Pub Date : 2022-05-25DOI: 10.1097/RNJ.0000000000000376
L. Pierce, Cheryl E. Gies
Abstract Background Effectively reading scientific publications, for example, research/quality improvement, is an acquired skill. Critical appraisal identifies articles’ strengths and weaknesses related to credibility and authenticity or appropriate standards. Aim To stimulate rehabilitation nurses’ interest/participation in reading to appraise published studies (using brief evaluation questions). Steps Approach Read in this order: (1) title, abstract, and key words (are these words clear and directly connected to identified problem?), (2) discussion and conclusion (how are results/findings interpreted; are there recommendations for actions?), (3) results/findings (do key outcomes relate to the problem?), (4) introduction and review of literature (what are main arguments for study/project; does the study build on what‘s already known?), (5) data collection and analysis methods (are materials/procedures described for gathering information and evaluation?), and (6) references (are citations accurate/up-to-date?). Discussion/Relevance/Conclusion Steps taken on this path help close the gap in reading to appraise scientific publications, discovering ways to build evidence-based rehabilitation nursing practices.
{"title":"Six Steps in Reading to Appraise Scientific Publications: Discover a Different Path","authors":"L. Pierce, Cheryl E. Gies","doi":"10.1097/RNJ.0000000000000376","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000376","url":null,"abstract":"Abstract Background Effectively reading scientific publications, for example, research/quality improvement, is an acquired skill. Critical appraisal identifies articles’ strengths and weaknesses related to credibility and authenticity or appropriate standards. Aim To stimulate rehabilitation nurses’ interest/participation in reading to appraise published studies (using brief evaluation questions). Steps Approach Read in this order: (1) title, abstract, and key words (are these words clear and directly connected to identified problem?), (2) discussion and conclusion (how are results/findings interpreted; are there recommendations for actions?), (3) results/findings (do key outcomes relate to the problem?), (4) introduction and review of literature (what are main arguments for study/project; does the study build on what‘s already known?), (5) data collection and analysis methods (are materials/procedures described for gathering information and evaluation?), and (6) references (are citations accurate/up-to-date?). Discussion/Relevance/Conclusion Steps taken on this path help close the gap in reading to appraise scientific publications, discovering ways to build evidence-based rehabilitation nursing practices.","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 1","pages":"168 - 178"},"PeriodicalIF":1.3,"publicationDate":"2022-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41514352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-21DOI: 10.1097/RNJ.0000000000000375
K. Mitchell
Abstract Poorly coordinated care transitions account for nearly one fifth of Medicare hospital readmissions within 30 days postdischarge. The primary aim of this pilot project was to determine the impact of the Reengineered Discharge (RED) Toolkit on patient knowledge for self-management, satisfaction with the discharge process, readiness for discharge, discharge time, and 30-day readmission rate following hip or knee joint replacement or revision surgeries. Staff adherence with the RED Toolkit was also measured. Thirty adult patients received the intervention of the RED Toolkit. Patient knowledge for self-management ranged from 85.2% to 92.6%; satisfaction with the discharge process scores increased from 33% to 59.2%; patient readiness for discharge scores increased from 2% to 64%. Discharge times decreased. On average, patients left the unit 5.67 (±2.52) hours after the written discharge order. The all-cause 30-day readmission rate was reduced to 3.3%. Staff achieved a RED Toolkit adherence rate of 86.8%. Findings provide a basis for developing a coordinated discharge planning process.
