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Improving Safety and Satisfaction in the Safety Monitoring Unit. 提高安全监察科的安全性和满意度。
Pub Date : 2024-10-01 Epub Date: 2024-06-17 DOI: 10.1097/JNN.0000000000000772
Dani Lynn Welch

Abstract: BACKGROUND: The safety monitoring unit (SMU) is a 4-bed unit designated for patients who require continual observation. Most experience some form of dementia, and agitation and aggression are not uncommon. When deescalation techniques do not work, request for help may be necessary. Referred to as Security Alert: Behavioral Assist (SABA), this system-wide message requires response from designated personnel. An increase in SABA events prompted this quality improvement project. METHODS: A survey sent to all unit staff members identified a need for specialized training on the care and management of SMU patients. Education on dementia care and deescalation techniques was provided by a certified dementia specialist and a psychiatry advanced practice registered nurse. Staff expressed a need for defined SMU admission criteria and the establishment of patient care guidelines. Patient care guidelines were developed. A structured schedule was implemented, and dedicated staff were hired to provide familiarity for patients. RESULTS: A postproject survey indicated a nonsignificant increase in staff satisfaction. Security Alert: Behavioral Assist events in the SMU decreased from an average of 3.6 to 1.75 episodes per month. CONCLUSION: Caring for SMU patients creates unique challenges to staff. Staff confidence and satisfaction were higher after implementing new SABA policies. This project could be replicated on similar units with ongoing leadership support and staff education.

摘要:背景:安全监控病房(SMU)是一个拥有 4 张床位的病房,专为需要持续观察的病人而设。大多数患者都患有某种形式的痴呆症,激动和攻击行为并不少见。当缓和技巧不起作用时,可能需要请求帮助。这一全系统信息被称为 "安全警报:行为协助(SABA)",要求指定人员做出响应。SABA 事件的增加促成了这一质量改进项目。方法:通过对所有病房工作人员进行调查,发现他们需要接受有关 SMU 患者护理和管理的专门培训。一名获得认证的痴呆症专家和一名精神科高级执业注册护士提供了痴呆症护理和降级技巧方面的教育。工作人员表示需要制定明确的 SMU 入院标准和病人护理指南。制定了病人护理指南。实施了结构化的时间表,并聘请了专职人员为患者提供熟悉的服务。结果:项目结束后的调查显示,员工的满意度没有显著提高。安全警报:SMU 的行为协助事件从平均每月 3.6 次减少到 1.75 次。结论:护理 SMU 病人给员工带来了独特的挑战。实施新的 SABA 政策后,员工的信心和满意度都有所提高。在领导层的持续支持和员工教育下,该项目可在类似科室推广。
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引用次数: 0
Impact of Illness Uncertainty on Health-Related Quality of Life in Patients With Unruptured Intracranial Aneurysms After Coil Embolization. 未破裂颅内动脉瘤患者线圈栓塞术后病情不确定性对健康相关生活质量的影响
Pub Date : 2024-10-01 Epub Date: 2024-06-21 DOI: 10.1097/JNN.0000000000000771
JiEun Lee, SukJeong Lee

Abstract: BACKGROUND: This study aimed to identify the impact of illness uncertainty on physical and mental health-related quality of life (HRQoL) in patients with unruptured intracranial aneurysms (UIAs) after coil embolization. METHODS: A cross-sectional study was conducted and HRQoL was evaluated using the Short Form-12 Health Survey Questionnaire, which assesses physical and mental HRQoL. RESULTS: The participants had a mean age of 56.4 years, and among them, 190 (71.2%) were women. Physical and mental HRQoL were negatively correlated with physical symptoms, anxiety, depression, and illness uncertainty. Mental HRQoL was positively correlated with social support. Physical HRQoL was significantly influenced by depression (β = -0.26, P = .004) and was not influenced by illness uncertainty (β = -0.10, P = .101). Mental HRQoL was significantly influenced by anxiety (β = -0.45, P < .001), depression (β = -0.19, P = .003), social support (β = 0.14, P = .004), and illness uncertainty (β = -0.14, P = .005). The finding that illness uncertainty influences HRQoL suggests a basis for interventions aimed at improving mental HRQoL by reducing illness uncertainty in patients with UIAs. CONCLUSION: The physical and mental HRQoL in patients with UIAs after coil embolization is negatively influenced by depression, whereas mental HRQoL is also affected by anxiety, illness uncertainty, and social support. These results may serve as reference data for the design and development of interventions to improve HRQoL in patients with UIAs after coil embolization.

