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

{"title":"The Essential Components of Adult Critical Care Neuroscience Nursing Orientation: A Delphi Study.","authors":"Marianne Beare Vyas, Cynthia Bautista, Lorin Daniels, Mary McKenna Guanci, Lori Rhudy","doi":"10.1097/JNN.0000000000000807","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000807","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Critical care neuroscience nursing is a specialized field requiring a complex knowledge base and unique clinical orientation. A comprehensive orientation for nurses new to this specialty can improve retention, performance, and satisfaction. Critical care neuroscience orientations are often hospital based and regionally specific, and lack a systematic approach. The aim of this research was to obtain expert consensus on the essential components of a 12- to 18-week critical care neuroscience nursing orientation. METHODS: A Delphi methodology was used to collect expert consensus on the components of a critical care neuroscience nursing orientation. Electronic surveys were distributed to 161 neuroscience critical care orientation experts in 2 Delphi rounds. Participant demographic data and a Likert rating scale (1-5) of literature-based components of a critical care neuroscience orientation were collected. Participants identified additional critical care neuroscience orientation components that were not included in the listed components in round 1 or round 2 of the survey. RESULTS: Round 1 of the survey had 38 responses (23.6%), and round 2 had 23 responses (14.2%). The round 1 survey included 47 elements, and 36 of 47 met the a priori threshold of ≥75% consensus of being important or very important. Two additional elements resulted from write-in recommendations. In round 2, 38 elements were included in the survey, and 37 of 38 elements met consensus. Expert consensus on the essential components of a critical care neuroscience orientation included 37 elements divided among 5 major components. CONCLUSION: Expert consensus was achieved on the essential components of a 12- to 18-week adult critical care neuroscience nursing orientation. Five components and 37 elements were agreed upon by expert consensus.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741774","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":"Reducing Blood Loss From Phlebotomy in Adult Neurocritical Care Patients: An Evidence-Based Practice Project.","authors":"Patricia J Simonowicz, Kristin Bott, Joy Elwell, Matthew N Jaffa","doi":"10.1097/JNN.0000000000000809","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000809","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Blood loss from phlebotomy is a significant cause of hospital-acquired anemia. Use of small-volume (Pedi) tubes in adult patients reduces blood loss by 40% and does not increase need for repeated labs. Although this practice is evidencebased, it has not been widely implemented. Using Pedi tubes for phlebotomy is a key component of blood management programs to decrease the incidence of hospital-acquired anemia and blood transfusions in the intensive care unit (ICU). Our aim was to implement the use of Pedi tubes for labs in the adult neurocritical care unit to demonstrate feasibility in this population. METHODS: This was a pre-/postintervention quality improvement project. All consecutive patients admitted to the neurocritical care unit from April 10, 2023, to October 10, 2023, aged 18-99 years, were included in the project. During the intervention period from July 10, 2023, to October 10, 2023, Pedi tubes were used for all laboratory draws except admission and crisis labs. A retrospective chart review from April 10 to July 9, 2024, established standard practice for comparison. We recorded hospital and ICU admission, nadir, and discharge hemoglobin, length of stay, number of rejected specimens, number of blood transfusions, discharge disposition, and 30-day readmission for all subjects. RESULTS: Pedi tube use was successfully implemented with significantly less need for repeat laboratory collections in the postintervention cohort (P = .001). Although no difference was noted in hemoglobin levels, there was a decrease in both ICU and hospital length of stay by 1 day in the intervention arm. Fewer transfusions were required in the intervention cohort. CONCLUSIONS: Small-volume tube use for phlebotomy in adult neurocritical care patients is feasible and can lead to decreased blood transfusion need in the ICU.