Browsing by Author "Newhouse, Robin P."

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    911 Calls for Emergency Medical Services in Heart Failure: A Descriptive Qualitative Study
    (Wolters Kluwer, 2022-09) Jung, Miyeon; Hays, Laura M.; Pang, Peter S.; Newhouse, Robin P.; Arkins, Thomas P.; O'Donnell, Daniel; Cook, Ryan; Gradus-Pizlo, Irmina; McAdams, Ellen; Pressler, Susan J.; School of Nursing
    Background Heart failure (HF) is a common condition leading to activation of emergency medical services (EMS). Objective The aim of this study was to describe reasons given by persons with HF, family members, or other caregivers for requesting EMS activation during 911 calls. Methods In this descriptive qualitative study, a content analysis was performed on transcribed audio files of 383 EMS requests involving 383 persons with HF in the community. Results One hundred forty-seven calls (38.4%) were placed by the family members, 75 (19.6%) were placed by the patients, 56 (14.6%) were placed by healthcare workers or personnel from living facilities, and the remaining calls (n = 105, 27.4%) were placed by others (eg, friends, neighbors, officers). Three broad categories of symptoms, signs, and events were identified as the reasons for an EMS request. Frequently reported symptoms were breathing problems (55.4%), chest pain (18.3%), and other pain (eg, head, extremities) (16.7%). Signs included decreased consciousness (15.4%), swelling (5.7%), and bleeding (5.0%). The reported events involved falls (8.1%), heart attack (6.3%), hypoxic episodes (6.0%), stroke (5.2%), and post–hospital-discharge complications (4.7%). In most calls (74.9%), multiple reasons were reported and a combination of symptoms, signs, and events were identified. Heart failure diagnosis was mentioned in fewer than 10% of the calls. Conclusions Overall, symptoms and signs of HF exacerbation were common reasons to activate 911 calls. Falls were frequently reported. Under the duress of the emergent situations surrounding the 911 call, callers rarely mentioned the existence of HF. Interventions are needed to guide patients with HF and their family members to promote the management of HF to reduce EMS activation as well as to activate EMS quickly for acute changes in HF conditions.
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    Engaging Patients with Heart Failure into the Design of Health System Interventions: Impact on Research Methods
    (2017-07-01) Newhouse, Robin P.; Johantgen, Meg; Thomas, Sue; Trocky, Nina; Dennison-Himmelfarb, Cheryl; Cheon, Jooyoung; Miller, Wanda; Gray, Tracy; Pruitt, Robin
    Purpose: To engage patients with heart failure (HF) to assess if changes are needed in a research study design, methods and outcomes when transferring interventions used in urban/community hospitals to rural hospital settings. Design: A qualitative structured interview was conducted. Method: Eight patients from two rural hospitals participated in an interview prior to discharge. Results: Patients validated the study design, measures and outcomes, but identified one area that should be added to the study protocol, symptom experience. Conclusion: Patient interviews validated that the intervention, methods and outcomes were important, but modifications to the study protocol resulted. Patient engagement in the conceptualization of patient centered outcome research is essential to guide the investigator approach to studies.
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    A study of Indiana University Health's spirit of inquiry and innovation during COVID
    (Elsevier, 2021-07) Carpenter, Janet S.; Draucker, Claire B.; Bartlett Ellis, Rebecca J.; Ferren, Melora D.; Gilbert, Jason H.; Newhouse, Robin P.; Von Ah, Diane; School of Nursing
    Background COVID-19 has required nursing innovations to meet patient care needs not previously encountered. Purpose The purpose of this study was to describe nursing innovations conceived, implemented, and desired during the first COVID-19 surge. Methods The investigators invited registered nurses employed across 16 Midwest hospitals (6,207) to complete the survey. Respondents provided demographics and written descriptions of innovations they conceived, witnessed, and desired. Investigators analyzed text responses using standard content analytic procedures and summarized quantitative demographics using percentages. Findings Nurses reported seven types of innovations that would (a) improve personal protective equipment (PPE), (b) limit the need to repeatedly don and doff PPE, (c) ensure safer practice, (d) conserve and access supplies, (e) provide patient and family education and support, (f) make team member communication more efficient, and (g) improve peer support. Discussion Nurses are in a unique position to generate innovative solutions to meet patient care needs under adverse and rapidly changing situations.
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    The Relationship Between Instrumental Activities of Daily Living and Hospitalizations: A Systematic Review and Meta-Analysis
    (2024-07) Collins, Jason Joseph; Newhouse, Robin P.; Levoy, Krisin; Basile, David P.; Jung, Miyeon
    Instrumental activities of daily living (IADL) have been defined as the activities for which their performance is necessary for continued independent living arrangements and that are more complex than routine activities of daily living. Evidence has reported the presence of IADL impairments in patients discharging from hospital. However, there is little research evaluating the role of IADLs as a modifiable risk factor in preventing hospitalizations among high-risk groups, such as heart failure. This oversight leaves gaps in discharge planning, in connecting patients to needed services that address impaired IADLs. The purpose of this dissertation was to improve knowledge of the relationship between IADLs and hospitalizations by: 1) describing the theory that underpins the relationship between IADLs and hospitalizations; 2) completing a systematic review to narratively synthesize the state of use of IADL scales across studies examining hospitalizations among high-risk groups (i.e., heart failure); 3) completing a meta-analysis to estimate the overall association between IADLs and hospitalizations among the high-risk groups; 4) conducting tests of moderation using meta-analytic techniques to determine whether the overall association between IADLs and hospitalizations varied based on certain IADL scale characteristics (e.g., number of components). Founded upon the Theory of Self-Care of Chronic Illness, the systematic search produced 4,932 articles, with 23 meeting criteria. The systematic review revealed that IADL discussions have been present in healthcare literature internationally since 1969; significant heterogeneity exists in the number of IADL components; the legacy work of Lawton and Brody (1969) remains prevalent but not panoptic; and IADLs have been studied in a wide variety of illnesses. The meta-analysis revealed that IADL impairments were positively associated with hospitalizations (OR=1.40, 95% CI: 1.24, 1.58; k=22, p<.001). Tests of moderation indicated that the IADL scale (QM=0.496, p=0.481) and item composition (QM=0.189, p=0.664) did not explain variation among effect sizes, indicating that the IADL scale formulation did not impact the relationship between IADLs deficits and hospitalizations. This dissertation provides compelling evidence that assessing IADLs may yield a significant opportunity to identify modifiable risk factors to reduce hospitalization. More work is needed to standardize IADL measurement at discharge to identify patients at high risk.