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

Abstract: This quality improvement project demonstrates that nursing leadership with Project Re-Engineered Discharge can effect change in the discharge process and improve patient outcomes.

Abstract: Rehabilitation nurses possess knowledge and skills that are ideally suited to a variety of roles. This article informs rehabilitation nurses about opportunities to work in private case management for medical-legal cases. A brief overview of the process of litigation gives nurses the context in which case management interventions are needed. Case examples illustrate the services that nurses provide to attorneys and their clients that help obtain needed care and aid in progressing litigation to resolution.

Purpose: The model of early rehabilitation for people with burns is still relatively novel in developing countries such as Egypt. The study examined the effect of a nurse-led rehabilitation program on functional outcomes in patients with severe hand burns.

Design: A quasi-experimental design was used in this study.

Methods: The study was completed in the burn unit of a teaching university hospital in Alexandria, Egypt, with a convenience sample of 80 patients with severe hand burns. Participants were consecutively assigned to one of two groups: control ( n = 40), which received only routine hospital care and clinical interventions, or intervention ( n = 40), which received routine hospital care and clinical interventions and a 4-week nurse-led rehabilitation program (health education including audiovisual aids and burn rehabilitation education booklet, social support, and hand rehabilitation exercises). To assess functional outcomes, both groups were given pre- and posttests of the Disabilities of the Arm, Shoulder and Hand outcome and the Hand Motor Function Observational Checklist questionnaires. Descriptive and inferential statistics were conducted.

Results: Functional outcomes were significantly improved in the intervention participants compared to the control participants ( t = 5.710, p < .001). The differences in index scores between the two groups were statistically significant ( p < .001).

Clinical relevance: The study provides information for burn rehabilitation nurses in developing countries to develop and test early interventions that improve functional outcomes in this population.

Conclusions: A 4-week nurse-led program may be a beneficial intervention for improving functional outcomes in adult patients with severe hand burns who are undergoing rehabilitation.

Purpose: Thirty-day readmissions often occur in rehabilitation patients and can happen for many reasons. One of those reasons is when patients do not fully understand how to effectively manage their health after discharge. The purpose of this evidence-based quality improvement project was to determine if implementing the teach-back intervention from the Agency for Healthcare Research and Quality's (AHRQ) Health Literacy Universal Precautions Toolkit would impact 30-day readmission rates among adult rehabilitation patients.

Methods: Data were collected from the electronic health record of rehabilitation patients. The comparative group included all rehabilitation admissions for 8 weeks prior to the intervention. The implementation group was composed of the rehabilitation admissions for 8 weeks post-implementation. All patients were then followed for 30 days postdischarge to capture readmissions.

Results: The total sample size was 79 ( n = 43 in the comparative group, n = 36 in the implementation group). There was a 45% decrease in the mean percentage of the 30-day readmission rate in the implementation group as compared with the comparative group.

Conclusion: Based on the results, using the teach-back intervention from AHRQ's Health Literacy Universal Precautions Toolkit may impact 30-day readmission rates.

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.

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.

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.