Faculty Bibliography
Searched for:
person:pr5
Total Results:
88
The Long-term Effect of a Nurse Residency Program, 2005-2012: Analysis of Former Nurse Residents
OBJECTIVE: Research on nurse residency programs (NRPs) typically focuses on retention within the 1-year NRP or perhaps an additional year beyond. Few have evaluated the long-term impact of NRP, and none have adopted a longitudinal approach to follow cohorts over time. This study, conducted in a large urban academic medical center (AMC), examines the effects of the NRPs on former nurse residents (NRs) in 8 cohorts (2005-2012) and compares those who left the institution with those who remain. BACKGROUND: Nurse residency programs have increased from home-grown programs to a standardized 1-year curriculum from national models designed for different types of RNs. Evidence exists that NRPs reduce attrition among new graduates and the Institute of Medicine recommends that all new RNs have access to NRPs. METHODS: Using data from human resources, administrative data, and online survey of former NRs, this is a retrospective, longitudinal study of former NRs in 1 AMC. Nine hundred eighty-seven new graduates completed the NRP from 2005 to 2012; 646 (63.5%) have stayed (stayers) at the institution. A total of 425 stayers responded to survey (65.8%), and 108 surveys were completed by former NRs who had left (leavers) (62.4%). RESULTS: On average, leavers stay for 2.18 years at the institution; stayers typically remained for 4.86 years, suggesting that retention beyond 2 years is dependent on complex set of circumstances beyond the "treatment effect" of the NRP program. Regardless of staying or leaving, respondents hold positive attitudes about the program; achieve high levels of certification, advanced education, and professional accomplishments; and report "transitioning from beginner to competent RN" and "senior staff support" as most valuable aspects of NRP. CONCLUSIONS: Retention among new graduates has improved significantly with the introduction of NRPs at this institution. Former NRPs report favorable assessments of the NRP, regardless of number of years since completion of the program and regardless of whether the individual remains employed in the institution. In addition, former NRs report high levels of professional accomplishments and commitment to nursing. However, without additional research, we cannot definitively tie these outcomes to the NRP.
PMID: 27214336
ISSN: 1539-0721
CID: 2114502
Early Discharge Planning and Improved Care Transitions: Pre-Admission Assessment for Readmission Risk in an Elective Orthopedic and Cardiovascular Surgical Population
BACKGROUND/METHODS: Readmission prevention is a marker of patient care quality and requires comprehensive, early discharge planning for safe hospital transitions. Effectively performed, this process supports patient satisfaction, efficient resource utilization, and care integration. This study developed/tested the utility of a predictive early discharge risk assessment with 366 elective orthopedic/cardiovascular surgery patients. Quality improvement cycles were undertaken for the design and to inform analytic plan. An 8-item questionnaire, which includes patient self-reported health, was integrated into care managers' telephonic pre-admission assessments during a 12-month period. RESULTS: Regression models found the questionnaire to be predictive of readmission (p
PMCID:5015549
PMID: 27616965
ISSN: 1568-4156
CID: 2246532
Evaluating the Short- and Long-term Outcomes of a Post-BSN Residency Program: Findings of a Retrospective Study of Nurse Residents, 2005-2012
OBJECTIVE: This retrospective study evaluates short- and long-term outcomes of the nurse residency program (NRP) at NYU Langone Medical Center from the perspective of former residents. BACKGROUND: Studies of NRPs focus primarily on retention rates. Little is known about the careers of former residents beyond completion of the program or their perceptions of the value of the NRP on their careers. METHODS: An online survey to 671 former residents from 2005 to 2012, who remain employed at NYU Langone Medical Center, was conducted in fall 2013 to assess their current employment and professional characteristics and assessment of program components. RESULTS: Findings from the 425 respondents (65.8%) revealed significant variations among the cohorts over time, suggesting that the perceived value of some program components emerge long after completion of NRP. CONCLUSION: The experiences and assessments of former residents demonstrate that certain program outcomes require longer time to emerge.
PMID: 26010283
ISSN: 1539-0721
CID: 1602972
Data makes the difference : the smart nurse
Silver Spring, Maryland : American Nurses Association, 2015
Extent: viii, 109 p. ; 23 cm
ISBN: 9781558106123
CID: 1783902
Research on cognitive impairment in community and home settings
Mounting evidence demonstrates the significant impact of cognitive impairment on the lives of older adult patients and their caregivers. In addition, cognitive impairment presents challenging conditions for healthcare providers who are frequently unprepared to manage the care of these patients. These developments have spawned a wide range of research to more effectively identify and diagnose individuals with cognitive impairments, to develop better strategies to differentiate the types of cognitive impairment, and more accurately estimate the incidence and prevalence of the different types of impairments within different treatment settings. The 4 articles presented in this article represent a small sampling of recent research on these topics. Each article possesses methodological and other limitations that limit the generalizability of their findings. Nonetheless, there are important lessons to be learned from each. The first article examines the effectiveness of using a single-item measure to screen for delirium, one form of cognitive impairment. The second article presents the findings of a systematic review of research articles that estimate the prevalence of missed and delayed diagnoses of dementia. Efforts to understand factors that contribute to missed or delayed diagnoses may result in more robust strategies to improve timely diagnoses and effective interventions. The third article attempts to differentiate the prevalence of cognitive impairment that does not progress to a diagnosis of dementia. The findings suggest that, contrary to conventional thought, not every patient with cognitive impairment will ultimately have dementia. The final article illustrates the difficulties of identifying community-dwelling older adults with dementia. Once identified, the authors determined that patients and their families have wide range of unmet needs that may be addressed with better preparation of healthcare providers. Future research may produce more robust evidence on these important topics.
