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

{"title":"A Retrospective Analysis of Ischemic Stroke Patients Supports That Very Early Mobilization Within 24 Hours After Intravenous Alteplase Is Safe and Possibly Beneficial.","authors":"Lisa Yanase,&nbsp;Diane Clark,&nbsp;Elizabeth Baraban,&nbsp;Tamela Stuchiner","doi":"10.1097/JNN.0000000000000731","DOIUrl":"10.1097/JNN.0000000000000731","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Stroke care guidelines recommend early mobilization of acute ischemic stroke patients, but there are sparse data regarding early mobilization of stroke patients receiving thrombolytic therapy. We developed the Providence Early Mobility for Stroke (PEMS) protocol to mobilize patients to their highest individual tolerance within 24 hours of stroke admission in 2010, and it has been in continuous use at our primary and comprehensive stroke centers for over a decade. In this study, we evaluated the PEMS protocol in all patients treated with intravenous alteplase without endovascular treatment. METHODS : This retrospective study includes 318 acute ischemic stroke patients treated with alteplase who were admitted to 2 urban stroke centers between January 2013 and December of 2017 and were mobilized with the PEMS protocol within 24 hours of receiving alteplase. Safety of PEMS was assessed by change in National Institutes of Health Stroke Scale at 24 hours by time first mobilized. Using multivariate and logistic regression models, we analyzed time first mobilized and 90-day modified Rankin scale (mRS). RESULTS : Median time first mobilized was 9 hours from administration of alteplase. For every hour delay in mobilization, the odds of being slightly or moderately disabled (mRS, 2-3) at 90 days increased by 7% (adjusted odds ratio, 1.07; P = .004), and the odds of being severely disabled or dead (mRS, 4-6) at 90 days increased by 7% (adjusted odds ratio, 1.07; P = .02). In addition, for every hour delay in mobilization, 24-hour National Institutes of Health Stroke Scale increased by 1.8%. DISCUSSION: Our results support that the PEMS protocol is safe, and possibly beneficial, for acute ischemic stroke patients treated with intravenous alteplase. Our protocol differs from other very early mobility protocols because it does not prescribe a \"dose\" of activity. Instead, each patient was mobilized to his/her individual highest degree as soon as it was safe to do so.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41184695","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":"Implementation of an Interprofessional Mobility Program in a Neurosurgical Intensive Care Unit.","authors":"Katie Broadway,&nbsp;Cristina M Nuila","doi":"10.1097/JNN.0000000000000729","DOIUrl":"10.1097/JNN.0000000000000729","url":null,"abstract":"<p><strong>Abstract: </strong>BACKGROUND: Emerging research suggests the need for implementation of mobility protocols and consistent evaluation of the impact on patient outcomes. Standardized mobility guidelines may be a solution for promoting nurse-driven mobility efforts and influencing a shift in the culture of mobility among nursing teams. In a 36-bed neurosurgical intensive care unit, 2 key areas of opportunity were identified related to patient mobility: strengthening of frontline nursing engagement in mobility and accuracy of documented early and safe mobilization. METHODS: Using a plan-do-study-act performance improvement framework, an interprofessional team developed a comprehensive early patient mobility program. Defined criteria and mobility rounds assisted in identifying the patient's functional ability and level of assistance. Nursing staff received education in case study format to enhance understanding and improve practical application of the phases of mobility. Chart reviews served as continuous assessment of documented mobilizations within the appropriate phases of mobility, and surveys evaluated staff perceptions of program success. RESULTS: On a rating scale of 1 to 5, clinicians reported a rating of 4.32 in overall observation that patients are safely mobilized earlier and more frequently and 4.48 on overall improvement in the neurosurgical intensive care unit culture of mobility. CONCLUSION: An interprofessional mobility program focusing on safe and early mobilization may improve overall culture, confidence, and empowerment of the frontline clinicians.