An experiential learning model applied to nurses working with patients with Creutzfeldt-Jakob disease

Creutzfeldt-Jacob disease (C/D) is a rare neurological disease, transmissible, incurable and always fatal affecting humans, as well as animals. In the 1980s, the "mad cow disease" (MCD) epidemic in the United Kingdom popularized prion diseases worldwide. However, this contributed to the proliferation of disinformation, causing confusion between C/D and MCD in the public, as well as in some health care providers. The purpose of this article is to describe the process utilized to develop, implement, and evaluate a workshop on CJD for nurses and other health care providers. Kolb's experiential teaching/learning model was used as a framework for this workshop. A workbook was developed to complement the participants' learning. Fifteen health care providers from the Alzheimer Society of Canada's Dementia Network agreed to participate in this educational project. The results indicated that the participants had limited knowledge about C/D. They felt ill prepared and uncomfortable in providing quality care to this patient population. The workshop generated new insights and knowledge about the disease and the needs of the patients and their families. Participants exchanged ideas for tailored interventions. An experiential teaching/learning model is a highly effective approach to increase knowledge and skills, as well as fostering reflective practice.

Creutzfeldt-Jakob disease: diagnosis and nursing care issues

Creutzfeldt-Jakob disease is a rare, progressive brain disease that affects both men and women. It causes a relentless deterioration in the ability to function physically, mentally and emotionally. Many nurses will never have cared for patients with the disease and there are many misconceptions regarding its cause, progress and the implications for care. Blaire Smith-Bathgate examines these issues.

Care management of Creutzfeldt-Jakob Disease within the United Kingdom

The purpose of this article is to review the management of health and social care provision for Creutzfeldt-Jakob Disease patients within the United Kingdom. The link between the epidemic of bovine spongiform encephalopathy (BSE) in cattle and the subsequent emergence of variant Creutzfeldt-Jakob Disease (vCJD) in humans during the mid 1990s created new mechanisms for the organization of health and social care for Creutzfeldt-Jakob Disease patients. This article draws on the experiences of two National Care Co-ordinators appointed to manage the care of Creutzfeldt-Jakob Disease patients throughout the United Kingdom, and identifies how additional money set aside by the Department of Health (DoH) is spent to overcome local difficulties in the timeliness or availability of services. The key issues that emerge include the positive benefits associated with care co-ordination and the difficulties encountered in developing flexible and individual care packages within existing health and social organizational structures.

Management of a CJD case. Part 1. Preoperative organisation of the case

Recent years have seen the rise of variant Creutzfeldt-Jacob Disease (vCJD), causing great concern amongst the public at large and healthcare professionals, and the implications of the disease are still to be properly determined. In this, the first of two articles, Beverley McNeil outlines the various risk categories of CJD patients, the planning of the case and the handling of associated instrumentation postoperatively. Next month's article will deal with the practicalities surrounding management of the case.

Variant Creutzfeldt-Jakob disease: need for mental health and palliative care team collaboration

People with a dementia syndrome and a superimposed terminal illness are increasingly being referred to palliative care services. Creutzfeldt-Jakob disease (CJD) is a dementia syndrome in the early stages of which people experience a variety of psychological symptoms that may lead to them being admitted to psychiatric services. People with CJD have died in psychiatric units. There is clearly a need for collaboration between mental health and palliative care services in providing care for people with CJD and other dementia syndromes. An inductive qualitative study of one case of variant CJD (vCJD) was carried out to explore issues that were raised in providing care for a young person with the disease who had died in a hospice unit. The study, which was a pilot for a larger study, highlights some of the complexities of providing care for people with an end-stage dementia and identifies the need for the development of education initiatives to increase knowledge and understanding of the end-of-life needs of people with CJD and other dementia syndromes, and their families.

Creutzfeldt-Jakob disease: two case studies

Creutzfeldt-Jakob disease (CJD) is a rapidly progressive, neurodegenerative disorder causing dramatic neuromuscular symptoms, profound dementia, and death. In this article, the epidemiology, etiology, modes of transmission, clinical manifestations, determination of possible/probable CJD diagnosis in life, and the postmortem neuropathology of definite CJD are discussed in depth. Case studies of two individuals, each affected by different subtypes of sporadic Creutzfeldt-Jakob disease (sCJD), are presented, along with a discussion of the many challenging nursing and psychosocial issues surrounding the supportive care of these individuals and families in life and death.