PMID: 23385176
ISSN: 1539-0713
CID: 1587482
Implementation and evaluation of a depression care model for homebound elderly
Depression affects 14% to 46% of homebound elderly and is costly and disabling. Home health agencies face significant challenges delivering effective depression care. In response, an evidence-based depression care model was developed in a home health agency. Twelve-month program evaluation data demonstrated a 2.99 mean reduction in depression scores (P < .0001) on the Geriatric Depression Scale and confirmed that a clinically effective, operationally feasible, and financially sustainable depression care model can be implemented in home health care.
PMID: 22824910
ISSN: 1550-5065
CID: 1587492
Peer education for secondary stroke prevention in inner-city minorities: design and methods of the prevent recurrence of all inner-city strokes through education randomized controlled trial
BACKGROUND: The highest risk for stroke is among survivors of strokes or transient ischemic attacks (TIA). However, use of proven-effective cardiovascular medications to control stroke risk is suboptimal, particularly among the Black and Latino populations disproportionately impacted by stroke. METHODS: A partnership of Harlem and Bronx community representatives, stroke survivors, researchers, clinicians, outreach workers and patient educators used community-based participatory research to conceive and develop the Prevent Recurrence of All Inner-city Strokes through Education (PRAISE) trial. Using data from focus groups with stroke survivors, they tailored a peer-led, community-based chronic disease self-management program to address stroke risk factors. PRAISE will test, in a randomized controlled trial, whether this stroke education intervention improves blood pressure control and a composite outcome of blood pressure control, lipid control, and use of antithrombotic medications. RESULTS: Of the 582 survivors of stroke and TIA enrolled thus far, 81% are Black or Latino and 56% have an annual income less than $15,000. Many (33%) do not have blood pressures in the target range, and most (66%) do not have control of all three major stroke risk factors. CONCLUSIONS: Rates of stroke recurrence risk factors remain suboptimal in the high risk, urban, predominantly minority communities studied. With a community-partnered approach, PRAISE has recruited a large number of stroke and TIA survivors to date, and may prove successful in engaging those at highest risk for stroke and reducing disparities in stroke outcomes in inner-city communities.
PMCID:3408803
PMID: 22710563
ISSN: 1559-2030
CID: 1587512
A review of factors influencing utilization of home and community-based long-term care: trends and implications to the nursing workforce
Over the past several decades, home- and community-based services (HCBS) have played an increasingly important role in providing care to patients with complex health problems and functional impairments, and in enabling patients to remain independent in their own homes. This article identifies developments in U.S. health care policy during the past three decades that have led to increases in demand for and utilization of home- and community-based health care. We discuss the implications of these policy developments, societal trends, and the unique opportunities they present for the nursing workforce. Descriptive analyses of data from the 2008 National Sample Survey of Registered Nurses (N = 28,402) reveal significant differences between nurses employed in HCBS and hospital settings, and provide little evidence that the nursing workforce has responded to the shifting needs for nursing resources in HCBS.
PMID: 22763360
ISSN: 1552-7468
CID: 1587502
Developing a competency tool for home health care nurse managers
ORIGINAL:0011693
ISSN: 1084-8223
CID: 2385692
Continuity in home health care: is consistency in nursing personnel associated with better patient outcomes?
A growing body of evidence suggests that patients who receive coordinated and uninterrupted health care services have better outcomes, more efficient resource utilization, and lower costs of health care. However, limited research has considered whether attributes of continuity in home health care service delivery are associated with improved patient outcomes. The present study examines the relationship between one dimension of continuity of care, consistency in nursing personnel, and three patient outcomes: hospitalization, emergent care, and improvement in activities of daily living. Analyses of data from a large population of home health patients (N=59,854) suggest that greater consistency in nursing personnel decreases the probability of hospitalization and emergent care, and increases the likelihood of improved functioning in activities of daily living between admission and discharge from home health care. These results provide preliminary evidence that efforts to decrease dispersion of nursing personnel across a series of home visits to patients may lead to improved outcomes. The implications of these findings for clinical practice and further research are discussed in the paper.
PMID: 22103703
ISSN: 1945-1474
CID: 1587522