</p>","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41144704","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 Scoping Review of the Incidence, Predictors, and Outcomes of Delirium Among Critically Ill Stroke Patients.","authors":"","doi":"10.1097/JNN.0000000000000655","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000655","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77072116","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 Person-Centered Approach to Understanding Stroke Survivor and Family Caregiver Emotional Health.","authors":"","doi":"10.1097/JNN.0000000000000644","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000644","url":null,"abstract":"","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80633539","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":"What can I do?","authors":"C. Stewart‐Amidei","doi":"10.1017/9781108900997.013","DOIUrl":"https://doi.org/10.1017/9781108900997.013","url":null,"abstract":"Often the people we work among see themselves as poor. We have the privilege of letting them know that they are not poor in God’s eyes but are valued and valuable. This is a transformation that can inspire communities to make positive changes for themselves. Changes that can also mobilise communities for mission, as they recognise the gifts and abilities that God has given them to share his good news with their neighbours.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75513527","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":"Thank You to Reviewers 2016.","authors":"Alexander, K. Al-Hafian, S. Amato, Kelly Anderson, C. Arbour, K. Austin, T. Bakas, JJ Baumann, Cynthia Bautista, E. Bay, C. Beal, Karen Bergman, Latresa","doi":"10.1097/JNN.0000000000000279","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000279","url":null,"abstract":"Lena Aadal Sheila Alexander Kathryn Al-Hafian Shelly Amato Kelly Anderson Caroline Arbour Kimberley Austin Tamilyn Bakas JJ Baumann Cynthia Bautista Esther Bay Claudia Beal Karen Bergman Latresa Billings Sharon Bottomley Marijean Buhse Nicole Burnham Christine Byrd V. Susan Carroll Cathy Cartwright Krystal Chamberlain Lauren Cittadino Amanda Cramer Daniel Crawford Dare Domico Clint Douglas Deborah Downey","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2017-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75381504","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":"Biobehavioral Framework of Symptom and Health Outcomes of Uncertainty and Psychological Stress in Parkinson Disease.","authors":"K. W. Austin, S. Ameringer, A. Starkweather, L. Cloud, J. Sturgill, R. Elswick","doi":"10.1097/JNN.0000000000000244","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000244","url":null,"abstract":"Parkinson disease (PD) is a debilitating, progressive neurodegenerative disorder characterized by complex motor and nonmotor symptoms that fluctuate in onset, severity, level of disability, and responsiveness to treatment. The unpredictable nature of PD and the inability to halt or slow disease progression may result in uncertainty and psychological stress. Uncertainty and psychological stress have important implications for symptom and health outcomes in PD. Uncertainty and psychological stress have been shown to worsen symptoms, functional capacity, and quality of life in chronic illnesses; however, the causal mechanisms have yet to be elucidated. We propose a biobehavioral framework for examining uncertainty and psychological stress in PD. The framework considers factors that may contribute to uncertainty and neuroendocrine-immune mechanisms of uncertainty and psychological stress that may influence symptom and health outcomes in PD, for the ultimate purpose of improving symptom and disease progression, functional capacity, and quality of life.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86593568","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":"Let Them Take the Pebble From Your Hand.","authors":"Daiwai M. Olson","doi":"10.1097/JNN.0000000000000193","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000193","url":null,"abstract":"G raduation season is right around the corner. Are you ready to assume your responsibility? Every spring, thousands of us will take a big step forward.Wemay celebrate our own personal success by earning a BSN or finishing graduate school. We may celebrate our friends and colleagues who walk across the graduation stage after years of spending nights and weekends in class. For some of us, graduation will be bittersweet, marking the day our daughters and sons prepare to set out on their own academic journeys. With graduation comes a new set of responsibilities. This history of the graduation ceremony goes back centuries and has evolved over time. Likely beginning as an Islamic tradition, graduation historically symbolized that the student was ready to become the teacher. Back then, no distinction was made between the type or level of degree. Scholar, bachelor, master, and doctor were essentially interchangeable terms used to describe someone who had earned the right to share what he or she had learned. They had earned the right to teach. The many