摘要:背景:本研究旨在确定疾病不确定性对线圈栓塞术后未破裂颅内动脉瘤(UIA)患者身心健康相关生活质量(HRQoL)的影响。方法:进行了一项横断面研究,并使用评估身心健康相关生活质量的简表-12 健康调查问卷对其进行了评估。结果:参与者的平均年龄为 56.4 岁,其中 190 人(71.2%)为女性。身体和心理 HRQoL 与身体症状、焦虑、抑郁和疾病不确定性呈负相关。心理 HRQoL 与社会支持呈正相关。身体的 HRQoL 受到抑郁的显著影响(β = -0.26,P = .004),但不受疾病不确定性的影响(β = -0.10,P = .101)。心理 HRQoL 受到焦虑(β = -0.45,P < .001)、抑郁(β = -0.19,P = .003)、社会支持(β = 0.14,P = .004)和疾病不确定性(β = -0.14,P = .005)的明显影响。疾病不确定性会影响患者的 HRQoL,这一发现为旨在通过减少 UIA 患者的疾病不确定性来改善其心理 HRQoL 的干预措施提供了依据。结论:线圈栓塞术后,UIAs 患者的身体和心理 HRQoL 受到抑郁的负面影响,而心理 HRQoL 也受到焦虑、疾病不确定性和社会支持的影响。这些结果可作为设计和开发干预措施的参考数据,以改善线圈栓塞术后 UIA 患者的 HRQoL。
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引用次数: 0
Implementing Advance Care Planning and Care Coordination in the Care for People With Parkinson Disease: A Feasibility Study. 在帕金森病患者护理中实施预先护理规划和护理协调:可行性研究。
Pub Date : 2024-10-01 Epub Date: 2024-08-16 DOI: 10.1097/JNN.0000000000000776
Herma Lennaerts-Kats, Laura Daeter, Anoek Forkink, Renate K Hukema, Bastiaan R Bloem, Kris C P Vissers, Marjan J Meinders, Marieke M Groot

Abstract: BACKGROUND: For people with a moderate stage of Parkinson disease (PD), dedicated care coordination combined with advance care planning (ACP) is highly needed. However, evidence is lacking. The objective of this study was to assess the feasibility and acceptability of the study processes to inform a larger randomized controlled trial, aiming the effectiveness of a combined intervention on ACP and care coordination for people with PD. METHODS: Two nurse practitioners with expertise in PD followed training on a combined intervention on ACP and care coordination. Patients were invited to participate in several sessions for a period of 12 months. Feasibility of the study was surveyed covering sample recruitment, attrition rate, eligibility, intervention delivery, number of ACP sessions, type of intervention administration, and satisfaction with the intervention. RESULTS: In total, 27 patients were invited to participate, and 20 (74%) enrolled into the study, together with 11 family caregivers; 7 patients (35%) dropped out. Most patients were men (n = 20), with a mean age of 73.4 (SD 8.2) years. In total, 71 ACP sessions were held (3.6 sessions per patient on average), of which 41% of the sessions were conducted face-to-face at home, 44% at the hospital, 11% over telephone, and 4% via a videoconference call. Patients perceived the intervention not only as supportive but also as confronting. CONCLUSION: The ACP aspect of the intervention was useful and feasible to stimulate patients to think about their current care situation as well as about future care. Care coordination was less profoundly provided and discussed.

摘要:背景:对于帕金森病(PD)中度患者而言,非常需要专门的护理协调与预先护理计划(ACP)相结合。然而,目前还缺乏相关证据。本研究的目的是评估研究过程的可行性和可接受性,为更大规模的随机对照试验提供依据,旨在研究对帕金森病患者进行预先护理规划和护理协调联合干预的有效性。方法:两名具有帕金森病专业知识的执业护士接受了关于ACP和护理协调联合干预的培训。患者应邀参加了为期 12 个月的多次培训。对研究的可行性进行了调查,包括样本招募、自然减员率、资格、干预实施、ACP疗程次数、干预实施类型以及对干预的满意度。结果:共有 27 名患者应邀参加了研究,其中 20 人(74%)与 11 名家庭护理人员一起加入了研究;7 名患者(35%)退出了研究。大多数患者为男性(n = 20),平均年龄为 73.4 岁(标准差为 8.2)。共进行了 71 次 ACP 治疗(平均每位患者 3.6 次),其中 41% 的治疗在家中面对面进行,44% 在医院进行,11% 通过电话进行,4% 通过视频电话会议进行。患者认为干预不仅是支持性的,也是对抗性的。结论:ACP 方面的干预措施对于激发患者思考其当前的护理状况和未来的护理是有用的,也是可行的。护理协调的提供和讨论不太深入。
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引用次数: 0
Neuroleadership: A Concept Analysis and Implications for Nursing. 神经领导力:概念分析及对护理工作的影响》。
Pub Date : 2024-10-01 Epub Date: 2024-08-22 DOI: 10.1097/JNN.0000000000000779
Ebtsam Aly Abou Hashish

