1
|
Fujita T, Iwaki M, Hatono Y. The role of nurses for patients with Parkinson's disease at home: a scoping review. BMC Nurs 2024; 23:318. [PMID: 38730392 PMCID: PMC11088224 DOI: 10.1186/s12912-024-01931-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 04/10/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Parkinson's disease is a neurodegenerative disease, and many patients are cared for at home by nurses. Parkinson's disease nurse specialists have been certified in several countries. This study aimed to provide an overview of what is known about the role of nurses in the care of patients with Parkinson's disease at home and to determine the differences between nurses and Parkinson's disease nurse specialists. METHODS A scoping review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines. PubMed, Scopus, Web of Science, and Cumulative Index to Nursing and Allied Health Literature were searched (keywords: Parkinson's disease AND nurse AND [community OR home]) for studies published in English up to September 2023 describing the nurse's role in caring for patients with Parkinson's disease at home. Studies without abstracts were removed, along with protocols, systematic reviews, and studies concerned with other diseases or including data that were difficult to distinguish from those of other diseases. Roles were described and organized by category. RESULTS A total of 26 studies were included. The nurses' roles were categorized as overall assessment and support, treatment management, safety assessment regarding falls, care for non-motor symptoms, palliative care, support for caregivers, education for care home staff, multidisciplinary collaboration, and provision of information on social resources. Medication management and education of care home staff were identified as roles of nurse specialists. CONCLUSIONS This study revealed the role of nurses caring for patients with Parkinson's disease at home. Because of the complexity of the patients' medication regimens, nurse specialists provide assistance, especially with medication management and the provision of education to care staff. This study will facilitate the preparation of nurses to acquire the knowledge and skills necessary to help patients with Parkinson's disease, even in countries where Parkinson's disease nurse specialists are not officially certified, and will help patients feel comfortable with the care they receive.
Collapse
Affiliation(s)
- Takako Fujita
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan.
| | - Miho Iwaki
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| | - Yoko Hatono
- Department of Health Sciences, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, 812-8582, Fukuoka, Japan
| |
Collapse
|
2
|
Collett J, Lawrie S, Bromley S, Harling P, Reed A, Brusco N, Coe S, Coebergh J, Carroll C, Roberts HC, Hu MT, Dawes H. A programme evaluation of 'First Steps': A peer-conceived, developed and led self-management intervention for people after a Parkinson's diagnosis. Clin Rehabil 2024; 38:403-413. [PMID: 37941369 PMCID: PMC10829422 DOI: 10.1177/02692155231210969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 10/13/2023] [Indexed: 11/10/2023]
Abstract
OBJECTIVE A diagnosis of Parkinson's often leads to uncertainty about the future and loss of perceived control. Peer support may offer a means to address these concerns and promote self-management. DESIGN A programme evaluation of the feasibility and potential effects of 'First Steps', utilising a pragmatic step wedge approach. Comparing First Steps (intervention) to (control) conditions.Setting: In the community at four sites in southern England.Participants: Newly diagnosed (≤ 12months) people with Parkinson's.Intervention: First Steps was a 2-day peer-conceived, developed and led intervention to support self-management.Main measures: At 0, 12 and 24 weeks anxiety and depression (Hospital, Anxiety and Depression Scale, HADS), daily functioning (World Health Organisation Disability Assessment Schedule, WHODAS), physical activity, quality of life (EQ5D), carer strain and service utilisation were assessed. RESULTS Between February 2018 and July 2019, 36 participants were enrolled into intervention and 21 to control conditions, all were included in statistical analysis. Lost to follow up was n = 1 (intervention) and n = 1 adverse event was reported (control, unrelated). Of the 36 allocated to the intervention n = 22 participants completed both days of First Steps during the study period. Completion of outcome measures was >95% at 24 weeks. Small effects favouring the intervention were found for HADS (odds ratio (OR) = 2.06, 95% confidence interval (CI) 0.24:17.84), Carer Strain Index (OR = 2.22, 95% CI 0.5:9.76) and vigorous (d = 0.42, 95% CI -0.12:0.97) and total physical activity (d = 0.41, 95% CI -0.13:0.95). EQ5D, WHOSDAS and service utilisation, was similar between groups. CONCLUSIONS First Steps was feasible and safe and we found potential to benefit physical activity, mental health and carer strain. Further research with longer-term follow up is warranted.
