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Data Is a Gift. 数据是一份礼物。
IF 2.3 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1097/JNN.0000000000000669
Lori M Rhudy
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引用次数: 0
Preparing a Pediatric Palliative Care Program for Sustainable Support: A Practice Reflection. 准备儿科姑息治疗方案的可持续支持:实践反思。
IF 2.3 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1097/JNN.0000000000000659
Kenneth J Pituch, Natalia Simon, Meaghann S Weaver, Lisa C Lindley
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引用次数: 1
Post-Thrombolytic Care Steps Up the Step-Down Unit. 溶栓后护理逐步提升降压单元。
IF 2.3 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1097/JNN.0000000000000662
Michelle Hill, Steve Potkrajac, Keesha Cunningham
n 1995, the National Institute of Neurologic Disorders and Stroke trial was published, prompting alteplase approval for acute ischemic stroke treatment. Since 1995, there have been quite a few changes in managing stroke patients post alteplase, including administration inclusion and exclusion criteria. With a few exceptions at high-performing academic centers, postalteplase patients are admitted to a critical care area for frequent monitoring during the first 24 hours regardless of stroke severity. The latest ischemic stroke guidelines from the American Heart/ American StrokeAssociation encourage treatment with alteplase in patients with mild but disabling symptoms regardless of the stroke severity score. Although this is good news for stroke patients, wewere facedwith challenges in critical care bed availability. Often, patients with a low stroke severity score who received alteplase would be prioritized admission to critical care over a patient with higher acuity and a greater need for critical care–level nursing care. Our organization is in the Midwest and composed of 1 comprehensive stroke center, 4 primary stroke centers, 5 affiliate hospitals, and vascular neurology coverage through telemedicine for 28 facilities across the state. Our comprehensive stroke center houses a 32-bed integrated stroke unit (ISU), a 32-bed neurocritical care unit (NCCU), and a 32-bed general neurology unit. As alteplase volumes increased, we saw an opportunity to expand the scope of care and knowledge by empowering the step-down registered nurses (RNs) to care for low-severity stroke scale patients on the ISU.
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引用次数: 1
Results From the Perceived Value of Certification Tool-12 Survey: Analysis of the Perceived Value of Certification Among Stroke and Neuroscience Nurses. 认证感知价值工具-12 调查结果:卒中和神经科学护士对认证价值的认知分析。
IF 1.5 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-10-01 Epub Date: 2022-06-30 DOI: 10.1097/JNN.0000000000000667
Suzy Mascaro Walter, Norma D McNair, Rebecca Banat, Tracey Anderson, Zheng Dai, Kesheng Wang

Abstract: AIM: The purpose of this study was to explore the perceived value of certification among those with a neuroscience or stroke nursing certification. METHODS: The Perceived Value of Certification Tool-12 (PVCT-12) consists of 12 value statements related to the benefits of certification, using a 4-point Likert scale ranging from strongly disagree to strongly agree. Descriptive statistics were used to determine the percentage of agreement among respondents with each of the PVCT-12 items. A generalized linear model approach was then used to estimate the associations between age, sex, race, experience, certification, highest degree earned, primary responsibility, and primary work setting with intrinsic and extrinsic values. An exploratory factor analysis was performed to identify factors on which related variables were found. RESULTS: The 632 certificants were predominantly female (90%) with a mean age of 54 years. Approximately 80% were White, followed by Asian (11%), Hispanic (4%), and Black (3%). Certification included certified neuroscience registered nurse (34%), stroke certified registered nurse (47%), or both (20%). Approximately 57% of the certificants work in critical care/medical-surgical units. Work setting included academic (46%) and community (42%). Responses indicated lower levels of agreement with the value statements regarding certification challenges, professional autonomy, being listened to, and monetary gain. Those in administration had statistically significant higher intrinsic and extrinsic value scores ( P = .005) as compared with those in nonadministrative roles. There was no significant difference on perceived intrinsic or extrinsic values for those who work in an academic environment versus those who work in a community environment ( P = .25). After factor analysis, the PVCT-12 was found to have 3 factors that accounted for 53.4% of the total variation in the data: recognition of specialization, personal achievement, and professional accomplishment. CONCLUSION: The PVCT-12 incorporated a Likert-type scale to provide levels of agreement for intrinsic and extrinsic values among stroke certified registered nurses and certified neuroscience registered nurses. To complement these findings, further research using open-ended questions is needed to improve our understanding of participant responses regarding complex values such as "autonomy" and the "extent of being listened to."

