Pub Date : 2025-06-01DOI: 10.1016/j.jvn.2025.01.003
Wafaa Ramadan Ahmed , Eman Kamel Hossny , Hanaa Moukhtar Ibrahim , Ahmed Khairy Sayed , Khaldoon Aied Alnawafleh , Neama Mamdouh Mostafa
Background: Peripheral artery disease is a circulatory problem causing reduced blood flow through the arteries. The study aimed to evaluate the efficacy of lifestyle modifications on severity and operating rates for patients with peripheral artery disease. Design and methods: An experimental study design was used with a purposive sample of 100 adult patients admitted to the vascular unit with peripheral artery disease aged ≥ 45 years. The study was carried out at the vascular surgery department and its outpatient clinic at Assiut University Hospital. Tools: (I) Patients’ interview questionnaire sheet; (II): Fagerström Tolerance Questionnaire; (III): The ankle-brachial index; (IV): The San Diego Claudication Questionnaire; and (V): Manipal lifestyle' modifications scale. Results: The mean age of patients in the study and control groups was 58.15±12.08 years. 84 % of study group patients experienced no pain, compared with 64 % of patients in the same group who experienced rest pain on admission. There was a decrease in amputation rates, with 12 % in the study group compared with 34 % in the control group of patients. More than three-quarters (76 %) had high lifestyle modification at follow-up compared with (96 %) of the study group having low lifestyle modification at admission. Conclusion and recommendation: Lifestyle modifications have a great effect on decreasing disease severity and operation rates. Peripheral artery disease patients should be included in a lifestyle modification program and closely monitored to decrease their disease severity and operative and amputation rates.
{"title":"Efficacy of life style modifications on severity, and operation rates for patients with peripheral artery disease","authors":"Wafaa Ramadan Ahmed , Eman Kamel Hossny , Hanaa Moukhtar Ibrahim , Ahmed Khairy Sayed , Khaldoon Aied Alnawafleh , Neama Mamdouh Mostafa","doi":"10.1016/j.jvn.2025.01.003","DOIUrl":"10.1016/j.jvn.2025.01.003","url":null,"abstract":"<div><div>Background: Peripheral artery disease is a circulatory problem causing reduced blood flow through the arteries. The study aimed to evaluate the efficacy of lifestyle modifications on severity and operating rates for patients with peripheral artery disease. Design and methods: An experimental study design was used with a purposive sample of 100 adult patients admitted to the vascular unit with peripheral artery disease aged ≥ 45 years. The study was carried out at the vascular surgery department and its outpatient clinic at Assiut University Hospital. Tools: (I) Patients’ interview questionnaire sheet; (II): Fagerström Tolerance Questionnaire; (III): The ankle-brachial index; (IV): The San Diego Claudication Questionnaire; and (V): Manipal lifestyle' modifications scale. Results: The mean age of patients in the study and control groups was 58.15±12.08 years. 84 % of study group patients experienced no pain, compared with 64 % of patients in the same group who experienced rest pain on admission. There was a decrease in amputation rates, with 12 % in the study group compared with 34 % in the control group of patients. More than three-quarters (76 %) had high lifestyle modification at follow-up compared with (96 %) of the study group having low lifestyle modification at admission. Conclusion and recommendation: Lifestyle modifications have a great effect on decreasing disease severity and operation rates. Peripheral artery disease patients should be included in a lifestyle modification program and closely monitored to decrease their disease severity and operative and amputation rates.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 2","pages":"Pages 63-72"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230273","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}
Peripheral artery disease (PAD) is a condition that affects blood vessels and may lead to complications such as foot or leg ulcers and gangrene. However, the level of awareness of PAD among the population of coastal Karnataka is not well known, and it is known that PAD has a significant negative impact on the quality of life of these patients. The objective of the present study was to assess knowledge, identify contributing factors, and quality of life among patients with PAD, and determine the associations between quality of life and selected demographic and clinical variables.
Methods
This hospital-based descriptive study was conducted among 202 patients with PAD. The demographic details, clinical parameters, knowledge of PAD, factors contributing to PAD, and quality of life of patients with PAD were assessed via validated data collection instruments.
