The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses最新文献

Abstract: BACKGROUND: Neuroscience nurses play a pivotal role in identifying nutritional risk factors, monitoring patients, and initiating interventions to optimize recovery outcomes. Patients with moderate to severe acquired brain injury (ABI) are at risk of undernutrition during subacute rehabilitation, yet prevalence is rarely described using recent diagnostic criteria. This study aimed to explore the Global Leadership Initiative on Malnutrition (GLIM) criteria in routinely collected clinical data and to describe undernutrition in patients with ABI at admission and discharge from in-hospital rehabilitation. METHODS: A quantitative descriptive study was conducted using nutritional data extracted from electronic health records stored in a clinical database. The analysis focused on GLIM criteria, including low body mass index (BMI), disease-related inflammation, and the risk of reduced food intake. RESULTS: A total of 2,645 patients were included. A low BMI was observed in 10% of 2,465 patients at admission and in 8% of 2,147 patients at discharge. Inflammation was present in 82% of 912 patients at admission and 71% of 420 at discharge. Reduced intake was noted in 61% of 1,745 patients at admission and 26% of 1,550 at discharge. Many patients did not meet the required combination of phenotypic and etiologic criteria for GLIM-defined malnutrition. CONCLUSION: Potential undernutrition, according to individual GLIM criteria, varied significantly at admission, with "low BMI" showing the lowest prevalence. This may indicate a substantial long-term nutritional risk among patients who appear well-nourished based on BMI. Furthermore, the lack of comprehensive data on individual criteria suggests that routinely collected clinical data may be insufficient for accurately assessing malnutrition.

Introduction: A global aging population seeking resolution of pain and functional decline from degenerative spine conditions is leading to an increasing number of spine surgeries. The recovery process is complex with many cognitive and physical actions performed by the patient, which can be conceptualized as patient work. Shaped by the dynamic patient work system (PWS), patient work is the time and effort patients complete at home and across health settings to meet their health goals. Our aim was to define factors in the PWS that influence the patient work of older adults' recovery during the hospital and posthospitalization phases as well as by discharge location after spine surgery.METHODS: Secondary data analysis (28 interviews) using deductive and inductive qualitative content analysis methods was used to describe PWS influencing factors. The Systems Engineering Initiative for Patient Safety 2.0 human factors framework (person, organization, task, tools and technology, and internal and external environments) guided independent (3 members) coding, codebook evolution, and team deductive analysis. Care phase and discharge location were further analyzed using team inductive analysis.RESULTS: In nearly all components, factor differences were present between discharge to home or skilled nursing facility or inpatient rehabilitation. These differences included pain severity, mobility, unexpected experiences, education not meeting their needs, the level of problem-solving required, and types of benchmarks to their goal of recovery.CONCLUSIONS: Our findings show that regardless of discharge disposition, older adults experience uncertainty and different needs during recovery that often generate invisible work in navigating the recovery process. Participants describe significant work to clarify any uncertainty and meet their recovery needs. Nursing has a pivotal role to further investigate strategies to help patients achieve their recovery goals.

Background: Despite more than 30 years of public health campaigns, critical gaps persist in community stroke symptom recognition and awareness of the importance of calling 9-1-1. Underserved communities experience disproportionately higher risk of stroke and poorer outcomes, and they have lower reported knowledge of stroke symptoms and are less likely to receive acute time-sensitive treatments. This quality improvement initiative outlines a pathway for stroke centers to address these disparities through reproducible and customizable pop-up health awareness events that also fulfill regulatory requirements.

Methods: The nurse leaders of 2 hospital stroke programs serving the same city in California developed a collaborative stroke awareness event at an urban farmers' market in a high-risk, underserved neighborhood. Volunteers conducted a brief intervention in the form of a survey to engage participants and share information.

Results: The event successfully engaged a diverse audience and fostered partnerships at a pop-up offering on one Sunday morning in May. A total of 128 community members participated, and 113 surveys were included in the final analysis. Pre-intervention, 42% of participants confidently recognized stroke symptoms, which increased to 88% postintervention ( P <0.0001). Participants' confidence in recognizing the importance of calling 9-1-1 increased from 22% preintervention to 93% postintervention ( P <0.0001).