traditions of graduation are actually reflections of necessity. Those long robes we all wore when we got our diplomas do indeed reflect learning but maybe not the way you think. Ages ago, scholars (teachers) spent their days teaching. Teaching meant being indoors. Being indoors meant being inside the cold damp halls of the academy. Students often arrived poor and unprepared for the learning environment. However, the scholars had learned a thing or two; they had learned how to keep warm and dry by wearing long robes. Anyone could easily distinguish student from teacher by looking to see who was smart enough to wear robes. Hence, robes became a symbol that one had become educated enough to take on the role of teacher. As nurses, we donned our graduation robes and accepted our diplomas. When we did this, we became part of the fabric of history, and thereby, we agreed to become teachers. We willingly accepted the burden of responsibility to teach our craft. Soon, hospitals and clinics will be bustling with newly graduated nurses; are you ready to assume your responsibility and teach them your craft?","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76076053","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":"Progressive Motor Deficits and Psychosis After Stroke: A Case Presentation.","authors":"Grace Small","doi":"10.1097/JNN.0000000000000183","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000183","url":null,"abstract":"N eurological deficits after a stroke are extremely common. Most patents experience dysarthria, aphasia, facial weakness, and weakness of upper and lower limbs after a stroke (Yanagida, Fujimoto, Inoue, & Suzuki, 2015). Facial hemiparesis, motor weakness of arms, and slurred or strange speech are associated as warning signs of stroke and signal the patient that urgent treatment is needed (National Heart, Lung, and Blood Institute, 2014). Fast treatment allows for quicker reperfusion of the brain tissue, limiting the amount of damage to the brain and the severity of the deficits experienced by the patient. The onset of neurological deficits from stroke is often several minutes after blockage or hemorrhage; however, deficits can continue to develop for up to several days after infarct (National Heart, Lung, and Blood Institute, 2014). Delayed motor deficits or progressive motor deficits (PMD) that develop several years after stroke are relatively rare in the literature. One notable case study discusses delayed neurological deterioration including worsening of dysarthria and ataxia several months after pontine hemorrhage (Menezes Cordeiro, Tavares,Reim,o, Geraldes, & Ferro, 2013). This progression was attributed to an increase in the area of hypertrophy in the pontine region, confirmedwithmagnetic resonance imaging (MRI) comparison (Menezes Cordeiro et al., 2013). However, research has shown that it is common for survivors of stroke to experience mental health disorders such as depression and anxiety; in fact, up to a third of survivors are eventually diagnosed with such disorders (Hackett, Yapa, Parag, & Anderson, 2005). Other mental health disorders such as delusions and hallucinations are not well documented in the literature. The purpose of this article is to gain a better understanding of delayed motor and psychological disorders in a stroke survivor.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2016-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82010767","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 Parkinson Disease: A Complex and Multifaceted Illness.","authors":"Apoorva Gopalakrishna, S. Alexander","doi":"10.1097/JNN.0000000000000162","DOIUrl":"https://doi.org/10.1097/JNN.0000000000000162","url":null,"abstract":"Parkinson disease is an incredibly complex and multifaceted illness affecting millions of people in the United States. Parkinson disease is characterized by progressive dopaminergic neuronal dysfunction and loss, leading to debilitating motor, cognitive, and behavioral symptoms. Parkinson disease is an enigmatic illness that is still extensively researched today to search for a better understanding of the disease, develop therapeutic interventions to halt or slow progression of the disease, and optimize patient outcomes. This article aims to examine in detail the normal function of the basal ganglia and dopaminergic neurons in the central nervous system, the etiology and pathophysiology of Parkinson disease, related signs and symptoms, current treatment, and finally, the profound impact of understanding the disease on nursing care.","PeriodicalId":94240,"journal":{"name":"The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2015-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81228798","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}