Results
The mean age was 60.35 (SD=1.04) years, and 86.1% were males. Among the participants, 77.7% had undergone surgery, 13.4% had a below-knee amputation, and 2.5% had forefoot amputation. The majority of the patients (75.8%) had a moderate level of knowledge, 18.8% had good knowledge, and very few (5.4%) had poor knowledge of PAD, with a median value of 10.5 (IQR 9–12), where the IQR represents the range between the 25th and 75th percentiles of the data, capturing the middle 50% of the distribution. The contributing factors of PAD, such as advanced age (42.6%), diabetes mellitus (76.7%), hypertension (60.4%), dyslipidemia (49%), smoking (26.2%), sedentary lifestyle (11.4%) and overweight (8.4%), were present among these patients. The quality-of-life score was low in areas of self-concept and feelings, with a median value of 8.57 (IQR 0–17.14), and positive adaptation scores were high, with a median value of 51.42 (IQR 40– 54.28). An association was found between PAD quality of life and advanced age (p=0.038), rural residency (p=0.006), and the clinical diagnosis of PAD with diabetes mellitus and hypertension (p=0.021).
Conclusion
The findings are concerning, as they reveal numerous complications and a significant incidence of amputation among patients. Moreover, the patients had moderate knowledge of PAD; hence, education materials were prepared to provide knowledge to these patients. Advanced age, diabetes mellitus, hypertension, dyslipidemia, smoking, a sedentary lifestyle, and overweight were the contributing factors identified among these patients. The quality-of-life score in the areas of self-concept and feelings was low. This study strongly identifies the need for general awareness of PAD, which can be prevented by lifestyle modifications. This study highlights the need for early PAD screening to prevent complications and major cardiovascular events.
{"title":"Impact of peripheral artery disease on daily living: A study on knowledge, contributing factors and quality of life among patients","authors":"Sanjivi Govind Govekar , Janet Prameela D'Souza , Reshma R. Kotian","doi":"10.1016/j.jvn.2025.02.002","DOIUrl":"10.1016/j.jvn.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Peripheral artery disease (PAD) is a condition that affects blood vessels and may lead to complications such as foot or leg ulcers and gangrene. However, the level of awareness of PAD among the population of coastal Karnataka is not well known, and it is known that PAD has a significant negative impact on the quality of life of these patients. The objective of the present study was to assess knowledge, identify contributing factors, and quality of life among patients with PAD, and determine the associations between quality of life and selected demographic and clinical variables.</div></div><div><h3>Methods</h3><div>This hospital-based descriptive study was conducted among 202 patients with PAD. The demographic details, clinical parameters, knowledge of PAD, factors contributing to PAD, and quality of life of patients with PAD were assessed via validated data collection instruments.</div></div><div><h3>Results</h3><div>The mean age was 60.35 (SD=1.04) years, and 86.1% were males. Among the participants, 77.7% had undergone surgery, 13.4% had a below-knee amputation, and 2.5% had forefoot amputation. The majority of the patients (75.8%) had a moderate level of knowledge, 18.8% had good knowledge, and very few (5.4%) had poor knowledge of PAD, with a median value of 10.5 (IQR 9–12), where the IQR represents the range between the 25th and 75th percentiles of the data, capturing the middle 50% of the distribution. The contributing factors of PAD, such as advanced age (42.6%), diabetes mellitus (76.7%), hypertension (60.4%), dyslipidemia (49%), smoking (26.2%), sedentary lifestyle (11.4%) and overweight (8.4%), were present among these patients. The quality-of-life score was low in areas of self-concept and feelings, with a median value of 8.57 (IQR 0–17.14), and positive adaptation scores were high, with a median value of 51.42 (IQR 40– 54.28). An association was found between PAD quality of life and advanced age (p=0.038), rural residency (p=0.006), and the clinical diagnosis of PAD with diabetes mellitus and hypertension (p=0.021).</div></div><div><h3>Conclusion</h3><div>The findings are concerning, as they reveal numerous complications and a significant incidence of amputation among patients. Moreover, the patients had moderate knowledge of PAD; hence, education materials were prepared to provide knowledge to these patients. Advanced age, diabetes mellitus, hypertension, dyslipidemia, smoking, a sedentary lifestyle, and overweight were the contributing factors identified among these patients. The quality-of-life score in the areas of self-concept and feelings was low. This study strongly identifies the need for general awareness of PAD, which can be prevented by lifestyle modifications. This study highlights the need for early PAD screening to prevent complications and major cardiovascular events.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 2","pages":"Pages 73-79"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230274","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}
To describe transitional care after hospital discharge to home in stroke survivors and their caregivers.