Collapse
Affiliation(s)
- Johnny Collett
- Centre for Movement, Occupational and Rehabilitation Sciences, OxINMAHR Oxford Brookes University, Oxfordshire, UK
| | - Sophie Lawrie
- Centre for Movement, Occupational and Rehabilitation Sciences, OxINMAHR Oxford Brookes University, Oxfordshire, UK
| | | | | | - Alex Reed
- European Parkinson's Therapy Centre, Brescia, Italy
| | - Natasha Brusco
- School of Primary and Allied Health Care, Rehabilitation, Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, Australia
| | - Shelly Coe
- Centre for Movement, Occupational and Rehabilitation Sciences, OxINMAHR Oxford Brookes University, Oxfordshire, UK
- Centre for Nutrition and Health, OxINMAHR Oxford Brookes University, Oxfordshire, UK
| | - Jan Coebergh
- Department of Neurology, St George's University Hospitals NHS Foundation Trust, London, UK
- Department of Neurology, Ashford St Peter's NHS Foundation Trust, Chertsey, UK
| | - Camille Carroll
- Translational and Clinical Research Institute, Newcastle University, Newcastle, UK
| | - Helen C Roberts
- Academic Geriatric Medicine, Faculty of Medicine, University of Southampton, Hampshire, UK
| | - Michele T Hu
- Oxford Parkinson's Disease Centre, Division of Neurology, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxfordshire, UK
| | - Helen Dawes
- NIHR Exeter BRC, Medical School, University of Exeter, Devon, UK
| |
Collapse
|
3
|
Copeland S, Anderson T, Carter G, Brown Wilson C, Stark P, Doumas M, Rodger M, O'Shea E, Creighton L, Craig S, McMahon J, Gillis A, Crooks S, Mitchell G. Experiences of People Living with Parkinson's Disease in Care Homes: A Qualitative Systematic Review. NURSING REPORTS 2024; 14:428-443. [PMID: 38391078 PMCID: PMC10885076 DOI: 10.3390/nursrep14010033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Revised: 02/08/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND Incidence of disability secondary to Parkinson's disease is increasing faster globally than any other neurological condition. The diverse appearance of symptomatology associated with Parkinson's, and the degenerative nature and subsequent functional decline, often increase dependence on caregivers for assistance with daily living, most commonly within a care home setting. Yet, primary literature and evidence synthesis surrounding these unique and complex care needs, challenges and the lived experiences of this population living in long-term nursing or residential facilities remains sparce. The aim of this review is to synthesize qualitative literature about the lived experience of people with Parkinson's disease living in care home settings. METHODS A systematic search of the literature was conducted in October 2023 across six different databases (CINAHL, Medline, EMBASE, PsycINFO, Scopus and Cochrane Library). The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) was used to guide this review. RESULTS Five articles met the inclusion criteria. Four themes were identified following evidence synthesis: (1) Unique pharmacological challenges. (2) Transitioning and adapting to care home life and routines. (3) Dignified care within care homes. (4) Multidisciplinary care vacuum in care homes. CONCLUSION This review revealed the significant and unique challenges for people with Parkinson's disease when transitioning into care homes. These are exacerbated by wider social care challenges such as staffing levels, skill mixes and attitudes as well as a lack of disease-specific knowledge surrounding symptomatology and pharmacology. The lack of multi-disciplinary working and risk-adverse practice inhibited person-centred care and autonomy and reduced the quality of life of people living with Parkinson's disease in care homes. Recommendations for practice highlight training gaps, the need for consistent and improved interdisciplinary working and better person-centred assessment and care delivery.
