Publications by authors named "Ruby Hoyem"
Anesthesia delivery models have long been shaped by workforce trends, state and federal regulations, economic incentives driven by reimbursement, and the normative preferences of provider and facility organizations. In recent years, there has been a significant shift toward greater use of more efficient certified registered nurse anesthetist (CRNA)-oriented delivery models observed at the national level Medicare data. However, given the wide range of these factors across states and regions, this shift has likely occurred at an uneven pace.
View Article and Find Full Text PDFThe coronavirus disease 2019 (COVID-19) pandemic prompted profound shifts in the delivery of critical healthcare services. A mixed-methods study was conducted to explore the impact of the pandemic on Certified Registered Nurse Anesthetist (CRNA) practice. The quantitative component involved a survey of CRNAs during the initial period of the pandemic to determine changes in practice and any relationship to removal of state and federal barriers.
View Article and Find Full Text PDFBackground: An ongoing shortage of anesthesia providers lends importance to the study of job satisfaction and retention among this critical workforce. Certified registered nurse anesthetists (CRNA) make up an increasing share of this workforce and the impact of factors affecting their satisfaction is not fully understood.
Purpose: Understanding the job satisfaction of Certified Registered Nurse Anesthetists (CRNA) and its determinants.
Article Synopsis
- Health care errors continue to be a major national issue, despite efforts to reduce them since a significant report in 2000.
- The pilot study aimed to assess how an eight-week mindfulness-based stress reduction program could influence the frequency of errors made by nurses in simulated clinical situations.
- Results showed that while not statistically significant, there were positive trends in clinical performance following mindfulness training, highlighting potential benefits such as enhanced listening skills and suggesting mindfulness as a valuable area for further research in nursing practice.
Advocacy, Research, and Anesthesia Practice Models: Key Studies of Safety and Cost-Effectiveness.
Policy Polit Nurs Pract
November 2019
The practice of anesthesia includes multiple competing practice models, including services delivered by anesthesiologists, independent practice by certified registered nurse anesthetists (CRNAs), and team-based approaches incorporating anesthesiologist supervision or direction of CRNAs. Despite data demonstrating very low risk of death and complications associated with anesthesia, debate among professional societies and policymakers persists over the superiority or equivalence among these models. The American Society of Anesthesiologists uses published findings as evidence for claims that anesthesia is safer when anesthesiologists lead in providing care.
View Article and Find Full Text PDFArticle Synopsis
- Dementia caregivers continue to feel the emotional toll of their role even after placing loved ones in long-term care, often facing chronic grief.
- The Chronic Grief Management Intervention (CGMI) is a 12-week program designed to educate and support caregivers in managing their grief, communication, and conflict resolution skills.
- A study with 83 caregivers showed that those who participated in the CGMI experienced significant improvements in their feelings of sadness and guilt over time.
The relationship between physical activity and cognition in older Latinos.
J Gerontol B Psychol Sci Soc Sci
September 2012
Objectives: The purpose of this study was to explore the relationship between minutes spent participating in light and moderate/vigorous-intensity physical activity (PA) and cognition in older Latinos, controlling for demographics, chronic health problems, and acculturation.
Method: A cross-sectional study design was used. Participants were self-identified Latinos, without disability, who had a score less than 14 on a 21-point Mini-Mental State Examination.
Background: To date, little is known about the physical activity (PA) levels and commonly reported modes of PA of older Latinos, and this information is critical to developing interventions for this population. The purpose of the current study was to examine PA assessed by self-report and accelerometer and to assess the influence of acculturation, gender, and age on the PA of urban community-dwelling older Latino adults.
Methods: Participants were self-identified Latinos, primarily women (73%), and individuals aged 50 to 59 (31%), 60 to 69 (30%), and 70+ (39%).
Background: To date, little is known about the physical activity (PA) levels and commonly reported modes of PA of older Latinos, and this information is critical to developing interventions for this population. The purpose of the current study was to examine PA assessed by self-report and accelerometer and to assess the influence of acculturation, gender, and age on the PA of urban community-dwelling older Latino adults.
Methods: Participants were self-identified Latinos, primarily women (73%), and individuals aged 50 to 59 (31%), 60 to 69 (30%), and 70+ (39%).
Background: The majority of Americans die in institutions although most prefer to die at home. States vary greatly in their proportion of home deaths. Although individuals' circumstances largely determine where they die, health policies may affect the range of options available to them.
View Article and Find Full Text PDFObjective: States vary greatly in their support for home- and community-based services (HCBS) that are intended to help disabled seniors live in the community. This article examines how states' generosity in providing HCBS affects the risk of nursing home admission among older Americans and how family availability moderates such effects.
Methods: We conducted discrete time survival analysis of first long-term (90 or more days) nursing home admissions that occurred between 1995 and 2002, using Health and Retirement Study panel data from respondents born in 1923 or earlier.