Home Care Admission Information: What Nurses Need and What Nurses Have. A Mixed Methods Study.

Effective communication between clinicians across care settings is fundamental for continuity of care and decreased risk of errors. The home care admission often starts without important information needed for formulation of the plan of care. We conducted a mixed methods analysis to investigate home care admission information from two perspectives: qualitative information regarding information nurses reported they needed during an admission, and quantitative information regarding information actually available. We mapped both data sets to an international specification for transitions in care information, the Continuity of Care Document (CCD). The information that homecare nurses said they needed mapped sufficiently (90%) to the CCD. Regarding available information: no observation had all the CCD information present; CCD information was missing in varying amounts across the admission documents. Nurses searching among pages of documentation for information which may not be present is inefficient and introduces patient safety concerns of increased risk for errors.

The "Overdrive" Mode in the "Complete Vocal Technique": A Preliminary Study.

"Complete Vocal Technique," or CVT, is an internationally widespread method for teaching voice. It classifies voicing into four types, referred to as "vocal modes," one of which is called "Overdrive." The physiological correlates of these types are unclear. This study presents an attempt to analyze its voice source and formant frequency characteristics. A male and a female expert of CVT sang a set of "Overdrive" and falsetto tones on the syllable /pᴂ/. The voice source could be analyzed by inverse filtering in the case of the male subject. Results showed that subglottal pressure, measured as the oral pressure during /p/ occlusion, was low in falsetto and high in "Overdrive", and it was strongly correlated with each of the voice source parameters. These correlations could be described in terms of equations. The deviations from these equations of the different voice source parameters for the various voice samples suggested that "Overdrive" phonation was produced with stronger vocal fold adduction than the falsetto tones. Further, the subject was also found to tune the first formant to the second partial in "Overdrive" tones. The results support the conclusion that the method used, to compensate for the influence of subglottal pressure on the voice source, seems promising to use for analyses of other CVT vocal modes and also for other types of phonation.

Data Visualization of Home Care Admission Nurses' Decision-Making.

The hospital to home care admission process is when nurses make important decisions about the post-transition episode, including medication reconciliation, plan of care, future visit patterns, and the inclusion of other disciplines. It is not clear how nurses get and use information to support decision-making. We conducted a focus group case study with six admitting home health nurses at a rural agency in Pennsylvania. We analyzed the data using thematic analysis and using our enhanced custom high level node-link diagram that highlights the relationships between decisions, tasks and information themes and sub-themes. The visualizations will be evaluated via review with home care subject matter experts.