Journal of Vascular Nursing最新文献

{"title":"Using a standardized pain management approach through regional anesthesia for major limb amputation patients","authors":"Sarah Meadowcroft DNP, ACNP-BC ,&nbsp;Johnny Gayden DNP, CRNA ,&nbsp;Suzanna Fitzpatrick DNP, ACNP-BC","doi":"10.1016/j.jvn.2024.11.003","DOIUrl":"10.1016/j.jvn.2024.11.003","url":null,"abstract":"<div><h3>Problem</h3><div>The Vascular Surgery department at a large academic institution lacked a formalized approach to manage complex pain experienced by patients undergoing major limb amputation (MLA). Consequently, MLA patients averaged 2,352.2 total morphine milliequivalent (MME) and had prolonged hospitalizations averaging 21 days.</div></div><div><h3>Purpose</h3><div>This quality improvement (QI) project is to create a formalized clinical approach for the provider to manage the MLA patient's pain effectively. This approach ensures the application of evidence-based regional anesthesia (RA) for all eligible MLA patients.</div></div><div><h3>Methods</h3><div>The 22 providers managing MLA patients assessed a numeric pain score (NPS) at the time of MLA consent. Patients reporting an NPS of four or higher were triaged into the RA section of this process where the provider requested RA application by the pain team. To ensure process completion, these clinicians completed an embedded MLA checklist in the daily progress note. Utilizing a QR code, the providers submitted identified barriers for implementation via a survey. The project lead performed chart audits assessing total MME, NPS, and length of stay (LOS).</div></div><div><h3>Results</h3><div>Vascular surgeons performed 11 MLAs, with 73 % completing the provider survey and 64 % compliance with the checklist. Of the MLA patients, 64 % reported NPS of four or higher, 57 % of which successfully received RA. The average NPS scores on post-operative day one improved from an average of 4.7 (pre-operative) to 3.2 on post-operative day one. However, the average NPS elevated to a score of five by discharge. These 11 MLA patients averaged a 28.4-day LOS and experienced a significant reduction (approximately 65 %) in total MME from pre-implementation requiring an average of 842.5 MME for their hospitalization.</div></div><div><h3>Conclusions</h3><div>While the new approach did not show improvement in LOS or NPS, there was a substantial reduction in total MME required by these patients. This formalized framework aids the effective management of the MLA patient's pain. For sustainability, improved education and sedation training of the advanced practice providers will allow for bedside RA application. There is a marked need to develop a formalized transition from RA to an oral pain regimen prior to discharge to provide adequate long-term coverage.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Pages 18-22"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for readers","authors":"","doi":"10.1016/S1062-0303(25)00011-1","DOIUrl":"10.1016/S1062-0303(25)00011-1","url":null,"abstract":"","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Page A3"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research Article: Corroon, J., Bradley, R., Grant, I., Daniels, M. R., Denenberg, J., Bancks, M. P., & Allison, M. A. (2024). Regular cannabis smoking and carotid artery calcification in the Multi-Ethnic Study of Atherosclerosis (MESA). Vascular medicine (London, England), 1358863 × 241287690. Advance online publication. https://doi.org/10.1177/1358863X241287690","authors":"Debra Kohlman-Trigoboff RN, MS, ACNP-BC, CVN","doi":"10.1016/j.jvn.2025.02.001","DOIUrl":"10.1016/j.jvn.2025.02.001","url":null,"abstract":"","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Pages 61-62"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information for authors","authors":"","doi":"10.1016/S1062-0303(25)00010-X","DOIUrl":"10.1016/S1062-0303(25)00010-X","url":null,"abstract":"","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Page A2"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The impact of training on satisfaction and anxiety levels in stroke patients receiving warfarin treatment","authors":"Fadime Aynal Msc RN ,&nbsp;Selda Arslan PhD","doi":"10.1016/j.jvn.2025.01.004","DOIUrl":"10.1016/j.jvn.2025.01.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Due to the narrow therapeutic range of warfarin, patients require close monitoring. This study aimed to examine the effects of training provided to stroke patients receiving warfarin treatment on their perception of satisfaction and state of anxiety.