{"title":"Impact of Reengineered Discharge Toolkit on Patients Undergoing Total Joint Surgeries","authors":"K. Mitchell","doi":"10.1097/RNJ.0000000000000375","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000375","url":null,"abstract":"Abstract Poorly coordinated care transitions account for nearly one fifth of Medicare hospital readmissions within 30 days postdischarge. The primary aim of this pilot project was to determine the impact of the Reengineered Discharge (RED) Toolkit on patient knowledge for self-management, satisfaction with the discharge process, readiness for discharge, discharge time, and 30-day readmission rate following hip or knee joint replacement or revision surgeries. Staff adherence with the RED Toolkit was also measured. Thirty adult patients received the intervention of the RED Toolkit. Patient knowledge for self-management ranged from 85.2% to 92.6%; satisfaction with the discharge process scores increased from 33% to 59.2%; patient readiness for discharge scores increased from 2% to 64%. Discharge times decreased. On average, patients left the unit 5.67 (±2.52) hours after the written discharge order. The all-cause 30-day readmission rate was reduced to 3.3%. Staff achieved a RED Toolkit adherence rate of 86.8%. Findings provide a basis for developing a coordinated discharge planning process.","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 1","pages":"121 - 128"},"PeriodicalIF":1.3,"publicationDate":"2022-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48129900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-04-20DOI: 10.1097/RNJ.0000000000000374
C. Fernandes, B. Magalhães, José Augusto Gomes, Célia Santos
Introduction The use of exergames has become an increasingly frequent intervention in rehabilitation, referred to as a fun and motivating activity that involves patients. This systematic review aimed to evaluate the effectiveness of exergames in the rehabilitation of the shoulder joint compared to other types of care. Methods We performed a systematic review and GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) evidence synthesis. The search was conducted using the following databases: MEDLINE, CINAHL, SPORTDiscus, SCOPUS, SciELO, Psychology and Behavioral Sciences Collection, Cochrane Central Register of Controlled Trials, and PEDRo. Databases were searched from the first record until July 2021. Randomized controlled trials using exergames as an intervention were included. Results The search resulted in 1,048 records. A total of 10 articles published between 2013 and 2020 met inclusion criteria and were reviewed for this study. A positive impact was observed in using exergames to increase shoulders’ range of motion, namely, extension, flexion, abduction, internal and external rotation, and functionality postinjury. Conclusions The results of this review provide evidence of the benefits of exergames in shoulder joint rehabilitation. However, more robust clinical trials need to be developed that assess the effectiveness of using exergames as a complement to traditional rehabilitation and assess participants’ degree of satisfaction, motivation, and adherence.
{"title":"Exergames to Improve Rehabilitation for Shoulder Injury: Systematic Review and GRADE Evidence Synthesis","authors":"C. Fernandes, B. Magalhães, José Augusto Gomes, Célia Santos","doi":"10.1097/RNJ.0000000000000374","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000374","url":null,"abstract":"Introduction The use of exergames has become an increasingly frequent intervention in rehabilitation, referred to as a fun and motivating activity that involves patients. This systematic review aimed to evaluate the effectiveness of exergames in the rehabilitation of the shoulder joint compared to other types of care. Methods We performed a systematic review and GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) evidence synthesis. The search was conducted using the following databases: MEDLINE, CINAHL, SPORTDiscus, SCOPUS, SciELO, Psychology and Behavioral Sciences Collection, Cochrane Central Register of Controlled Trials, and PEDRo. Databases were searched from the first record until July 2021. Randomized controlled trials using exergames as an intervention were included. Results The search resulted in 1,048 records. A total of 10 articles published between 2013 and 2020 met inclusion criteria and were reviewed for this study. A positive impact was observed in using exergames to increase shoulders’ range of motion, namely, extension, flexion, abduction, internal and external rotation, and functionality postinjury. Conclusions The results of this review provide evidence of the benefits of exergames in shoulder joint rehabilitation. However, more robust clinical trials need to be developed that assess the effectiveness of using exergames as a complement to traditional rehabilitation and assess participants’ degree of satisfaction, motivation, and adherence.","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 1","pages":"147 - 159"},"PeriodicalIF":1.3,"publicationDate":"2022-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47875391","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-28DOI: 10.1097/RNJ.0000000000000371
Yi-Ya Chang, S. Chang, Xaviera Xiao, Carl P. C. Chen
Abstract Purpose The aim of this study was to explore the rehabilitation experiences and perceptions of patients with neurological disorders who have used the Lokomat Augmented Feedback module, a robot-assisted gait training device. Design A qualitative descriptive study was conducted. Methods Purposive sampling was employed to recruit participants with neurological disorders who have used the Lokomat. Semistructured face-to-face interviews were completed in northern Taiwan. Interviews were recorded and transcribed verbatim. Thematic analysis was used. Results Thirteen interviews were analyzed. Three themes were identified: learning to walk again, inspiring the fighting spirit, and the joys and worries of technological innovation. Conclusions Strong positive emotions and logistical concerns were associated with the use of the Lokomat. Clinical Relevance Encouraging patients while also being transparent about the challenges involved in the rehabilitation process and helping set realistic goals is critical. Furthermore, attention directed toward anticipating and mitigating the physical strain associated with the Lokomat is important.
