Several results seemed to challenge conventional assumptions of what precipitates NHA among persons with dementia. Caregiver stressors in conjunction with care recipient characteristics are important to consider when assessing NHA risk. The findings emphasize the need to construct more complex models of institutionalization when designing risk measures to target interventions.

Education sessions need to involve fewer lectures and more practical, interactive exercises that focus on developing specific skills. Follow-up contact is a valuable method for helping people make a healthy adjustment to living with diabetes.

This population‐based study investigated the relationship between stresses (hassles) and burnout for 30 family caregivers and their institutionalized demented elderly. The Burnout Measure, the Patient Hassles Scales and the Nursing Home Hassles Scale were used. Hassles included: patient hassles (cognitive, behavior, basic ADL) and nursing home hassles (caregiver – staff, patient – staff, practical/logistical). The caregiver's characteristics are described in relation to burnout and the caregiver's most frequent hassles are discussed. All subscales except basic ADL were correlated to burnout. However, regression analysis showed the nursing home hassles to be the most important stresses explaining variance in burnout among family caregivers. Copyright © 2000 John Wiley & Sons, Ltd.

A screening tool consisting of a limited number of characteristics readily available early in the hospital stay that were shown to be highly predictive of the use of specialized discharge planning services was developed. The application of such a tool will hopefully assist providers to deploy services appropriately and in a timely fashion.

It has been documented that up to 40% of the workday of nurses is taken up by meeting the ever-increasing demands of the systems of healthcare delivery in which nurses are employed. These demands include the need for increasing documentation, for learning new and seemingly ever-changing procedures, and for adapting to turnover in management and administration. Attention to these issues also means that 40% of that workday is not available to patients. Believing that these increasing demands are affecting nurses' decisions to remain in nursing or to leave, a group of Minnesota nurses and nurse educators examined the work environments of nurses and the issues related to those environments. The result of this examination was discovery of a phenomenon affecting all nurses that may be central to the projected shortage of nurses. The phenomenon is complexity compression-what nurses experience when expected to assume additional, unplanned responsibilities while simultaneously conducting their multiple responsibilities in a condensed time frame. The phenomenon was validated by a group of 58 nurses who participated in focus groups that led to the identification of factors influencing the experience of complexity compression. These factors were clustered into six major themes: personal, environmental, practice, systems and technology, administration/management, and autonomy/control. Further validation studies are planned with the population of practicing professional nurses in the state of Minnesota.

This research tested the effectiveness of the second tier of interventions in a two-tiered nursing intervention model designed to improve quality of care for residents in long-term care facilities (LTCFs). The first tier of the model called for gerontological advanced practice nurses (GAPNs) to provide direct care and to teach staff to implement care protocols for residents with incontinence, pressure ulcers, depression, and aggression. Results of the first-tier study indicated significant improvement in resident outcomes in incontinence, pressure ulcers, and aggression. In the second tier, GAPNs added a set of organization-level (OL) interventions including membership on the LTCF quality assurance committee and collaborating with staff on problem-solving teams. Analysis following the addition of OL interventions revealed significant improvement in both depression scores and in the trajectory of depression in residents of the LTCF where OL interventions were used.

We tested the effectiveness of a nursing intervention model to improve health, function, and return-home outcomes in elders with hip fracture via a 2-year randomized clinical trial. Thirty three elders (age > 65 years) were tracked from hospital discharge to 12 months postfracture. The treatment group had a gerontologic advanced practice nurse as postacute care coordinator for 6 months who intervened with each elder regardless of the postacute care setting, making biweekly visits and/or phone calls. The coordinator assessed health and function, and informed elders, families, long-term care staff, and physicians of the patient's progress. The control group had care based on postacute facility protocols. Nonnormal distribution of data led to nonparametric analysis using Freidman's test with post hoc comparisons (Mann-Whitney U tests, Bonferroni adjustment). The treatment group had better function at 12 months on several activities and instrumental activities of daily living, and no differences in health, depression, or living situation.

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