Abstract: BACKGROUND: Neuroleadership in nursing is a specialized leadership approach that integrates insights from social neuroscience with nursing leadership practices, aiming to proficiently lead healthcare teams to enhance patient care, staff productivity, and organizational outcomes. Yet, the exploration of neuroleadership in nursing remains limited. AIM: The aim of this study was to provide an analysis of the concept of neuroleadership and its implications in the nursing context. METHODS: Walker and Avant's 8-step methodology was used for this concept analysis, including identifying the concept, clarifying the purpose of the analysis, exploring the uses of the concept, and defining its attributes, model and contrary cases, antecedents and consequences, and its empirical referents. A comprehensive search included PubMed, CINAHL, and ERIC, between 2000 and 2023. RESULTS: This concept analysis significantly contributes to the literature by providing a comprehensive overview of neuroleadership as a distinct form of nursing leadership. It covers key aspects such as definition, attributes, uses, cases, antecedents, consequences, and empirical evidence, and highlights the importance of specialized education, practical experience, and leadership attributes in this domain. The findings could serve as determinants for establishing a neuroleadership framework and developing a structured questionnaire to measure neuroleadership among nurses and nurse leaders, thereby addressing existing empirical reference gaps. CONCLUSION: Nurse leaders adopting a neuroleadership approach can gain insights into how cognitive processes shape nurses' behaviors and motivation, which directly impact patient outcomes and care quality. Further research is needed to assess the practical impact of neuroleadership and validate its factors and model case in clinical nursing practice.

摘要:背景:护理中的神经领导是一种专门的领导方法,它将社会神经科学的见解与护理领导实践相结合,旨在熟练地领导医疗团队,以提高患者护理水平、员工工作效率和组织成果。然而,对护理神经领导力的探索仍然有限。目的:本研究旨在分析神经领导力的概念及其对护理工作的影响。方法:本概念分析采用 Walker 和 Avant 的 8 步方法,包括确定概念、明确分析目的、探索概念的用途,以及定义其属性、模式和相反案例、前因和后果及其经验参考。在 2000 年至 2023 年期间,对 PubMed、CINAHL 和 ERIC 进行了全面检索。结果:本概念分析全面概述了作为护理领导力独特形式的神经领导力,对文献做出了重要贡献。它涵盖了定义、属性、用途、案例、前因、后果和实证等关键方面,并强调了专业教育、实践经验和领导特质在这一领域的重要性。研究结果可作为建立神经领导力框架和开发结构化问卷的决定因素,以衡量护士和护士领导者的神经领导力,从而解决现有的实证参考差距。结论:采用神经领导方法的护士领导者可以深入了解认知过程是如何塑造护士的行为和动机的,而这直接影响到患者的治疗效果和护理质量。还需要进一步的研究来评估神经领导力的实际影响,并在临床护理实践中验证其因素和模型案例。
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引用次数: 0
Letter to the Editor: Digital Badging Is Dissemination Beyond the Edge of the Page. 数字徽章是超越页面边缘的传播。
Pub Date : 2024-10-01 Epub Date: 2024-07-05 DOI: 10.1097/JNN.0000000000000777
Samantha Orr
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引用次数: 0
Letter to the Editor: Evaluating RÁPIDO as a Spanish Stroke Awareness Mnemonic. 致编辑的信:评估 RÁPIDO 作为西班牙语卒中认知记忆法的效果。
Pub Date : 2024-10-01 Epub Date: 2024-08-06 DOI: 10.1097/JNN.0000000000000781
Fnu Alfandy, Nicole Burnham, Cynthia Jovanov
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引用次数: 0
Assessing Delirium in Patients With Neurological Diseases. 评估神经系统疾病患者的谵妄。
Pub Date : 2024-10-01 Epub Date: 2024-08-22 DOI: 10.1097/JNN.0000000000000773
Maja Gjerløv Nisgaard, Signe Vestergaard Boesen, Janet Jensen

