No abstract

Point-of-care technology for home care use will be the final step in enterprise-wide healthcare electronic communications. Successful implementation of home care point-of-care technology hinges upon nurses' attitudes toward point-of-care technology and its use in clinical practice. This study addresses the factors associated with home care nurses' attitudes using Stronge and Brodt's Nurse Attitudes Toward Computers instrument. In this study, the Nurses Attitudes Toward Computers instrument was administered to a convenience sample of 138 nurses employed by a large midwestern home care agency, with an 88% response rate. Confirmatory factor analysis corroborated the Nurses Attitudes Toward Computers' 3-dimensional factor structure for practicing nurses, which was labeled as nurses' work, security issues, and perceived barriers. Results from the confirmatory factor analysis also suggest that these 3 factors are internally correlated and represent multiple dimensions of a higher order construct labeled as nurses' attitudes toward computers. Additionally, two of these factors, nurses' work and perceived barriers, each appears to explain more variance in nurses' attitudes toward computers than security issues. Instrument reliability was high for the sample (.90), with subscale reliabilities ranging from 86 to 70.

Home care agencies often fail to commit adequate resource time preparing nurses for POC technology. Successful implementations need to incorporate human issues in addition to the technical aspects for POC. This article discusses the experiences and perceptions of nurses who participated in a pilot POC training group. The pilot group and key elements of the training are presented. The results of a focus group present the major POC focus of importance for the nurses.

Cognitive impairment is a serious and pervasive problem for ill elderly uersons in the institutional setting. Older individuals exit Lhese fdlities quickly, often requiring continued formal health care services in their homes. The prevalence of delirium and/ or dementia in older, medically ill home health clients has not been investigated.It was the purpose of this descriptive study to systematically screen a sample of elderly admissions to a visiting nurse association for cognitive impairment. One hundred individuals over the age of sixty-five were given the Mini-Mental State Exam (Folstein, Folstein & McHugh, 1975) on admission to lhe agency. Information on demographics and health status was retrieved from routine chart forms: -Prevalence of imoairment was 61 %. Imoaired individuals differed significantly from heir intact counterparts in relation to race, functional limitations, institutional length-of-stay and use of medications impacting on the central nervous &stem.

The need for primary medical care in the home will increase with a growing elderly and disabled population. The effectiveness of the service must be assessed in light of its relatively high costs. The aim of this study was to evaluate VNA HouseCalls of Greater Cleveland, Ohio during its first year of operations. The program targets high-risk older adults using teams of advanced practice nurses and physicians. The pilot evaluation focused on the attainment of identified program goals. Data collection techniques included clinical record review (N = 139), mailed referral source satisfaction survey, and both mailed and telephone interview patient satisfaction surveys. The results showed that the typical patient served by VNA HouseCalls was a homebound woman in advanced old age with regular family contact and both physical and mental disorders. When asked, the typical patient indicated that without the program she would not have received the care that she needed.VNA HouseCalls helped in preventing functional decline and reducing hospitalization. It received high satisfaction ratings from both referral sources and patients. Study findings suggest that primary care in the home bears further examination for addressing community need and affecting positive patient outcomes for high risk older adults.