Collapse
Affiliation(s)
- Shannon Copeland
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Tara Anderson
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Gillian Carter
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | | | - Patrick Stark
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Mihalis Doumas
- School of Psychology, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Matthew Rodger
- School of Psychology, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Emma O'Shea
- Centre for Gerontology and Rehabilitation, School of Medicine, University College Cork, T12 YN60 Cork, Ireland
| | - Laura Creighton
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Stephanie Craig
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - James McMahon
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Arnelle Gillis
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Sophie Crooks
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| | - Gary Mitchell
- School of Nursing and Midwifery, Queen's University Belfast, Belfast BT9 7BL, UK
| |
Collapse
|
4
|
Ellis DM, Dowdell EB, Romero de Slavy J, Hummel LL, Kropkowski LR, Vernon GM, Calara H, Houton E, Wackrow K, Matar N, Bernhardt PW. Supporting Parkinson's disease medication safety for nurses in the acute care setting through an educational intervention study. J Nurs Scholarsh 2023; 55:1106-1115. [PMID: 37358023 DOI: 10.1111/jnu.12923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 05/14/2023] [Accepted: 06/12/2023] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Patient medication safety in the acute care setting is a foundational action provided by nurses and healthcare providers for safe patient care. Hospitalization of patients with Parkinson's disease (PD) can be dangerous due to the unique and variable medication regimen required. Patients with PD often have their medication administered inappropriately in the acute care setting (e.g., holding a PD medication in preparation for surgery, not administering the medication on the patient's home schedule, and delaying administration). The research question posed in this study was the following: does a PD medication educational intervention in the clinical setting enhance knowledge, comfort, and competence of practicing nurses in the care of patients with PD regarding their medication safety? DESIGN A mixed methods study design was used for this 5-month, two-part study with a sample of practicing RNs at three different hospitals. Part one of the study assessed nurses' initial knowledge of PD and PD medication safety and included an educational intervention. Part two of the study occurred 3 months later and evaluated if knowledge from the educational intervention was retained. METHODS The study was conducted in two parts and included a pre-test, educational intervention, post-test, and follow-up test 3 months later. The educational intervention consisted of a 15-minute video of two PD advanced practice nurses being interviewed regarding the general care of a patient with PD. The pre-test, post-test, and follow-up test were identical and consisted of six questions regarding knowledge, comfort, and self-perceived competency. Participants were additionally asked three open-ended questions at follow-up to gain insight on the effectiveness of the educational intervention. RESULTS A total sample of 252 RNs participated in this study. Statistically significant improvements in knowledge, comfort, and self-perceived competency were observed in the post-test scores compared to pre-test scores. These statistically significant improvements were retained after 3 months, despite a 42.9% decrease in the number of responders (n = 252 vs. n = 144). Additionally, compared to the post-test, there were no statistically significant declines in knowledge, comfort, or competency in the follow-up test. Qualitative findings indicated that the training regarding PD medications was retained and found to be valuable, even if it was seldom applied in practice. CONCLUSION A review of the literature and this study both support the need for increased education for practicing nurses as it relates to PD and PD medication safety. Healthcare systems, organizations, and associations that support continuing education for nurses create a stronger workforce. Education has been found to keep nurses up to date on the latest advances in care and treatment while also providing exposure to other areas of nursing beyond their clinical settings. CLINICAL RELEVANCE Promoting better patient outcomes through safe medication administration is a hallmark of nursing care excellence. This study found that supporting the use of an educational intervention of PD medication safety for nurses improved RN levels of knowledge, comfort, and competency up to 3 months later. As the population of those with PD increases, healthcare systems, and nurses must now, more than ever, be poised to care for these individuals. This is a critical point in PD patient care since persons with PD are hospitalized 1.5 times more than their peers without PD.
