The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses最新文献

{"title":"Comparing Tenecteplase and Alteplase for Acute Ischemic Stroke.","authors":"Chen-Chen Tu, Hanqi Kelly Mao, Jennifer L Wessol","doi":"10.1097/JNN.0000000000000821","DOIUrl":"10.1097/JNN.0000000000000821","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Acute ischemic stroke (AIS) is a leading cause of mortality and disability. Patients who receive thrombolytic therapy promptly tend to have better outcomes. Although alteplase (tPA) is the standard Food and Drug Administration-approved thrombolytic for AIS treatment, recent American Heart Association guidelines suggest that tenecteplase (TNK) can be used as an alternative. This project compares the cost-effectiveness and clinical outcomes of TNK versus tPA in AIS treatment. Key outcomes include door-to-needle time, length of stay, National Institutes of Health Stroke Scale scores, and the incidence of hemorrhagic conversion events. METHODS: The project involved retrospective analysis through medical chart reviews at a thrombectomy-capable stroke center in a Pacific Northwest community hospital. Data were collected from 175 AIS patients treated with either tPA (82) or TNK (93) between March 2022 and December 2023. Patients eligible for thrombolytic therapy received tPA before March 15, 2023, with TNK used thereafter. Selection criteria adhered to American Heart Association guidelines and clinicians' judgment. RESULTS: Although door-to-needle times were similar ( P = .20), excluding outliers revealed a significant difference favoring TNK ( P = .04). No significant group differences were observed for demographics, National Institutes of Health Stroke Scale scores, length of stay, or post-intracerebral hemorrhage rates. Tenecteplase use resulted in over $40 000 in medication savings during the project period. CONCLUSION: Tenecteplase offers comparable safety and efficacy to tPA for treating AIS, with the added benefit of cost savings. Although clinical outcomes did not significantly differ between the 2 drugs, TNK's reduced cost and ease of administration make it an attractive option, particularly in resource-limited settings. These results support the current organizational treatment protocol favoring TNK.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"127-131"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143401184","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":"Development and Psychometric Testing of a Tool to Measure Nursing Care Intensity for Stroke Patients.","authors":"Amalia Ferrara, Paolo Iovino, Valentina Magni, Maria Rosa Dibuono, Tiziana Brunelli, Rosaria Mastrorocco, Cinzia Favilla, Silvia Giacomelli, Pio Cerchia, Laura Rasero","doi":"10.1097/JNN.0000000000000825","DOIUrl":"10.1097/JNN.0000000000000825","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Nurses play a crucial role in the care of stroke patients improving health outcomes. However, stroke nursing care is complex, and an instrument available to monitor the patient dependence over time and an efficient management of care would be beneficial for the stroke care units. The purpose of this study is to develop and psychometrically test an instrument to measure nursing care intensity for patients admitted to stroke units. METHODS: A 3-step process was implemented. First, item generation was performed based on an established theory. Second, content validity was assessed on the generated pool of items, and finally, the instrument was tested on a sample of 1200 stroke patients at admission and discharge time points, to test its psychometric properties. RESULTS : Item generation was driven by the theory of Roper-Logan-Tierney, and a total of 13 items were derived. Content validity led to the elimination of 5 items. The final instrument, the Chart of Nursing Assessment in Stroke (STROKE-CNA), was made of 8 items. Confirmatory factor analysis had a supportive fit (root mean square error of approximation = 0.077, comparative fit index = 0.99), indicating structural validity. Scores of the instrument at admission were significantly lower than at discharge ( P < .001, Cohen d = 1.42), indicating longitudinal validity. The changes in STROKE-CNA scores between admission and discharge were positively correlated with the corresponding changes in scores on the Scandinavia Stroke Scale ( r = 0.57, P < .001), confirming adequate responsiveness. The STROKE-CNA scores were negatively correlated with age (admission: r = -0.22, P < .001; discharge: r = -0.28, P < .001), indicating convergent validity. Internal consistency was adequate at 0.93, and interrater reliability was optimal, with Cohen kappa ranging between 0.61 and 0.99. CONCLUSIONS : The STROKE-CNA has promising validity and reliability when used for assessing nursing care complexity of patients admitted to stroke units.