| Learning Objective #1: Discuss the many different types of patient-care delivery systems and how they affect the cost of health care | |||
| Learning Objective #2: Understand the cost-saving implications of the evidence-based relationship between the cord blood acid-base analysis and APGAR scores |
Sample: A convenience sample of 978 from 2,397 archival records where both a cord blood acid-base analysis and Apgar scores were performed on each term- and post-term newborn.
Conceptual Framework and Literature Review: All aspects of patient care is carefully examined in light of cost. Nursing must drive the decisions that effect costs. The Resource-Driven Model looks at quality and quantity. It assumes the nurse's time and resources are finite and the nurse must plan within constraints of accessible and available manpower, supplies, and equipment. The policy to obtain a cord blood sample at every delivery is costly and puts staff at risk for blood and body fluid exposure. The cord blood value is not used to make clinical decisions pertaining to the resuscitation of the newborn. The literature review focused on the concept of best practice, umbilical cord blood acid-base analysis, and role of the nurse manager.
Method: A Pearson's product-moment correlation between these three measures, cord blood acid-base analysis and the Apgar scores at one- and five-minute intervals was used.
Findings: Significant and direct relationships between cord blood acid-base analysis and the Apgar scores at one- and five- minute intervals suggesting that newborns scored at approximately the same level on the respective measures.
Conclusion: Nurse Managers have an expanded role that includes all personnel and their specific roles, as well as unit resources. Policies that affect unit costs and staff time and staff safety become their concern. Evidenced-based “best-practice” research can and does support the nurse manager in maintaining only policies that have improved patient outcomes as there goal.