摘要:目的:本研究旨在探讨获得神经科学或中风护理认证的人员对认证价值的感知。方法:认证感知价值工具-12(PVCT-12)由 12 个与认证益处相关的价值陈述组成,采用李克特 4 点量表,从非常不同意到非常同意不等。我们使用描述性统计来确定受访者对 PVCT-12 各项目同意的百分比。然后使用广义线性模型方法估计年龄、性别、种族、经验、认证、最高学位、主要职责和主要工作环境与内在和外在价值之间的关联。还进行了探索性因子分析,以确定发现相关变量的因子。结果:632 名认证者主要为女性(90%),平均年龄为 54 岁。约 80% 为白人,其次是亚裔(11%)、西班牙裔(4%)和黑人(3%)。认证包括神经科学认证注册护士(34%)、中风认证注册护士(47%)或两者(20%)。约 57% 的认证者在重症监护/内科-外科部门工作。工作环境包括学术环境(46%)和社区环境(42%)。调查结果显示,对认证挑战、专业自主、被倾听和金钱收益等价值声明的认同度较低。与非行政人员相比,行政人员的内在和外在价值得分在统计学上明显更高(P = .005)。在学术环境中工作的人与在社区环境中工作的人在感知到的内在或外在价值方面没有明显差异 ( P = .25)。经过因子分析,发现 PVCT-12 有 3 个因子,占数据总变化的 53.4%:对专业的认可、个人成就感和职业成就感。结论:PVCT-12 采用李克特量表,提供了中风认证注册护士和神经科学认证注册护士内在和外在价值观的一致程度。为了补充这些研究结果,还需要使用开放式问题进行进一步研究,以加深我们对参与者对 "自主性 "和 "被倾听的程度 "等复杂价值观的反应的理解。
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引用次数: 0
The Prephase Nursing in Levodopa Carbidopa Intestinal Gel Therapy. 左旋多巴肠凝胶治疗的前期护理。
IF 2.3 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1097/JNN.0000000000000671
Pierluigi Lezzi, Roberto Lupo, Tania Lezzi, Elsa Vitale

Abstract: INTRODUCTION: Parkinson disease (PD) affects approximately 1% of women and men worldwide, particularly older than 60 years. It is a multisystem and neurodegenerative disease with genetics and environmental factors that result in deficits in the production of neurotransmitters, including dopamine. The levodopa-carbidopa intestinal gel (LCIG) system delivers a continuous infusion of levodopa directly into the proximal small intestine via percutaneous endoscopic jejunostomy, largely bypassing gastric emptying and absorption problems and producing more stable plasma concentrations of levodopa, eliminating the development of motor complications (dyskinesias). The aim of this review was to summarize scientific evidence on the nursing role that, together with the multidisciplinary team, made the patient's choice in this therapeutic path (pre-LCIG phase). METHODS: A literature review was carried out, conducted on the MEDLINE databases (through PubMed), The Cochrane Library, Google Scholar, and CINAHL (through EBSCO). Relevant articles for the topic were found to identify indexed primary studies that investigated the relationship between the nurse and the patient/caregiver with PD who undertakes treatment with LCIG according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. RESULTS: Nineteen studies were included in the review. The selected studies suggested how the pre-LCIG phase of patient choice and the subsequent education and training could avoid selection errors for these therapeutic paths. CONCLUSION: Trained and specialized nursing staff who carry out an adequate pre-LCIG phase associated to the multidisciplinary team improved the choice of the patient and the start of treatment and, consequently, the quality of life of PD patients.

摘要:简介:帕金森病(PD)影响全球约1%的女性和男性,尤其是60岁以上的老年人。它是一种多系统和神经退行性疾病,遗传和环境因素导致包括多巴胺在内的神经递质产生缺陷。左旋多巴-卡比多巴肠道凝胶(LCIG)系统通过经皮内镜空肠造口术将左旋多巴连续输注直接输送到近端小肠,在很大程度上绕过了胃排空和吸收问题,产生更稳定的左旋多巴血浆浓度,消除了运动并发症(运动障碍)的发生。本综述的目的是总结护理作用的科学证据,与多学科团队一起,使患者选择这种治疗途径(lcig前阶段)。方法:对MEDLINE数据库(通过PubMed)、Cochrane图书馆、Google Scholar和CINAHL(通过EBSCO)进行文献综述。根据系统评价和荟萃分析清单的首选报告项目,发现了与该主题相关的文章,以确定索引的主要研究,调查了护士与接受LCIG治疗的PD患者/护理人员之间的关系。结果:本综述纳入了19项研究。所选的研究表明,lcig前阶段的患者选择和随后的教育和培训如何避免这些治疗途径的选择错误。结论:训练有素和专业的护理人员进行适当的lcig前阶段,并与多学科团队相结合,改善了患者的选择和治疗的开始,从而提高了PD患者的生活质量。
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引用次数: 0
Preferences Toward Attributes of Disease-Modifying Therapies: The Role of Nurses in Multiple Sclerosis Care. 对疾病改善疗法属性的偏好:护士在多发性硬化症护理中的作用。
IF 2.3 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1097/JNN.0000000000000661
Beatriz Del Río-Muñoz, Cristina Azanza-Munarriz, Noelia Becerril-Ríos, Haydee Goicochea-Briceño, Rosalía Horno, Alejandro Lendínez-Mesa, César Sánchez-Franco, Mònica Sarmiento, Guillermo Bueno-Gil, Nicolás Medrano, Jorge Maurino