</div></div><div><h3>Methods</h3><div>This quasi-experimental study used a pretest-posttest design with similar groups and a control group.</div></div><div><h3>Results</h3><div>Comparison of the posttest scores on the Duke Anticoagulation Satisfaction Scale revealed that the experimental group had significantly lower mean scores on the positive subscale and the total scale compared to the control group. When the Time in Therapeutic Range (TTR) status was evaluated, it was observed that 69.9 % of the patients in the intervention group and 21.7 % of the patients in the control group achieved a TTR ratio of 60 % or above.</div></div><div><h3>Conclusions</h3><div>Training provided to stroke patients receiving warfarin therapy improved their TTR ratio and increased their satisfaction levels but did not affect their anxiety levels. Based on these findings, it is recommended to prepare standardized training materials to enhance patient outcomes.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Pages 55-60"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case report: Treatment of chronic venous ulceration","authors":"Eleanor Dunlap DNP, ACNP-BC,&nbsp;Suzanna Fitzpatrick DNP, ACNP-BC, FNP-BC, FAANP,&nbsp;Khanjan Nagarsheth MD","doi":"10.1016/j.jvn.2024.11.005","DOIUrl":"10.1016/j.jvn.2024.11.005","url":null,"abstract":"<div><h3>Introduction</h3><div>Chronic venous insufficiency (CVI) is a complex condition characterized by venous hypertension that can cause pain, swelling, edema, skin changes, or ulcerations of the leg, involving either the deep or superficial venous system. Venous ulcerations result from elevated ambulatory venous pressure or venous hypertension, leading to limb edema. The mainstay of treatment for this edema has been and continues to be compression therapy. Despite optimal medical therapy with external compression, venous ulcers of the lower extremities can be a chronic, long-term problem with recurrence rates as high as 70 %.</div></div><div><h3>Case Report</h3><div>Herein, we describe a case of utilizing the best medical and surgical therapies including advanced wound care products to treat CVI and close chronic venous ulceration. A 66-year-old African American man with a history of heart failure and preserved ejection fraction, hypertension, hepatitis C, and CVI with recurrent bilateral venous ulcerations presented to the vascular surgery clinic for evaluation. Imaging was suggestive of normal arterial perfusion, and a venous reflux study, which was positive for diffuse venous reflux in the right leg along with an area of the greater saphenous vein in the calf with an arterial waveform concerning for arterial-venous fistula. He underwent sclerotherapy to the perforator vein, which was acting as an AVF feeding the ulceration. Conservative treatment with Unna boot and compression, the wound decreased in size and serial debridement with advanced wound care products were used to made to aid in the closure of this chronic wound.</div></div><div><h3>Conclusion</h3><div>Chronic venous insufficiency can lead to venous leg ulcerations, accounting for 80 % of all leg ulcerations. Treatment of the underlying CVI with surgical intervention and conservative compression therapy may not be enough to close a chronic venous ulcer alone. The SVS guidelines on managing venous ulcerations include comprehensive care, including compression therapy, local wound debridement, control of bioburden, wound moisture balance, and the possible use of advanced wound care products for chronic wounds.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Pages 23-26"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing anxiety in men undergoing surveillance in the NHS abdominal aortic aneurysm screening programme: A survey of screening staff in England","authors":"Elizabeth Lumley ,&nbsp;Jane Hughes ,&nbsp;Alan Elstone ,&nbsp;Jo Hall ,&nbsp;Niall MacGregor-Smith ,&nbsp;Jonathan Michaels ,&nbsp;Akhtar Nasim ,&nbsp;Stephen Radley ,&nbsp;Phil Shackley ,&nbsp;Gerry Stansby ,&nbsp;Emily Wood ,&nbsp;Alicia O'Cathain","doi":"10.1016/j.jvn.2024.11.002","DOIUrl":"10.1016/j.jvn.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>AAA is an enlargement in the aorta that can increase in size and rupture. In England, the National Health Service (NHS) AAA Screening Programme offers screening to all men aged 65 to identify those with an AAA. Men with small or medium sized aneurysm enter surveillance where they receive ultrasound scans annually or every three months respectively. Due to concerns about mortality from AAA rupture, anxiety levels may be high for men and their families and impact on their quality of life.