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143528103","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":"Understanding the Causes of Delayed Decision-Making by Family Members of Stroke Patients Eligible for Thrombolytic Therapy.","authors":"Guoyin Han, Sihui Lu, Hongyi Chen, Huihui Zhang, Xiaowei Huang, Yibing Tan","doi":"10.1097/JNN.0000000000000826","DOIUrl":"10.1097/JNN.0000000000000826","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Thrombolytic therapy is an effective intervention for acute ischemic stroke. However, the timely administration of this treatment can be hindered by delayed decision-making on the part of family members. Little is known about the reasons for their delay in making decisions. METHODS: This qualitative interview study used face-to-face, individual, semistructured interviews with 16 participants from 2 tertiary hospital neurology wards in Guangdong, China. The interviews were analyzed using inductive content analysis, and descriptive statistics were used to summarize participants' characteristics. RESULTS: Three main themes emerged: a large family communication network, struggling with bleeding risk, and seeking distance treatment advice. CONCLUSION: In China, family members make decisions on behalf of patients and are affected by various factors in the decision-making process, resulting in delayed decision-making. They may experience psychological conflicts when deciding whether to permit thrombolysis, and they tend to seek information from external sources without understanding thrombolysis. Healthcare professionals caring for stroke patients eligible for thrombolytic therapy should provide decision-making support programs tailored to the specific needs of these family members to reduce delayed decision-making.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"138-143"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574929","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":"Evaluating the Value of Certification Among Noncertified Neuroscience Nurses.","authors":"Suzy Mascaro Walter, Norma D McNair, Rebecca Banat, Tracey Anderson, Zheng Dai, Kesheng Wang","doi":"10.1097/JNN.0000000000000831","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000831","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND : Nurses who obtain voluntary specialty certification have higher levels of perceived value for certification compared with noncertified nurses. By identifying and fostering the lesser held perceived values, peers and organizations may increase the overall perceived value of certification among noncertified neuroscience nurses, which, in turn, could lead to higher certification attainment. METHODS : This was a cross-sectional descriptive exploratory design after a survey completed by noncertified neuroscience nurses. Certified neuroscience (CNRN) and stroke certified registered nurses (SCRN) were used as a comparison group. The nurses reported the benefits of certification using the Perceived Value of Certification Tool 12. Logistic regression was used to determine the presence of significant differences in value statement responses among the 2 groups. Percentage of agreement with the value statements among noncertified nurses was also reported. RESULTS : A total of 338 noncertified neuroscience nurses completed the survey. Participants reported a mean age of 44.7 years, and 88% were female. About 68% of participants were White/Non-Hispanic. Among the 12 value statements, noncertified neuroscience nurses reported the highest levels of agreement with statements related to validation of knowledge, personal accomplishment, and commitment to neuroscience nursing. The lowest levels of agreement were associated with being listened to, professional autonomy, and higher pay. Logistic regression demonstrated that certified neuroscience nurses (n = 640) had significant higher levels of agreement with 8 of the 12 value statements compared with noncertified neuroscience nurses . CONCLUSION : Support for certification among neuroscience nurses cannot rely upon 1 source. Although hospitals and professional organizations play a significant role, peer support from certified neuroscience nurses is needed for fostering the value of certification. Further research using open-ended questions to provide detail regarding noncertificant responses to the 8 value statements may provide additional insight needed to strategize certification achievement.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":"57 3","pages":"132-137"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045642","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":"A Primer for Big Data Research: A Protocol Reflection.","authors":"Jiayue Xiong, Rozina Bhimani, Chih-Lin Chi, Siobhan McMahon, Lisa Anderson","doi":"10.1097/JNN.0000000000000829","DOIUrl":"10.1097/JNN.0000000000000829","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"144-147"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712292","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":"Use of AANN Seizure and Epilepsy Certificate Program to Improve Neuroscience Nurse's Knowledge and Confidence.","authors":"Shivani Bhatnagar, Allison Nelsen, Mariah Eisner, Adam Ostendorf","doi":"10.1097/JNN.0000000000000824","DOIUrl":"10.1097/JNN.0000000000000824","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND : Epilepsy centers and epilepsy monitoring units (EMUs) specialize in the care of individuals with epilepsy, often requiring patients to undergo evaluations that may increase their risk of injury or status epilepticus. The National Association of Epilepsy Centers has established an accreditation framework for these centers, which includes epilepsy-specific training for nurses in level 3 and 4 facilities. The American Association of Neuroscience Nurses (AANN) launched