Design
A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
Methods
A systematic review was conducted using the following electronic databases: PubMed, CINAHL, Scopus, and Web of Science. This systematic review included studies examining transition care from hospital to home in stroke survivors.
Results
Thirty studies were included in this systematic review. The main intervention observed in this systematic review was educational. Intervention programs, such as health coaching activities, home visits, telephone follow-up, and informative intervention during transition care from hospitals to home, could improve quality of life, self-efficacy, physical function, and activities of daily living in both stroke survivors and caregivers. This systematic review will help nurses and physicians to implement specific interventions during transitional period for stroke survivors, supporting and improving care delivery during this critical period.
Conclusions
This study supports educational and informative interventions to improve the physical functioning, quality of life, and self-efficacy of stroke survivors and reduce caregiver strain.
目的探讨脑卒中幸存者及其照护者出院后的过渡性护理。采用系统评价和荟萃分析首选报告项目（PRISMA）指南进行DesignA系统评价。方法采用PubMed、CINAHL、Scopus、Web of Science等电子数据库进行系统评价。本系统综述包括对中风幸存者从医院到家庭的过渡护理的研究。结果本系统综述纳入了30项研究。本系统综述中观察到的主要干预措施是教育干预。干预方案，如健康指导活动、家访、电话随访和从医院到家庭过渡护理期间的信息干预，可以改善中风幸存者和照顾者的生活质量、自我效能、身体功能和日常生活活动。这一系统综述将有助于护士和医生在过渡时期为中风幸存者实施具体的干预措施，支持和改善这一关键时期的护理服务。结论：本研究支持教育和信息干预，以改善中风幸存者的身体功能、生活质量和自我效能，并减少照顾者的压力。
{"title":"The transitional care from hospital to home for stroke survivors and their caregivers: A systematic review","authors":"Mayra Veronese RN, MSN, Ercole Vellone PhD, FESC, FAAN (Associate Professor), Rosaria Alvaro FESC, FAAN (Professor), Gianluca Pucciarelli PhD, FAHA (Assistant Professor)","doi":"10.1016/j.jvn.2025.03.002","DOIUrl":"10.1016/j.jvn.2025.03.002","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe transitional care after hospital discharge to home in stroke survivors and their caregivers.</div></div><div><h3>Design</h3><div>A systematic review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using the following electronic databases: PubMed, CINAHL, Scopus, and Web of Science. This systematic review included studies examining transition care from hospital to home in stroke survivors.</div></div><div><h3>Results</h3><div>Thirty studies were included in this systematic review. The main intervention observed in this systematic review was educational. Intervention programs, such as health coaching activities, home visits, telephone follow-up, and informative intervention during transition care from hospitals to home, could improve quality of life, self-efficacy, physical function, and activities of daily living in both stroke survivors and caregivers. This systematic review will help nurses and physicians to implement specific interventions during transitional period for stroke survivors, supporting and improving care delivery during this critical period.</div></div><div><h3>Conclusions</h3><div>This study supports educational and informative interventions to improve the physical functioning, quality of life, and self-efficacy of stroke survivors and reduce caregiver strain.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 2","pages":"Pages 86-98"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230276","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}
Pub Date : 2025-06-01DOI: 10.1016/S1062-0303(25)00039-1
{"title":"Information for authors","authors":"","doi":"10.1016/S1062-0303(25)00039-1","DOIUrl":"10.1016/S1062-0303(25)00039-1","url":null,"abstract":"","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 2","pages":"Page A2"},"PeriodicalIF":1.1,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144230271","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}
Health literacy has been demonstrated to be a factor that influences patients’ ability to retain clinical education and counselling.
Aims
To describe: (1) the importance of health literacy in the prevention of stroke; (2) the correlation of risk factors with health literacy; and (3) the importance of health literacy in post-stroke outcomes.
Methods
A systematic review was conducted using the following databases: PubMed (via Medline), CINAHL (via EBSCO), PsycINFO (via EBSCO), and Web of Science (via EBSCO) for studies focused on health literacy in stroke. We included qualitative, quantitative and observational studies. The critical appraisal tool of JBI-Checklists was used to assess the methodological quality of the included studies.
Results
Thirty-three studies, involving 35,935 participants, were selected for this systematic review. Most of the studies (41 %) were cross-sectional. Health literacy levels among the general population and stroke patients were found to be relatively low, indicating the need for increased stroke education. Hypertension and stress were the most frequently identified risk factors while pregnancy and oral contraceptives, and anticoagulants were the least. People at risk of stroke have indicated a desire for more practical information and individually tailored behavioral interventions.