Abstract: BACKGROUND: Nurses play an essential role in coordinating the care of patients with multiple sclerosis (MS) throughout their disease trajectory in a complex treatment landscape. The aim of this study was to assess nurses' preferences toward different disease-modifying therapy attributes. METHODS: We conducted a multicenter, noninterventional, cross-sectional study in collaboration with the Sociedad Española de Enfermería Neurológica. Nurses actively involved in MS care were invited to participate in the study. Prevention of disability progression, preservation of cognitive function, side effect profile and safety monitoring, and method of administration were the treatment attributes tested. Conjoint analysis was used to assess preferences in 8 simulated treatment options and rank them from most to least preferred. RESULTS: A total of 98 nurses were included in the study. The mean (SD) age was 44.7 (9.8) years, and 91.8% were female with a mean (SD) time of experience in MS care of 7.5 (5.4) years. Participants prioritized preservation of cognition (38.6%), followed by preventing disability progression (35.2%) and side effect risk and safety monitoring (13.5%). Route and frequency of administration were the least preferred attributes (7.4% and 5.3%, respectively). Estimated utilities were consistent across the sample according to sociodemographic and professional practice characteristics. CONCLUSIONS: Nurses' preferences toward treatments were mainly driven by efficacy attributes. This information may support the role of nurses in the multidisciplinary management of MS facilitating shared decision making.

摘要:背景:在复杂的治疗环境中,护士在协调多发性硬化症(MS)患者的整个疾病轨迹中发挥着至关重要的作用。本研究的目的是评估护士对不同疾病改善治疗属性的偏好。方法:我们与Sociedad Española de Enfermería Neurológica合作进行了一项多中心、非介入、横断面研究。积极参与MS护理的护士被邀请参与研究。预防残疾进展、保持认知功能、副作用概况和安全性监测以及给药方法是治疗属性的测试。采用联合分析对8种模拟治疗方案进行偏好评估,并将其从最喜欢到最不喜欢进行排序。结果:共纳入98名护士。平均(SD)年龄为44.7(9.8)岁,91.8%为女性,平均(SD) MS护理经验为7.5(5.4)年。参与者优先考虑的是保持认知(38.6%),其次是预防残疾进展(35.2%)和副作用风险和安全监测(13.5%)。给药途径和给药频率是最不受欢迎的属性(分别为7.4%和5.3%)。根据社会人口学和专业实践特征,整个样本的估计效用是一致的。结论:护士对治疗的偏好主要受疗效属性驱动。这一信息可能支持护士在多发性硬化症多学科管理中的作用,促进共同决策。
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引用次数: 1
Protective Orders: A Discussion on Needs, Necessity, and Liability. 保护令:关于需要、必要性和责任的讨论。
IF 2.3 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1097/JNN.0000000000000664
Emily Rogers, Sarah Peacock, Amanda Tomlinson, Christan Santos
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引用次数: 0
Effect of the Preparatory School FAST Stroke Educational Program. 预备学校FAST中风教育计划的效果。
IF 2.3 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-10-01 DOI: 10.1097/JNN.0000000000000665
Abdul Salam, Ashfaq Shuaib, Saadat Kamran, Iman Hassanin, Nosheen Shahid, Mohammed S Al-Darwish, Rubina Bibi, Maher Saqqur, Numan Amir, Elaine T Miller

Abstract: BACKGROUND: The aim of this study was to assess the effectiveness of FAST stroke educational program among all preparatory school students in the state of Qatar. METHODS: The pretest-posttest experimental research design was used to evaluate the effectiveness of the FAST educational program in Qatar. A 30-minute audiovisual presentation was given to improve knowledge of stroke. We included grade 7 to 9 students during the academic year 2018-2019. The FAST program consisted of a pretest, an educational intervention, and immediate and long-term posttests at 2 months. RESULTS: A sample of 1244 students completed presurvey and immediate postsurvey, with an average age of 13.5 (1.12) years (range, 11-18 years) and 655 (53%) females. Students had significantly ( P < .01) greater knowledge of stroke signs, symptoms, and risk factors at intermediate posttest (5.9 [2.6] and 6.2 [2.4]) and at 2 months posttest (5.6 [2.8] and 5.6 [2.7]) compared with pretest (4.8 [2.6] and 4.9 [2.6], respectively). Students also had a higher self-efficacy to seek assistance, which was sustained from pretest to long-term posttest. CONCLUSION: The FAST program improved stroke knowledge that was retained at 2 months.

