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Background: Most critical thinking assessment tools are resource intensive and require significant time and money to administer. Moreover, these tools are not tailored to evaluate critical thinking skills among inpatient rehabilitation facility (IRF) nurses. This pilot study explores the efficacy of using short videos to evaluate critical thinking for nurses working in an IRF., Methods: We developed and filmed 3 clinical scenarios representative of common IRF events that require critical thinking on behalf of the nurse. Thirty-one IRF nurses participated in the study and independently scored their own critical thinking skills using a visual analog scale. Using the same scale, nurse managers and assistant managers who worked closely with the nurses also rated the critical thinking ability of each nurse. The nurse then viewed and responded in narrative form to each of the 3 videos. A scoring rubric was used to independently evaluate the critical thinking skills for each nurse based on the nurses' responses., Results: Nurses rated their own critical thinking skills higher than mangers rated them (m = 85.23 vs 62.89). There was high interrater reliability for scoring video 1k (0.65), video 2k (0.90), and video 3k (0.84)., Conclusion: The results demonstrate efficacy for further study of low-cost alternatives to evaluate critical thinking among neuroscience nurses providing IRF care., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 American Association of Neuroscience Nurses.)

Purpose: Autonomic dysreflexia (AD) is associated with spinal cord injury, manifesting in symptoms of high blood pressure, bradycardia, headache, diaphoresis, and anxiety. Nurses often manage these symptoms; thus, nursing knowledge of AD is crucial. The purpose of this study was to improve AD nursing knowledge while exploring differences between simulation and didactic learning in nurse education., Design and Methods: This prospective pilot study used two types of learning (simulation vs. didactic) to determine if one was superior to the other regarding nursing knowledge of AD. Nurses were given a pretest, randomized to simulation or didactic learning, and then given a posttest 3 months later., Results: Thirty nurses were enrolled in this study. Seventy-seven percent of nurses held a BSN degree with an average of 15.75 years in nursing. The mean knowledge scores for AD at baseline for the control (13.9 [2.4]) and intervention (15.5 [2.9]) groups were not statistically different ( p = .1118). The mean knowledge scores for AD after either didactic- or simulation-based education for the control (15.5 [4.4]) and intervention (16.5 [3.4]) groups were not statistically different ( p = .5204)., Clinical Relevance: Autonomic dysreflexia is a critical clinical diagnosis that requires prompt nursing intervention to prevent threatening consequences. This study focused on how different methods of education best benefited AD knowledge acquisition and how simulation versus didactic learning impacts overall nursing education., Conclusions: As a whole, providing nurses with AD education was helpful in improving their understanding of the syndrome. However, our data suggest that both didactic and simulation are equally effective methods to increase AD knowledge., (Copyright © 2023 Association of Rehabilitation Nurses.)

Background: Triage and neurological assessment of the 1.7 million traumatic brain injuries occurring annually is often done by nurse practitioners and physician assistants in the emergency department. Subjective assessments, such as the neurological examination that includes evaluation of the pupillary light reflex (PLR), can contain bias. Quantitative pupillometry (QP) standardizes and objectifies the PLR examination. Additional data are needed to determine whether QP can predict neurological changes in a traumatic brain injury (TBI) patient., Purpose: This study examines the effectiveness of QP in predicting neurological decline within 24 hours of admission following acute TBI., Methodology: This prospective, observational, clinical trial used pragmatic sampling to assess PLR in TBI patients using QP within 24 hours of ED admission. Chi-square analysis was used to determine change in patient status, through Glasgow Coma Scale (GCS), at baseline and within 24 hours of admission, to the QP., Results: There were 95 participants included in the analysis; of whom 35 experienced neuroworsening, defined by change in GCS of >2 within the first 24 hours of admission. There was a significant association between an abnormal Neurological Pupil index (NPi), defined as NPi of <3, and neuroworsening (p < .0001). The sensitivity (51.43%) and specificity (91.67%) of abnormal NPi in predicting neuroworsening were varied., Conclusion: There is a strong association between abnormal NPi and neuroworsening in the sample of TBI patients with high specificity and moderate sensitivity., Implications: NPi may be an early indicator of neurological changes within 24 hours of ED admission in patients with TBI., Competing Interests: Competing interests: Dr Olson is the Editor-in-Chief for the Journal of Neuroscience Nursing. The study did not receive external funding and the remaining authors declare no conflicts of interest., (Copyright © 2022 American Association of Nurse Practitioners.)