Collapse
Affiliation(s)
- Diane M Ellis
- Biosion USA, Inc., Newark, Delaware, USA
- Villanova University M. Louise Fitzpatrick College of Nursing (Ret), Villanova, Pennsylvania, USA
- Edmond J. Safra Visiting Nurse Faculty Program at the Parkinson's Foundation, Philadelphia, Pennsylvania, USA
| | | | | | | | | | - Gwyn M Vernon
- Edmond J. Safra Visiting Nurse Faculty Program at the Parkinson's Foundation, Philadelphia, Pennsylvania, USA
- University of PA Parkinson's Disease and Movement Disorders Center, Department of Neurology, Philadelphia, Pennsylvania, USA
| | - Heintje Calara
- Clinical Practice Liaison, Neurocrine Biosciences, San Diego, California, USA
| | - Erin Houton
- Shady Grove Medical Center, BSN-RN, Adventist Healthcare, Rockville, Maryland, USA
| | | | | | - Paul W Bernhardt
- Mathematics and Statistics Department, College Liberal Arts and Science, Villanova University, Villanova, Pennsylvania, USA
| |
Collapse
|
5
|
Hess SP, Levin M, Akram F, Woo K, Andersen L, Trenkle K, Brown P, Ouyang B, Fleisher JE. The impact and feasibility of a brief, virtual, educational intervention for home healthcare professionals on Parkinson's Disease and Related Disorders: pilot study of I SEE PD Home. BMC MEDICAL EDUCATION 2022; 22:506. [PMID: 35761252 PMCID: PMC9238152 DOI: 10.1186/s12909-022-03430-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 05/04/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Individuals with advanced Parkinson's Disease (PD) and Parkinson-related disorders (PRD) are frequently referred for home allied therapies and nursing care, yet home healthcare professionals have limited training in PD/PRD. While recognizing the need for such care, patients and families report home healthcare professionals are unfamiliar with these conditions, which may be driven by neurophobia and may contribute to suboptimal care and early termination of services. We sought to determine the feasibility and effects of a virtual, multimodal educational intervention on PD knowledge, confidence, and empathy among home health professionals. METHODS Home health nurses, occupational therapists, physical therapists and physical therapy assistants, and speech-language pathologists participated in a daylong, virtual symposium on advanced PD/PRD, combining focused lectures, discipline-specific breakout sessions, immersive virtual reality vignettes, and interactive panels with both patients and families, and movement disorders and home healthcare experts. Participants completed online pre- and post-symposium surveys including: demographics; PD/PRD knowledge (0-10 points possible); empathy (Interpersonal Reactivity Index); and 10-point scales of confidence with and attitudes towards individuals with PD/PRD, respectively. Pre-post intervention changes and effect sizes were evaluated with paired t-tests and Cohen's d. We performed qualitative analyses of post-symposium free-text feedback using a grounded theory approach to identify participants' intentions to change their practice. RESULTS Participants had a mean improvement of 3.1 points on the PD/PRD knowledge test (p < 0.001, d = 1.97), and improvement in confidence managing individuals with PD/PRD (p = 0.0003, d = .36), and no change in empathy. The interactive, virtual format was rated as effective by 95%. Common themes regarding symposium-motivated practice change included: interdisciplinary collaboration; greater involvement and weighting of the patient and caregiver voice in care plans; attention to visit scheduling in relation to patient function; recognition and practical management of the causes of sudden change in PD/PRD, including infections and orthostatic hypotension. CONCLUSIONS A virtual, multimodal, brief educational pilot intervention improved PD/PRD-specific knowledge and confidence among home healthcare nurses and allied health professionals. Future studies are necessary to test the short- and long-term effects of this intervention more broadly and to investigate the impact of this education on patient and caregiver outcomes.
Collapse
Affiliation(s)
- Serena P Hess
- Department of Neurological Sciences, Section of Movement Disorders, Rush University Medical Center, 1725 W. Harrison Street, Suite 755, Chicago, IL, 60612, USA
| | - Melissa Levin
- Department of Neurological Sciences, Section of Movement Disorders, Rush University Medical Center, 1725 W. Harrison Street, Suite 755, Chicago, IL, 60612, USA
- Chicago Medical School - Rosalind Franklin University, 3333 Green Bay Road, North Chicago, IL, 60064, USA
| | - Faizan Akram
- Department of Neurological Sciences, Section of Movement Disorders, Rush University Medical Center, 1725 W. Harrison Street, Suite 755, Chicago, IL, 60612, USA
| | - Katheryn Woo
- Department of Neurological Sciences, Section of Movement Disorders, Rush University Medical Center, 1725 W. Harrison Street, Suite 755, Chicago, IL, 60612, USA
- Loyola University Chicago College of Arts and Sciences, 1032 W. Sheridan Road, Chicago, IL, 60660, USA
| | - Lauren Andersen
- Department of Physical Therapy, Rush University Medical Center, 1725 W. Harrison Street, Suite 440, Chicago, IL, 60612, USA
- Rush Physical Therapy, Select Medical, 1725 W. Harrison Street, Chicago, IL, 60612, USA
| | - Kristie Trenkle
- Rush Physical Therapy, Select Medical, 1725 W. Harrison Street, Chicago, IL, 60612, USA
- Department of Occupational Therapy, Rush University Medical Center, 1725 W. Harrison Street, Suite 440, Chicago, IL, 60612, USA
| | - Patricia Brown
- Memorycare Corporation, 634 Brooklyn Drive, Aurora, IL, 60502, USA
| | - Bichun Ouyang
- Department of Neurological Sciences, Section of Movement Disorders, Rush University Medical Center, 1725 W. Harrison Street, Suite 755, Chicago, IL, 60612, USA
| | - Jori E Fleisher
- Department of Neurological Sciences, Section of Movement Disorders, Rush University Medical Center, 1725 W. Harrison Street, Suite 755, Chicago, IL, 60612, USA.
