Critical care nursing clinics of North America
-
Subarachnoid hemorrhage (SAH) is a catastrophic event that carries a mortality rate of 25% to 50%, with 10% to 15% of patients dying before reaching a hospital. Approximately 30,000 aneurysms rupture each year in the United States. Aneurysmal SAH accounts for 2% to 5% of all new strokes each year. ⋯ As many as 46% of SAH survivors have long-term cognitive impairment, with impact on functional status and quality of life. Modern therapy offers the opportunity to reduce the morbidity of SAH by reducing secondary injury, preventing complications, and reducing the risk of future bleeding events. For most people, an aneurysmal rupture is a life-changing event.
-
Crit Care Nurs Clin North Am · Dec 2009
ReviewTelestroke: state of the science and steps for implementation.
Telemedicine or telehealth has been broadly defined as the use of telecommunications technologies to provide medical information and services. The use of telemedicine in the treatment of stroke-telestroke-has shown great promise in improving patient access to recommended stroke treatments in rural and other underserved areas. This article reviews the literature, discusses the potential impact, and makes recommendations for the use of this technology. It concentrates on the role of nurses, the potential impact, barriers, and promises of telestroke science.
-
Crit Care Nurs Clin North Am · Dec 2009
Postgraduate fellowship education and training for nurses: the NET SMART experience.
The Neurovascular Education and Training in Stroke Management and Acute Reperfusion Therapy (NET SMART) program for advanced practice nursing (APN) offers a first-of-its-kind, academic, postgraduate, fellowship program for APNs that is modeled after physician academic fellowship programs but supported by a flexible Internet-based platform. This article details the rationale, methods, and preliminary results of the NET SMART APN experience, which serves as a unique template for the development of academic postgraduate nursing fellowship programs across a variety of specialty practices.
-
Crit Care Nurs Clin North Am · Dec 2009
Hyperacute ischemic stroke management: reperfusion and evolving therapies.
Management of acute ischemic stroke patients is organized around several priorities aimed at ensuring optimal patient outcomes, the first of which is reperfusion therapy, followed by determination of pathogenic mechanism by provision of a comprehensive workup to determine probable cause of the ischemic stroke or transient ischemic attack, for the purpose of providing appropriate prophylaxis for subsequent events. Provision of secondary prevention measures along with therapies that prevent complications associated with neurologic disability, and evaluation for the most appropriate level of rehabilitation services are the final priorities during acute hospitalization. This article provides an overview of reperfusion therapies and emerging hemodynamic treatments for hyperacute ischemic strokes. Gaps in the scientific evidence that are driving current blood flow augmentation research are identified.
-
Crit Care Nurs Clin North Am · Dec 2009
The neuroscience acute care nurse practitioner: role development, implementation, and improvement.
As the number and opportunities for acute care nurse practitioners (ACNPs) continue to increase, the successful integration of these providers into the health care setting becomes more of a challenge. This article outlines strategies for role development, implementation, and evaluation to optimize the performance of the neuroscience ACNP role. The concepts presented are applicable across all acute-care specialties that use ACNPs.