Abstract: BACKGROUND: Delirium is a common complication during hospitalization. Its consequences are severe, including reduced function, delayed rehabilitation, dementia, institutionalization, and death. Assessing delirium in neurological patients can be challenging due to the impact of neurological deficits. Therefore, the aim was to investigate the agreement between 2 delirium screening tools, factors associated with delirium, and assessing delirium in neurological patients. METHODS: This prospective observational study was conducted in 2 neurological units, using daily delirium screening. Intensive Care Delirium Screening Checklist and 2 versions of the Confusion Assessment Method were used to asses delirium in adult patients without baseline dementia, alcohol/drug detoxification, or palliative care. Descriptive analyses determined the number of delirium scores, and the analytical analyses were logistic regressions and a κ coefficient. RESULTS: The agreement between the screening tools was found to be substantial (κ = 0.71). Logistic regression analysis showed that the risk factors for a positive delirium screening were home care before admission (Confusion Assessment Method: odds ratio [OR], 4.21 [95% confidence interval (CI), 1.67-10.63]; Intensive Care Delirium Screening Checklist: OR, 6.14 [95% CI, 2.85-13.23]) and aphasia/dysarthria (Confusion Assessment Method: OR, 4.9 [95% CI, 1.32-6.81]; Intensive Care Delirium Screening Checklist: OR, 2.76 [95% CI, 1.3-5.87]). In total, 18.7% (n = 20/107) of the screening scores were positive. Specifically, the Confusion Assessment Method showed positive scores for 13.0% (n = 14/107) of participants, whereas the Intensive Care Delirium Screening Checklist showed positive scores for 16.8% (n = 18/107). CONCLUSION: The screening tools had a substantial degree of agreement. Therefore, nurses can use both screening tools to detect delirium in patients with neurological disorders. However, care should be taken in patients with aphasia to avoid misclassification with the Brief-Confusion Assessment Method. Moreover, special attention should be directed toward patients with language difficulties such as aphasia/dysarthria and those who received home care services before admission. These areas warrant further investigation in clinical practice and future studies.

摘要:背景:谵妄是住院期间常见的并发症。其后果十分严重,包括功能减退、康复延迟、痴呆、入院治疗和死亡。由于神经功能缺损的影响,对神经系统患者的谵妄进行评估具有挑战性。因此,本文旨在研究两种谵妄筛查工具之间的一致性、与谵妄相关的因素以及对神经科患者谵妄的评估。方法:这项前瞻性观察研究在两个神经科病房进行,采用每日谵妄筛查。使用重症监护谵妄筛查核对表和两种版本的意识模糊评估方法,对无痴呆症基线、无酒精/药物戒毒或无姑息治疗的成年患者进行谵妄评估。描述性分析确定了谵妄评分的数量,分析采用了逻辑回归和κ系数。结果:筛查工具之间的一致性很好(κ = 0.71)。逻辑回归分析表明,谵妄筛查阳性的风险因素是入院前的家庭护理(意识模糊评估法:几率比[OR],4.21[95% 置信区间(CI),1.67-10.63];重症监护谵妄筛查清单:OR,6.14[95% 置信区间(CI),1.67-10.63]):OR,6.14 [95% CI,2.85-13.23])和失语/构音障碍(混淆评估法:OR,4.9 [95% CI,1.32-6.81];重症监护谵妄筛查核对表:OR,2.76 [95% CI,1.3-5.87])。总共有 18.7% (n = 20/107)的筛查得分呈阳性。具体来说,13.0%(n = 14/107)的参与者在 "意识模糊评估方法 "中获得了阳性分数,而 16.8%(n = 18/107)的参与者在 "重症监护谵妄筛查核对表 "中获得了阳性分数。结论:两种筛查工具在很大程度上是一致的。因此,护士可以使用这两种筛查工具来检测神经系统疾病患者的谵妄。不过,对于失语症患者,应注意避免使用 "简易融合评估法 "进行错误分类。此外,还应特别注意有语言障碍(如失语/构音障碍)的患者和入院前接受过家庭护理服务的患者。这些方面值得在临床实践和未来研究中进一步探讨。
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引用次数: 0
Anxiety Symptoms and Disease Severity in Parkinson Disease. 帕金森病患者的焦虑症状与疾病严重程度
Pub Date : 2024-10-01 Epub Date: 2024-07-01 DOI: 10.1097/JNN.0000000000000770
Ainslie Whitmarsh, Suzy Protea, Jessie S Gibson