Conclusion: An event plan for offering stroke awareness information enabled the facilitating hospitals to effectively share critical health information and gain insights into the communities served. The survey responses suggested significant improvement in stroke awareness within a limited timeframe. The collaborative event also succeeded in fostering relationships across organizations, departments, and between health care and the community.

Abstract: BACKGROUND: Multiple sclerosis (MS) is a neurological disease that manifests differently in men and women, including variations in clinical progression and symptoms. Despite the relevance of these differences, research exploring disparities in sexuality and relationships remains limited. Therefore, this study aimed to identify differences between men and women in alterations in sexual function and relationship adjustment in a Spanish sample of people with MS.METHODS: A descriptive cross-sectional study was conducted involving 208 adults recruited through 13 Spanish MS associations. An electronic form was used to collect sociodemographic and sexuality-related variables. The Multiple Sclerosis Intimacy and Sexuality Questionnaire-15 and the Dyadic Adjustment Scale-13 were also included in the data collection process.RESULTS: Men with MS reported greater concerns about sexually satisfying their partner ( P < 0.001) and more frequent feelings of sexual insecurity ( P = 0.001) than women. Differences in sexual function were also observed in physiological aspects, with erectile dysfunction being more prevalent in men than vaginal lubrication difficulties in women ( P = 0.031). Regarding relationship adjustment, no significant differences were identified ( P = 0.816). However, a significant correlation was found between relationship adjustment and alterations in sexual function in men ( P = 0.038).CONCLUSIONS: The results of this study point to meaningful differences between men and women with MS in how sexual function is experienced, with men reporting greater concerns related to both physiological (erectile dysfunction) and psychological (worries about satisfying their partner and insecurity) difficulties. Regarding relationship adjustment, overall levels were similar between groups; however, poorer sexual function was significantly associated with worse adjustment only among men. These specific differences should be taken into account when addressing sexuality in clinical care, as considering these disparities may contribute to more comprehensive, personalized, and effective interventions for people with MS.

Abstract: BACKGROUND: Before implementing an educational intervention, there is a need to establish baseline knowledge levels such that the outcome of said intervention can be fairly evaluated. Before developing a structured nursing educational intervention, we aimed to assess nursing knowledge, nursing confidence regarding that knowledge, and the accuracy of the knowledge. METHODS: We distributed a 50-item validated neurological assessment test (NAT) questionnaire to 70 nurses working at a teaching hospital in Kenya. There were no personal identifiers collected and the NAT was made available in both electronic and paper formats to facilitate responses. RESULTS: The 64 nurses who returned the questionnaire had median knowledge scores of 22% (14% to 32%); median confidence scores of 61% (37% to 87%); and median accuracy scores of 38% (31.3% to 45.6%). There was a strong association between confidence and knowledge ( r2 =0.66; P <0.0001); and between knowledge and accuracy ( r2 =0.35; P <0.0001); but not between confidence accuracy ( r2 =0.03; P =0.112). CONCLUSION: The NAT questionnaire was useful in assessing baseline confidence levels, knowledge, and accuracy of that knowledge. Nurses in this sample had moderate to high confidence that extended beyond the accuracy of their knowledge base. There is a need for targeted international educational interventions to improve neuroscience nursing knowledge.

Abstract: INTRODUCTION: In pediatric epilepsy monitoring units (EMU), nurses are essential in assessing seizure activity and neurological status. One critical element of neurological evaluation is the pupillary light reflex (PLR), traditionally assessed manually with low interrater reliability. Quantitative pupillometry offers a more accurate and reliable method for evaluating PLR, yet its use in EMUs has not been well described. The objective is to describe the implementation of quantitative pupillometry in a pediatric EMU through a nurse-led initiative. METHODS: A collaborative effort between nursing and physician leadership introduced the NPi-200 pupillometer in a pediatric EMU. Nurses received hands-on training, and a standardized electronic order was developed to integrate the tool into clinical workflows. Accessibility issues were addressed by relocating the device to a central nursing station. RESULTS: Over the pilot period, 40 patients underwent pupillometry assessments, with 88% yielding complete data. No adverse events occurred. Nurses reported the device was easy to use and successfully incorporated it into their routine care, even for children with developmental delay. CONCLUSION: Pupillometry can be effectively and safely implemented in the pediatric EMU setting through a nurse-driven process. This initiative demonstrated high usability, safety, and integration into clinical practice, supporting its broader use for neurological monitoring in epilepsy care.