{"title":"The Experiences of Robot-Assisted Gait Training in Patients With Neurological Disorders: A Qualitative Study","authors":"Yi-Ya Chang, S. Chang, Xaviera Xiao, Carl P. C. Chen","doi":"10.1097/RNJ.0000000000000371","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000371","url":null,"abstract":"Abstract Purpose The aim of this study was to explore the rehabilitation experiences and perceptions of patients with neurological disorders who have used the Lokomat Augmented Feedback module, a robot-assisted gait training device. Design A qualitative descriptive study was conducted. Methods Purposive sampling was employed to recruit participants with neurological disorders who have used the Lokomat. Semistructured face-to-face interviews were completed in northern Taiwan. Interviews were recorded and transcribed verbatim. Thematic analysis was used. Results Thirteen interviews were analyzed. Three themes were identified: learning to walk again, inspiring the fighting spirit, and the joys and worries of technological innovation. Conclusions Strong positive emotions and logistical concerns were associated with the use of the Lokomat. Clinical Relevance Encouraging patients while also being transparent about the challenges involved in the rehabilitation process and helping set realistic goals is critical. Furthermore, attention directed toward anticipating and mitigating the physical strain associated with the Lokomat is important.","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 1","pages":"129 - 137"},"PeriodicalIF":1.3,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46461746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-28DOI: 10.1097/RNJ.0000000000000368
K. Hunter, S. Dahlke, M. Kalogirou, Matthew Pietrosanu, Jean A. C. Triscott, W. Savard, A. Wagg
Abstract Purpose The aim of this study was to pilot a process of engaging geriatric rehabilitation patients in the assessment and management of their continence concerns. Design A descriptive study was conducted. Methods The study has four phases: (1) staff education on continence with a pre–post knowledge quiz, (2) design of patient engagement process by a working group, (3) a 6-week pilot of a patient symptom questionnaire and process of engaging patients with audits of disciplinary admission histories and documentation, and (4) patient and staff feedback surveys. Results Patients in geriatric rehabilitation identify a range of bladder and bowel symptoms. However, there was little documented evidence from the interprofessional team that corresponded to patients’ reported symptoms. Conclusion Further research into symptoms bothersome to patients and engagement of both patients and the interprofessional team in addressing these in the rehabilitation setting is needed. Clinical Relevance to Rehabilitation Nursing Patients admitted to geriatric rehabilitation have a range of bladder and bowel symptoms which need to be addressed.
