Linking nursing care interventions with client outcomes: a community-based application of an outcomes model.

This article describes a conceptual model that provides an organizing framework for assessing client outcomes in community-based settings. The "Outcomes Model for Community-Based Settings" (OMCBS) examines the relationships among structure, process, and outcomes juxtaposed to the dimensions of client, provider, and setting including sample measures for each variable. OMCBS incorporates the Omaha System including its comprehensive list of client health problems, nursing interventions, and an outcome rating scale assessing client knowledge, behavior, and health status to standardize nursing care and client outcomes. The OMCBS provides a strategy to evaluate the effectiveness of nursing interventions for clients in a variety of milieus.

A study of functional status among elders at two academic nursing centers.

Using the Older Americans Resources and Services (OARS) tool, this study examined quality of life related to functional status in 68 elderly clients at two community-based nurse-managed centers (NMCs) in California. Undergraduate and graduate nursing students administered the OARS to three cohort groups. Data from the tool were used to assess functional independence among these clients and organize and evaluate the quality of nursing care delivered at the centers. The study provides the basis for evidence-based nursing care that integrates research strategies and the nursing process.

The role of governance in improving clinical outcomes: opportunities for nurses.

In this article, the authors explore how the role of governance has changed in response to the field of performance measurement and the wide variety of governance trends and share their views and experiences as nurses who have had the opportunity to serve in governance roles. Recommendations are provided for nurse executives interacting with the governance structures of their organizations. Finally, strategies are shared for nurses interested in pursuing governance opportunities in their local communities.

Transforming the curriculum while serving the community: strategies for developing community-based sites.

Developing community-based clinical opportunities for students is a challenge. At San Jose State University (SJSU) School of Nursing, faculty transformed the curriculum by developing community-based experiences directed by faculty and delivered by students during clinical practice. These innovative clinical experiences provide a structure to educate students and enhance the ability to bring health care to underserved people in a community. This article describes the structure and processes for implementing the new experiences and offers strategies to guide other faculty interested in developing community-based experiences.

Nurse-managed centres: an innovative structure for nursing education and care.

The development of nursing centres in the USA began in the late 1800s with the concept of community-based nursing care provided by district and visiting nurses. Primary roles included health promotion and safeguarding hygiene in addition to caring for the sick. Established in 1893, the Henry Street Settlement in New York, a public health nursing system providing direct access to health care, became a model for other agencies in the USA.

Social policy statements: guidelines for decisionmaking.

As healthcare providers, nurses have a professional responsibility to act on behalf of the public they serve by influencing health policy. One tool that can direct nurses in this political activity is a social policy statement. Its importance and strategies for use are described below.

Facilitating research utilization: a model for nurse managers.

Nursing research utilization has been studied and models have been developed by many nursing groups. However, the important role of the nurse administrator or manager in promoting utilization of research has been neglected. This pilot study used a nursing diagnosis--alterations in comfort (pain)--to identify common and expected variables in selected studies. Findings from this research together with the literature on research utilization models provided the foundation for the development of a preliminary model for nurse managers. The authors discuss this process and make recommendations for implementation.

The tools of management: keeping high touch in a high tech world.

Three of Naisbitt's Megatrends: information processing, high tech/high touch and participatory management--welded into tools of management--have particular relevance for nurses throughout the world. Their use is explored in this paper delivered at a Special Interest Session in Tel Aviv at the ICN Congress.

The research tradition of nursing: an emerging issue.

Authors have recently questioned the scientific method as the one appropriate model for nursing research. However, when nursing's research tradition is examined, one can see that it has not been limited solely to the scientific method. Both observational and experimental research have been used. The nursing research tradition, which has provided methods for answering questions relevant to the discipline in each historical period, continues to evolve to meet changing demands. The problem is not what research method to use but what research question to ask and how the question can be answered best.