‘The Lynchpin of the Acute Stroke Service’—An envisioning of the scope and role of the advanced nurse practitioner in stroke care in a qualitative study

Laird, Liz; McCauley, Claire; Ryan, Assumpta; Beattie, Alison

doi:10.1111/jocn.15523

Cited by 6 publications

(8 citation statements)

References 28 publications

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“…Competent nurses’ roles include having up-to-date knowledge about stroke treatments, sharing best practice guidelines, instilling clinical confidence, and demonstrating transformational leadership. The critical point is whether such competent nurses will be able to translate clinical confidence into autonomous clinical decision-making [ 25 ]. Based on this perspective, nursing practice for patients with acute CVA may be improved by increasing the proportion of CNs and CNSs among SCU nurses in the future.…”

Section: Discussionmentioning

confidence: 99%

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Nurses’ Awareness and Actual Nursing Practice Situation of Stroke Care in Acute Stroke Units: A Japanese Cross-Sectional Web-Based Questionnaire Survey

Yukari

Ito

Yasuhara

et al. 2021

IJERPH

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The awareness of care provided by stroke care unit (SCU) nurses in Japan to patients with an acute cerebrovascular accident (CVA) and the characteristic differences in their actual nursing practice were evaluated. A cross-sectional web-based questionnaire survey was administered to 1040 SCU nurses. Data collection and reporting procedures followed the STROBE Statement Checklist for cross-sectional studies. Exploratory factor analysis, using 52 observation items, identified eight factors with a factor loading > 0.4. For all factors, the actual practice was significantly lower than the awareness of the importance of nursing care for patients with acute CVA. Awareness and actual practice of recognition of patients’ physical changes (RPPCs) were high. The actual practice of RPPCs and preventing the worsening of acute stroke and related symptoms varied, depending on years of experience in acute phase stroke care. RPPCs in actual practice had a significantly higher score among certified nurses or certified nurse specialists. Their awareness of the importance of collaborating with therapists was low. On-the-job training can improve nurses’ competence and prevent worsening conditions in patients with CVA. An emphasis on enhancing practice experience toward patients with acute CVA and facilitating the deployment of certified nurses in SCUs can improve nursing care practice.

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Section: Discussionmentioning

confidence: 99%

“…In the United Kingdom, the role of advanced nurse practitioners in acute stroke care has been studied [ 25 ]. The effects of Japan’s 2009 introduction of stroke rehabilitation nursing professional development for certified nurses (CNs) to become “stroke nurses” have not been fully examined [ 26 ].…”

Section: Introductionmentioning

confidence: 99%

Nurses’ Awareness and Actual Nursing Practice Situation of Stroke Care in Acute Stroke Units: A Japanese Cross-Sectional Web-Based Questionnaire Survey

Yukari

Ito

Yasuhara

et al. 2021

IJERPH

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“… 47 This study responds to the advocacy for advanced nursing practice care pathways in the AIS, and explores the relationship between nursing interventions and clinical outcomes. 48 As previously described, not all patients can obtain rehabilitation services in the hospital, even among the patients receiving rehabilitation. The most common therapy is isolated PT for motor dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Rehabilitation Nursing versus Usual Therapist-Led Treatment in Patients with Acute Ischemic Stroke: A Randomized Non-Inferiority Trial

Wang¹,

Zhang²,

Chen³

et al. 2021

CIA

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Purpose To determine the effectiveness of rehabilitation nursing program interventions in patients with acute ischemic stroke. Patients and Methods An assessment-blinded randomized controlled trial was conducted at a tertiary referral hospital in China. Eligible patients were stratified according to their weighted corticospinal tract lesion load and then randomly assigned to an experimental group (n = 121) or a control group (n = 103). The experimental group received rehabilitation nursing from well-trained, qualified nurses (30 minutes per session, two sessions per day for seven consecutive days). The control group received therapist-led rehabilitation with the same timing and frequency. Comparative analysis of the primary outcomes was performed to determine non-inferiority with a predetermined non-inferiority margin. The primary outcomes were the Motor Assessment Scale, Fugl-Meyer Assessment, and the Action Research Arm Test assessed at baseline and after seven days of treatment. The secondary outcomes were the modified Barthel Index, the National Institutes of Health Stroke Scale, and the modified Rankin Scale, evaluated before and after the intervention and at 4 and 12 weeks of follow-up. Results Two hundred participants completed the trial. In both groups, all outcomes improved significantly after seven days and at follow-ups. The rehabilitation nursing program was non-inferior to therapist-led treatment with lower 95% confidence limits beyond the margins for primary outcomes ( P < 0.001). Conclusion Both treatments had comparable effects; however, no definite conclusion could be drawn. Adequately powered studies are required.

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“…ANPs play an integral role across many disciplines of medicine (Denton G, 2021; Laird and McCauley, 2020; Stewart I, 2021). In the field of ophthalmology, ANPs have long been working in outpatients' clinics, managing patients with both acute eye problems and chronic conditions such as glaucoma, age-related macular degeneration, and cataracts (Slight & Marsden, 2009; Stanford P, 2020; Bhatt R, 2007).…”

Section: Discussionmentioning

confidence: 99%

Comparing the outcomes of YAG laser anterior capsulotomies performed by an advanced nurse practitioner to ophthalmologists in the management of anterior capsular contraction syndrome

Moussa

Ch'ng

Kalogeropoulos

et al. 2022

J Am Assoc Nurse Pract

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Background:Anterior capsular contraction syndrome (ACCS) describes the progressive fibrotic phimosis of the anterior capsular bag that usually occurs a few months after cataract surgery. YAG laser anterior capsulotomy (YAGAC) is the most common treatment option due to the low-risk profile of this intervention.Purpose:In this series, we evaluated the outcomes of an advanced nurse practitioner (ANP) in conducting this laser intervention, comparing the results with those of ophthalmologists.Methodology:Our study represents a single-centre, retrospective, continuous case series of 108 eyes that underwent YAGAC due to ACCS between January 2017 and July 2020 at the Birmingham and Midland Eye Centre, the second largest tertiary referral centre in the United Kingdom.Results:The groups treated by ANPs and ophthalmologists were similar in respect to age, gender, and laterality of the laser procedure. Eyes treated by ophthalmologists had significantly more ocular comorbidities (p < .001), the most common of which was glaucoma. Although the complication rate was higher in the ophthalmologist group, it did not reach statistical significance. However, there was a trend toward significance in the retreatment rate, with 8.6% (7/81) of eyes lasered by ophthalmologists requiring further YAGAC, and no repeat procedure was needed in the ANP group.Conclusions:YAGAC leads to good visual outcomes and a low complication rate in both ophthalmologist and ANP groups.Implications:Advanced nurse practitioners can deliver results that are comparable with those of experienced ophthalmologists.

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‘The Lynchpin of the Acute Stroke Service’—An envisioning of the scope and role of the advanced nurse practitioner in stroke care in a qualitative study

Cited by 6 publications

References 28 publications

Nurses’ Awareness and Actual Nursing Practice Situation of Stroke Care in Acute Stroke Units: A Japanese Cross-Sectional Web-Based Questionnaire Survey

Nurses’ Awareness and Actual Nursing Practice Situation of Stroke Care in Acute Stroke Units: A Japanese Cross-Sectional Web-Based Questionnaire Survey

Effectiveness of Rehabilitation Nursing versus Usual Therapist-Led Treatment in Patients with Acute Ischemic Stroke: A Randomized Non-Inferiority Trial

Comparing the outcomes of YAG laser anterior capsulotomies performed by an advanced nurse practitioner to ophthalmologists in the management of anterior capsular contraction syndrome

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