{"title":"Pilot of Patient Engagement in Continence Care on Geriatric Rehabilitation Units","authors":"K. Hunter, S. Dahlke, M. Kalogirou, Matthew Pietrosanu, Jean A. C. Triscott, W. Savard, A. Wagg","doi":"10.1097/RNJ.0000000000000368","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000368","url":null,"abstract":"Abstract Purpose The aim of this study was to pilot a process of engaging geriatric rehabilitation patients in the assessment and management of their continence concerns. Design A descriptive study was conducted. Methods The study has four phases: (1) staff education on continence with a pre–post knowledge quiz, (2) design of patient engagement process by a working group, (3) a 6-week pilot of a patient symptom questionnaire and process of engaging patients with audits of disciplinary admission histories and documentation, and (4) patient and staff feedback surveys. Results Patients in geriatric rehabilitation identify a range of bladder and bowel symptoms. However, there was little documented evidence from the interprofessional team that corresponded to patients’ reported symptoms. Conclusion Further research into symptoms bothersome to patients and engagement of both patients and the interprofessional team in addressing these in the rehabilitation setting is needed. Clinical Relevance to Rehabilitation Nursing Patients admitted to geriatric rehabilitation have a range of bladder and bowel symptoms which need to be addressed.","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 1","pages":"109 - 118"},"PeriodicalIF":1.3,"publicationDate":"2022-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45689463","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-18DOI: 10.1097/RNJ.0000000000000367
Jessica Pope Mitro, J. M. L. Pomeroy, S. Osman, Virina Matta, Cindy Cai, S. Garfinkel, A. Weinstein
Abstract Purpose This study aimed to understand rehabilitation nurses’ perceptions of research information, related barriers, and avenues for future research, specifically in those caring for individuals with burn injury, spinal cord injury, or traumatic brain injury. Design Qualitative semistructured interviews were conducted. Methods Eighteen interviews were conducted. A thematic network approach identified codes and developed basic, organizing, and global themes. Results Researchers identified factors that facilitated research uptake, determined organizational structures that support research culture, and described nurse engagement with literature. Conclusions Although participants desired to engage with the research literature, they identified barriers including time constraints, heavy workloads, and lack of access. To facilitate research uptake, research must be easily accessible, be easily digestible, and include clinical practice recommendations. Research must expand its scope to address issues relevant to the rehabilitation population. Clinical Relevance Our findings may be used to drive improvements in research competence, facilitate knowledge translation, and support evidence-based practice among rehabilitation nurses.
{"title":"Access, Utilization, and Implementation of Research Among Rehabilitation Nurses: A Qualitative Study","authors":"Jessica Pope Mitro, J. M. L. Pomeroy, S. Osman, Virina Matta, Cindy Cai, S. Garfinkel, A. Weinstein","doi":"10.1097/RNJ.0000000000000367","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000367","url":null,"abstract":"Abstract Purpose This study aimed to understand rehabilitation nurses’ perceptions of research information, related barriers, and avenues for future research, specifically in those caring for individuals with burn injury, spinal cord injury, or traumatic brain injury. Design Qualitative semistructured interviews were conducted. Methods Eighteen interviews were conducted. A thematic network approach identified codes and developed basic, organizing, and global themes. Results Researchers identified factors that facilitated research uptake, determined organizational structures that support research culture, and described nurse engagement with literature. Conclusions Although participants desired to engage with the research literature, they identified barriers including time constraints, heavy workloads, and lack of access. To facilitate research uptake, research must be easily accessible, be easily digestible, and include clinical practice recommendations. Research must expand its scope to address issues relevant to the rehabilitation population. Clinical Relevance Our findings may be used to drive improvements in research competence, facilitate knowledge translation, and support evidence-based practice among rehabilitation nurses.","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 1","pages":"99 - 108"},"PeriodicalIF":1.3,"publicationDate":"2022-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42183142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-10DOI: 10.1097/RNJ.0000000000000369
R. LeBlanc, C. Jacelon
Abstract Purpose The aim of this study was to explore associations between social support, sense of control, and attributed dignity in persons aged 65 years and older who self-manage multiple chronic conditions while living in the community. Design A descriptive, nonexperimental, correlational design was used in this study. Methods Eighty-nine participants completed telephone surveys that measured social support, sense of control and attributed dignity. Regression analysis was used to identify associations. Results Participants were independent in seven of the eight instrumental activities of daily living, with participants having an average of 11 (±4) chronic conditions. Significant positive relationships between social support, perceived sense of control, and attributed dignity were identified. Conclusions Positive social support is strongly associated with perceived sense of control and attributed dignity. Clinical Relevance Healthcare professionals, especially rehabilitation nurses, can assess social support and offer ways to improve social support, thus enhancing sense of control and attributed dignity. These concepts enhance older individuals’ ability to manage multiple chronic conditions.
