Rehabilitation Nursing最新文献

Purpose: The aim of this study was to evaluate the ability of the Hester Davis Scale (HDS), Section GG, and facility fall risk assessment scores to predict patients who fall during inpatient rehabilitation.

Design: This study was an observational quality improvement project.

Methods: Nurses administered the HDS in parallel to the facility's current fall risk assessment and Section GG of the Centers for Medicare & Medicaid Services Inpatient Rehabilitation Facility Patient Assessment Instrument. Receiver operating characteristic curves were compared in 1,645 patients. Relationships of individual scale items to falls were also assessed.

Results: The HDS (area under the curve [AUC] = .680, 95% CI [.626, .734]), facility fall risk assessment (AUC = .688, 95% CI [.637, .740]), and Section GG scores (AUC = .687, 95% CI [.638, .735]) adequately identified patients who fell. AUCs did not significantly differ between assessments. HDS scores of ≥13, facility scores of ≥14, and Section GG scores of ≤51 resulted in the highest sensitivity/specificity balance.

Conclusions: HDS, facility fall risk assessment, and Section GG scores adequately and similarly identified patients of mixed diagnoses at risk of falling in inpatient rehabilitation.

Clinical relevance to the practice of rehabilitation nursing: Rehabilitation nurses have several options including the HDS and Section GG to identify patients at greatest risk of falling.

Purpose: The aim of this study was to describe the lived experiences of a serious stroke survivor.

Design: This is a hermeneutic phenomenological case study.

Methods: Data were collected via observations and conversations during 75 visits, 14 brief audiotaped interviews, field notes, and conversations with family members, close friends, and care providers.

Findings: Seven themes emerged that form the general structure of the lived experience of surviving a serious stroke. These themes were organized around four fundamental existential themes including space, time, body, and relationships.

Clinical relevance to the practice of rehabilitation nursing: Spend intentional time with patients beyond the initial stroke rehabilitation period to better understand the experience, individualize care, identify meaningful activities previously engaged in, and identify people who may be willing to partner with them to continue participation in the meaningful activities.

Conclusion: Hermeneutic phenomenology allows the essence of the stroke survival experience to be revealed and contributes to better understanding of the phenomenon.

Purpose: This integrative review aims to identify the triggers for rapid response team (RRT) activation and their outcomes in pediatric patients and to compare them with those of adult patients. In addition, this integrative review synthesizes the outcomes of cardiopulmonary resuscitation (CPR), intensive care unit (ICU) admission, length of hospital stay, and mortality following RRT activation.

Method: An integrative review using the Whittemore and Knafl methodology was undertaken with a search of three large databases (PubMed, Ovid MEDLINE, and CINAHL) and found 25 relevant studies published in the years 2017 through 2022.

Results: Tachypnea, decreased oxygen saturation, tachycardia, changes in blood pressure, and level of consciousness were the most common triggers in both populations. However, specific activation triggers differed between children and adults.

Conclusions: The most common triggers for RRT are detectable through vital signs monitoring; therefore, vigilant tracking of patients' vital signs is critical and can provide early clues to clinical deterioration.