Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses最新文献

{"title":"Community reintegration: getting back to life!","authors":"D. Humpage","doi":"10.1002/J.2048-7940.2001.TB02210.X","DOIUrl":"https://doi.org/10.1002/J.2048-7940.2001.TB02210.X","url":null,"abstract":"","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"64 1","pages":"85-7"},"PeriodicalIF":0.0,"publicationDate":"2001-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88930398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Family caregiver expectations and management of the stroke trajectory.","authors":"M. Burman","doi":"10.1002/J.2048-7940.2001.TB02212.X","DOIUrl":"https://doi.org/10.1002/J.2048-7940.2001.TB02212.X","url":null,"abstract":"Less than 20% of stroke survivors enter rehabilitation or long-term care facilities after their stroke. Stroke recovery is extremely variable and the resulting uncertainty places a heavy burden on the survivors' family caregivers. According to the trajectory framework, chronic conditions have a defined course that can be shaped and managed. This grounded theory study, part of a larger research project, explored the expectations of family caregivers of the stroke trajectory and their management strategies. Thirteen family caregivers of stroke patients in a sparsely populated area participated in semi-structured interviews. The caregivers were without ideas about what the recovery of their loved ones would be like and had difficulty making projections about the trajectory. They used several strategies, however, in attempts to manage the stroke trajectory. They constructed a positive recovery, reconstituted family life, maintained family routines, created a safety net, and redoubled self-reliance. The findings have implications for how nurses support family caregivers of stroke survivors.","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"5 1","pages":"94-9"},"PeriodicalIF":0.0,"publicationDate":"2001-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79137859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring and expressions of stability by urban family caregivers of persons with stroke within African American family systems.","authors":"L. Pierce","doi":"10.1002/J.2048-7940.2001.TB02213.X","DOIUrl":"https://doi.org/10.1002/J.2048-7940.2001.TB02213.X","url":null,"abstract":"Expressions of stability by urban family caregivers are the focus of this study. Data presented here were collected as part of a larger ethnographic descriptive study that examined caregivers' (N = 24) experience and the meaning of caring as it influences their ability to care for persons with stroke within their African American family systems. For family caregivers, unmet needs and problems with caregiving may occur as depleted resources are compounded by urban decay in many communities. This study was completed within the Framework of Systemic Organization described by Friedemann, in which families, as open systems, strive for well-being. Stability in the family, a component of well-being, addresses traditions and common behavior patterns rooted in basic values and cultural beliefs. Through data analysis, four themes concerning expressions of stability were identified for all caregivers. Caring expressions of stability are defined as (a) emotional burden; (b) evasion of conflicts; (c) motivation from love and a sense of duty between caregivers, the care recipients, and their families; and (d) a filial, ethereal value. Rehabilitation nurses can incorporate these expressions of stability into their assessment, intervention, and evaluation processes, and thereby increase the potential to strengthen successful caring and stability within the caregivers' family systems.","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"100 1","pages":"100-7, 116"},"PeriodicalIF":0.0,"publicationDate":"2001-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76553968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Extending a rehabilitation pathway to include multiple providers: outcomes and pitfalls.","authors":"J. Pearson","doi":"10.1002/J.2048-7940.2001.TB01926.X","DOIUrl":"https://doi.org/10.1002/J.2048-7940.2001.TB01926.X","url":null,"abstract":"Patients commonly experience a complete new set of caregivers as they progress from acute to subacute care settings. As a result, managing continuity of care, patient satisfaction, and cost containment across the rehabilitation continuum becomes impossible. In addition, accountability for overall outcomes is fragmented, and patients often feel abandoned by their primary caretakers. To eliminate these problems, a rehabilitation liaison nurse followed patients from the acute to subacute setting. A mutually beneficial partnership evolved between the facilities. Continuity of care improved, transdisciplinary teams shared resources, the subacute length of stays decreased significantly, and patients gained a sense of support throughout the continuum of care. This article describes the development of an extended pathway, clinical implications for rehabilitation of joint replacement patients, some unexpected outcomes, and the role of a rehabilitation liaison nurse.","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"26 1","pages":"54-7, 65"},"PeriodicalIF":0.0,"publicationDate":"2001-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84475082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving care practices for patients with multidrug-resistant organisms: one facility's evolution.","authors":"V. Kennedy, S. Steinfeld, G. Sims","doi":"10.1002/J.2048-7940.2001.TB01927.X","DOIUrl":"https://doi.org/10.1002/J.2048-7940.2001.TB01927.X","url":null,"abstract":"The care of patients with multidrug-resistant organisms (MDROs) varies in rehabilitation settings. Implementation of strict contact isolation in some facilities may limit patients from reaching their rehabilitation goals. This article describes our rehabilitation and long-term acute care facility's efforts to develop a policy that would enable patients with MDROs to meet their rehabilitation goals within a safe environment. A multidisciplinary team developed a two-track care process allowing staff to quickly identify appropriate activities for these patients. The team also developed educational materials for staff and families, addressed cleaning practices, and standardized the criteria for follow-up cultures and discontinuation of isolation. The MDRO policy was instituted throughout the hospital in August 1999. The incidence of nosocomially acquired MDROs has decreased slightly from the baseline rate of .076 per 100 patient days to .039 per 100 patient days during the 4-month period following the implementation of the policy.","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"192 1","pages":"58-60, 63-5"},"PeriodicalIF":0.0,"publicationDate":"2001-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74186124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quality care in the new era of PPSs.","authors":"S. Dean‐Baar","doi":"10.1002/J.2048-7940.2001.TB01922.X","DOIUrl":"https://doi.org/10.1002/J.2048-7940.2001.TB01922.X","url":null,"abstract":"Susan