{"title":"Social Influences on Perceptions of Sense of Control and Attributed Dignity Among Older People Managing Multiple Chronic Conditions","authors":"R. LeBlanc, C. Jacelon","doi":"10.1097/RNJ.0000000000000369","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000369","url":null,"abstract":"Abstract Purpose The aim of this study was to explore associations between social support, sense of control, and attributed dignity in persons aged 65 years and older who self-manage multiple chronic conditions while living in the community. Design A descriptive, nonexperimental, correlational design was used in this study. Methods Eighty-nine participants completed telephone surveys that measured social support, sense of control and attributed dignity. Regression analysis was used to identify associations. Results Participants were independent in seven of the eight instrumental activities of daily living, with participants having an average of 11 (±4) chronic conditions. Significant positive relationships between social support, perceived sense of control, and attributed dignity were identified. Conclusions Positive social support is strongly associated with perceived sense of control and attributed dignity. Clinical Relevance Healthcare professionals, especially rehabilitation nurses, can assess social support and offer ways to improve social support, thus enhancing sense of control and attributed dignity. These concepts enhance older individuals’ ability to manage multiple chronic conditions.","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 1","pages":"92 - 98"},"PeriodicalIF":1.3,"publicationDate":"2022-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45567349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-02DOI: 10.1097/RNJ.0000000000000366
Shelly Amato-Curran, K. Green, Terrie Rader, Adrianne Shimek
Abstract This study aimed to (1) describe the rehabilitation hospital course after diagnosis with COVID-19 and the impact on functional outcomes and discharge destination and (2) compare outcomes for patients with and without COVID-19-related debility. Design A descriptive cohort study was performed. Methods Retrospective data were collected for 63 patients aged >18 years with COVID-19- or non-COVID19-related debility between January 2015 and September 2020. Results Patients admitted with COVID-19-related debility had a mean length of stay of 20.35 days. 15.4% were transferred back to acute service, 92.3% required respiratory interventions, and 88.5% were discharged to the same residence. Patients with COVID-19-related debility were significantly older, required more respiratory interventions, and had a longer length of stay than the non-COVID-19 group. No significant differences were found in functional outcomes. Conclusions Functional outcomes improved, allowing most patients to return to their same residence. Clinical Relevance Patients with COVID-19-related debility responded to rehabilitation as well as the non-COVID-19 group.
{"title":"COVID-19: The Effects on the Course, Outcomes, and Discharge Destination From Acute Rehabilitation","authors":"Shelly Amato-Curran, K. Green, Terrie Rader, Adrianne Shimek","doi":"10.1097/RNJ.0000000000000366","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000366","url":null,"abstract":"Abstract This study aimed to (1) describe the rehabilitation hospital course after diagnosis with COVID-19 and the impact on functional outcomes and discharge destination and (2) compare outcomes for patients with and without COVID-19-related debility. Design A descriptive cohort study was performed. Methods Retrospective data were collected for 63 patients aged >18 years with COVID-19- or non-COVID19-related debility between January 2015 and September 2020. Results Patients admitted with COVID-19-related debility had a mean length of stay of 20.35 days. 15.4% were transferred back to acute service, 92.3% required respiratory interventions, and 88.5% were discharged to the same residence. Patients with COVID-19-related debility were significantly older, required more respiratory interventions, and had a longer length of stay than the non-COVID-19 group. No significant differences were found in functional outcomes. Conclusions Functional outcomes improved, allowing most patients to return to their same residence. Clinical Relevance Patients with COVID-19-related debility responded to rehabilitation as well as the non-COVID-19 group.","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 1","pages":"84 - 91"},"PeriodicalIF":1.3,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47712612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-03-01DOI: 10.1097/RNJ.0000000000000351
Brian C Peach, Samantha Cooney, Sadie Richards
Purpose: The primary objective of this scoping review was to identify prominent cognitive impairment sequelae in adult survivors of an intensive care unit admission for acute respiratory distress syndrome (ARDS).
