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Delirium Screening of Patients on a Neuroscience Step-Down Unit. 神经科学降压单元患者谵妄筛查。
Malissa A Mulkey, DaiWai M Olson, Sarah Misrahi, Sonya R Hardin

This project aimed to identify patients who had experienced a stroke and were at risk for delirium earlier, and implement evidence-based protocols to reduce overall length of stay and mortality. Nurses were motivated to perform screening and implement strategies that benefit patients who had experienced acute stroke. Results suggest early identification and treatment of delirium, use of prevention strategies, and treatment of the underlying etiology can improve patient outcomes and reduce cost of care.

该项目旨在识别早期经历过中风并有谵妄风险的患者,并实施基于证据的方案,以减少总住院时间和死亡率。护士被激励去进行筛查和实施有利于急性中风患者的策略。结果表明,早期识别和治疗谵妄,使用预防策略和治疗潜在的病因可以改善患者的预后和降低护理成本。
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引用次数: 0
Using a Behavioral Response Team on Non-Psychiatric Nursing Units. 在非精神病护理单位使用行为反应小组。
Deborah Dahnke, Malissa A Mulkey

Negative behaviors often are directed toward nursing staff in verbal or physical assaults. Nursing staff on non-psychiatric units may not be prepared to manage such situations and need additional support. Behavioral Emergency Response Teams (BERTs) have been effective in supporting nursing staff faced with patients exhibiting these behaviors.

在言语或身体攻击中,消极行为往往针对护理人员。非精神科病房的护理人员可能没有做好应对这种情况的准备,需要额外的支持。行为应急小组(BERT)在支持护理人员面对表现出这些行为的患者方面是有效的。
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引用次数: 0
Calming the Agitated Patient: Providing Strategies to Support Clinicians. 安抚激动的病人:提供策略,以支持临床医生。
Malissa A Mulkey, Cindy L Munro

Agitation is a symptom of many medical and psychiatric disorders that can manifest along a spectrum of severity. Agitation often delays treatment onset, potentially impacting morbidity and mortality, and may require emergency interventions. Management of acute agitation centers around three main goals: early recognition and treatment of the underlying etiology, rapid control of the behavior, and prevention of harm to the patient and personnel. Nurses should increase use of validated techniques, including frequent and sufficient reality orientation, validation therapy, and strategies that improve the individual's quality of life.

躁动是许多医学和精神疾病的症状,可以沿着严重程度的谱表现出来。躁动往往延迟治疗开始,潜在地影响发病率和死亡率,并可能需要紧急干预。急性躁动的管理围绕三个主要目标:早期识别和治疗潜在的病因,快速控制行为,预防对患者和人员的伤害。护士应增加有效技术的使用,包括频繁和充分的现实导向、有效治疗和改善个人生活质量的策略。
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引用次数: 0
Confusion Assessment Method (CAM) 混淆评估法(CAM)
Q3 Nursing Pub Date : 2020-08-13 DOI: 10.4324/9781003076391-15
Inouye, Dyck, Alessi, Balkin, Siegal, Horwitz
WHY: Delirium is present in 10%-31% of older medical inpatients upon hospital admission and 11%-42% of older adults develop delirium during hospitalization Delirium is associated with negative consequences including prolonged hospitalization, functional decline, increased use of chemical and physical restraints, prolonged delirium post hospitalization, and increased mortality. Delirium may also have lasting negative effects including the development of dementia within two years (Ehlenbach et al., 2010) and the need for long term nursing home care (Inouye, 2006). Predisposing risk factors for delirium include older age, dementia, severe illness, multiple co-morbidities, alcoholism, vision impairment, hearing impairment, and a history of delirium. Precipitating risk factors include acute illness, surgery, pain, dehydration, sepsis, electrolyte disturbance, urinary retention, fecal impaction, and exposure to high risk medications. Delirium is often unrecognized and undocumented by clinicians. Early recognition and treatment can improve outcomes. Therefore, patients should be assessed frequently using a standardized tool to facilitate prompt identification and management of delirium and underlying etiology. BEST TOOL: The Confusion Assessment Method (CAM) is a standardized evidence-based tool that enables non-psychiatrically trained clinicians to identify and recognize delirium quickly and accurately in both clinical and research settings. The CAM includes four features found to have the greatest ability to distinguish delirium from other types of cognitive impairment. There is also a CAM-ICU version for use with non-verbal mechanically ventilated patients (See Try This: ® CAM-ICU). VALIDITY AND RELIABILITY: Both the CAM and the CAM–ICU have demonstrated sensitivity of 94-100%, specificity of 89-95% and high inter-rater reliability (Wei, Fearing, Eliezer, Sternberg, & Inouye, 2008). Several studies have been done to validate clinical usefulness. STRENGTHS AND LIMITATIONS: The CAM can be incorporated into routine assessment and has been translated into several languages. The CAM was designed and validated to be scored based on observations made during brief but formal cognitive testing, such as brief mental status evaluations. Training to administer and score the tool is necessary to obtain valid results. The tool identifies the presence or absence of delirium but does not assess the severity of the condition, making it less useful to detect clinical improvement or deterioration. FOLLOW-UP: The presence of delirium warrants prompt intervention to identify and treat underlying causes and provide supportive care. Vigilant efforts need to continue across the healthcare continuum to preserve and restore baseline mental status. (2010). Association between acute care and critical illness hospitalization and cognitive function in older adults.based geriatric nursing protocols …
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引用次数: 9
A Systematic Review of Care Needs for Surgical Patients with Chronic Opioid Use. 慢性阿片类药物使用手术患者护理需求的系统回顾。
Rachel French, Matthew D McHugh, Eileen Lake, J Margo Brooks Carthon

An understudied aspect of the opioid crisis with implications for nursing is care of hospitalized surgical patients with chronic opioid use. Care needs of these patients are not well understood. This systematic review identified salient care needs and explored the role of nursing in meeting these needs.