[Prion diseases]

This article is a retrospective review about cases of diseases caused by prions cared for in our hospital over a 17 year period. The objective was to establish specific guidelines for treatment, norms and attitudes in order to achieve greater understanding, effectiveness and quality care for these patients as well as counsel all teams involved in their care, in light of the advances made in investigation over most recent years and the absence of publications in nursing journals about this topic.

Nursing patients with variant Creutzfeldt-Jakob disease at home

Variant Creutzfeldt-Jakob Disease (vCJD) is a rare variant of a rare neurodegenerative disease, with a rapid and fatal course. The emergence of vCJD in humans in 1996 is believed to have resulted from the consumption of bovine spongiform encephalopathy (BSE)-infected meat. By July 2002, the number of vCJD cases in the UK had increased to over 120 and it is not yet known how many more people will be affected. The majority of affected individuals are cared for within their own homes with the support of their families. Community nurses face several challenges in managing the rapid deterioration and complex emotional, cognitive, behavioural and physical problems associated with vCJD. In her capacity as a National CJD Care Coordinator for the UK the author outlines the pathogenesis of vCJD, identifies key caring issues that emerge during the clinical course of the disease and makes suggestions about the nursing care required.

Creutzfeldt-Jakob disease: extending palliative care nursing knowledge

In a 12-month period six people died from Creutzfeldt-Jakob disease (CJD) in a Melbourne hospice. CJD is a rare neurodegenerative disease, which commonly follows an explosive course unabated into the terminal phase. For the purposes of this article the care of six patients was audited using a retrospective chart review and a focus group was conducted with nurses involved in their care. The nurses faced considerable challenges as they endeavoured to provide comfort and support for these patients. The differences in the illness trajectory of CJD in relation to the more common experiences of illness progression in advanced cancer are discussed in the context of palliative care. This review focuses on the particular care issues of six people with CJD and their families at the end of life. The personal issues experienced by the nurses who provided palliative care are also explored. The need for the future development of guidelines for families and health professionals who care for people with CJD is highlighted.

[Safety measures for handling laboratory specimen and patients with Creutzfeldt-Jakob disease]

Creutzfeldt-Jakob disease (CJD) is a transmissible subacute spongiform encephalopathy that invariably leads to death. The presumed causative agent, the prion protein, is highly resistant to inactivation and has a long incubation period. Physical contact with CJD patients (as in clinical care) entails no risk of transmission. During procedures such as lumbar puncture where contact with infected material is possible, precautions are necessary. Precautions are: the use of gloves, maximal protection of people who come in contact with contaminated tissue (e.g. pathologist and histological laboratory worker) and transportation of samples in a closed and labelled container. For laboratory research the tissue must be submerged in 92-98% formic acid for 1 hour. All used materials and instruments must be decontaminated properly, using for instance NaOH, NaClO, guanidine thiocyanate or steam autoclaving. If adequate precautions are taken contact with contaminated materials can be safe.

Nursing care of the resident with Creutzfeldt-Jakob disease

This article encompasses care of the resident and family and dealing with the staff's concerns regarding this rare, infectious dementia. Comparison is made between Alzheimer's disease and Creutzfeldt-Jakob disease, the symptoms and causative agent, precautions that need to be followed, nursing care and medications used in maintaining the resident's comfort, and the maximum quality of life possible during the course of this terminal disease.

Creutzfeldt-Jakob disease: a family-centered approach

Care of the patient with CJD requires particular attention to infection control and optimizing comfort. It also demands a great deal of consideration to family needs. Although none of these nursing interventions can change the final outcome for these patients, each may have an effect on the outcome for the family. A nurse with a finely tuned sense of ethics, who can prioritize the compassionate delivery of comfort, safety, and support, can make a great difference in the way a family copes with their loss.

Creutzfeldt-Jakob disease: assessment and management

1. Creutzfeldt-Jakob disease (CJD) is a progressive neurologic disease that occurs in approximately one in one million individuals annually. 2. CJD affects late middle-aged and elderly individuals, with a peak occurrence between the ages of 55 and 75. 3. The disease is thought to be caused by an unknown virus that enters the central nervous system, causing neuron destruction and replacing the destroyed neurons with plaques. 4. There is no known cure or treatment for CJD, and the time span from onset of symptoms until death is 6 to 12 months.