</div></div><div><h3>Aim</h3><div>To obtain the views of staff providing Abdominal Aortic Aneurysm (AAA) screening on how best to help men in surveillance to manage AAA-related anxiety.</div></div><div><h3>Methods</h3><div>A cross-sectional online survey of the 38 AAA regional screening services in England was conducted. Four staff with different roles from each service (doctor, nurse, manager and scanning technician) were asked to complete an online questionnaire.</div></div><div><h3>Results</h3><div>The response rate was 71 % (27/38) for regional AAA screening services and 65 % (99/152) for the staff approached. 93 % (79/84) of respondents strongly or somewhat agreed that men in surveillance may need help to manage anxiety. The size of the aneurysm was rated as the factor most likely to cause anxiety. 63 % (51/81) considered AAA Programme Nurses to be the best people to deliver an intervention. Staff suggested that improved information about AAA and associated risks, group support/networking sessions, and more contact with the screening service were ways of helping with management of anxiety.</div></div><div><h3>Conclusion</h3><div>Staff providing AAA screening recognised that being in surveillance can cause anxiety for men and their families, and identified that potential interventions, such as organised support groups and improved provision of information, might help manage anxiety. Programme Nurses were considered the ideal healthcare professional to help men in surveillance manage AAA-related anxiety.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Pages 10-17"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Understanding adherence to guideline-recommended therapy in patients with peripheral artery disease: A qualitative study","authors":"Smaragda Lampridou RGN, MSc, PhD (c) ,&nbsp;Layla Bolton Saghdaoui RGN, PhD (c) ,&nbsp;Maria Reguenga RGN ,&nbsp;Alun Huw Davies MA, DM, DSc, FRCS, FHEA, FEBVS, FACPh ,&nbsp;Mary Wells RGN, PhD, Professor","doi":"10.1016/j.jvn.2025.01.002","DOIUrl":"10.1016/j.jvn.2025.01.002","url":null,"abstract":"<div><h3>Objectives</h3><div>Adherence to peripheral arterial disease (PAD) treatment remains low, despite its benefit for secondary disease prevention. Currently, there is no qualitative research exploring why this is the case. This study aimed to explore patients’ lived experiences of PAD and its treatment, their motivation to adherence and barriers to non-adherence.</div></div><div><h3>Methods</h3><div>Semi-structured qualitative interviews were conducted with patients with PAD from diverse backgrounds and varying adherence levels. The Perceptions and Practicalities Approach framed the topic guide and guided analysis. Interviews were recorded, transcribed verbatim, and analysed thematically. A public and patient involvement group supported the pilot testing of the topic guide and the data analysis.</div></div><div><h3>Results</h3><div>Twelve participants (eight men and four women, with an age range between 56 and 78) participated in the study. Six themes were identified: (1) Treatment necessity and effectiveness, (2) Information, (3) Mind-over-matter, (4) Concerns, (5) Physical environment, (6) Social and healthcare professional interactions. Patients perceiving their treatment to be effective were more likely to be adherent. However, some patients did not see themselves as being on treatment as they were not getting better. Participants expressed a lack of support and a need for detailed information and individualised care.</div></div><div><h3>Conclusion</h3><div>Our findings illustrate that patients’ perceptions of treatment effectiveness seem to influence their adherence. To enhance adherence, future research should focus on improving treatment understanding, optimising patient experiences, addressing claudication pain management, and supporting patients to be more motivated to make changes.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Pages 46-54"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early identification of vascular access site complications and frequent heart rate and blood pressure monitoring after cardiac catheterization: A scoping review","authors":"Janelle Beaudry Clark BSN, RN-BC ,&nbsp;Kristiina Hyrkas PhD, RN","doi":"10.1016/j.jvn.2024.08.001","DOIUrl":"10.1016/j.jvn.2024.08.001","url":null,"abstract":"<div><h3>Background</h3><div>Nurses perform frequent heart rate (HR) and blood pressure (BP) monitoring, a widespread and longstanding practice, after cardiac catheterization (CC) to identify vascular access site complications for femoral and radial arterial approach in adult patients.