Evaluation of a client care delivery model, Part 2: Variability in client outcomes in community home nursing.
Using similar variables, Part II explores variation in client outcomes such as OMAHA knowledge, behavior, and SF-36 scores. Medical and nursing diagnoses explained large variations in client outcomes. Clients cared for by degree-prepared nurses improved knowledge and behavior scores. Unanticipated case complexity was negatively associated with client outcome even with nursing intervention. The study revealed that "for every unit increase in assignment of baccalaureate-prepared nurses, clients will on average demonstrate an 80% greater likelihood of improvement in knowledge scores and a 120% greater likelihood of improvement in behavior scores in relation to their health condition at discharge." This two-part study has offered insight into the controllable variables influencing the cost and quality of home care services.
O'Brien-Pallas
Linda-Lee
LL
Nursing Effectiveness, Utilization and Outcomes Research Unit, Home Care Evaluation and Research Center, Faculty of Nursing, University of Toronto, Ontario, Canada.
Irvine Doran
Diane
D
Murray
Michael
M
Cockerill
Rhonda
R
Sidani
Souraya
S
Laurie-Shaw
Brenda
B
Lochhaas-Gerlach
Jacquelyn
J
D002170:Canada; D003152:Community Health Nursing / Q000191:economics / Q000458:organization & administration*; D003695:Delivery of Health Care / Q000191:economics / Q000458:organization & administration / Q000592:standards* / Q000706:statistics & numerical data; D006699:Home Care Services / Q000592:standards*; D006801:Humans; D008137:Longitudinal Studies; D016294:Models, Nursing; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D018709:Statistics, Nonparametric