of behavior, cognition and status in the intervention group were (2.86±0.23) , (2.51±0.53) and (3.39±0.41) , which were higher than those in the control group [ (2.17±0.54) , (1.62±0.49) and (2.44±0.37) ] (P<0.05) . Conclusions Continuing nursing based on Omaha system shows the common problems in postoperative rehabilitation of patients with hypertensive cerebral hemorrhage and provides standardized proposal for rehabilitation nursing to achieve better nursing effects. Key words: Rehabilitation nursing; Hypertensive cerebral hemorrhage; Continuing nursing; Omaha System

Francis La Flesche and Ethnography: Writing, Power, Critique

Abstract Francis La Flesche, an early ethnographer who grew up in the Omaha tribe, has much to teach us about representing peoples and ways of life. By examining writings by and about La Flesche during his lifetime, we can see that he engaged and challenged power structures on many levels and in many contexts. La Flesche worked as an informant and interpreter, and wrote autobiographical, fictional, and ethnographic works. In his writings, both the content and structure tended to disrupt emic and etic perspectives and address the complexities of representing subjectivity and culture.

Effects of home rehabilitation manual on the cognition behavior situation and rehabilitation effect in patients with anterior cruciate ligament reconstruction

Objective To explore the effects of home rehabilitation manual on rehabilitation of patients undergoing anterior cruciate ligament reconstruction. Methods A total of 118 cases of patients with anterior cruciate ligament reconstruction were randomly divided into the intervention group and the control group from May 2014 to May 2015, with 56 cases in the intervention group and 62 cases in the control group. Patients in the control group received routine discharge guidance and follow-up, while patients in the intervention group, received an assessement on nursing problems by Omaha system 1 d before discharge. We made home rehabilitation manuals according to problems, and provided systemic professional guidance from their diet and activities, use of crutch and leg holder, the intervention of pain and swelling, the neuro-musculo-skeletal function training, and the nursing management of anxiety and sleeping disorders. The rehabilitation effect in two groups before surgery and 12 weeks after surgery were compared by Lysholm score. The improving effect of main nursing problems in knowledge, behavior and situation 1 d before discharge, and 2 weeks, 4 weeks, 8 weeks, 12 weeks after surgery between two groups were compared. Results There was no significant difference in the knee joint Lysholm score before surgery (P>0.05). 12 weeks after surgery, the Lysholm score of the intervention group was (72.83±1.95), and it was (71.35±2.13) of the control group (t=3.792, P<0.05). After surgery, the score of knowledge, behavior, situation about the problems of pain, neuro-musculo-skeletal function, personal care, physical activity, sleep and rest patters were all increaseing with the prolonged of time, and the score of the intervention group was higher than that of the control group (P<0.05). Conclusions Home rehabilitation manual can improve the score of knowledge, behavior and situation about the main nursing problems of patients with anterior cruciate ligament reconstruction. It also can raise the Lysholm score of patients, and promote the rehabilitation. Key words: Rehabilitation nursing; Anterior cruciate ligament; Home rehabilitation manual; Cognition; Behavior; Situation; Omaha system

Application of Omaha system-based case management model in ICU patients with severe respiratory failure

Objective To explore the effects of Omaha system-based case management model on the prognosis of ICU patients with severe respiratory failure. Methods Totally 84 cases of patients with severe respiratory failure in our hospital from June 2014 to June 2016 were selected and divided into the observation group (n=42) and the control group (n=42) according to random number table. Patients in the control group were given routine nursing during ventilation, while patients in the observation group were given Omaha system-based case management model. The prognosis and complications of patients in two groups were compared. Results The level of blood lactate, the scores of acute physiology and chronic health evaluation system (APACHEⅡ), and the rates of ventilator-dependent, ventilator associated pneumonia (VAP) and reintubation were all lower than the data in the control group, while the time of mechanical ventilation and staying in ICU, as well as the total hospitalization time were all shorter than the time in the control group (P<0.05). Conclusions The Omaha system-based case management model can effectively improve the prognosis of ICU mechanically ventilated patients with severe respiratory failure, shorter the hospitalization time, and improve patient satisfaction. Key words: Respiration, artificial; Prognosis; Severe respiratory failure; Omaha system; Case management model

Development of a cardiac rehabilitation management program for patients with PCI based on Omaha System