a certificate program for the seizure and epilepsy healthcare professional, addressing this educational requirement. This study assessed the effects of the AANN epilepsy certificate on nursing knowledge and self-reported confidence in delivering care in an EMU. METHODS : This prospective cohort study involved 39 neuroscience nurses who completed a 20-item knowledge assessment and self-reported measures of knowledge and confidence using a Likert scale before and after completing the AANN epilepsy certificate, followed by 2 additional evaluations. RESULTS : The mean scores on the epilepsy knowledge check increased from 12.3 to 16.1 ( P < .001). This improvement in knowledge was correlated with the highest terminal degree attained ( P = .046), but not with years of experience, time spent in neurology, pediatric nurse certification, or the frequency of work in the EMU. In addition, self-reported confidence scores rose from 19.0 to 22.1 ( P < .001). Based on chart review of the 2 months before and after completion of the modules, the time from seizure identification to seizure treatment decreased from a mean of 6.5 to 4 minutes. CONCLUSION : The completion of the AANN certificate program enhanced the epilepsy-related knowledge and confidence of neuroscience nurses. These educational modules help to meet accreditation requirements for epilepsy centers and provide substantial benefits for nurses.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"104-107"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712398","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":"Some People Fart When They Laugh.","authors":"DaiWai M Olson","doi":"10.1097/JNN.0000000000000830","DOIUrl":"10.1097/JNN.0000000000000830","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"101"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143618123","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":"Factors Affecting Functional Improvement in the Initial Months of Recovery After Stroke: A Pilot Study.","authors":"Mary C Forgea, Carla Jungquist, Jeanne Langan, Chin-Shang Li, Christina Zaccarini, Rebecca A Lorenz","doi":"10.1097/JNN.0000000000000828","DOIUrl":"10.1097/JNN.0000000000000828","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: The purpose of this study is to examine factors affecting functional improvement among survivors of stroke during the initial months of stroke recovery. METHODS: A 1-group repeated measures sequential mixed methods design was used. Quantitative longitudinal data were collected on admission, discharge, and postdischarge from the inpatient rehabilitation unit to evaluate the change in patient engagement and the relationship between environmental, personal, and behavioral factors, and functional independence. Semistructured interviews were conducted up to 6 months postdischarge. RESULTS: The sample included 27 participants with a mean age of 64.67 (SD = 13.56). There was a significant increase in patient engagement from admission to discharge ( P < .0001), followed by a nonsignificant decrease from discharge to follow-up ( P = .36). The change in functional improvement from admission to discharge was significant ( P < .0001). Stroke severity was the only significant predictor of functional improvement ( P = .008). There was a significant but weak negative correlation between Patient Health Engagement scale (PHE-s®) total score and sleep disturbance ( r = -0.344, P = .008) and sleep disturbance and self-efficacy ( r = -0.362, P = .005). There was a moderate positive correlation between PHE-s total score and self-efficacy ( r = 0.662, P < .001). Five participants participated in follow-up interviews. The 5 main themes that emerged from interview data were (1) feeling happy to be home, (2) wishing recovery was quicker, (3) living with disability, (4) overcoming obstacles, and (5) social support. CONCLUSION: This pilot study provides insight into the experiences of survivors of stroke during rehabilitation and recovery. The results of this study indicate a need for additional support (eg, transportation, social/emotional) for survivors of stroke after discharge from the rehabilitation unit. Further research to investigate the barriers and facilitators of recovery for survivors of stroke after discharge and the development of interventions aimed at improving sustainable recovery outcomes is needed.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"120-126"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143560311","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":"Stroke Risk Prediction and Diabetes Management in Multiethnic Rural Communities.","authors":"Sheena Ramazanu, Agani Afaya, Ang Seng Hock Martin, Priya Baby","doi":"10.1097/JNN.0000000000000823","DOIUrl":"10.1097/JNN.0000000000000823","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"119"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143443056","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":"AANN 2024: Reflecting on a Year of Growth and Impact.","authors":"Kimberly S Meyer, Erin Fecske","doi":"10.1097/JNN.0000000000000827","DOIUrl":"10.1097/JNN.0000000000000827","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"102-103"},"PeriodicalIF":0.0,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143559836","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}