Conclusions
The results of this study highlighted the deficiency in health literacy among different populations. We noticed that even a simple educational intervention can help to improve health literacy. Targeting the general public is important in order to rapidly translate knowledge into action and to reduce the time from symptom onset to hospital arrival as time plays an important role in stroke.
健康素养已被证明是影响患者接受临床教育和咨询的能力的一个因素。目的：(1)健康素养在卒中预防中的重要性；(2)危险因素与健康素养的相关性；(3)健康素养对脑卒中后预后的重要性。方法采用PubMed（通过Medline）、CINAHL（通过EBSCO）、PsycINFO（通过EBSCO）和Web of Science（通过EBSCO）等数据库对卒中健康素养相关研究进行系统回顾。我们包括定性、定量和观察性研究。使用JBI-Checklists这一关键评估工具来评估纳入研究的方法学质量。结果33项研究共纳入35,935名受试者。大多数研究（41%）是横断面研究。一般人群和中风患者的健康素养水平相对较低，这表明需要加强中风教育。高血压和压力是怀孕和口服避孕药时最常见的危险因素，抗凝血剂是最少的。有中风风险的人表示希望获得更实用的信息和个性化的行为干预。结论本研究结果突出了不同人群健康素养的不足。我们注意到，即使是简单的教育干预也可以帮助提高健康素养。针对一般公众是很重要的，以便迅速将知识转化为行动，并缩短从症状出现到到达医院的时间，因为时间在中风中起着重要作用。
{"title":"Health literacy in stroke disease: A systematic review","authors":"Migena Ymeraj RN, MSc , Fatjon Kotica RN, MSc , Giorgia Bozzolan RN, MSc , Gennaro Rocco PhD, MScN, Ed.M, RN, FFNMRCSI, FESNO, FAAN , Michele Virgolesi RN, PhD (Assistant Professor) , Rosaria Alvaro RN, MSN, FESC, FAAN (Professor) , Ercole Vellone RN, PhD, FESC, FAAN (Associate Professor) , Gianluca Pucciarelli RN, PhD, FAHA (Associate Professor)","doi":"10.1016/j.jvn.2025.01.001","DOIUrl":"10.1016/j.jvn.2025.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Health literacy has been demonstrated to be a factor that influences patients’ ability to retain clinical education and counselling.</div></div><div><h3>Aims</h3><div>To describe: (1) the importance of health literacy in the prevention of stroke; (2) the correlation of risk factors with health literacy; and (3) the importance of health literacy in post-stroke outcomes.</div></div><div><h3>Methods</h3><div>A systematic review was conducted using the following databases: PubMed (via Medline), CINAHL (via EBSCO), PsycINFO (via EBSCO), and Web of Science (via EBSCO) for studies focused on health literacy in stroke. We included qualitative, quantitative and observational studies. The critical appraisal tool of JBI-Checklists was used to assess the methodological quality of the included studies.</div></div><div><h3>Results</h3><div>Thirty-three studies, involving 35,935 participants, were selected for this systematic review. Most of the studies (41 %) were cross-sectional. Health literacy levels among the general population and stroke patients were found to be relatively low, indicating the need for increased stroke education. Hypertension and stress were the most frequently identified risk factors while pregnancy and oral contraceptives, and anticoagulants were the least. People at risk of stroke have indicated a desire for more practical information and individually tailored behavioral interventions.</div></div><div><h3>Conclusions</h3><div>The results of this study highlighted the deficiency in health literacy among different populations. We noticed that even a simple educational intervention can help to improve health literacy. Targeting the general public is important in order to rapidly translate knowledge into action and to reduce the time from symptom onset to hospital arrival as time plays an important role in stroke.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Pages 33-45"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548961","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}
Pub Date : 2025-03-01DOI: 10.1016/j.jvn.2024.12.001
Arzu Aslan Basli Ass. Prof., RN, MSc, PhD, Duygu Kurt Ass. Prof., RN, MSc, PhD
Background
Deep vein thrombosis (DVT) is a major life-threatening complication in surgical patients. It is the responsibility of the surgical team (including the nurse) to determine the risk of DVT. The nurses play an important role in the identification and management of DVT risks.