阿片类药物危机对护理影响的一个未充分研究的方面是住院手术患者慢性阿片类药物使用的护理。这些病人的护理需要还没有得到很好的了解。本系统综述确定了突出的护理需求,并探讨了护理在满足这些需求中的作用。
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引用次数: 0
Nurses' Health Study 护士健康研究
Q3 Nursing Pub Date : 2020-02-02 DOI: 10.32388/eewxwj
T he Nurses' Health Study was begun in 1976 with the establishment of a cohort of 120,700 women aged 30-55 and was principally designed to assess risk factors for breast cancer. Cohort members initially resided in 11 geographically dispersed states representing the Northeast (Massachusetts, Connecticut, New York, New Jersey, Pennsylvania, Maryland), Northcentral (Ohio, Michigan), the West (California) and the South (T exas, Florida); although the majority of participants still reside in the original 11 states, members of the cohort currently live in all 50 states. T hese women report on exposures and disease outcomes every two years and follow-up in the cohort has been maintained at a level of better than 90% through 1990. Qeios · Definition, February 2, 2020
护士健康研究始于1976年,对120,700名年龄在30-55岁之间的妇女进行了队列研究,主要目的是评估乳腺癌的风险因素。队列成员最初居住在11个地理上分散的州,分别是东北部(马萨诸塞州、康涅狄格州、纽约州、新泽西州、宾夕法尼亚州、马里兰州)、中北部(俄亥俄州、密歇根州)、西部(加利福尼亚州)和南部(德克萨斯州、佛罗里达州);虽然大多数参与者仍然居住在最初的11个州,但该队列的成员目前居住在所有50个州。这些妇女每两年报告一次暴露和疾病结果,到1990年,该队列的随访一直保持在90%以上的水平。Qeios·定义,2020年2月2日
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引用次数: 160
Stroke Transitions of Care. 中风护理的过渡。
Shelia Y Ross, Sarah Roberts, Helen Taggart, Carl Patronas

This quality improvement project focused on improving patient education and patient satisfaction, and reducing all-cause 30-day readmissions. A 72-hour discharge follow-up telephone call was completed in patients discharged home with diagnosis of stroke.

这个质量改进项目的重点是提高患者教育和患者满意度,减少全因30天再入院。对诊断为中风出院的患者进行出院后72小时的电话随访。
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引用次数: 0
The Patient's Experience in Total Knee Arthroplasty: Past-Now-Future. 患者在全膝关节置换术中的经验:过去-现在-未来。
Hale Turhan Damar, Bilik Özlem

Total knee arthroplasty (TKA) affects patients' lives in many ways. In this descriptive qualitative study, effects of knee problems were identified as influential on patients' decisions during the preopera- tive period. Patients also stated they experienced difficulties postop- eratively that were unique to TKA.

全膝关节置换术(TKA)在许多方面影响着患者的生活。在这个描述性定性研究中,膝关节问题的影响被确定为术前患者决策的影响因素。患者还表示,他们经历了术后困难,这是TKA独有的。
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引用次数: 0
Nurse Residency Program Designed for a Large Cohort of New Graduate Nurses: Implementation and Outcomes. 为大批新毕业护士设计的护士住院医师计划:实施和结果。
Janet T Crimlisk, Margaret M Grande, Gintas P Krisciunas, Kim V Costello, Eduarda G Fernandes, Martha Griffin

A nurse residency program was designed to train a large group of new graduate nurses hired into multiple specialty areas. The program included a generalist 1 month 5 day/week clinical orientation followed by specialty clinical orientation with ongoing generalist education. Retention rate after 1 year was 91%.

护士实习计划的目的是培训一大批新毕业的护士进入多个专业领域。该项目包括1个月5天/周的多面手临床指导,随后是专业临床指导和持续的多面手教育。1年后的保留率为91%。
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引用次数: 0
The Use of Intravenous Ibuprofen and Intravenous Acetaminophen in Surgical Patients and the Effect on Opioid Reduction. 手术患者静脉注射布洛芬和对乙酰氨基酚的应用及其对阿片类药物减少的影响。
Tracy M Kwan, Marisa Sullivan

Healthcare providers typically use opioids to treat postoperative pain. Use of intravenous ibuprofen and acetaminophen as adjuncts to opioids is evaluated for potential to reduce opioid use and improve postoperative pain management.

医疗保健提供者通常使用阿片类药物治疗术后疼痛。静脉使用布洛芬和对乙酰氨基酚作为阿片类药物的辅助治疗,以评估减少阿片类药物使用和改善术后疼痛管理的潜力。
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引用次数: 0
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Medsurg nursing : official journal of the Academy of Medical-Surgical Nurses
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