Objective To establish a cardiac rehabilitation management program for patients with percutaneous coronary intervention(PCI) based on Omaha System. Methods Delphi method was used to interview 27 experts from October to December 2015, and we took two rounds mailing interview. Results The effective returning rates of the first and second round mailing interview were 100% and 92.60%. The authority coefficient of the experts was 0.92, and the coordination coefficient of experts′ opinion was 0.19.Eventually, the cardiac rehabilitation management program included 13 project indicators, 37 assessment indicators, 37 intervention indicators and 5 follow-up time indicators. Conclusions The result of the study is reliable and it may provide references for medical institutions to having a comprehensive knowledge of patients with PCI, thus they can accurately improve the effect of PCI cardiac management and offer evidence for reducing adverse cardiac events. Key words: Delphi technique; Cardiac rehabilitation; Omaha system; Percutaneous coronary intervention

Kurt E. Kinbacher.Urban Villages and Local Identities: Germans from Russia, Omaha Indians, and Vietnamese in Lincoln, Nebraska.

Kurt E. Kinbacher.<i>Urban Villages and Local Identities: Germans from Russia, Omaha Indians, and Vietnamese in Lincoln, Nebraska</i>.

Feasibility of Describing Wellbeing and Strengths at the Community Level Utilizing the Omaha System.

Capturing strengths at the community level offers an emergent perspective to a strength-based approach for population health. The Omaha System standardized terminology has been found feasible to describe individual strengths in patient care planning. This study depicts results of using the Omaha System to capture strengths at the community level. Descriptive statistics and visualization were used to examine patterns of strengths and signs/symptoms by Omaha System Problem concept based on the secondary data analysis from 118 student-generated community assessments. Results suggest that it is feasible to use the Omaha System as a method classifying strengths and problems at the community level. The relationship between strengths and signs/symptoms is consistent with the pattern observed at the individual-level. Utilizing a strength-based model may provide robust information about community strengths leading to new approaches to population health management in support of community wellbeing.

Geo-spatial Informatics in International Public Health Nursing Education.

This poster describes results of an undergraduate nursing informatics experience. Students applied geo-spatial methods to community assessments in two urban regions of New Zealand and the United States. Students used the Omaha System standardized language to code their observations during a brief community assessment activity and entered their data into a mapping program developed in Esri ArcGIS Online, a geographic information system. Results will be displayed in tables and maps to allow comparison among the communities. The next generation of nurses can employ geo-spatial informatics methods to contribute to innovative community assessment, planning and policy development.

Wearable Technology Surveillance Data for the Personal Health Record Using the Omaha System: Noise Exposure, Cardiovascular and Stress Biomarkers.

This poster describes a method to prepare noise and health data from wearable technology for standardized representation in the electronic personal health record thus enabling individuals to identify noise-related health risks. Using a case study approach, the authors demonstrate transformation of data to the Omaha System standardized terminology in order to depict the data graphically in a personal health record.

Student Documentation of Community Strengths Using Omaha System Terminology.

Student Documentation of Community Strengths Using Omaha System Terminology.

Urban Villages and Local Identities: Germans from Russia, Omaha Indians, and Vietnamese in Lincoln, Nebraska. By Kurt E. Kinbacher

Urban Villages and Local Identities: Germans from Russia, Omaha Indians, and Vietnamese in Lincoln, Nebraska . Plains Histories Series. By Kurt E. Kinbacher. Foreword by Timothy R. Mahoney. (Lubbock: Texas Tech University Press, 2015. xiv + 265 pp. Illustrations, maps, tables, notes, index. $39.95, paper.) This is a major piece of scholarship, daring in its use of four languages and ambitious in its incorporation of languages, cultures, and various aspects of diversity. Moreover, author Kurt E. Kinbacher has built into much of his study components of history, political science, and sociology, among other disciplines. The result is a study framed by multicultural concepts, which provide a uniformity that cuts across the entire work, despite the specific significant differences between the Volga Germans (Germans originally from Russia), Omaha Native Americans, and Vietnamese. For each group, … ebarkan{at}csusb.edu

Assessment of health problems among the disabled elderly in nursing homes based on the Omaha System

Objective To evaluate the health problems existed in the disabled elderly in nursing homes in Zhejiang province and assess the knowledge, behavior and status of each existed health problem. Methods By cross-sectional study, a total of 50 disabled elderly in four nursing homes in Zhejiang province were assessed. Results The common health problems of the disabled elderly in nursing homes were personal care, oral health, social contact, physical activity, vision, neuro-musculo-skeletal function, mental health, cognition, medication regimen, and pain. Among the common health problems, the knowledge, behavior and status in personal care, oral health, mental health, and pain were more severer than others. Conclusions A lot of health problems exist among the disabled elderly in nursing homes. A comprehensive and targeted care should be used to improve patients′ health. Key words: Health status; Health behavior; Nursing home; Disabled; Omaha system