</div></div><div><h3>Objective</h3><div>The objective of this scoping review was to answer two questions: (1) how does the available evidence support frequent HR and BP monitoring after CC via femoral and radial approach in adult patients and (2) how does this practice prompt bedside nurses in identifying the procedure's major vascular access site complications, including bleeding, hematoma, and pseudoanurysm?</div></div><div><h3>Method</h3><div>Following the scoping review approach, literature search was conducted (PubMed, CINAHL, Google Scholar) by two co-authors and medical librarian. We reviewed, evaluated, and analyzed the evidence from twenty articles.</div></div><div><h3>Results</h3><div>The reviewed medical and nursing literature revealed findings challenging the present practice. Out of fifteen research studies, five found frequent HR and BP monitoring after CC to be uninformative while the remaining ten did not report frequent vital signs. Two research articles reported that vascular complications after CC were discovered by RNs directly assessing the access site or by the patients themselves, unrelated to HR and BP. Five non-research articles were included, which all recommended frequent HR and BP monitoring.</div></div><div><h3>Conclusions</h3><div>Frequent HR and BP assessment during the recovery period is not supported by empirical research despite being consistently recommended by nursing guidelines and expert opinion articles. Current evidence supports frequent vascular access site assessments and patient education.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"42 4","pages":"Pages 228-239"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with chronic limb-threatening ischemia: Experiences of their disease, treatment, and care in a cross-sectoral setting. A scoping review","authors":"Susanne Friis Soendergaard RN. Ph.D. Post.doc. ,&nbsp;Ane Simony MD, PhD., Associate professor ,&nbsp;Johanne Louise Christiansen PhD, Associate Professor ,&nbsp;Henrik Sehested Laursen Cand.Scient.bibl ,&nbsp;Marie Dahl RN. PhD. Associate Professor","doi":"10.1016/j.jvn.2024.08.002","DOIUrl":"10.1016/j.jvn.2024.08.002","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients facing chronic limb-threatening ischemia (CLTI) experience significant burdens, impacting their physical, emotional, and social well-being. They require extensive care from multidisciplinary healthcare professionals across primary and secondary settings. Managing CLTI necessitates strict patient adherence to treatment protocols to prevent severe complications. Surprisingly, previous studies have overlooked these patients' unique perspectives, highlighting the need to explore their experiences and challenges.</div></div><div><h3>Objective</h3><div>The objective of this review was to systematically identify, examine, and conceptually map extant literature on patients with CLTI in the context of living with the condition, and explore their experiences of receiving treatment and care within a cross-sectoral setting.</div></div><div><h3>Methods</h3><div>A systematic search was completed on 18 September 2023 with no methodological or format restrictions. We identified the population, concept, and context to pinpoint the delineate the focus of this review process. The JBI methodology for scoping reviews and the PRISMA-ScR checklist were followed.</div></div><div><h3>Results</h3><div>Based on our search, we found ten relevant scientific qualitative and/or quantitative sources and one non-scientific source. We identified four main maps: 1) <em>Dependency on others is my new life condition,</em> 2) <em>I'm more than the sum of my conditions</em>, 3) <em>I'm lost in chaos, be alert to all of me</em>, and 4) <em>Give me more time, my body and mind are under attack</em>.</div></div><div><h3>Conclusion</h3><div>This scoping review describes how patients’ lives are affected by CLTI and provides insights into their perception of shared decision-making, treatment, and care. The review reveals the need for a more person-centered approach to care. To nuance person-centred care further, it is necessary to consider the impact of patients’ cultural values and preferences. However, this area is marked by a notable research gap.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"42 4","pages":"Pages 240-250"},"PeriodicalIF":1.1,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}