JOURNAL OF NEUROSCIENCE NURSING (JNN) 是美国神经科学护士协会的官方期刊，包含有关影响护理、理论和研究的神经外科和神经学技术进展的原创文章，以及对神经科学作用的评论医疗保健团队中的护士。该杂志为在神经科学患者护理的不同领域工作的护士和医疗保健专业人员提供信息，例如多专业和神经科学重症监护病房、普通神经科学单位、联合单位（神经/正畸、神经肌肉/康复、神经精神病学、神经老年病学）、康复单位、内外科单位、儿科单位、急诊和创伤科以及外科。该信息适用于在临床、研究、行政和教育环境中工作的专业人员。

The Journal of Neuroscience Nursing (JNN) is the official journal of the American Association of Neuroscience Nurses. It publishes original articles on advancements in neurosurgical and neurological techniques that impact nursing, theory, and research, as well as commentaries on the role of neuroscience in healthcare teams. The journal provides valuable information for nurses and healthcare professionals working in various areas of neuroscience patient care, including multidisciplinary and neuroscience intensive care units, general neuroscience units, combined units (such as neurology/orthopedics, neuromuscular/rehabilitation, neuropsychiatry, neurogeriatrics), rehabilitation units, medical and surgical units, pediatric units, emergency and trauma departments, and surgical units. This information is relevant for professionals working in clinical, research, administrative, and educational settings.

《Journal of Neuroscience Nursing》（JNN）是美国神经科学护士协会的官方期刊，发表关于神经外科和神经学技术进展的原创文章，这些进展对护理、理论和研究有重要影响。此外，期刊还包含对神经科学在医疗保健团队中作用的评论。该杂志为在神经科学患者护理各个领域工作的护士和医疗保健专业人员提供信息，涵盖的领域包括多专业和神经科学重症监护病房、普通神经科学单位、联合单位（如神经/正畸、神经肌肉/康复、神经精神病学、神经老年病学）、康复单位、内外科单位、儿科单位、急诊和创伤科以及外科。该信息适用于在临床、研究、行政和教育环境中工作的专业人员。

Journal of Neuroscience Nursing

BACKGROUND: By 2030, there will be approximately 7.6 million stroke survivors (SSs) in the United States, yet comprehensive transitional care (TC) for stroke is not widely available. Stroke strikes without warning and leaves in its wake a "storm" of uncertainty for SSs and caregivers (CGs) as they encounter a myriad of unmet physical, mental, emotional, and financial needs that are not wholly addressed by passive healthcare delivery systems. Needed is a stroke-specific TC model that bridges this storm to active delivery of SS and CG postacute care. Naylor's Transitional Care Model (NTCM) has not been examined for how it can frame comprehensive stroke care. The purpose of this study was to solicit SS and CG descriptions of TC experiences to inform the NTCM with refined operational definitions and exemplars specific to stroke. METHODS: Focus groups conducted for this qualitative descriptive study were guided by interview questions based on the 8 NTCM operational definitions. Data were analyzed using inductive and deductive qualitative content analysis methods. RESULTS: Post-acute-stroke care does not comprehensively meet the needs of SSs and CGs. Participants described TC deficits across all 8 NTCM components. Two new subcomponents that could be applied for a stroke-specific NTCM emerged: psychological and transportation challenges. CONCLUSION: Unmet needs identified by SSs and CGs were used to extend NTCM specific to the stroke population and to develop the Recommendations and Exemplars for Stroke Specific Comprehensive Transitional Care Delivery (see Supplementary Digital Content, available at http://links.lww.com/JNN/A385). Researchers and practitioners can use the findings to develop and deliver more comprehensive TC to SSs and CGs.

Lorre Laws

Leslie Ritter

Lois Loescher

Marylyn McEwen

Stroke-Specific Refinements to Naylor's Transitional Care Model to Address the Storm of Uncertainty and Unmet Survivor and Caregiver Needs

针对中风患者的Naylor过渡护理模式改进：应对不确定性风暴及满足幸存者和护理者未满足的需求

Hypothermia has been shown to have neuroprotective effects and may have benefit in the treatment of head injuries. However, it is a controversial treatment in traumatic brain injury, and to date, there are no specific recommendations for its use. This article examines six research studies investigating the use of hypothermia as a treatment in patients with traumatic brain injury. All studies were prospective trials and compared a controlled normothermia group with a hypothermia group. Studies were compared by sample population, methods of hypothermia, outcomes, and conclusions. The leading variable in each study was hypothermia. However, each study used a different method of cooling, goal temperature, and duration of cooling. Through the comparison of these studies, a recommendation for change in practice cannot be made. Nevertheless, there may be benefits to hypothermia in traumatic brain injury, and suggestions for future research are identified.

Kristin Rupich

The Use of Hypothermia as a Treatment for Traumatic Brain Injury

低温疗法在创伤性脑损伤治疗中的应用

Objective: This systematic review describes effects of body temperature alterations defined as fever, controlled normothermia, and spontaneous or induced hypothermia on outcome after traumatic brain injury (TBI) in adults. Data Sources: A search was conducted using PubMed, Cochrane Library database, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and ISI Web of Science in July 2013 with no back date restriction except for induced hypothermia (2009). Study Selection: Of 1366 titles identified, 712 were reviewed. Sixteen articles met inclusion criteria: randomized controlled trials in hypothermia since 2009 (last Cochrane review) or cohort studies of temperature in TBI, measure core and/or brain temperature, neurologic outcome reporting, primarily adult patients, and English language publications. Exclusion criteria were as follows: most patients with non-TBI diagnosis, primarily pediatric patients, case reports, or laboratory/animal studies. Data Synthesis: Most studies found that fever avoidance resulted in positive outcomes including decreased length of stay in the intensive care unit; mortality; and incidence of hypertension, elevated intracranial pressure, and tachycardia. Hypothermia on admission correlated with poor outcomes. Controlled normothermia improved surrogate outcomes. Prophylactic induced hypothermia is not supported by the available evidence from randomized controlled trial. Conclusion: Setting a goal of normothermia, avoiding fever, and aggressively treating fever may be most important after TBI. Further research is needed to characterize the magnitude and duration of temperature alteration after TBI, determine if temperature alteration influences or predicts neurologic outcome, determine if rate of temperature change influences or predicts neurologic outcome, and compare controlled normothermia versus standard practice or hypothermia.

Lori Kennedy Madden

Holli A. DeVon

A Systematic Review of the Effects of Body Temperature on Outcome After Adult Traumatic Brain Injury

成人创伤性脑损伤后体温对预后的影响：系统综述

Induced hypothermia (IH) continues to become a more prevalent treatment modality in neurocritical care. Reducing core temperature has been shown to protect brain tissue during injury and disease. IH has been particularly beneficial in the medical management of refractory intracranial hypertension and malignant cerebral edema. These pathologies are often the result of diffuse cerebral edema after traumatic brain injury, malignant ischemic stroke, or intracerebral hemorrhage. Although there are many benefits to IH, it is not without complications. Chief among these is shivering, which decreases oxygen delivery to brain tissue, increases metabolic demands, and consequently reduces nutrient delivery. This article will review indications for IH administration, methods of providing IH, nursing responsibilities, and identifying and/or managing complications.

Courtney J. Cook

Induced Hypothermia in Neurocritical Care: A Review

神经重症监护中的诱导低温：综述

The aim of this study was to evaluate the effectiveness of evidence-based guidelines for fever management of critically ill adult patients with brain injury.We used a pretest-posttest design with 48 patients 19 years or older admitted to an intensive care unit after surgery for brain injury. We applied evidence-based guidelines only to an experimental group of 24 patients and compared with 24 control patients who did not receive evidence-based guidelines. Experimental and control groups were matched 1:1 using the Acute Physiology and Chronic Health Evaluation II score. Data included the proportion of patients with reduced fever and time to normalized temperature.The proportion of patients whose temperature fell to normal after fever was 4.5 times higher in the experimental group than in the control group. The time it took the patients' highest fever to fall to normal during their intensive care unit stay was 4.84 times faster in the experimental group than in the control group (hazard ratio, 4.84; 95% confidence interval, 1.79-13.11; P = .002).Evidence-based guidelines for fever management in patients with a brain injury can be used in nursing practice with rapid response, improving healthcare efficiency and contributing to better outcomes for critically ill patients.

Jung Min Lee

Ju Ryoung Moon

Hye Jeong Kim

Do Yeon Kwon

Ja Young Shin

Evaluation of Evidence-Based Guidelines for Fever Management in Critically Ill Adult Patients With Brain Injury

基于证据的脑损伤危重成年患者发热管理指南评估

ABSTRACT BACKGROUND: The epilepsy monitoring unit (EMU) is an independent unit for video electroencephalogram monitoring of epilepsy patients, with the aim of capturing typical seizure events. Because of the uncontrolled seizure frequency, there may be safety risks for patients, such as falling, trauma, aspiration, status epilepticus, and sudden unexpected death in epilepsy. This study aims to evaluate the application effect of comprehensive safety projects on safety management in a pediatric EMU. METHODS: From June 2022 to May 2024, a preevaluation and postevaluation study was conducted at the EMU of a tertiary grade A children's specialized hospital in China. The intervention group carried out a unit-based comprehensive safety project, including nurse safety culture training, establishing a normalized mechanism for safety improvement, and developing evidence-based safety prevention strategies. RESULTS: The response time of paroxysmal events in the intervention group was shorter than that in the control group ( P &lt; .05). The scores of implementation of safety precautions and emergency measures in the intervention group were higher than those in the control group ( P &lt; .05). The nursing-related complications in the intervention group were lower than those in the control group ( P &lt; .05). CONCLUSION: The comprehensive unit-based safety project management mode can effectively improve the quality of EMU nursing care for children and reduce nursing-related complications.

Haiqin Wang

Hui Gan

Qin Zhou

Li Dai

A Comprehensive Unit-Based Safety Program to Enhance the Safe Management of Children in an Epilepsy Monitoring Unit

基于单元的综合安全计划以加强癫痫监测单元中儿童的安全管理

ABSTRACT BACKGROUND: Better self-management of chronic diseases may benefit patient functional status, medication effectiveness, lifestyle, and psychosocial health. Self-efficacy, disease perception, social support, anxiety, and depression are determinants of self-management behaviors in individuals with chronic illnesses. There remains a gap in the empirical exploration of the influence of these factors on self-management behaviors in young Chinese stroke survivors. This study examined how these factors affect specific self-management behaviors. METHODS: Validated instruments were used to evaluate patient self-efficacy, disease perception, social support, anxiety, and depression in a cross-sectional study. Structural equation modeling was used to examine the hypothesis. RESULTS: Self-efficacy and social support showed a positive correlation with self-management (0.421 and 0.446, respectively; P &lt; .001). Disease perception, anxiety, and depression were negatively correlated with self-management (−0.158 and −0.336, respectively; P &lt; .05). The structural equation model fit the data very well; social support had a direct positive effect on self-management ( t = 3.002, P &lt; .05) and self-efficacy ( t = 5.773, P &lt; .001). However, the presence of social support had a positive impact on reducing anxiety and depression ( t = −5.046, P &lt; .001). Furthermore, self-efficacy positively affected self-management ( t = 1.226, P &lt; .05), whereas anxiety and depression ( t = −1.190, P &lt; .05) and disease perception ( t = −1.068, P &lt; .05) had adverse effects on self-management. CONCLUSION: Medical staff and caregivers can improve patient self-management by helping them recognize the disease, reducing negative perceptions, communicating more for better understanding and care, intervening in anxiety and depression, and promoting mental health. This is especially important for young stroke patients.

Rongfang Zhang

Xiaojing Li

Huanli Luo

Jiangtao Niu

Huimin Zhang

Effect of Self-efficacy, Disease Perception, Social Support, Anxiety, and Depression on Self-management in Young Patients With Stroke

自我效能、疾病感知、社会支持、焦虑和抑郁对年轻卒中患者自我管理的影响

Questions or comments about this article may be directed to DaiWai Olson, PhD RN CCRN FNCS, at [email protected]. D.M.O. is a Professor, Departments of Neurology and Neurosurgery, University of Texas Southwestern, Dallas TX. Dr Olson is the editor of the Journal of Neuroscience Nursing.

DaiWai M. Olson

Nursing Myth, Meet Nursing Evidence

护理迷思，遇见护理实证

ABSTRACT Background: Over 795 000 US people per year experience a stroke, and 10% are younger than 50 years. After a stroke, posttraumatic stress disorder (PTSD) affects 10% to 30% of those patients and may compromise a survivor's secondary prevention compliance. At an inner-city clinic in Maryland where up to 300 young adult stroke survivors are followed, zero patients were screened for PTSD. A quality improvement project was implemented to screen for PTSD in a young adult stroke survivor clinic and to provide them with psychotherapy referrals and follow-up. Methods: Over 15 weeks in the fall of 2023, all patients presenting to the young adult stroke survivor clinic were screened for PTSD using the Posttraumatic Stress Disorder Checklist-5 validated screening tool. Providers and medical staff were all educated on the tool before implementation. Results: During the 15-week implementation period, 72 patients presented to the clinic. Posttraumatic stress disorder screening was completed for 88.9% (64/72). Of those, 32.8% (21/64) completed the Posttraumatic Stress Disorder Checklist-5 via the electronic health record, and 67.2% (43/64) completed it by in-person screening. Of the 64 patients screened, 12 patients screened positive for PTSD (18.8%, 12/64). Among those screening positive, 75% (9/12) were given a referral for psychotherapy. Conclusions: Literature reports that PTSD compromises stroke survivors' ability to optimize their health after a stroke. Screening identifies those experiencing symptoms of PTSD, providing an opportunity for referral and treatment. Results show that routine care of young stroke survivors can effectively include screening for PTSD.

Caitlin Palmisano

Madelyn O'Neal

Mary Ann Bautista

Carol A. O'Neil

Suzanna Fitzpatrick

Assessing Adherence to Posttraumatic Stress Disorder Screening in Young Stroke Survivors

评估年轻中风幸存者对创伤后应激障碍筛查的依从性

ABSTRACT BACKGROUND : Blood loss from phlebotomy is a significant cause of hospital-acquired anemia. Use of small-volume (Pedi) tubes in adult patients reduces blood loss by 40% and does not increase need for repeated labs. Although this practice is evidencebased, it has not been widely implemented. Using Pedi tubes for phlebotomy is a key component of blood management programs to decrease the incidence of hospital-acquired anemia and blood transfusions in the intensive care unit (ICU). Our aim was to implement the use of Pedi tubes for labs in the adult neurocritical care unit to demonstrate feasibility in this population. METHODS : This was a pre-/postintervention quality improvement project. All consecutive patients admitted to the neurocritical care unit from April 10, 2023, to October 10, 2023, aged 18–99 years, were included in the project. During the intervention period from July 10, 2023, to October 10, 2023, Pedi tubes were used for all laboratory draws except admission and crisis labs. A retrospective chart review from April 10 to July 9, 2024, established standard practice for comparison. We recorded hospital and ICU admission, nadir, and discharge hemoglobin, length of stay, number of rejected specimens, number of blood transfusions, discharge disposition, and 30-day readmission for all subjects. RESULTS : Pedi tube use was successfully implemented with significantly less need for repeat laboratory collections in the postintervention cohort ( P = .001). Although no difference was noted in hemoglobin levels, there was a decrease in both ICU and hospital length of stay by 1 day in the intervention arm. Fewer transfusions were required in the intervention cohort. CONCLUSIONS : Small-volume tube use for phlebotomy in adult neurocritical care patients is feasible and can lead to decreased blood transfusion need in the ICU.

Patricia J. Simonowicz

Kristin Bott

Joy Elwell

Matthew N. Jaffa

Reducing Blood Loss From Phlebotomy in Adult Neurocritical Care Patients: An Evidence-Based Practice Project

减少成人神经重症监护患者静脉穿刺失血：基于证据的实践项目

Abbreviation	J. Neurosci. Nurs.
Journal Impact	1.58
Quartiles(Global)	NURSING(Q3)

ISSN	0888-0395, 1945-2810
h-index	50

Publication Information	Publisher: Lippincott Williams and Wilkins Ltd.，Publishing cycle: Bimonthly，Journal Type: journal，Open Access Journals: No
Basic data	Year of publication: 1986，Proportion of original research papers: 90.48%，Self Citation Rate:26.70%， Gold OA Rate: 6.45%
Average review cycle	网友分享经验：>12周，或约稿
Average recruitment ratio	网友分享经验：容易

Journal of Neuroscience Nursing

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