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Tytuł:
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Feasibility of Nurse-Led Multidimensional Outcome Assessments in the Neuroscience Intensive Care Unit.
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Autorzy:
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Schlichter E; Erika Schlichter is a bedside critical care nurse, UCHealth, University of Cincinnati Medical Center, and a member of the Collaborative for Research on Acute Neurological Injuries (CRANI), University of Cincinnati, Cincinnati, Ohio.
Lopez O; Omar Lopez is a research coordinator with the Division of Neuro-critical Care, Department of Neurology and Rehabilitation Medicine, University of Cincinnati Medical Center, and a member of CRANI.
Scott R; Raymond Scott is a medical student, College of Medicine, University of Cincinnati Medical Center.
Ngwenya L; Laura Ngwenya is an assistant professor, Department of Neurology and Rehabilitation Medicine and Department of Neurosurgery, University of Cincinnati Medical Center, and Director, Neurotrauma Center, University of Cincinnati Gardner Neuroscience Institute, Cincinnati, Ohio. She is a cofounder of CRANI.
Kreitzer N; Natalie Kreitzer is an assistant professor, Department of Emergency Medicine, University of Cincinnati Medical Center, and a member of CRANI.
Dangayach NS; Neha S. Dangayach is an assistant professor, Department of Neurology, Icahn School of Medicine and Mount Sinai Health System, New York, New York.
Ferioli S; Simona Ferioli is an assistant professor, Department of Neurology and Rehabilitation Medicine, University of Cincinnati Medical Center, and a member of CRANI.
Foreman B; Brandon Foreman is an associate professor, Department of Neurology and Rehabilitation Medicine, University and Department of Neurosurgery, University of Cincinnati Medical Center. He is a cofounder of CRANI.
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Źródło:
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Critical care nurse [Crit Care Nurse] 2020 Jun 01; Vol. 40 (3), pp. e1-e8.
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Typ publikacji:
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Journal Article
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Język:
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English
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Imprint Name(s):
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Publication: : Aliso Viejo, CA : American Association of Critical-Care Nurses
Original Publication: [Bridgewater, N.J. : Simms Associates, c1980-
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MeSH Terms:
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Critical Care/*statistics & numerical data
Critical Care Nursing/*methods
Critical Illness/*psychology
Critical Illness/*therapy
Outcome Assessment, Health Care/*methods
Outcome Assessment, Health Care/*statistics & numerical data
Quality of Life/*psychology
Adult ; Aged ; Aged, 80 and over ; Cohort Studies ; Feasibility Studies ; Female ; Humans ; Intensive Care Units/statistics & numerical data ; Male ; Middle Aged ; Neuroscience Nursing/statistics & numerical data ; Nurse's Role ; Ohio ; Time Factors
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Grant Information:
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T32 NS047996 United States NS NINDS NIH HHS
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Entry Date(s):
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Date Created: 20200602 Date Completed: 20210614 Latest Revision: 20210614
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Update Code:
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20240104
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DOI:
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10.4037/ccn2020681
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PMID:
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32476030
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Background: The outcome focus for survivors of critical care has shifted from mortality to patient-centered outcomes. Multidimensional outcome assessments performed in critically ill patients typically exclude those with primary neurological injuries.
Objective: To determine the feasibility of measurements of physical function, cognition, and quality of life in patients requiring neurocritical care.
Methods: This evaluation of a quality improvement initiative involved all patients admitted to the neuroscience intensive care unit at the University of Cincinnati Medical Center.
Interventions: Telephone assessments of physical function (Glasgow Outcome Scale-Extended and modified Rankin Scale scores), cognition (modified Telephone Interview for Cognitive Status), and quality of life (5-level EQ-5D) were conducted between 3 and 6 months after admission.
Results: During the 2-week pilot phase, the authors contacted and completed data entry for all patients admitted to the neuroscience intensive care unit over a 2-week period in approximately 11 hours. During the 18-month implementation phase, the authors followed 1324 patients at a mean (SD) time of 4.4 (0.8) months after admission. Mortality at follow-up was 38.9%; 74.8% of these patients underwent withdrawal of care. The overall loss to follow-up rate was 23.6%. Among all patients contacted, 94% were available by the second attempt to interview them by telephone.
Conclusions: Obtaining multidimensional outcome assessments by telephone across a diverse population of neurocritically ill patients was feasible and efficient. The sample was similar to those in other cohort studies in the neurocritical care population, and the loss to follow-up rate was comparable with that of the general critical care population.
(©2020 American Association of Critical-Care Nurses.)
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