Gerontological Nursing Interventions Research Center (GNIRC)

Title: Hospital Nursing Effectiveness: Elders with CPOD/TJR
Principal Investigator : Cindy Scherb, PhD, RN
Study Site : Winona State University

Abstract
The total joint replacement (TJR) and chronic obstructive pulmonary disease (COPD) populations are high cost, high volume hospitalizations for older persons and the healthcare organization. The percentage of people over the age of 65 will continue to increase for many years and it is likely that the elderly population will continue to use the resource intensive services of acute care hospitals. It is necessary to identify the most pertinent nursing interventions to achieve the desired outcomes, so readmissions, complications, and costs can be reduced. Although the use of large data sets is emphasized for health care effectiveness research, data needed to assess nursing effectiveness are lacking. Standardized clinical nursing data, that are retrievable, are rare in single institutions and even more rare in multiple systems that include services across care settings. This pilot study proposes to: 1) determine if the variables that are needed to assess the extent that nursing interventions influence patient outcomes for specific patient populations are available in the hospitals' computerized systems, 2) demonstrate that the variables can be retrieved and downloaded into a data warehouse for data analysis, 3) describe the nursing diagnoses, interventions, and outcomes that are most frequently linked by nurses who care for elders with TJR and COPD, and 4) describe the intervals of measurement, change, and variation in outcome status throughout the hospital length of stay for the elders with TJR and COPD at 4 midwestern intermediate hospitals. The proposed pilot study will enable subsequent innovative research using standardized clinical data from nurses documenting their practice in integrated information systems across multiple sites.