Assessing the Mental Health of Refugees Using the Refugee Health Screener-15.

In 2017, 352 refugees were relocated to the Kansas City, Kansas area. As part of the relocation process, newly arrived refugees receive physical and mental health screenings. This study is a retrospective analysis of the results of 92 Refugee Health Screener-15 (RHS-15) surveys collected from February to December 2017 and interviews with the healthcare providers who administered the surveys in a primary care clinic.

Leading Change: A Case Study of the First Independent Critical-Access Hospital to Achieve Magnet® Designation.

Objective: The aim of this study was to understand how nurses in a 25-bed critical-access hospital (CAH) led change to become the 1st to achieve Magnet®.

Background: Approximately 21% of the US population lives in rural areas served by CAHs. Rural nurse executives are particularly challenged with limited resources.

Costs of a Staff Communication Intervention to Reduce Dementia Behaviors in Nursing Home Care.

Context: Persons with Alzheimer's disease and other dementias experience behavioral symptoms that frequently result in nursing home (NH) placement. Managing behavioral symptoms in the NH increases staff time required to complete care, and adds to staff stress and turnover, with estimated cost increases of 30%. The Changing Talk to Reduce Resistivenes to Dementia Care (CHAT) study found that an intervention that improved staff communication by reducing elderspeak led to reduced behavioral symptoms of dementia or resistiveness to care (RTC).

A novel method for expediting the development of patient-reported outcome measures and an evaluation across several populations.

Item response theory (IRT) models provide an appropriate alternative to the classical ordinal confirmatory factor analysis (CFA) during the development of patient-reported outcome measures (PROMs). Current literature has identified the assessment of IRT model fit as both challenging and underdeveloped (Sinharay & Johnson, 2003; Sinharay, Johnson, & Stern, 2006). This study evaluates the performance of Ordinal Bayesian Instrument Development (OBID), a Bayesian IRT model with a probit link function approach, through applications in two breast cancer-related instrument development studies.

Communication with Residents and Families in Nursing Homes at the End of Life.

Communication with residents and their families is important to ensure that the end-of-life experience is in accordance with resident's wishes. A secondary analysis was conducted to determine: (a) who should communicate with the resident/family about death and dying; (b) when communication should occur around death and dying, obtaining a "DNR" order, and obtaining a hospice referral; and (c) what differences exist in communication about death and dying between Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and unlicensed staff. Greater than 90% of staff (=2,191) reported that the physician or social worker should communicate about death and dying with residents/families, but only 53% thought that direct care staff should talk with them.

A novel method for expediting the development of patient-reported outcome measures and an evaluation of its performance via simulation.

Background: Developing valid and reliable patient-reported outcome measures (PROMs) is a critical step in promoting patient-centered health care, a national priority in the U.S. Small populations or rare diseases often pose difficulties in developing PROMs using traditional methods due to small samples.

Linking Unit Collaboration and Nursing Leadership to Nurse Outcomes and Quality of Care.

Objective: The objective of this study is to identify the effects of unit collaboration and nursing leadership on nurse outcomes and quality of care.

Background: Along with the current healthcare reform, collaboration of care providers and nursing leadership has been underscored; however, empirical evidence of the impact on outcomes and quality of care has been limited.

Methods: Data from 29742 nurses in 1228 units of 200 acute care hospitals in 41 states were analyzed using multilevel linear regressions.

Evaluation of Elements of the Nursing Worklife Model Using Unit-Level Data.

The practice environment is important to nurse satisfaction and patient outcomes. Laschinger and Leiter posited causal relationships by development and testing of the Nursing Worklife Model (NWLM). Using a secondary analysis of unit-level data (N = 3,203; medical, surgical, medical-surgical, critical-care, and step-down units) from the 2011 National Database for Nursing Quality Indicators®, hypothesized pathways of the NWLM were tested using structural equation modeling.

Expediting Clinical and Translational Research via Bayesian Instrument Development.

Developing valid and reliable instruments is crucial but costly and time-consuming in health care research and evaluation. The Food and Drug Administration and the National Institutes of Health have set up guidelines for developing patient-reported outcome instruments. However, the guidelines are not applicable to cases of small sample sizes.