Dean-Baar, PhD RN CRRNFAAN Editor We are on the brink of a new era in rehabilitation. Eighteen years after diagnosis-related groups (DRG) were instituted as the basis for payment for acute hospital services, a prospective payment system (PPS) will be used by Medicare to pay for inpatient rehabilitation services. The Health Care Financing Administration (HCFA) identified a set of laudable objectives for development of the PPS for inpatient rehabilitation facilities. The objectives outlined in the proposed rules for the PPS included the (a) creation of a beneficiary-centered payment system that promotes quality of care, access to care, and continuity of care, and is administratively feasible while controlling costs; (b) provision of incentives to furnish services as efficiently as possible without diminishing the quality of care or limiting access to care; (c) creation ofa payment system that is fair and equitable to facilities, beneficiaries, and the Medicare program; and (d) recognition of legitimate cost differences among settings and group patients and services in clinically coherent categories that reflect similar resource use. It will be no small feat to accomplish all these objectives. The concern among rehabilitation providers is that the cost concerns will eventually win out in the struggle between the goals to control costs and the goals related to promoting quality and access to care. Ofcourse, HCFA is concerned about the potential for providers to \"upcode\" and \"game\" the system. There is sometimes a fine line between knowing the rules of the game to legitimately maximize the amount of payment received for services provided rather than to inflate the amount ofpayment received. Although the providers who play the game to inflate the payment are few in comparison to the rest of the field, they do exist in enough numbers to make it a realistic concern for HCFA, as evidenced by the fraud cases that make the news in increasing numbers. The tensionbetweengoalsofqualityandaccess and goals of cost containmentis certainly not new to rehabilitation. We began to feel it when the inpatient acute providers began to discharge patients quicker and sicker to rehabilitation settings. The Balanced Budget Refinement Act of 1999 requires implementation ofan inpatient rehabilitation PPS this year.As a result, the payment system that is implemented may not accurately reflect the actual costs of providing services. This is especially true in that the historic data used to project costs probably don't accurately reflect staff time resource use within the case mix groups. Although studies of staff time measurement have been conducted, the data were not available in time to include in the determination of the initial system. In addition, many arguments have been made that the current PPS for inpatient acute care does not adequately cover the costs of providing care, which leads to the early discharge of acute patients to other levels of care. As a result, t","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"10 8 1","pages":"42"},"PeriodicalIF":0.0,"publicationDate":"2001-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84451861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using rehabilitation theory to teach medical-surgical nursing to undergraduate students.","authors":"L. Neal","doi":"10.1002/J.2048-7940.2001.TB01929.X","DOIUrl":"https://doi.org/10.1002/J.2048-7940.2001.TB01929.X","url":null,"abstract":"Medical-surgical nursing has been taught at the undergraduate level using several approaches (Bocchi, Pessuto, & Dell'Aqua, 1996; Hinzman, 1996). Although a review of the literature indicates that nursing schools have had some success offering classes that focus on rehabilitation principles and theory, there is no literature about medical-surgical nursing that is taught from a rehabilitation perspective. This article describes an undergraduate medical-surgical nursing course that teaches students how to care for the chronically ill using rehabilitation theory and principles.","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"11 1","pages":"72-5, 77"},"PeriodicalIF":0.0,"publicationDate":"2001-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79399356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'They never told us anything': postdischarge instruction for families of persons with brain injuries.","authors":"B. Paterson, B. Kieloch, J. Gmiterek","doi":"10.1002/J.2048-7940.2001.TB01925.X","DOIUrl":"https://doi.org/10.1002/J.2048-7940.2001.TB01925.X","url":null,"abstract":"This article reports on an analysis of why some families of survivors of traumatic brain injury (TBI) do not perceive that they were prepared for the postdischarge experience, despite discharge planning and teaching by rehabilitation hospital staff and third-party insurance adjusters. Findings are presented of a research study involving single interviews with seven families of survivors of TBI and interviews with four focus groups of healthcare professionals and third-party insurance adjusters who had cared, or were currently caring, for the injured person. Most family members did not recall being taught about what to expect or resources available to them. Healthcare professionals and insurance adjusters, however, stated that extensive discharge planning and multidisciplinary teaching conferences with patients and their families had been held before the patients were discharged. Reasons for such a discrepancy in perceptions are suggested. Implications of these findings for healthcare professionals who conduct discharge teaching in rehabilitation facilities are identified.","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"1 1","pages":"48-53"},"PeriodicalIF":0.0,"publicationDate":"2001-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85713857","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Team case management: how to get your staff out of 'jail'.","authors":"J. Hammond","doi":"10.1002/j.2048-7940.2001.tb01924.x","DOIUrl":"https://doi.org/10.1002/j.2048-7940.2001.tb01924.x","url":null,"abstract":"Our patients have not only a \"guardian angel\" to see that their needs are being met, but also an entire team of \"Guardian Angels\" to watch over them. I am very proud of our unit and pleased to be able to provide this service to our community. We have been able to accomplish this through teamwork!","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"38 1","pages":"46-7"},"PeriodicalIF":0.0,"publicationDate":"2001-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87731182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding the proposed rules for acute rehabilitation prospective payment.","authors":"B. Bianchi","doi":"10.1002/J.2048-7940.2001.TB01923.X","DOIUrl":"https://doi.org/10.1002/J.2048-7940.2001.TB01923.X","url":null,"abstract":"","PeriodicalId":94188,"journal":{"name":"Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses","volume":"23 1","pages":"44-5"},"PeriodicalIF":0.0,"publicationDate":"2001-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82620744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}