Design: A scoping review was performed.
Methods: Search terms were entered into multiple EBSCOhost databases. Articles pertaining to pediatric survivors, not in English, lacking cognitive impairment sequelae, or focused on a single sequela were excluded; 12 articles remained.
Results: Cognitive impairment developed in 83.5% of patients with ARDS prior to discharge and persisted in 51.3% (n = 300/585) of survivors at the 1 year mark after discharge (range: 16.7%-100% across studies). Prominent sequelae included impairments in executive function, mental processing speed, immediate memory, and attention/concentration.
Conclusions: Survivors of an intensive care unit stay for ARDS often develop cognitive impairment persisting long after their admission. Clinicians in rehabilitation facilities should screen for these sequelae and connect survivors with treatment to improve cognitive outcomes.
Clinical relevance: Early recognition of prominent cognitive impairment sequelae by rehabilitation clinicians and referrals to neuropsychologists by providers are critical to limiting the severity of impairment.
{"title":"Prominent Cognitive Impairment Sequelae in Adult Survivors of Acute Respiratory Distress Syndrome.","authors":"Brian C Peach, Samantha Cooney, Sadie Richards","doi":"10.1097/RNJ.0000000000000351","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000351","url":null,"abstract":"<p><strong>Purpose: </strong>The primary objective of this scoping review was to identify prominent cognitive impairment sequelae in adult survivors of an intensive care unit admission for acute respiratory distress syndrome (ARDS).</p><p><strong>Design: </strong>A scoping review was performed.</p><p><strong>Methods: </strong>Search terms were entered into multiple EBSCOhost databases. Articles pertaining to pediatric survivors, not in English, lacking cognitive impairment sequelae, or focused on a single sequela were excluded; 12 articles remained.</p><p><strong>Results: </strong>Cognitive impairment developed in 83.5% of patients with ARDS prior to discharge and persisted in 51.3% (n = 300/585) of survivors at the 1 year mark after discharge (range: 16.7%-100% across studies). Prominent sequelae included impairments in executive function, mental processing speed, immediate memory, and attention/concentration.</p><p><strong>Conclusions: </strong>Survivors of an intensive care unit stay for ARDS often develop cognitive impairment persisting long after their admission. Clinicians in rehabilitation facilities should screen for these sequelae and connect survivors with treatment to improve cognitive outcomes.</p><p><strong>Clinical relevance: </strong>Early recognition of prominent cognitive impairment sequelae by rehabilitation clinicians and referrals to neuropsychologists by providers are critical to limiting the severity of impairment.</p>","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 2","pages":"72-81"},"PeriodicalIF":1.3,"publicationDate":"2022-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39548984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2022-02-04DOI: 10.1097/RNJ.0000000000000361
E. Squires, K. Shafer, Barbara Winters-Todd, B. Granger
Abstract Purpose Nursing assistant turnover is a growing healthcare concern that negatively impacts healthcare organization work environments and has significant financial implications. The purpose of this study was to implement a career ladder program for rehabilitation nursing technicians—nursing assistants who specialize in performing care duties aligned with therapeutic goals in inpatient rehabilitation. The study evaluated the effect on organizational quality metrics of employee engagement, job satisfaction, and annual turnover of rehabilitation nursing technicians. Design This pilot study was conducted using a quality improvement approach and a between-subjects pretest–posttest design. Methods A three-tier career ladder intervention for rehabilitation nursing technicians in a 76-bed inpatient rehabilitation facility was implemented. Employee engagement and job satisfaction were evaluated in all rehabilitation nursing technicians (n = 44), with a pre-implementation sample size of n = 23 and a post-implementation sample size of n = 21, from January 2020 through December 