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Transitions of care for stroke and TIA
ConclusionHospital length of stay, age, insurance status, discharge disposition, comorbidities, and readmission rates were identified as important elements affecting TOC for stroke and TIA. Information from patient surveys indicated that emotional health, follow‐up with care providers, stroke education, and point of contact are important elements during the transition periods after stroke and TIA. Implications for practiceBoth providers and patients should inform the development of a comprehensive TOC program that spans in‐hospital to multiple care settings, including the home, which is essential. The advanced practice...
Source: Journal of the American Academy of Nurse Practitioners - March 4, 2015 Category: Nursing Authors: Helena N. Haynes, Matthew J. Gallek, Kate G. Sheppard, Kendra W. Drake, Leslie S. Ritter Tags: QUALITY IMPROVEMENT Source Type: research

Prime movers: Advanced practice professionals in the role of stroke coordinator
ConclusionFive of 11 facilities independently chose to staff stroke coordinator positions with APPs. Analysis indicated that APPs emerged as boundary spanners across services and disciplines who played an important role in coordinating evidence‐based, facility‐level approaches to AIS care. The presence of APPs was related to engaging in group‐based evaluation of performance data, implementing stroke protocols, monitoring care through data audit, convening interprofessional meetings involving planning activities, and providing direct care. Implications for practiceThe presence of APPs appears to be an influential feat...
Source: Journal of the American Academy of Nurse Practitioners - April 1, 2017 Category: Nursing Authors: Nicholas A. Rattray, Teresa M. Damush, Cherie Luckhurst, Catherine J. Bauer ‐Martinez, Barbara J. Homoya, Edward J. Miech Tags: RESEARCH ‐ QUALITATIVE Source Type: research

Use of direct oral anticoagulants for stroke prevention in elderly patients with nonvalvular atrial fibrillation
ConclusionsDOACs are at least as effective as warfarin for stroke prevention in elderly patients with NVAF. Compared with warfarin, DOACs were associated with reduced risk of intracranial hemorrhage, while some DOACs demonstrated an increase in other bleeding events (e.g., gastrointestinal). The faster onset and offset of action and fewer food and drug interactions of DOACs may be an advantage over warfarin for some patients. Implications for practiceDOACs are an alternative to warfarin with overall equivalent safety and efficacy in elderly patients with NVAF, and may be preferable for some. Stroke risk must always be bala...
Source: Journal of the American Academy of Nurse Practitioners - August 14, 2017 Category: Nursing Authors: Lynn B. Oertel, Annemarie E. Fogerty Tags: REVIEW ‐ SPONSORED Source Type: research

Sensitivity and Specificity of a Nurse Dysphagia Screen in Stroke Patients.
CONCLUSIONS: An easy-to-use, institutionally developed nurse dysphagia screening tool successfully identified patients with swallowing difficulties after stroke later diagnosed by SLP. PMID: 26434033 [PubMed - indexed for MEDLINE]
Source: Medsurg Nursing : Official Journal of the Academy of Medical-Surgical Nurses - November 30, 2015 Category: Nursing Tags: Medsurg Nurs Source Type: research

Nonvitamin K antagonist oral anticoagulants in everyday practice: Stroke prevention in atrial fibrillation and treatment of venous thromboembolism
ConclusionsAll four NOACs are equivalent to or better than warfarin for the treatment of VTE and stroke prevention in AF, and may reduce the risk of bleeding complications, particularly intracranial bleeding. Implications for practiceNOACs may benefit some patients by avoiding the numerous food or drug interactions and frequent laboratory monitoring associated with warfarin. Adherence to proper dosing is critical for NOAC efficacy and safety.
Source: Journal of the American Academy of Nurse Practitioners - December 17, 2015 Category: Nursing Authors: Barbara A. Bentz Tags: REVIEW Source Type: research

Stroke Transitions of Care.
Authors: Ross SY, Roberts S, Taggart H, Patronas C Abstract This quality improvement project focused on improving patient education and patient satisfaction, and reducing all-cause 30-day readmissions. A 72-hour discharge follow-up telephone call was completed in patients discharged home with diagnosis of stroke. PMID: 30304593 [PubMed]
Source: Medsurg Nursing : Official Journal of the Academy of Medical-Surgical Nurses - October 14, 2018 Category: Nursing Tags: Medsurg Nurs Source Type: research

Dabigatran etexilate: An alternative to warfarin for patients with nonvalvular atrial fibrillation
ConclusionsSignificant evidence from the PETRO and RE‐LY trials and postmarketing analyses of dabigatran etexilate indicate that this direct thrombin inhibitor is as efficacious as warfarin in ischemic stroke prevention. In fact, the studies found that patients taking dabigatran etexilate had fewer incidences of ischemic stroke and intracranial hemorrhage than those taking warfarin. Risk for major gastrointestinal bleeding appears to be higher than that for warfarin. Implications for practicePatients taking dabigatran etexilate do not require blood work to assess international normalized ratio (INR) levels. Because this ...
Source: Journal of the American Academy of Nurse Practitioners - July 25, 2014 Category: Nursing Authors: Katie A. Scott, Karen A. Amirehsani Tags: CLINICAL PRACTICE Source Type: research

Hypertrophic cardiomyopathy in adults: An overview
ConclusionsAlthough HCM is the most prevalent genetic disorder affecting the heart, it often goes undiagnosed until midlife after patients show symptoms of myocardial remodeling. Adults with cardiomyopathy suffer SCD or adverse events such as stroke and heart failure from HCM. Early diagnosis will prevent SCD, improve quality of life, and slow patient's progression to heart failure. Implications for practiceEarly recognition of HCM in adults by their primary care providers will improve patients’ quality of life and reduce incidence of SCD, heart failure, and stroke.
Source: Journal of the American Academy of Nurse Practitioners - June 1, 2014 Category: Nursing Authors: Cynthia Jacobs Tags: CE ARTICLE Source Type: research

Cells to Society: Year of the Nurse / Global Impact
This study establishes baseline sociodemographic and clinical characteristics of hospitalized patients in Nepal who were experiencing heart failure.     Read more   Maternal Health ...
Source: Johns Hopkins University and Health Systems Archive - February 6, 2020 Category: Nursing Source Type: news

Delirium Screening of Patients on a Neuroscience Step-Down Unit
Medsurg Nurs. 2021 Nov-Dec;30(6):414-418.ABSTRACTThis project aimed to identify patients who had experienced a stroke and were at risk for delirium earlier, and implement evidence-based protocols to reduce overall length of stay and mortality. Nurses were motivated to perform screening and implement strategies that benefit patients who had experienced acute stroke. Results suggest early identification and treatment of delirium, use of prevention strategies, and treatment of the underlying etiology can improve patient outcomes and reduce cost of care.PMID:36466745 | PMC:PMC9718572
Source: Medsurg Nursing : Official Journal of the Academy of Medical-Surgical Nurses - December 5, 2022 Category: Nursing Authors: Malissa A Mulkey DaiWai M Olson Sarah Misrahi Sonya R Hardin Source Type: research

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