摘要:背景:本研究的目的是评估FAST卒中教育计划在卡塔尔所有预科学校学生中的有效性。方法:采用前测后测实验研究设计,对卡塔尔FAST教育项目的有效性进行评价。通过30分钟的视听演示来提高对中风的认识。我们包括了2018-2019学年的7至9年级学生。FAST项目包括前测、教育干预以及2个月时的即时和长期后测。结果:共1244名学生完成了调查前后的即时调查,平均年龄为13.5(1.12)岁(11-18岁),其中女性655名(53%)。与测试前(分别为4.8[2.6]和4.9[2.6])相比,学生在测试中期(5.9[2.6]和6.2[2.4])和测试后2个月(5.6[2.8]和5.6[2.7])对中风体征、症状和危险因素的了解显著(P < 0.01)增加。学生在寻求帮助方面也有较高的自我效能感,这种自我效能感从测试前持续到测试后。结论:FAST项目改善了2个月时脑卒中知识的保留。
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引用次数: 0
Healthcare Professionals' Electroencephalography Competency: A Disconnect Between Self-Assessment and Objective Testing. 医疗保健专业人员的脑电图能力:自我评估与客观测试之间的脱节。
IF 2.3 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-08-01 DOI: 10.1097/JNN.0000000000000653
Elina Linnavuori, Helena Leino-Kilpi, Minna Stolt
ABSTRACT BACKGROUND: The role of the healthcare professional (HCP) in performing high-quality electroencephalography (EEG) is critical to ensuring accurate results. This study analyzes HCPs' subjectively and objectively assessed EEG competence to provide information on their EEG competence and competence needs for the development of their education and training. METHODS: The study was a descriptive cross-sectional study. The target group of the study was HCPs working in the clinical neurophysiology departments of university hospitals in Finland. The research data were collected using the EEG Competence instrument created for this research. The instrument consisted of a self-assessment section and a knowledge test component. RESULTS: The participants (N = 65; response rate, 81%) consisted of 34 registered nurses and 31 laboratory technologists. In the self-assessment section, the highest mean score was in patient observation (mean, 4.6) and the lowest was in EEG theoretical knowledge (mean, 3.9). In the test section, most of the respondents (73.8%) answered all questions correctly (maximum, 6 points). There was a positive correlation between age, work experience, own satisfaction with EEG competence, and subjective self-assessment. Those familiar with EEG guidelines and who participated in training days assessed their competence as significantly better (P < .05). Respondents who read EEG-related literature on their own identified artifacts better (P = .005). CONCLUSIONS: Laboratory technologists' and registered nurses' subjectively and objectively assessed EEG competence was high. In the future, the EEG competence instrument should be developed further, and more research is needed to assess its psychometric properties to provide more information on HCPs' competence in the diagnostic process.
摘要:背景:医疗保健专业人员(HCP)在进行高质量脑电图(EEG)时的作用是确保准确结果的关键。本研究通过对医护人员主客观脑电能力评估的分析,为医护人员的脑电能力和能力需求提供信息,为医护人员的教育培训提供依据。方法:本研究为描述性横断面研究。该研究的目标群体是在芬兰大学医院临床神经生理学部门工作的医护人员。研究数据采集采用为本研究设计的脑电能力仪。该仪器由自我评估部分和知识测试部分组成。结果:受试者(N = 65;应答率为81%),包括34名注册护士和31名实验室技术人员。自评部分,患者观察得分最高(平均4.6分),脑电图理论知识得分最低(平均3.9分)。在测试部分,绝大多数(73.8%)答对了所有问题(最高6分)。年龄、工作经验、自己对脑电图能力的满意度与主观自我评价呈正相关。熟悉脑电图指南和参加过培训日的患者对能力的评价显著提高(P < 0.05)。阅读脑电图相关文献的回答者更好地识别了他们自己的工件(P = .005)。结论:实验室技术人员和注册护士主客观脑电能力评价较高。今后,脑电图能力测试仪还需进一步发展,并对其心理测量特性进行更多的研究,以进一步了解医护人员在诊断过程中的能力。
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引用次数: 1
Nurses Lead the Way for In-Hospital Stroke Care. 护士引领院内中风护理。
IF 2.3 3区 医学 Q4 CLINICAL NEUROLOGY Pub Date : 2022-08-01 DOI: 10.1097/JNN.0000000000000652
Josh Snavely
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引用次数: 0
期刊
Journal of Neuroscience Nursing
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