Urban villages and local identities: Germans from Russia, Omaha Indians, and Vietnamese in Lincoln, Nebraska

Urban villages and local identities: Germans from Russia, Omaha Indians, and Vietnamese in Lincoln, Nebraska

Assessment of health problems of hypertensive patients in community-based by using an international standardized nursing language

Objective To explore the application of an international standardized nursing language (Omaha System) to assess community hypertensive patients in environmental, psycho-social, physiological and health related behavioral domain problems and existed health problems about knowledge, behavior and status level, so as to provide reference and intervention for hypertension disease. Methods A total of 116 hypertensive patients were selected from on community in Yichang, Hubei province, and were assessed health problems by Problem Classification Scheme of Omaha System, so as to quantify the knowledge, behavior and status level of health problem. Results This assessment found out that there were 31 health problem in environmental, psycho-social, physiological and health related behavior domains; over 50% patients had common existence of health problem including circulation, nutrition, health care supervision, vision, cognition, medicine treatment plan, mental health and oral health. Conclusions Hypertensive patients in the community are faced to multiple health problems from different domains. The appropriate intervention for hypertensive patients should be taken to improve patients′ knowledge, behavior and status in the related health problems besides circulation. Key words: Community; Hypertension; Health problem; Assessment; Omaha System

Life among the Indians: First Fieldwork among the Sioux and Omahas by Alice C. Fletcher (review)

Reviewed by: Life among the Indians: First Fieldwork among the Sioux and Omahas by Alice C. Fletcher Robin Ridington Life among the Indians: First Fieldwork among the Sioux and Omahas. By Alice C. Fletcher. Edited and with an introduction by Joanna C. Scherer and Raymond J. DeMallie. Lincoln: University of Nebraska Press, 2013. ix + 418 pp. Illustrations, drawings, maps, notes, bibliography, index. $65.00 cloth. Alice Fletcher was a pioneer of what we now call participant observation ethnography as well as applied anthropology. She began her career as a lecturer on subjects having to do with American Indian antiquity and women’s issues. Because of this background she was already proficient in public speaking and writing for an educated audience when she began her first fieldwork at the age of 43. Fletcher undertook her travels to the Rosebud Sioux and Omaha reservations as a freelance writer, intent on being the first to document the lives of Indian women from “the Indian’s point of view” (101). She had previously met Thomas Henry Tibbles, his Omaha wife, Suzette, and her half-brother Francis LaFlesche on their tour of the East with Ponca chief Standing Bear. They agreed to be her guides to Indian country. At the Rosebud Sioux reservation she was witness to abuses by an Indian agent who proudly informed her, “I’ll have you understand that I regulate everything on this reservation but the weather” (121). She was horrified at the chaotic government distribution of cattle at Rosebud and was witness to the Sioux’s poverty and despair, which solidified her negative opinion of the reservation system. Following her time with the Sioux she returned to the Omahas, where she was welcomed into the family of Joseph LaFlesche. As a keen observer and eloquent writer, she recorded important details of Omaha social organization and ceremonial life. Fletcher’s views on assimilation and the transfer of reservation land to the hands of individual tribal members reflected the opinion of her host family. Joseph La-Flesche was a member of the “young men’s party” and [End Page 181] lived in the “village of the make-believe whitemen.” The narrative ends with Fletcher taking a position as land allotment officer for the government. Fletcher completed Life among the Indians in 1886 and hoped to have it published before the end of the decade. For reasons unknown, Charles Scribner, to whom she submitted the manuscript, never brought it into print. Fletcher went on to her pursuits as allotment agent and, in 1890, holder of the Thaw Fellowship, which supported her work without the need to publish commercially. Fletcher, with her collaborator and later coauthor Francis LaFlesche, went on to publish The Omaha Tribe in 1911. It elaborated on much of the ethnographic information in the earlier work, which was intended for a popular audience. The 1911 publication, however, in no way supplants the material finally published here by the University of Nebraska Press and skillfully introduced and annotated by Joanna C. Scherer and Raymond J. DeMallie. Fletcher uses reconstructed dialogue throughout the book and writes in a style that does not sound foreign or dated to the contemporary reader. Her writing reflects an Omaha way of storytelling. Her acceptance into the LaFlesche family gave her access to rich information about Omaha tribal life. She was sometimes told, laughingly, “Don’t you know you are almost as good as an Indian” (274). The book is an important contribution to Plains Indian ethnography and still an engrossing read. The best of premodern ethnographic writing, which this is, continues to have both literary and historical value. Robin Ridington Professor Emeritus of Anthropology University of British Columbia Copyright © 2015 Center for Great Plains Studies, University of Nebraska–Lincoln