| |
Collapse
|
6
|
Aminabad ED, Mobed A, Hasanzadeh M, Hosseinpour Feizi MA, Safaralizadeh R, Seidi F. Sensitive immunosensing of α-synuclein protein in human plasma samples using gold nanoparticles conjugated with graphene: an innovative immuno-platform towards early stage identification of Parkinson's disease using point of care (POC) analysis. RSC Adv 2022; 12:4346-4357. [PMID: 35425437 PMCID: PMC8980998 DOI: 10.1039/d1ra06437a] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 02/16/2022] [Accepted: 01/16/2022] [Indexed: 12/18/2022] Open
Abstract
Parkinson's disease (PD) or simply Parkinson's is a long-term degenerative disorder of the central nervous system, which mainly affects the motor system. Consequently, the detection and quantification of related biomarkers play vital roles in the early-stage diagnosis of PD. In the present study, an innovative electrochemical immunosensor based on gold nanoparticle-modified graphene towards bioconjugation with biotinylated antibody (bioreceptor) was developed for the ultra-sensitive and specific monitoring of the alpha-synuclein (α-synuclein) protein. The synergistic effects between the gold nanoparticles (AuNPs) and graphene drastically enhanced the electrochemical activity of the resulting materials. The enhanced conductivity of the substrate together with the increase in its surface area improved the sensitivity and lowered the detection limit of the capture layer. For the first time, the α-synuclein protein was measured in human plasma samples using bioconjugated AuNP-Gr bioconjugated specific antibody with an acceptable linear range of 4 to 128 ng mL−1 and a lower limit of quantification (LLOQ) of 4 ng mL−1. Accordingly, it is expected that this diagnostic method may be produced in the near future for clinical applications and high-throughput screening of PD using point of care (POC) analysis. Parkinson's disease (PD) or simply Parkinson's is a long-term degenerative disorder of the central nervous system, which mainly affects the motor system.![]()
Collapse
Affiliation(s)
- Esmaeil Darvish Aminabad
- Department of Biology, Faculty of Natural Sciences, Tabriz University, Tabriz, Iran
- Pharmaceutical Analysis Recent Center, Tabriz University of Medical Sciences, Tabriz 51664, Iran
| | - Ahmad Mobed
- Pharmaceutical Analysis Recent Center, Tabriz University of Medical Sciences, Tabriz 51664, Iran
- Physical Medicine and Rehabilitation Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Hasanzadeh
- Pharmaceutical Analysis Recent Center, Tabriz University of Medical Sciences, Tabriz 51664, Iran
| | | | - Reza Safaralizadeh
- Department of Biology, Faculty of Natural Sciences, Tabriz University, Tabriz, Iran
| | - Farzad Seidi
- Jiangsu Co-Innovation Center for Efficient Processing and Utilization of Forest Resources and International Innovation Center for Forest Chemicals and Materials, Nanjing Forestry University, Nanjing 210037, China
| |
Collapse
|
7
|
Mazé S, Corvol A, Auffret M. [Oral antiparkinsonian treatments, nursing practices in Ehpad]. SOINS. GERONTOLOGIE 2022; 27:15-18. [PMID: 35120717 DOI: 10.1016/j.sger.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Parkinson's disease is a complex, chronic and debilitating disease that requires a personalised treatment regimen, focusing on the regular administration of medication. The management of these treatments can be tricky in institutions for the dependent elderly, particularly when oral administration is difficult. A preliminary survey was carried out in order to establish the current state of nursing practices in these institutions.
