Western journal of nursing research
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Multicenter Study Comparative Study
Methodological issues in explaining maternal outcomes: anesthesia provider characterizations and resource variation.
Anesthesia provider models were characterized based on responsibilities and technique privileges and the distribution of clinical resource and process variables using a survey of 1,135 hospitals offering obstetric care in eight representative states. The resulting models were then analyzed by resource availability. ⋯ Traditional characterizations of provider fail to capture differences in technique privileges. Clinical resource variables and the scope of technique privileges should be included in the study of anesthesia provider credentials on outcomes.
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Multicenter Study Comparative Study
Is the medical record an accurate reflection of patients' symptoms during acute myocardial infarction?
Documentation of symptoms in the medical record provides clinicians and researchers with valuable information about the patient's experience during acute myocardial infarction (AMI). To examine the consistency between the patient's reported symptoms and the medical record, 215 patients were interviewed and their medical records examined for information about their admission symptoms. Chest pain was the most frequently reported and recorded symptom, and there was good agreement between the patient's report and the medical record. ⋯ Time of symptom onset was identified by 87.9% of patients but only documented in 60.5% of medical records. Clinicians may be recording those symptoms that support the AMI diagnosis and not those perceived to be less relevant. Findings suggest that the medical record is an inaccurate and inadequate source of information about patients' actual experience of AMI symptoms.