Reflections on 50 Years of Neuroscience Nursing: The Growth of Stroke Nursing.

Over the past 50 years, the Journal of Neuroscience Nursing (JNN) has grown from a neurosurgical focus to the broader neuroscience focus alongside the professional nursing organization that it supports. Stroke care in JNN focused on the surgical treatment and nursing care for cranial treatment of conditions such as cerebral aneurysm, carotid disease, arteriovenous malformation, and artery bypass procedures. As medical science has grown and new medications and treatment modalities have been successfully trialed, JNN has brought to its readership this information about recombinant tissue plasminogen activator, endovascular trials, and new assessment tools such as the National Institute of Health Stroke Scale. JNN is on the forefront of publishing nursing research in the areas of stroke caregiver needs and community education for rapid treatment of stroke and stroke risk reduction. The journal has been timely and informative in keeping neuroscience nurses on the forefront of the changing world of stroke nursing.

Sustainability of a nurse-driven early progressive mobility protocol and patient clinical and psychological health outcomes in a neurological intensive care unit.

OBJECTIVES: To determine sustainable impact of an early progressive mobility protocol on mobility level and clinical outcomes. DESIGN/METHODS: Prospective, longitudinal, comparative study using three time points (pre-, immediate post-intervention and 12-month post-intervention sustainability). Analyses included comparative statistics and multivariable modelling. Data were collected by clinical nurses, from administrative databases. Psychological health data were collected using a valid, reliable tool. SETTING: Patients treated in a 22-bed Neurological Intensive Care Unit of a quaternary-care medical centre. OUTCOME MEASURES: Highest mobility level, length of stay, mortality, discharge disposition, quality metrics and psychological profile including depression, anxiety, and hostility. RESULTS: Amongst 260 pre-intervention, 377 post-implementation, and 480 twelve-month post-implementation patients (N = 1117) walking increased post-implementation and was sustained at the eight-month assessment, p < .001. After multivariable adjustment, unit and hospital length of stay and psychological distress were reduced compared to the pre-early mobility programmes (all p < .001). There were no differences in discharge disposition (i.e., home vs skilled nursing facility), mortality or quality metrics. CONCLUSION: Ongoing implementation of an early mobility programme in a neurological intensive care environment led to sustained improvement in patients' level of mobility, length of unit and hospital stay, depression, anxiety and hostility levels.

Developing a Mobile App for Neuroscience Nurses.

In this month's Magnet® Perspectives column, the recipient of the 2016 Magnet Nurse of the Year® Award for New Knowledge, Innovations, and Improvements shares her journey to develop and disseminate a mobile application for nurses who care for neurological patients. "Neuroscience nurse" puts the latest, evidence-based information at the fingertips of nurses at the bedside in an effort to increase confidence when caring for patients with stroke, traumatic brain injury, and other neurological impairments.Nurse practitioner Christi DeLemos explains where she got the idea and how she went about implementing it. She also discusses the ways in which the Magnet® environment at University of California (UC) Davis Medical Center encouraged and supported her. Since neurological nurse was released in 2015, more than 3000 users in 19 countries have downloaded it. The app's success led to the production of a teaching video to help nurses perform a neurological examination. In addition to her role at UC Davis Medical Center, DeLemos is president of the World Federation of Neuroscience Nurses.

Neuroscience nursing research: trend analysis from 1989 to 2010.

This study extends an earlier investigation (DiIorio et al., 2004) regarding neuroscience studies published in four nursing journals over the period from 1989 to 2000. A literature review was conducted from 2001 to 2010 with the same search strategy performed by DiIorio from 1989 to 2000. A trend analysis comparing the articles published in the period of 2001-2008 with those published from 1993 to 2000 (odds ratio [OR], 95% confidence interval [CI]) was performed. From 1989 to 2010, a total of 607 articles were published, 2.2 articles per month. A significantly increased number of publications on neuroscience nursing research have emerged comparing 2001-2008 versus 1993-2000 (OR = 2.1, 95% CI [1.22, 3.29]; p = .00). From 1989 to 2000, neurological problems were the predominant object of study (389 articles, 64.1%), followed by neurotrauma problems (156, 25.7%) and those neurosurgical problems (31, 5.1%). Moreover, a progressive reduction of studies focusing on neurological problems (OR = 0.42, 95% CI [0.26, 0.68]; p = .00) has emerged comparing 2001-2008 versus 1993-2000. The setting chosen for the study from 1989 to 2000 was mainly hospitals (211, 34.8%) followed by long-term care (125, 20.6%) and the home environment (77, 12.7%). Over the years (2001- 2008 vs. 1993-2000), studies performed at the home level were lower (OR = 0.27, 95% CI [0.15, 0.47]; p = .00), whereas those carried out at the hospital level and at the long-term care level have increased. Research in neuroscience nursing has continued to grow in the last decade, involving more patients who are mainly women. In the coming years, quasiexperimental, experimental, or complex intervention designs, involving the various care settings and along the trajectories of illnesses of patients who have an acute phase but especially in a long-term phase, are needed.