Collapse
Affiliation(s)
- Stéphanie Mazé
- Centre hospitalier universitaire de Rennes, site Pontchaillou, 2 rue Henri-le-Guilloux, 35033 Rennes cedex 9, France.
| | - Aline Corvol
- Centre hospitalier universitaire de Rennes, site Pontchaillou, 2 rue Henri-le-Guilloux, 35033 Rennes cedex 9, France
| | - Manon Auffret
- EA 4712 Comportement et noyaux gris centraux, université de Rennes 1, 2 avenue du Professeur-Léon-Bernard, 35043 Rennes cedex; Institut des neurosciences cliniques de Rennes, 1 rue Anatole-le-Braz, 35700 Rennes, France
| |
Collapse
|
8
|
SARIÇAM G, KAHVECİ K, AKDOĞAN D. Palyatif Bakımda Nörolojik Hastalıklarda Hemşirelerin Bilgisi Yeterlimi? KAHRAMANMARAŞ SÜTÇÜ İMAM ÜNIVERSITESI TIP FAKÜLTESI DERGISI 2021. [DOI: 10.17517/ksutfd.834227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
9
|
Development of a Joint Commission Disease-Specific Care Certification Program for Parkinson Disease in an Acute Care Hospital. J Neurosci Nurs 2020; 51:313-319. [PMID: 31626076 DOI: 10.1097/jnn.0000000000000472] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patients with Parkinson disease (PD) admitted to the hospital for any reason are at a higher risk of hospital-related complications. Frequent causes include delays in administering PD medications or use of contraindicated medications. The Joint Commission Disease-Specific Care (DSC) program has been used to establish a systematic approach to the care of specific inpatient populations. Once obtained, this certification demonstrates a commitment to patient care and safety, which is transparent to the public and can improve quality of care. METHODS We formalized our efforts to improve the care of hospitalized patients with PD by pursuing Joint Commission DSC. An interprofessional team was assembled to include nurses, therapists, physicians, pharmacists, performance improvement specialists, and data analysts. The team identified quality metrics based on clinical guidelines. In addition, a large educational campaign was undertaken. Application to the Joint Commission for DSC resulted in a successful June 15, 2018 site visit. To our knowledge, this is the first DSC program in PD in an acute care hospital. CONCLUSION Using the established platform of DSC certification from the Joint Commission, we developed a program based on relevant metrics that aims to address medication management of patients with PD admitted to the hospital. Our hope is to improve the care of this vulnerable patient population.
Collapse
|
10
|
Carroll V, Deutschmann K, Andrews J. Purposeful collaboration: Enriching lives for people with Parkinson’s disease. AUSTRALASIAN JOURNAL OF NEUROSCIENCE 2020. [DOI: 10.21307/ajon-2020-004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
|
11
|
Lennaerts H, Groot M, Rood B, Gilissen K, Tulp H, van Wensen E, Munneke M, van Laar T, Bloem BR. A Guideline for Parkinson's Disease Nurse Specialists, with Recommendations for Clinical Practice. JOURNAL OF PARKINSONS DISEASE 2018; 7:749-754. [PMID: 28800338 DOI: 10.3233/jpd-171195] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Parkinson's Disease Nurse Specialists (PDNS) play an important role in the care for patients with Parkinson's disease (PD) and their caregivers. Until now, there were no nursing guidelines in PD, and interventions were based solely on daily clinical practice because there is no evidence to support the merits of nursing interventions. Consequently, there is little uniformity in current care delivery. OBJECTIVE Developing a guideline for PDNS. METHODS We developed a guideline based on a questionnaire among PDNS and a literature review, supplemented with expert opinion plus the input of patients and caregivers. The questionnaire was filled in by 97 PDNS and 51 generic nurses with knowledge of PD to identify barriers in PD nursing care. Subsequently, we did a systematic literature search and transformed these sources of information into practice recommendations, which were developed according to international standards for guideline development. RESULTS Based on the results of the questionnaire we identified seven specific core areas: defining the role of PDNS in terms of caseload, education, competences and care coordination; medication adherence; provision of information and education; coping; caregiver support; urogenital function and orthostatic hypotension. The systematic literature search identified 186 studies, of which 33 studies were finally analyzed. Furthermore, we developed practice recommendations based on good clinical practice for the following areas: self-care, mental functioning, mobility, nutrition, sexuality, work, sleep, palliative care and complementary (integrative) care. CONCLUSION This guideline provide ground to harmonize care delivery by PDNS in clinical practice, and offer a foundation for future research.
