Practical Application of Theory to Uncover and Alter Conditions That Influence Clinical Outcomes in Children with Asthma

2.50
Hdl Handle:
http://hdl.handle.net/10755/160571
Type:
Presentation
Title:
Practical Application of Theory to Uncover and Alter Conditions That Influence Clinical Outcomes in Children with Asthma
Abstract:
Practical Application of Theory to Uncover and Alter Conditions That Influence Clinical Outcomes in Children with Asthma
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2002
Author:Cox, Karen, PhD(c)
P.I. Institution Name:University of Missouri-Columbia
Title:Program Manager
Contact Address:Sinclair School of Nursing, S235 Nursing Building, Columbia, MO, 65211, USA
Contact Telephone:573.882.6987
An association between nursing practice and patient outcome improvements must be demonstrated for the nursing profession to claim that nurses substantially contribute to health and well-being of clients. In this study, health care system gaps associated with asthma symptom control have come to light and have been altered as a result of the articulation of the pediatric asthma literature with Orem's Self-Care Deficit Nursing Theory (SCDNT). Asthma is the most frequent reason for preventable hospital admissions among children regardless of race or socio-economic status. Since asthma hospitalizations are preventable, an implicit assumption is that parents are not optimally managing the illness condition. SCDNT provides a valuable model for the examination and determination of specific thoughts, decisions, and actions required of competent care givers. Using Crabtree and Miller's (1999) template analysis and SCDNT, 14 conditions were uncovered in the pediatric asthma literature that, if not present, would interfere with competent action by care givers. All but two of these 14 conditions are influenced by factors at least partly controlled by the health care system. Given this new understanding, a unique partnership between a health care system and a Medicaid managed care health plan was forged to remove health care system barriers that interfere with asthma symptom control. Interventions were designed and implemented to improve under-diagnosis, under-treatment, continuity, access, and parent teaching. Using claims data, a pre-post comparison of health care utilization and asthma medication refill rates resulted in a reduction of asthma hospitalizations from 0.8 admissions per 1,000 enrollees to 0.6 and emergency room visits by 13%. The rate of inhaled anti-inflammatory refills increased from 3.8 to 6.5 refills per 1000 members. When improvements in outcomes such as these are clearly linked with problem solving and interventions directed from nursing theory, researchers validate the substance and contributions of the nursing profession.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePractical Application of Theory to Uncover and Alter Conditions That Influence Clinical Outcomes in Children with Asthmaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160571-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Practical Application of Theory to Uncover and Alter Conditions That Influence Clinical Outcomes in Children with Asthma</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2002</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Cox, Karen, PhD(c)</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Missouri-Columbia</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Program Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Sinclair School of Nursing, S235 Nursing Building, Columbia, MO, 65211, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">573.882.6987</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">CoxK@health.missouri.edu</td></tr><tr><td colspan="2" class="item-abstract">An association between nursing practice and patient outcome improvements must be demonstrated for the nursing profession to claim that nurses substantially contribute to health and well-being of clients. In this study, health care system gaps associated with asthma symptom control have come to light and have been altered as a result of the articulation of the pediatric asthma literature with Orem's Self-Care Deficit Nursing Theory (SCDNT). Asthma is the most frequent reason for preventable hospital admissions among children regardless of race or socio-economic status. Since asthma hospitalizations are preventable, an implicit assumption is that parents are not optimally managing the illness condition. SCDNT provides a valuable model for the examination and determination of specific thoughts, decisions, and actions required of competent care givers. Using Crabtree and Miller's (1999) template analysis and SCDNT, 14 conditions were uncovered in the pediatric asthma literature that, if not present, would interfere with competent action by care givers. All but two of these 14 conditions are influenced by factors at least partly controlled by the health care system. Given this new understanding, a unique partnership between a health care system and a Medicaid managed care health plan was forged to remove health care system barriers that interfere with asthma symptom control. Interventions were designed and implemented to improve under-diagnosis, under-treatment, continuity, access, and parent teaching. Using claims data, a pre-post comparison of health care utilization and asthma medication refill rates resulted in a reduction of asthma hospitalizations from 0.8 admissions per 1,000 enrollees to 0.6 and emergency room visits by 13%. The rate of inhaled anti-inflammatory refills increased from 3.8 to 6.5 refills per 1000 members. When improvements in outcomes such as these are clearly linked with problem solving and interventions directed from nursing theory, researchers validate the substance and contributions of the nursing profession.</td></tr></table>en_GB
dc.date.available2011-10-26T23:04:18Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:04:18Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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