Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses最新文献

Purpose: The purpose of this study was to explore the process, benefits, and challenges of patient-centered Trio rounding in acute inpatient rehabilitation from the perspectives of nurses and physicians.

Design: A descriptive qualitative design was used in this study.

Methods: Focus group interviews (FGIs) involving 27 nurses and physicians were thematically analyzed using Dedoose. A descriptive survey of rounding practices was conducted.

Findings: Five primary themes were identified: (1) interprofessional team collaboration; (2) patient safety and quality of care; (3) communication, education, and patient/family partnering; (4) synchronicity of workflow; and (5) participants' recommendation to develop rehabilitation Trio rounding standard process. Themes were consistent with Picker's patient-centered care principles. Findings from a survey on current rounding practice done prior to the FGI reinforced participants' discussion on challenges in conducting patient-centered Trio rounding.

Conclusions: Trio rounding in acute inpatient rehabilitation is a complex process challenged by asynchronous workflow and patients' therapy schedules. Nurses and physicians reported benefits outweighed challenges for Trio rounding in acute rehabilitation.

Clinical relevance: The study provided valuable recommendations to develop acute inpatient rehabilitation Trio rounding standard process.

Purpose: The purpose of this study was to characterize the unmet needs and concerns of working-age caregivers of stroke survivors and to explore the relationships between these unmet needs and concerns and factors such as stroke survivor functional independence, caregiver strain, caregiver self-efficacy, caregiver perceived social support, and caregiver quality of life (QoL).

Design: Cross-sectional descriptive design was used in this study.

Methods: Participants ( N = 103) completed an online survey. Descriptive statistics, bivariate Pearson correlation, and linear regression analysis was performed.

Results: Negative correlations were found between caregiver needs and concerns and both stroke survivor functional independence and caregiver self-efficacy. Positive correlations were identified between caregiver needs and concerns and caregiver strain. In multiple regression models, stroke survivor functional independence, caregiver self-efficacy, race, and gender were statistically significantly associated with caregiver QoL.

Clinical relevance to the practice of rehabilitation nursing: Results of this study can inform nurses as they collaborate with informal caregivers and researchers in optimizing the rehabilitation and discharge process and aiding in the support of caregiver QoL.

Conclusion: Working-age caregivers of stroke survivors expressed many needs and concerns. These needs, along with other factors, can affect outcomes including QoL in caregivers and stroke survivors.

Abstract: It began with a challenge from our Chief Nursing Officer. As a Magnet hospital, it was time for our nurse residency program to be recognized as an accredited program for new graduate nurses. This article shares our experience using the Association of Rehabilitation Nurses competency statements in a creative way when applying for recognition as the first American Nurses Credentialing Center-accredited specialty hospital nurse residency program. Although these competency statements were used initially to meet the requirements of the accreditation application process, they also led to the creation of a document that serves two purposes. First, it can be used to instruct new graduate nurses on the structure and processes of a nurse residency program in which competency statements are used to guide curriculum development. Second, it can be used to inform nurse residency program managers on new graduate nurses' progress throughout the nurse residency program by tracking competency completion. The end result of this accredited program is a new graduate nurse who understands not only what it means to be a nurse but also what it means to be a rehabilitation specialty nurse.

Purpose: Cognitive impairment is a common complication in persons with multiple sclerosis (MS). Using a mobile application has been shown to improve patient's awareness of cognitive symptoms. The purpose of this quality improvement project was to improve awareness of cognitive symptoms in adult patients with MS using a mobile application.

Design: A pre/post-implementation quality improvement design was used.

Methods: Patients were instructed to download the application MS Care Connect. Patients completed a pre/post-questionnaire regarding their awareness of cognitive symptoms and if they were likely to discuss symptoms with providers. They were instructed to use the application to rate the severity of their cognitive symptoms at least weekly.

Results: Thirty-two patients completed both pre- and post-implementation questionnaires. No significant change in awareness of cognitive symptoms was found; however, patients were more likely to discuss cognitive changes with their healthcare team. In the 18 patients who used the application, a total of 60 cognitive symptom ratings were reported.

Clinical relevance to the practice of rehabilitation nursing: Nurses may recommend use of a mobile application for patients to track their cognitive symptoms; however, further research is needed.

Conclusion: This project showed that adding a mobile application did not change awareness of patients' cognitive symptoms.

Purpose: The aim of this study was to explore the perceived meaning of traumatic brain injury (TBI) over the first-year postinjury among older adults and to explore if and how meaning changes.

Design: A longitudinal multiple-case study design was used.

Methods: Semistructured face-to-face interviews were completed at 1 week and 1, 3, 6, and 12 months postinjury. Transcripts were analyzed using inductive thematic analysis.

Results: Fifty-five interviews were conducted with 12 participants. Four themes were identified: gratitude, vulnerability and dependence, slowing down and being more careful, and a chance for reflecting on life. Most participants' perceptions of their TBI remained either consistently positive or negative over the first-year postinjury.

Clinical relevance: Nurses should elicit and support patients' positive illness perceptions regarding their brain injury, which can contribute to a higher quality of life. For those patients with negative illness perceptions, nurses should provide resources in order to support coping and resilience following brain injury.

Conclusions: This study is the first study to explore individual perceptions over time of the meaning made from experiencing TBI among older adults. Findings can serve as a foundation for tailored supportive interventions among older adults following TBI to maximize quality of life.

Purpose: The aim of this study was to develop and pilot an educational curriculum for healthcare providers to better understand community-acquired pressure injury (CAPrI) prevention in veterans living with spinal cord injury (SCI).

Methods: The Thomas six-step process model guided curricular development and evaluation. Curriculum development followed six steps: (1) problem identification and general needs assessment from a literature review and qualitative research triangulating provider and veteran perspectives of CAPrI prevention in SCI, (2) target needs assessment using a focus group with 14 experienced practicing interprofessional SCI providers, (3) creation of module goals and objectives with content review from experts ( n = 8), (4) development of curriculum content and educational strategies, (5) implementation of a pilot ( n = 4), and (6) evaluation of satisfaction and curriculum content via survey and focus group.

Results: A five-module online curriculum was evaluated positively and is available publicly. Modules include (1) CAPrI Prevention Clinical Guidelines for the Provider, (2) CAPrI Prevention from the Veteran Perspective, (3) Building Collaborative Relationships, (4) Accessing Resources, and (5) Team Approach. Pilot participants stated objectives were met; they were satisfied with the module. The participants did recommend some changes.

Clinical relevance: Understanding CAPrI prevention can inform rehabilitation nursing care.

Conclusions: An asynchronous educational curriculum can support nurses in integrating preventive care in community-dwelling veterans living with SCI.