Collapse
Affiliation(s)
- Herma Lennaerts
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
| | - Marieke Groot
- Department of Anaesthesiology, Pain and Palliative Care, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Berna Rood
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
| | - Koen Gilissen
- Department of Neurology, Medical centre Alkmaar, Alkmaar, The Netherlands
| | - Hella Tulp
- Department of Neurology, Elkerliek Hospital, Helmond, The Netherlands
| | - Erik van Wensen
- Department of Neurology, Gelre Hospital, Apeldoorn, The Netherlands
| | - Marten Munneke
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
| | - Teus van Laar
- Department of Neurology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Bastiaan R Bloem
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Neurology, Nijmegen, The Netherlands
| |
Collapse
|
12
|
MacCosham B, Webb E, Oey J, Gravelle F. Constraints, Facilitators, and Stages of Behavioral Change in Physical Activity for Individuals with Parkinson’s Disease. AMERICAN JOURNAL OF HEALTH EDUCATION 2018. [DOI: 10.1080/19325037.2018.1449684] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
13
|
DiBartolo MC. Enhancing Care for Hospitalized Patients With Parkinson's Disease: Development of a Formal Educational Program for Nursing Staff. J Gerontol Nurs 2017; 43:18-22. [PMID: 28253409 DOI: 10.3928/00989134-20170223-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Accepted: 01/12/2017] [Indexed: 11/20/2022]
Abstract
Although not generally a primary admission diagnosis, Parkinson's disease (PD) can be a significant comorbidity during hospitalization. Hospitalized individuals with PD can experience a variety of complications, such as confusion, pneumonia, and urinary infections. More than 20% of patients experience deterioration in symptoms and hospital stays are extended by an average of 4 days. Late, omitted, or inappropriate medications are frequent culprits leading to serious consequences, including falls and aspiration. To address an identified gap in staff knowledge about PD, a formal educational program was developed to review its etiology, symptoms, treatments, and unique considerations in care and medication administration. This 2-hour intervention comprises a knowledge pre-test, PowerPoint® presentation, two concise handouts for reference, discussion of an unfolding case study, and review of the Aware in Care kit. Nurses can play a key role in educating staff to reduce avoidable hospital-related complications and enhance outcomes for this vulnerable group. [Journal of Gerontological Nursing, 43(5), 18-22.].
Collapse
|
14
|
Kang MY, Ellis-Hill C. How do people live life successfully with Parkinson's disease? J Clin Nurs 2015; 24:2314-22. [PMID: 25939827 DOI: 10.1111/jocn.12819] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/17/2015] [Indexed: 01/08/2023]
Abstract
AIMS AND OBJECTIVES The aim of this paper is to explore how people live life successfully with Parkinson's disease and what contributed to the level of success. OBJECTIVES To examine the level of success as defined by people with Parkinson's disease. To find what contributed to the level of success. BACKGROUND Self-care support has gained importance for supporting people with their chronic diseases including Parkinson's disease. Although self-care and life adjustments can improve patients' general well-being, it is unclear which approaches best facilitate positive adjustments to illness. DESIGN Semi-structured interviews with participants with Parkinson's disease. METHODS Eight participants living with Parkinson's disease for 2-16 years were recruited from a Parkinson's disease voluntary group in the UK. Interviews covered their perceived level of success and the factors which they perceived led to that success. Thematic analysis was used to analyse the data. RESULTS Participants rated a high level of success in living with Parkinson's disease with an average personal rating 75/100 despite facing difficulties. Successful living was perceived to have taken place when people were either (1) able to return to their usual state of health or (2) considered themselves to be stable within a new/readjusted state of health. Aspects which were perceived to support positive psychosocial adjustment included a positive mindset, determination, acceptance of new challenges and family support. CONCLUSION Maintaining usual life and physical ability is the major concern among the people with Parkinson's disease. It would be helpful for health care professionals to identify what constitutes a 'usual' life for that person and to support them to develop a positive mindset and acceptance of new challenges, drawing on the determination of the person as well as any available family support. RELEVANCE TO CLINICAL PRACTICE In supporting self-care, it is helpful to gain information about the subjective experience of living with Parkinson's disease including their perceived level of success at the time and what led to that perceived success for that person.
