Gerontological Nursing Interventions Research Center (GNIRC)

Title: Elders' Costly DRGs: Nursing Effect on Outcome Change
Principal Investigator: Meridean Maas, PhD, RN, FAAN

Study Site: The University of Iowa

Abstract
This pilot study application proposed to analyze the effectiveness of nursing interventions using data from multiple databases, including a clinical nursing database with unifrom standardized languages for nursing diagnoses, nursing interventions, and nursing-sensitive patient outcomes. The data are generated by 3 Midwestern, Mayo Health System community hospitals and associated home care and nursing home settings. The purpose of the pilot study is to prepare for a larger study to evaluate the effectiveness of nursing interventions for older persons with Congestive Heart Failure (CHF) [DRG 127] and Pneumonia [DRG 89, 90] who are hospitalized and discharged to Home Care or nursing home/long term care (LTC) settings. The use of uniform clinical nursing data and the importance of evaluating the effectiveness of nursing interventions for elders with CHF and pneumonia, leading causes of disability and death that consume a large proportion of health care dollars, have clear significance for nursing, other health care disciplines, health care organizations, plicy makers, and consumers of health care. Study aims include evaluation of data collection, mapping, and management protocols; description of nursing diagnoses, interventions, patient outcomes, and their linkages; change in outcome status and intervals of measurement; medical diagnoses and severity; and other disciplines' interventions for older CHF and pneumonia patients across and within the care settings; and determination of the number of subjects (elders with CHF (DRG 127) and pneumonia (DRG 89 and 90)), within and across the care settings, needed for statistical power in a larger study to be submitted for external funding.