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741752","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":"Can Multiple Sclerosis-Related Symptoms Determine Sleep Disorders?","authors":"Ayyüce Tuba Koçak, Ayşe Uçar, Selda Arslan, Ali Ulvi Uca","doi":"10.1097/JNN.0000000000000801","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000801","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Sleep disorders are common and various in persons with multiple sclerosis (PwMS). However, their assessment and management remain in the background compared with motor symptoms. This study was conducted to better understand sleep disorders in PwMS and to analyze sleep problems and their predictive symptoms. METHODS: This cross-sectional design study was conducted with 136 PwMS. Data were collected using a participant identification form, Pittsburgh Sleep Quality Index, Insomnia Severity Index, Epworth Sleepiness Scale, and Stop-Bang Test. In data analysis, 1-way analysis of variance, t test and Pearson correlation, and multiple regression analysis were used. RESULTS: The study found that 51.5% of the participants have poor sleep quality, 36.8% have insomnia, 24.3% have excessive daytime sleepiness, and 19.9% were at risk of obstructive sleep apnea. Symptoms of forgetfulness (β = 0.199), depression (β = 0.223), pain (β = 0.278), and increased urinary frequency at night (β = 0.236) explain approximately 40% of the change in sleep quality score; difficulty swallowing (β = 0.218), depression (β = 0.253), and pain (β = 0.313) symptoms explain 33% of the change in insomnia score; fatigue (β = 0.292) and anxiety (β = 0.409) symptoms explain 32% of the change in sleepiness score. CONCLUSIONS: PwMS start to experience sleep disorders in the early stages of the disease, some characteristics affect sleep disorders, and the symptoms they experience explain sleep disorders at significant rates. Sleep disorders should be evaluated by nurses and interdisciplinary healthcare teams from the early stages of multiple sclerosis with different aspects and to include predictive symptoms in the interventions to be implemented to reduce sleep disorders.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776143","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":"Pilot Study of Weighted Blankets on Agitation.","authors":"Adrianne Dimas, Angela Lober, Renae Reeves","doi":"10.1097/JNN.0000000000000799","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000799","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Hospitalized patients who have had neurological trauma often require interventions to reduce agitation. Weighted blankets deliver deep pressure touch stimulation, which influences parasympathetic activity through increased vagal tone, to induce calmness and reduce sympathetic activation and reduction of the stress response. The purpose of this study was to investigate the effect of weighted blankets as an intervention on agitation scores in hospitalized adults who have experienced neurologic trauma. METHOD: This was a quasi-experimental design, pilot study with a convenience sample of patients who experienced neurological trauma. Participants who met the inclusion criteria received a weighted blanket that remained in place for 30 minutes. The Agitated Behavior Scale was used to measure the effect of the weighted blanket before and after the intervention with each participant serving as their own control. RESULTS: Twelve participants were included in the study. Related-samples Wilcoxon signed rank test indicated a significant difference for heart rate (P = .05) and Agitated Behavior Scale scores (P = .005). There were no significant differences with blood pressure or oxygen saturation levels. CONCLUSION: This pilot study demonstrated a reduction in agitation scores with the use of a weighted blanket. The deep pressure touch stimulation provided by a weighted blanket may provide a low-risk intervention to decrease agitation and prevent escalation. Future studies with larger sample sizes may demonstrate weighted blankets to decrease agitation and provide an adjunct therapy for patients.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776127","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":"Novel Seizure Assessment Tool for Unified Seizure Evaluation: Correspondence.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1097/JNN.0000000000000805","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000805","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142776124","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 Evaluation of a Care Needs Scale for Parents of Children With Tourette Syndrome.","authors":"Yu-Jing Zhang, Mei-Yin Lee, Huei-Shyong Wang, Yue-Cune Chang","doi":"10.1097/JNN.0000000000000804","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000804","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Tourette syndrome (TS) is a chronic neurodevelopmental disorder that begins in school-age children. Although TS is not life-threatening, the tics and comorbidities can impact a child's physical and mental health, as well as interpersonal interactions. Understanding the care needs of parents of children with TS is essential for providing healthcare services that effectively support these children. The aim of the study was to develop and evaluate the psychometric properties of the care