Collapse
Affiliation(s)
- Mi-Young Kang
- School of Health Sciences, University of Southampton, Southampton, UK.,School of Applied Social Sciences, University of Durham, Durham, UK
| | | |
Collapse
|
15
|
Skelly R, Brown L, Fakis A, Kimber L, Downes C, Lindop F, Johnson C, Bartliff C, Bajaj N. Does a specialist unit improve outcomes for hospitalized patients with Parkinson's disease? Parkinsonism Relat Disord 2014; 20:1242-7. [PMID: 25264022 PMCID: PMC4228081 DOI: 10.1016/j.parkreldis.2014.09.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2014] [Revised: 07/15/2014] [Accepted: 09/08/2014] [Indexed: 11/23/2022]
Abstract
Objective Suboptimal management of Parkinson's disease (PD) medication in hospital may lead to avoidable complications. We introduced an in-patient PD unit for those admitted urgently with general medical problems. We explored the effect of the unit on medication management, length of stay and patient experience. Methods We conducted a single-center prospective feasibility study. The unit's core features were defined following consultation with patients and professionals: specially trained staff, ready availability of PD drugs, guidelines, and care led by a geriatrician with specialty PD training. Mandatory staff training comprised four 1 h sessions: PD symptoms; medications; therapy; communication and swallowing. Most medication was prescribed using an electronic Prescribing and Administration system (iSOFT) which provided accurate data on time of administration. We compared patient outcomes before and after introduction of the unit. Results The general ward care (n = 20) and the Specialist Parkinson's Unit care (n = 24) groups had similar baseline characteristics. On the specialist unit: less Parkinson's medication was omitted (13% vs 20%, p < 0.001); of the medication that was given, more was given on time (64% vs 50%, p < 0.001); median length of stay was shorter (9 days vs 13 days, p = 0.043) and patients' experience of care was better (p = 0.01). Discussion If replicated and generalizable to other hospitals, reductions in length of stay would lead to significant cost savings. The apparent improved outcomes with Parkinson's unit care merit further investigation. We hope to test the hypothesis that specialized units are cost-effective and improve patient care using a randomized controlled trial design. We prospectively evaluated a specialist Parkinson's unit for in-patients. Patients who received Parkinson's unit care had shorter length of stay. Patients who received Parkinson's unit care had better experience of care. More Parkinson's medication was given on time. Less Parkinson's medication was omitted.
Collapse
Affiliation(s)
- Rob Skelly
- Department of Medicine for the Elderly, Royal Derby Hospital, Derby, UK.
| | - Lisa Brown
- Department of Neurology, Royal Derby Hospital, Derby, UK
| | - Apostolos Fakis
- Research & Development Department, Royal Derby Hospital, Derby, UK
| | - Lindsey Kimber
- Research & Development Department, Royal Derby Hospital, Derby, UK
| | - Charlotte Downes
- Research & Development Department, Royal Derby Hospital, Derby, UK
| | - Fiona Lindop
- Specialist Assessment & Rehabilitation Centre, London Road Community Hospital, Derby, UK
| | - Clare Johnson
- Specialist Assessment & Rehabilitation Centre, London Road Community Hospital, Derby, UK
| | - Caroline Bartliff
- Specialist Assessment & Rehabilitation Centre, London Road Community Hospital, Derby, UK
| | - Nin Bajaj
- Department of Neurology, Royal Derby Hospital, Derby, UK
| |
Collapse
|