5072.0: Wednesday, November 15, 2000 - 9:30 AM

Abstract #14942

Measuring client outcomes of the chronically ill: The effectiveness of interventions in a rural nursing center, using a differentiated practice model

Laura Anderko, RNPhD, Mary Uscian, RNMSC, and Trudy DeWaters, RNMSGNPND. School of Nursing, Northern Illinois University, 1240 Normal Road, DeKalb, IL 60115-2894, 815 753-6575, kase@foxvalley.net

Creating a process for evaluating interventions and their outcomes is vital for nurses to maintain an important role in the health care market as effective and essential providers. However, little research has been conducted. The TriCounty Community Health Center (Center) was established to increase access to health care to underserved rural residents. The Center employs a differentiated practice model (DPM) of nursing in which interventions are targeted to client systems that match the nurse's level of educational preparation and competence. Past findings indicate that using a DPM can positively impact client outcomes in acute, episodic illnesses. This study focuses on measuring client outcomes for chronic illness, namely, hypertension. It is hypothesized that there will be a significant improvement between pre- and post-intervention scores for knowledge, behavior, and status for hypertensive clients in the areas of Prescribed Medication Regime and Nutrition. A one group before and after design is being utilized, with data collection beginning January 2000 and ending June 2000 for the 42 clients who qualified for the study. In the fall of 1999, the outcome measurement tool was developed using the Omaha Classification System, tested for reliability and validity, piloted, revised and re-tested. Nursing interventions are assigned based on the Center's DPM. Chi-square analysis will be conducted in the Summer of 2000 to determine if significant improvements have been realized. Outcomes will also be grouped and analyzed by variables such as smoking status, exercise level, weight, age, and educational level.

Learning Objectives: 1. Describe the differentiated nursing practice model as it relates to service provision and evaluation of the targeted population at the TriCounty Community Health Center. 2. Identify how knowledge, behavior, and status measures for hypertensive clients were evaluated, using the Omaha Classfication System. 3. Discuss implications of using the Omaha Classification System for evaluting client outcomes for a variety of chronic diseases in a primary care setting

Keywords: Outcomes Research, Nurse Managed Centers

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA