A descriptive study of function in acute motor stroke.

The functional independence measure (FIM) instrument was introduced in 1987 and has proven to be a useful tool for measuring disability in different patient populations. The FIM instrument data collected during inpatient rehabilitation for stroke is very informative, as it is voluminous, comprehensive, and has a uniform reporting mechanism. In contrast to inpatient rehabilitation, there is a paucity of FIM instrument data on acute stroke patients. The purpose of this study was to describe functional level of 100 patients within the first 24 hours of acute care admission. The mean total FIM instrument score was 94.05 (SD +/- 19.31, range = 38-120), the mean motor domain subscore was 61 (SD +/- 17.8, range 23-85), and cognitive was 33.4 (SD +/- 3.3, range 15-35). Significant group differences were identified for age, gender, and disposition for total and/or domain subscores. Significant differences in age, gender, employment, and disposition were found for clinical subscales. This study fills a gap in current knowledge, that of baseline total FIM instrument scores, domain subscores, and six clinical subscales on one particular group of stroke patients, those with a primary motor stroke.

Biological and behavioral correlates of stroke and depression.

Stroke is the third leading cause of death in the United States. Depression following stroke is a major problem as it can increase the morbidity. A greater understanding of the biological and behavioral correlates of stroke and depression enhances the practice of neuroscience nurses interacting with stroke patients. There is an ongoing debate as to whether patients with left or right-sided lesions have higher rates of depression. Current research suggests neurochemical correlates of stroke and depression; however, behavioral problems do relate, to a large extent, to the different behavioral manifestations seen in left and right-sided lesions. Furthermore, these biological and behavioral correlates have important implications for assessment and treatment modalities.

New developments in managing transient ischemic attack and acute stroke.

During this decade, which has been designated the decade of the brain, the event of transient ischemic attack (TIA) or acute ischemic stroke is considered a brain attack requiring rapid diagnosis and treatment. This increased focus on the clinical problems of TIA and stroke has resulted in rapid advances in management of this patient population. This article will highlight for critical care nurses some of the many advances in patient management of TIA and stroke that have occurred in the past few years. Advances in the areas of diagnostic studies, pharmacologic interventions, and nursing care will be covered. Furthermore, some of the new developments on the horizon will be summarized.

Pilot project on functional outcome in stroke.

The purpose of this pilot project was to compare the outcome of stroke survivors cared for on an Acute Stroke Unit (ASU) to those who received care on a routine medical-surgical unit. The sample included a total of 88 patients, 68 admitted to an acute stroke unit and 20 admitted to a medical-surgical unit. The Functional Index Measure was used to assess in-hospital functional gains in the two groups. There appeared to be a trend toward increased functional gains in the group of stroke patients cared for on the Acute Strike Unit as compared to the group of patients cared for on medical-surgical units. These findings provide a foundation for neuroscience nurses and other health care professionals to study functional gains after stroke.

Neurotoxins: a neuroscience nursing challenge.

Societal awareness of toxins in general has been heightened in the past few decades with the increased focus on environmental concerns. The medical profession has been aware of the effects of some toxins such as lead and mercury for centuries, while other toxins have more recently been identified. Neuroscience nurses are challenged to be aware of the neurological effects of lesser known toxins, such as ciguatera and methyl bromide, and to meet the complex needs of patients who are suffering from the effects of toxic levels of these substances.

Development of printed teaching materials for neuroscience patients.

Neuroscience nurses are challenged by the current climate of cost containment and the nursing shortage to continue to provide quality patient education. One strategy for meeting this challenge is to follow the process outlined in this overview for the development and use of printed materials.

Home antibiotic therapy for brain abscesses.

Patients with brain abscesses now have the option of receiving intravenous antibiotic therapy at home. However, before discharge from the hospital, these patients require significant education in aseptic technique, general catheter care, medication administration, and troubleshooting. Also provided is a review of the pathology, signs, symptoms, diagnosis, and treatment of adult brain abscesses.

Three collaborative research projects involving neuroscience nurses.

Traumatic head injury and stroke affect millions of persons in the United States each year. Neuroscience nurses have the unique opportunity to be involved in collaborative research projects concerning these health problems. The goal of much research on head injury and stroke is to increase the qualitative survival of patients. This paper describes three collaborative clinical research projects that have involved neuroscience nurses. How nurses have influenced and been influenced by various aspects of these projects, the roles they played in the projects, and associated nursing implications are discussed.

Restoring social competence in minor head-injury patients.

The Department of Neurological Surgery at the University of Virginia was awarded a grant from the Robert Wood Johnson Foundation for a project entitled "Restoring Social Competence: Interventions to Reduce the Physical and Socioeconomic Consequences of Injury." This article describes the role nurse clinicians played in the project and identifies the most effective and efficient nursing contributions in achieving the project goals. Data collected by nurse clinicians, nursing strategies of management, and nursing interventions to treat the consequences of minor head injury are presented. Changes in minor head injury management at the Department of Neurological Surgery have resulted in more efficient use of nurses and decreased economic and psychosocial costs to patients.