needs scale for parents of children with TS (CNS-PCTS) in Taiwan. METHODS: This study used a methodological design. The scale was developed by preliminarily identifying relevant items and dimensions through a systematic review of the literature. A pilot test with 30 participants and exploratory factor analysis (EFA) confirmed the subscales and items pertaining to the care needs of the parents. Data analysis included content validity, item analysis, internal consistency, test-retest reliability, and EFA. The Chinese version of the Pittsburgh Sleep Quality Index was adopted to assess the discriminant validity of the CNS-PCTS. RESULTS: Two hundred fifty-six parents of children with TS completed the scale. The scale-level content validity index was 0.92. The EFA revealed that the CNS-PCTS consisted of 13 items, with the factor loadings ranging from 0.656 to 0.83, and covered 3 factors: getting information about TS, assisting children in social engagement, and obtaining parenting support. The discriminant validity showed a positive correlation between the Chinese version of the Pittsburgh Sleep Quality Index and the CNS-PCTS. Cronbach's α coefficients of the subscales ranged from 0.89 to 0.94, and the intraclass correlation coefficient was 0.94. CONCLUSION: The CNS-PCTS demonstrated satisfactory psychometric properties. It helps health professionals understand parents' care needs and assess the effectiveness of interventions. Confirmatory factor analysis can be performed in future studies to provide more rigorous validity.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607875","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":"The Effect of Interventions on Quality of Life, Depression, and the Burden of Care of Stroke Patients and Their Caregivers: A Systematic Review.","authors":"Hossein Bakhtiari-Dovvombaygi, Akbar Zare-Kaseb, Amir Mohamad Nazari, Yusof Rezazadeh, Fatemeh Bahramnezhad","doi":"10.1097/JNN.0000000000000803","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000803","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: The impact of stroke is a global concern for health policymakers. A large proportion of survivors require long-term support from family members who are typically unprepared for their caregiving duties. This study determined the effect of different interventions on quality of life (QoL), depression, and the burden of care of stroke patients and their caregivers. METHODS: A systematic review was conducted from 2000 up to May 2023. Study inclusion criteria were as follows: individuals serving as informal caregivers for stroke survivors 18 years and older, devoting a significant portion of their time to the care of such survivors; involvement in psychoeducational, informational, supportive, psychosocial, or combined interventions; exposure to standard or conventional care practices; evaluation of outcomes relating to the QoL for stroke caregivers, depression, caregiver burden, and levels of stroke survivors; and consideration of randomized controlled trials and quasi-experimental studies. RESULTS: Thirty-seven studies met the inclusion criteria and were synthesized in this systematic review. Details of intervention were divided into 3 groups: educational and psychoeducational programs, multidisciplinary approaches, and support and caregiver skill-building programs; 12 studies focused on different interventions affecting the QoL, 23 studies focused on the burden of stroke caregivers, and 20 studies focused on depression of stroke patients and their caregivers. CONCLUSION: The desired effectiveness of particular interventions was evident in the results, although conflicting findings have emerged. The study emphasizes the need for well-structured preliminary studies for each intervention type. More studies on interventions and outcomes might lead secondary researchers to conduct analyses to ensure the certainty of results.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142607877","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":"Analysis of Factors and Clinical Outcomes of Planned Tracheal Extubation Failure in Neurosurgical Intensive Care Unit Patients.","authors":"Haotian Wu, Jinsong Shen, Yan Xu","doi":"10.1097/JNN.0000000000000796","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000796","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Planned tracheal extubation failure is a common occurrence among patients in the neurosurgical intensive care unit (NICU) because of the complex nature of neurocritical injuries, and the failure could result in a poor prognosis. METHODS: We observed and recorded the patients with tracheal intubation in the NICU of a hospital in Shanghai from June 2021 to December 2022 and analyzed data from planned tracheal extubation, categorizing patients by success or failure, and compared outcomes between the two groups while investigating contributing factors. RESULTS: A total of 156 patients were