Objective
This study aims to evaluate the risk of DVT and the implementation of preventive nursing practices among patients hospitalized in surgical wards.
Material and Method
The descriptive cross-sectional study was conducted among patients who underwent inpatient surgical procedures in the surgical wards of Orthopedics and Traumatology, General Surgery, Cardiovascular Surgery, and Neurosurgery of a university hospital during a six-month period from October 2023 to March 2024. Data were collected using the “Introductory Information and Nursing Interventions Identification Form” and the “Autar Deep Vein Thrombosis Risk Assessment Scale”.
Results
During the postoperative period, 31.6 % of patients were mobilized within the first 8 h, 64.5 % used graduated compression stockings, 92.3 % did not receive intermittent pneumatic compression, 66.5 % received anticoagulant medication, and 52.3 % did not perform foot and leg exercises. The mean total score of the Autar DVT Risk Assessment Scale was 12.03±4.29. According to the Autar DVT Risk Assessment Scale, 29 % of the patients were classified as high risk for deep vein thrombosis. Of the patients with high risk for DVT, 17.8 % underwent mobilization within the first 8 h, 64.5 % underwent graduated compression, 8.9 % underwent intermittent pneumatic compression, 84.4 % received anticoagulant, and 40 % performed foot and leg exercises.
Conclusions
The study results suggest that preventive nursing practices for DVT are consistent with evidence-based practices. Standardizing mobilization protocols, incorporating foot and leg exercises, and using evidence-based checklists are recommended for the prevention of DVT.
{"title":"Deep vein thrombosis risk and preventive nursing practices in surgical patients: A descriptive cross-sectional study","authors":"Arzu Aslan Basli Ass. Prof., RN, MSc, PhD, Duygu Kurt Ass. Prof., RN, MSc, PhD","doi":"10.1016/j.jvn.2024.12.001","DOIUrl":"10.1016/j.jvn.2024.12.001","url":null,"abstract":"<div><h3>Background</h3><div>Deep vein thrombosis (DVT) is a major life-threatening complication in surgical patients. It is the responsibility of the surgical team (including the nurse) to determine the risk of DVT. The nurses play an important role in the identification and management of DVT risks.</div></div><div><h3>Objective</h3><div>This study aims to evaluate the risk of DVT and the implementation of preventive nursing practices among patients hospitalized in surgical wards.</div></div><div><h3>Material and Method</h3><div>The descriptive cross-sectional study was conducted among patients who underwent inpatient surgical procedures in the surgical wards of Orthopedics and Traumatology, General Surgery, Cardiovascular Surgery, and Neurosurgery of a university hospital during a six-month period from October 2023 to March 2024. Data were collected using the “Introductory Information and Nursing Interventions Identification Form” and the “Autar Deep Vein Thrombosis Risk Assessment Scale”.</div></div><div><h3>Results</h3><div>During the postoperative period, 31.6 % of patients were mobilized within the first 8 h, 64.5 % used graduated compression stockings, 92.3 % did not receive intermittent pneumatic compression, 66.5 % received anticoagulant medication, and 52.3 % did not perform foot and leg exercises. The mean total score of the Autar DVT Risk Assessment Scale was 12.03±4.29. According to the Autar DVT Risk Assessment Scale, 29 % of the patients were classified as high risk for deep vein thrombosis. Of the patients with high risk for DVT, 17.8 % underwent mobilization within the first 8 h, 64.5 % underwent graduated compression, 8.9 % underwent intermittent pneumatic compression, 84.4 % received anticoagulant, and 40 % performed foot and leg exercises.</div></div><div><h3>Conclusions</h3><div>The study results suggest that preventive nursing practices for DVT are consistent with evidence-based practices. Standardizing mobilization protocols, incorporating foot and leg exercises, and using evidence-based checklists are recommended for the prevention of DVT.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Pages 27-32"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548962","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}
Dysphagia, a common yet often underdiagnosed neurological symptom after an acute stroke, can lead to life-threatening aspiration pneumonia. A three-month chart review at the project site revealed 42.5 % incidence of aspiration among acute stroke patients, necessitating additional intervention and cost for stabilization. Literature suggests that early dysphagia screening using a validated tool is associated with decreased aspiration and complications. However, the project site employed a screening tool that lacks validation, and completion within 24 h was <50 %. This quality improvement initiative aimed to reduce aspiration risk among acute stroke patients by implementing the Yale Swallow Protocol tool (YSP), within 24 h of admission.
