OCTOBER 1984, VOL 40, NO 4 A O R N J O U R N A L _.

are both detailed and clear. Nurses should find this book, with its writing

style designed to make the book more enjoyable, a refreshing change. I would particularly rec- ommend this book to the student; it is most informative.

MARYLOU WELDY, RN, CNOR

VA MEDICAL CENTER HOT SPRINGS, SD

OR STAFF NURSE

Munaging Under Medicare Prospective Pricing. American Hospital Association. American Hos- pital Association, 840 N Lake Shore Dr, Chicago, IL 6061 1 , 1983.

A comprehensive compilation of the various as- pects of Medicare prospective payment, the American Hospital Association (AHA) has de- veloped this guide to introduce the hospital in- dustry to the new system of reimbursement.

The structure of each chapter greatly facili- tates its use. Each chapter is written in outline form, beginning with identification of objectives and concluding with a summary of the contents. A reference list accompanies each chapter.

The chapters on the evolution of prospective pricing and legislative summary set the stage for subsequent chapters, which address the impact on individual departments within the hospital and on various disciplines within the institution. The various components of the financial impact of diagnosis-related groups (DRGs) are ex- plained in depth. Guidelines and examples, many in graph form, depict methods for comput- ing reimbursement in various settings, and they are done in a manner that makes them easy to understand.

The seven key components in organizational strategy are identified as education, medical rec- ords, information systems, utilization manage- ment, human resources management, medical staff, and nursing. A chapter is devoted to each area, and strategies for cost savings under the prospective payment system are discussed for each.

This book will be an excellent guide to the complex reimbursement system. It brings the

various aspects of prospective payment into focus and introduces a system for preparing to meet this challenge.

The AHA notes in the beginning that this book was designed to help hospitals cope with the initial steps of managing under Medicare pro- spective pricing. As such, then, its utility will diminish as hospitals gain experience with the system. AHA will follow this publication with others as the system progresses.

FRAN KOCH, R N

S c o n & WHITE MEMORIAL HOSPITAL TEMPLE, TEX

DIRECTOR, SURGICAL SERVICES

Pain: A Nursing Approach to Assessrnerit and Analysis. Noreen T Meinhart, Margo McCaf- fery . Appleton-Century-Crofts, Norwalk, Conn, 1983, 390 pp.

Pain: A Nursing Approach to Assossnwnt and Analysis has been thoroughly researched and referenced, and it is well worth reading. The book is divided into two parts; the preexisting factors that influence the pain experience and components of the pain experience. Chapters conclude with references and suggested read- ings.

A three-chapter section is concerned with the preexisting factors that contribute to the way a patient reacts to pain levels. These chapters in- clude the neurophysiology of pain, cultural as- pects of pain, and psychologicat factors. Sensa- tion and experience of pain, pain syndromes, and the patient with pain are a part of the second section.

The authors ' philosophy is carried throughout the book; that is, failure to treat pain is inhumane and constitutes professional negligence. This well-written book would appeal to nurses, physicians, or nursing students. There arc de- tailed illustrations, assessment worksheets, and examples of flow sheets to be used in monitoring the patient.

The primary goal of the book is to help hcalth care professionals understand the clinical prob- lems of bodily pain with their associated detri- mental effects for patients. The goal has bcen

526