Application of bayesian methodology to measure equivalence between two rating scales.

Background: Little is known about measuring equivalence between two rating scales. Measuring the equivalence between two rating scales requires a study design and analysis conducive to clear interpretation of actual equivalence with simple inferences.

Objective: The aim of this study was to show the use of bayesian methodology in determining equivalence within a simulated content validity study (to establish equivalence, not content validity).

Symptom occurrence and associated clinical factors in nursing home residents with cancer.

Little is known about the factors that contribute to symptoms in nursing home residents with cancer. We compared rates of symptoms in residents with (n = 1,022) and without cancer (n = 9,910) and examined physiologic, psychologic and situational factors potentially related to symptoms in residents with cancer. Pain, shortness of breath, vomiting, weight loss, and diarrhea were significantly (p < .

Modeling efficiency at the process level: an examination of the care planning process in nursing homes.

Objective: To examine the efficiency of the care planning process in nursing homes.

Methods: We collected detailed primary data about the care planning process for a stratified random sample of 107 nursing homes from Kansas and Missouri. We used these data to calculate the average direct cost per care plan and used data on selected deficiencies from the Online Survey Certification and Reporting System to measure the quality of care planning.

Care planning integrity in nursing facilities.

Background: Although there is some evidence of improved quality in nursing home care after the implementation of the 1987 Omnibus Budget Reconciliation Act regulations, the nursing processes that contribute to that improvement are not well understood. Assumptions that the mandated tools for resident assessment and care planning account for the change remain uninvestigated.

Objectives: To generate an empirically supported conceptual model of care planning integrity, incorporating five subconstructs: coordination, integration, interdisciplinary team, restorative perspective, and quality.

Unmet symptom management needs of nursing home residents with cancer.

Nursing home residents living with cancer have unacceptably high percentages of unrelieved pain and other symptoms. However, residents with cancer have received relatively little attention in the literature to date. This article provides an overview of previous symptom research for residents with cancer, explores clinical and organizational factors that impede effective symptom management, and proposes an agenda for future research and clinical practice.

Care planning efficiency for nursing facilities.

The project reported here is the first in a series of cost analyses regarding the care planning process among 107 facilities. Process-based costing strategies and data envelopment analyses identified nursing facilities with efficient and less-efficient care planning processes. Having more people and more time devoted to the care planning process did not assure quality or efficiency.

Issues in nursing: strategies for an Internet-based, computer-assisted telephone survey.

The study describes the design and implementation of an Internet-based, computed-assisted telephone survey about the care-planning process in 107 long-term care facilities in the Midwest. Two structured telephone surveys were developed to interview the care planning coordinators and their team members. Questionmark Perception Software Version 3 was used to develop the surveys in a wide range of formats.

The NDNQI-Adapted Index of work satisfaction.

The valid measurement of nurses' job satisfaction is critical because job satisfaction is important for the retention of qualified nurses to provide patient care in hospitals. Two studies were conducted to adapt the Stamps Index of Work Satisfaction (1997b) to measure work satisfaction at the patient care unit level for use by the National Database of Nursing Quality Indicators (NDNQI). In Study 1 (n = 918 RNs) exploratory factor analysis of data obtained using the NDNQI-Adapted Index replicated the conceptual dimensions of the Stamps measure.

Process-based costing.

Understanding how quality improvement affects costs is important. Unfortunately, low-cost, reliable ways of measuring direct costs are scarce. This article builds on the principles of process improvement to develop a costing strategy that meets both criteria.

The effect of anticipatory strategies on the first day of smoking cessation.

The authors tested a model hypothesizing the predictors and the effects of anticipatory strategy use on the 1st day of smoking cessation using data from 63 participants in an ecological momentary assessment study of smoking cessation. Remaining abstinent on the 1st day of cessation was not associated with mean level of urges to smoke during tempting situations but was associated with anticipatory strategy use, which accounted for 18% of the variance. Getting rid of cigarettes contributed the most to this effect (beta = -.