Methods
Over a 15-week implementation period in the fall of 2023, the YSP tool was included in the nurses' admission bundle at a stroke-certified neurological intermediate care unit. All eligible patients screened using the YSP tool were referred to a speech-language pathologist (SLP) if they failed the test. Nurses received education prior to and during implementation. Weekly audits assessed the number of patients screened and the utilization of the YSP tool.
Result
Out of 63 eligible patients, 37 (59 %) were screened within 24 h of admission. Of those screened, 29 met exclusion criteria in step one and were referred for SLP evaluation. Four failed the water swallow test in step two and were referred to SLP, and 4 passed the screening and were cleared for regular diet. Three patients were identified with aspiration pneumonia of the 37 screened. Overall, there were 59 % compliance with using the tool.
Conclusion
YSP is a quick, easy-to-follow, and effective tool to screen acute stroke patients within 24 h of admission. Further studies should explore its implementation in other areas including the Emergency Department where acute stroke patients are initially encountered. Nurses can safely utilize the tool with ongoing education on aspiration prevention.
{"title":"Swallow evaluation tool to reduce aspiration among acute stroke patients: A quality improvement project","authors":"Ekta Koirala DNP, FNP- BC, Carolyn Greely DNP, CRNP, BSN, Suzanna Fitzpatrick DNP, ACNP-BC, FNP-BC, FAANP","doi":"10.1016/j.jvn.2024.11.001","DOIUrl":"10.1016/j.jvn.2024.11.001","url":null,"abstract":"<div><h3>Problem & Purpose</h3><div>Dysphagia, a common yet often underdiagnosed neurological symptom after an acute stroke, can lead to life-threatening aspiration pneumonia. A three-month chart review at the project site revealed 42.5 % incidence of aspiration among acute stroke patients, necessitating additional intervention and cost for stabilization. Literature suggests that early dysphagia screening using a validated tool is associated with decreased aspiration and complications. However, the project site employed a screening tool that lacks validation, and completion within 24 h was <50 %. This quality improvement initiative aimed to reduce aspiration risk among acute stroke patients by implementing the Yale Swallow Protocol tool (YSP), within 24 h of admission.</div></div><div><h3>Methods</h3><div>Over a 15-week implementation period in the fall of 2023, the YSP tool was included in the nurses' admission bundle at a stroke-certified neurological intermediate care unit. All eligible patients screened using the YSP tool were referred to a speech-language pathologist (SLP) if they failed the test. Nurses received education prior to and during implementation. Weekly audits assessed the number of patients screened and the utilization of the YSP tool.</div></div><div><h3>Result</h3><div>Out of 63 eligible patients, 37 (59 %) were screened within 24 h of admission. Of those screened, 29 met exclusion criteria in step one and were referred for SLP evaluation. Four failed the water swallow test in step two and were referred to SLP, and 4 passed the screening and were cleared for regular diet. Three patients were identified with aspiration pneumonia of the 37 screened. Overall, there were 59 % compliance with using the tool.</div></div><div><h3>Conclusion</h3><div>YSP is a quick, easy-to-follow, and effective tool to screen acute stroke patients within 24 h of admission. Further studies should explore its implementation in other areas including the Emergency Department where acute stroke patients are initially encountered. Nurses can safely utilize the tool with ongoing education on aspiration prevention.</div></div>","PeriodicalId":45419,"journal":{"name":"Journal of Vascular Nursing","volume":"43 1","pages":"Pages 1-9"},"PeriodicalIF":1.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143548966","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}
Pub Date : 2025-03-01DOI: 10.1016/j.jvn.2024.11.003
Sarah Meadowcroft DNP, ACNP-BC , Johnny Gayden DNP, CRNA , Suzanna Fitzpatrick DNP, ACNP-BC
Problem
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.
Purpose
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.
Methods
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).
Results
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.
Conclusions
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.
{"title":"Using a standardized pain management approach through regional anesthesia for major limb amputation patients","authors":"Sarah Meadowcroft DNP, ACNP-BC , Johnny Gayden DNP, CRNA , 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}
Pub Date : 2025-03-01DOI: 10.1016/S1062-0303(25)00011-1
{"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}
Pub Date : 2025-03-01DOI: 10.1016/j.jvn.2025.02.001
Debra Kohlman-Trigoboff RN, MS, ACNP-BC, CVN
{"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}
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