2020. Twelve rehabilitation nursing technicians participated in the intervention, which consisted of online learning modules, added job responsibilities, and continuing education and were included in the post-implementation sample size. Nondirectional statistical tests were performed with the level of significance set at .05 (two tailed). Findings A majority of the pre–post intervention sample (n = 44) were female (91%), African American (91%), and aged 30–59 years. Employee engagement increased from 78% favorable in 2019 to 86% favorable in 2020. Overall job satisfaction improved from 74% favorable in 2019 to 86% favorable in 2020. Annual turnover decreased from 35% in 2019 to 31% in 2020. Conclusion In this pilot study, a career ladder program for rehabilitation nursing technicians was effective in increasing and improving employee engagement and job satisfaction while reducing turnover. Clinical Relevance Rehabilitation nursing technicians are crucial members of the interdisciplinary rehabilitation team providing direct bedside care to optimize patient function. Rehabilitation nursing technician career ladders have the capacity to engage an often underrecognized employee population by creating a positive work environment that promotes job growth and retention in the rehabilitation setting.
{"title":"Engaging Rehabilitation Technicians Through a Career Ladder During a Pandemic","authors":"E. Squires, K. Shafer, Barbara Winters-Todd, B. Granger","doi":"10.1097/RNJ.0000000000000361","DOIUrl":"https://doi.org/10.1097/RNJ.0000000000000361","url":null,"abstract":"Abstract Purpose Nursing assistant turnover is a growing healthcare concern that negatively impacts healthcare organization work environments and has significant financial implications. The purpose of this study was to implement a career ladder program for rehabilitation nursing technicians—nursing assistants who specialize in performing care duties aligned with therapeutic goals in inpatient rehabilitation. The study evaluated the effect on organizational quality metrics of employee engagement, job satisfaction, and annual turnover of rehabilitation nursing technicians. Design This pilot study was conducted using a quality improvement approach and a between-subjects pretest–posttest design. Methods A three-tier career ladder intervention for rehabilitation nursing technicians in a 76-bed inpatient rehabilitation facility was implemented. Employee engagement and job satisfaction were evaluated in all rehabilitation nursing technicians (n = 44), with a pre-implementation sample size of n = 23 and a post-implementation sample size of n = 21, from January 2020 through December 2020. Twelve rehabilitation nursing technicians participated in the intervention, which consisted of online learning modules, added job responsibilities, and continuing education and were included in the post-implementation sample size. Nondirectional statistical tests were performed with the level of significance set at .05 (two tailed). Findings A majority of the pre–post intervention sample (n = 44) were female (91%), African American (91%), and aged 30–59 years. Employee engagement increased from 78% favorable in 2019 to 86% favorable in 2020. Overall job satisfaction improved from 74% favorable in 2019 to 86% favorable in 2020. Annual turnover decreased from 35% in 2019 to 31% in 2020. Conclusion In this pilot study, a career ladder program for rehabilitation nursing technicians was effective in increasing and improving employee engagement and job satisfaction while reducing turnover. Clinical Relevance Rehabilitation nursing technicians are crucial members of the interdisciplinary rehabilitation team providing direct bedside care to optimize patient function. Rehabilitation nursing technician career ladders have the capacity to engage an often underrecognized employee population by creating a positive work environment that promotes job growth and retention in the rehabilitation setting.","PeriodicalId":49631,"journal":{"name":"Rehabilitation Nursing","volume":"47 1","pages":"43 - 49"},"PeriodicalIF":1.3,"publicationDate":"2022-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"61792969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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