The Advanced Practice Nurse Will See You Now: Impact of a Transitional Care Clinic on Hospital Readmissions in Stroke Survivors.

BACKGROUND: There is a paucity of evidence-based, posthospital stroke care in the United States proven to reduce preventable hospital readmissions. LOCAL PROBLEM: Follow-up with a provider after hospitalization for stroke or transient ischemic attack had low compliance rates. This may contribute to preventable readmissions. METHODS: A retrospective, descriptive chart review to determine whether an advanced practice registered nurse (APRN)-led transitional care clinic for stroke survivors impacted 30- and 90-day hospital readmissions. Readmissions between clinic patients and nonclinic patients were compared. INTERVENTIONS: The site implemented an APRN-led transitional care stroke clinic to improve patient transitions from hospital to home. RESULTS: The 30-day readmission proportion was significantly higher in nonclinic patients (n = 335) than in clinic patients (n = 68) (13.4% vs 1.5%, respectively; P = .003). The 90-day readmission proportion was numerically higher in nonclinic patients (12.8% vs 4.4%, respectively; P = .058). CONCLUSIONS: The results suggest the APRN-led clinic may impact 30-day hospital readmissions in stroke/transient ischemic attack survivors.

Comparison of Bispectral Index™ values during the flotation restricted environmental stimulation technique and results for stage I sleep: a prospective pilot investigation.

OBJECTIVE: To determine whether Bispectral Index™ values obtained during flotation-restricted environment stimulation technique have a similar profile in a single observation compared to literature-derived results found during sleep and other relaxation-induction interventions. RESULTS: Bispectral Index™ values were as follows: awake-state, 96.6; float session-1, 84.3; float session-2, 82.3; relaxation-induction, 82.8; stage I sleep, 86.0; stage II sleep, 66.2; and stages III-IV sleep, 45.1. Awake-state values differed from float session-1 (%difference 12.7%; Cohen's d = 3.6) and float session-2 (%difference 14.8%; Cohen's d = 4.6). Relaxation-induction values were similar to float session-1 (%difference 1.8%; Cohen's d = 0.3) and float session-2 (%difference 0.5%; Cohen's d = 0.1). Stage I sleep values were similar to float session-1 (%difference 1.9%; Cohen's d = 0.4) and float session-2 (%difference 4.3%; Cohen's d = 1.0). Stage II sleep values differed from float session-1 (%difference 21.5%; Cohen's d = 4.3) and float session-2 (%difference 19.6%; Cohen's d = 4.0). Stages III-IV sleep values differed from float session-1 (%difference 46.5%; Cohen's d = 5.6) and float session-2 (%difference 45.2%; Cohen's d = 5.4). Bispectral Index™ values during flotation were comparable to those found in stage I sleep and nadir values described with other relaxation-induction techniques.