Abstract: BACKGROUND: Anxiety is prevalent in Parkinson disease (PD), negatively affecting quality of life for patients and their families. Targeted anxiety interventions are needed that account for variables such as disease severity; however, there is insufficient evidence regarding the trajectory of anxiety along the disease course. OBJECTIVE: The aim of this study was to investigate the association between disease severity and anxiety symptoms in a PD sample. METHODS: This descriptive study used secondary data analyses of data from a web-based survey study of individuals with PD in the United States. Participants were 21 years or older, had access to the Internet, and were given a diagnosis of PD (N = 72). We performed multiple regression analyses to assess the relationship between patient-reported disease severity and anxiety symptoms. RESULTS: There was a statistically significant association between disease severity and anxiety symptoms in people with PD, after controlling for all 5 explanatory variables (sex, age, wearing off, disease severity, and disease duration) ( P < .001). Age and wearing off PD medication also had statistically significant, although smaller, effects on anxiety symptoms ( P < .05). CONCLUSION: Disease severity was related to increased anxiety symptoms among individuals with PD. Anxiety intervention research is needed, and future studies should account for variations in disease severity and medication effects in both intervention and study design.

摘要:背景:焦虑症在帕金森病(PD)中十分普遍,对患者及其家人的生活质量造成了负面影响。需要考虑到疾病严重程度等变量,采取有针对性的焦虑干预措施;然而,关于焦虑在疾病过程中的轨迹,目前还没有足够的证据。目的:本研究旨在调查帕金森病样本中疾病严重程度与焦虑症状之间的关联。方法:这一描述性研究使用了二手数据分析,这些数据来自一项针对美国帕金森病患者的网络调查研究。参与者年龄在 21 岁或以上,可以上网,并被诊断为帕金森病(N = 72)。我们进行了多元回归分析,以评估患者报告的疾病严重程度与焦虑症状之间的关系。结果:在控制了所有 5 个解释变量(性别、年龄、服药时间、疾病严重程度和病程)后,帕金森病患者的疾病严重程度与焦虑症状之间存在统计学意义上的显著关联(P < .001)。年龄和停用帕金森病药物对焦虑症状的影响也有统计学意义,但影响较小(P < .05)。结论:疾病严重程度与帕金森病患者焦虑症状的增加有关。需要进行焦虑干预研究,未来的研究应在干预和研究设计中考虑疾病严重程度和药物效果的变化。
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引用次数: 0
Management of Idiopathic Intracranial Hypertension: A Case Report. 特发性颅内高压的治疗:病例报告。
Pub Date : 2024-10-01 Epub Date: 2024-06-17 DOI: 10.1097/JNN.0000000000000774
Xiang-Ling Huang, Pao-Hui Tseng, Wan-Hsiang Wang, Sheng-Tzung Tsai

Abstract: BACKGROUND: Idiopathic intracranial hypertension (IIH) is a neurological disorder characterized by elevated intracranial pressure, affecting predominantly obese women of childbearing age. Early recognition and comprehensive management are vital for preventing severe complications, particularly vision loss. METHODS: This study reports a case of a 27-year-old woman who presented with chronic headaches and blurred vision. Notable findings included headaches that were intensified upon waking and exacerbated by activities that elevated intracranial pressure. The patient also reported nausea, vomiting, transient visual obscurations, and pulsatile tinnitus. After a clinical examination, she was given a diagnosis of IIH. RESULTS: The patient underwent a lumbar-peritoneal shunt procedure to alleviate her symptoms in conjunction with medication treatment. This case study highlights the importance of a multidisciplinary approach in diagnosing and treating IIH. In particular, weight management emerged as a crucial preventive measure against IIH recurrence. CONCLUSION: A multidisciplinary team strategy can enhance outcomes and quality of life, accentuating the need for continued research into IIH recurrence, treatments, and wider implications.