Abstract: Hypertension (HTN) affects over one third of adults in the United States. Blood pressure (BP) management and patient education are provided by physicians, advanced practice clinicians, pharmacists, and nurses. In the traditional medical/clinic model, physicians have provided and directed HTN care. However, advanced practice nurses and pharmacists are also well trained and positioned to manage HTN. The purpose of this study was to explore the feasibility of an HTN clinic, led by a nurse practitioner (NP) and PharmD, specifically analyzing if targeted HTN can be achieved in this setting. Registry data were used to analyze the initial and the most recent visit BP levels in patients who were seen in an NP/PharmD-led HTN clinic. Measures of central tendency and differences between initial and most recent visit were also compared. A total of 46 patients were included in this analysis. Data showed that there was no statistically significant difference in the first visit (144/86) and the most recent visit (138/84) BP ( p = .26), but that there was a clinical trend in decreasing BP as well as narrowing of BP ranges and interquartile ranges between visit. The NP/PharmD-led clinic is feasible and can help lower BP and narrow ranges toward targeted BP., Competing Interests: Competing interests: The authors report no conflicts of interest., (Copyright © 2022 American Association of Nurse Practitioners.)

Abstract: Alzheimer disease (AD) is a devastating diagnosis. Milieu therapy and memory activities have been shown to improve self-worth and improve mood in AD patients, but adherence to these activities is challenging. This prospective randomized pilot study examined adherence to memory recall activities using positive reinforcement and explored the impact on self-worth and depression. Pretest-posttest scores and data abstraction were used to measure protocol adherence, self-worth (Rosenberg Self-Esteem Scale), cognitive decline (Mini-Mental Status Examination), and symptoms of depression (Geriatric Depression Scale). Among 22 mild AD participants, there were no statistically significant differences in pretest versus posttest scores for all measures. The results suggest that the intervention of memory recall did not enhance self-worth, improve the status of memory recall, or lower symptoms of depression. Additionally, positive reinforcement did not play a role in adherence to accessing the tasks., Competing Interests: Competing interests: The authors report no conflicts of interest., (Copyright © 2019 American Association of Nurse Practitioners.)

Purpose: The aim of the study was to determine if listening to music may reduce anxiety experienced by stroke patients during acute rehabilitation., Design: A prospective, nonblinded, randomized study in an inpatient rehabilitation setting., Methods: Fifty participants were randomized into two groups: (1) 1 hour of music (intervention) or (2) no music (control). All participants completed pretest anxiety and depression screening and 44 completed the posttest anxiety screening. Differences between groups were determined using chi-square and t tests., Findings: After listening to music for 1 hour, participants who completed the posttest (n = 44) reported significantly less anxiety (p < .0001) compared to before the intervention. The control group showed no difference in their pre- and posttest anxiety scores (p = .84). No differences were determined among age, gender, or diagnostic groups., Conclusions: These findings demonstrate that music intervention may help lessen anxiety in rehabilitation patients poststroke., Clinical Relevance: Offering musical intervention to stroke patients in rehabilitation may lessen symptoms of anxiety.

Purpose: This study examined the effectiveness of the consensus model (Clinical Advisory Board for Intermittent Catheterization [CABIC] method) for teaching clean intermittent self-catheterization (ISC). The primary hypothesis was that the CABIC method of teaching ISC would result in higher ISC knowledge and performance scores., Design: Prospective, non randomized, pre-post study of an educational intervention of ISC education with nursing students., Methods: Nursing students completed a self-report pre-/posttest, education of the CABIC method, and video recording of the CABIC method using same-gendered manikins. The Le Danseur Instrument (LDI) was used to grade the video-recorded demonstration., Findings: Fifty participants completed three phases of the study. Paired t test showed statistically significant improvement in ISC knowledge. A mean score of 92-93 demonstrated a high level of participant education retention., Conclusions: The CABIC method of teaching clean ISC is associated with improvement in generalized clean ISC knowledge and performance scores., Clinical Relevance: The CABIC method can be integrated into clinical practice as an evidence-based approach to teaching ISC.