included, 133 (85.3%) of whom were successfully extubated and 23 (14.7%) were not. The results of logistic regression analysis demonstrated that the Glasgow Coma Scale score before extubation (OR, 0.643; 95% CI, 0.444-0.931; P = .020) and the frequency of respiratory secretions suctioning before tracheal extubation (OR, 0.098; 95% CI, 0.027-0.354; P < .001) were independent risk factors for extubation failure. We also found that the extubation failure group experienced a significantly longer ICU stay and incurred higher hospitalization costs. CONCLUSIONS: Poor Glasgow Coma Scale scores and a high frequency of respiratory secretions suctioning before tracheal extubation were the main factors contributing to tracheal extubation failure in NICU patients. To avoid tracheal extubation failure and adverse outcomes, these two factors should be carefully assessed before tracheal extubation.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142484780","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":"Improving Safety and Satisfaction in the Safety Monitoring Unit.","authors":"Dani Lynn Welch","doi":"10.1097/JNN.0000000000000772","DOIUrl":"10.1097/JNN.0000000000000772","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: The safety monitoring unit (SMU) is a 4-bed unit designated for patients who require continual observation. Most experience some form of dementia, and agitation and aggression are not uncommon. When deescalation techniques do not work, request for help may be necessary. Referred to as Security Alert: Behavioral Assist (SABA), this system-wide message requires response from designated personnel. An increase in SABA events prompted this quality improvement project. METHODS: A survey sent to all unit staff members identified a need for specialized training on the care and management of SMU patients. Education on dementia care and deescalation techniques was provided by a certified dementia specialist and a psychiatry advanced practice registered nurse. Staff expressed a need for defined SMU admission criteria and the establishment of patient care guidelines. Patient care guidelines were developed. A structured schedule was implemented, and dedicated staff were hired to provide familiarity for patients. RESULTS: A postproject survey indicated a nonsignificant increase in staff satisfaction. Security Alert: Behavioral Assist events in the SMU decreased from an average of 3.6 to 1.75 episodes per month. CONCLUSION: Caring for SMU patients creates unique challenges to staff. Staff confidence and satisfaction were higher after implementing new SABA policies. This project could be replicated on similar units with ongoing leadership support and staff education.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"152-156"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141332802","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":"Impact of Illness Uncertainty on Health-Related Quality of Life in Patients With Unruptured Intracranial Aneurysms After Coil Embolization.","authors":"JiEun Lee, SukJeong Lee","doi":"10.1097/JNN.0000000000000771","DOIUrl":"10.1097/JNN.0000000000000771","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: This study aimed to identify the impact of illness uncertainty on physical and mental health-related quality of life (HRQoL) in patients with unruptured intracranial aneurysms (UIAs) after coil embolization. METHODS: A cross-sectional study was conducted and HRQoL was evaluated using the Short Form-12 Health Survey Questionnaire, which assesses physical and mental HRQoL. RESULTS: The participants had a mean age of 56.4 years, and among them, 190 (71.2%) were women. Physical and mental HRQoL were negatively correlated with physical symptoms, anxiety, depression, and illness uncertainty. Mental HRQoL was positively correlated with social support. Physical HRQoL was significantly influenced by depression (β = -0.26, P = .004) and was not influenced by illness uncertainty (β = -0.10, P = .101). Mental HRQoL was significantly influenced by anxiety (β = -0.45, P < .001), depression (β = -0.19, P = .003), social support (β = 0.14, P = .004), and illness uncertainty (β = -0.14, P = .005). The finding that illness uncertainty influences HRQoL suggests a basis for interventions aimed at improving mental HRQoL by reducing illness uncertainty in patients with UIAs. CONCLUSION: The physical and mental HRQoL in patients with UIAs after coil embolization is negatively influenced by depression, whereas mental HRQoL is also affected by anxiety, illness uncertainty, and social support. These results may serve as reference data for the design and development of interventions to improve HRQoL in patients with UIAs after coil embolization.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":" ","pages":"146-151"},"PeriodicalIF":0.0,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474245","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}