摘要:背景:特发性颅内高压(IIH)是一种以颅内压升高为特征的神经系统疾病,主要影响育龄期肥胖妇女。早期识别和综合治疗对于预防严重并发症,尤其是视力丧失至关重要。方法:本研究报告了一例 27 岁女性的病例,她曾出现慢性头痛和视力模糊。值得注意的是,患者的头痛在起床后加剧,并在颅内压升高的活动中加剧。患者还报告了恶心、呕吐、一过性视物模糊和搏动性耳鸣。经过临床检查,她被诊断为 IIH。结果:患者在接受药物治疗的同时,还接受了腰腹分流术,缓解了症状。本病例研究强调了多学科方法在诊断和治疗 IIH 中的重要性。尤其是体重管理是预防 IIH 复发的关键措施。结论:多学科团队策略可提高治疗效果和生活质量,因此有必要继续研究 IIH 复发、治疗方法和更广泛的影响。
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引用次数: 0
A Multidisciplinary Approach to Increase Dysphagia Compliance in Stroke Patients. 提高中风患者吞咽困难顺应性的多学科方法。
Pub Date : 2024-10-01 Epub Date: 2024-07-05 DOI: 10.1097/JNN.0000000000000778
Stacy L Serber, Noah Wachtel, Madison Fox, Corrine Petrushonis

Abstract: BACKGROUND: The objective was to optimize conditions that increase dysphagia compliance after stroke-a measure recognized by The Joint Commission in designating institutions as primary or comprehensive stroke centers and by the American Heart Association that promotes stroke treatment adherence and bestows achievement and quality awards. Failure to meet stroke measures, including medication documentation, may produce poor patient outcomes that directly affect consumer confidence and choice of treatment facility. Stroke patient care requires multidisciplinary team collaboration to manage multiple factors; variations in practice create fallouts that need correction, the absence of which jeopardizes standards for maintaining stroke center designation. PURPOSE: Aims were to determine the nature of dysphagia fallouts in our quaternary academic teaching hospital, assess multidisciplinary workflows and barriers to success, and develop strategies to enhance dysphagia compliance. DESCRIPTION: We used a multidisciplinary approach using James Reason's Swiss cheese model to examine compliance. The clinical nurse specialist interviewed physicians, advanced practice providers, pharmacists, speech-language pathologists (SLPs), nurses, and informaticists to ascertain discipline-specific success barriers, targeting top issues for each discipline to develop solutions. Unit educators unified their dysphagia reduction strategies; physicians, pharmacists, and informaticists collaborated to clarify standardized medication route orders and to increase electronic health record swallow screen visibility to multidisciplinary users; and SLPs adjusted workflow and documentation. EVALUATION: Outcomes included reinforcing correct nursing charting, pharmacy oral-to-feeding tube conversion order revision, optimization of delivery and awareness of medication routes, electronic health record system enhancements, and SLPs aligning documentation with nursing medication administration. The multidisciplinary approach proved successful and increased dysphagia compliance by 9.6% ( P = .001). These outcomes contributed to a successful The Joint Commission survey, redesignation as a comprehensive stroke center, and American Heart Association Gold Plus achievement award.

摘要:背景:目的是优化提高中风后吞咽困难依从性的条件--这是联合委员会在指定机构为初级或综合中风中心时以及美国心脏协会在促进中风治疗依从性和授予成就与质量奖时所认可的一项措施。不遵守包括用药记录在内的卒中治疗措施可能会导致不良的患者预后,直接影响消费者的信心和对治疗机构的选择。脑卒中患者的治疗需要多学科团队的合作,以管理多种因素;实践中的差异会造成需要纠正的问题,而不纠正则会危及维持脑卒中中心称号的标准。目的:旨在确定我们四级学术教学医院中吞咽困难脱落的性质,评估多学科工作流程和成功的障碍,并制定提高吞咽困难依从性的策略。说明:我们使用詹姆斯-里森的瑞士奶酪模型,采用多学科方法来检查依从性。临床护理专家采访了医生、高级医疗服务提供者、药剂师、言语病理学家 (SLP)、护士和信息学家,以确定各学科的成功障碍,并针对各学科的首要问题制定解决方案。科室教育者统一了吞咽困难减少策略;医生、药剂师和信息学家通力合作,明确了标准化用药路径指令,并提高了电子健康记录吞咽屏幕对多学科用户的可见性;言语语言病理学家调整了工作流程和文档。评估:成果包括加强正确的护理图表制作、药房口服管到喂食管转换单的修订、优化给药和了解用药路径、增强电子健康记录系统,以及 SLPs 调整文档与护理用药管理。事实证明,多学科方法取得了成功,吞咽困难患者的依从性提高了9.6%(P = .001)。这些成果促成了联合委员会调查的成功、综合中风中心的重新认定以及美国心脏协会金牌成就奖的获得。
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引用次数: 0
期刊
The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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