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☐ ☆ ✇ Evidence-Based Nursing

Preoperative functional performance is the best predictor for loss of independence after major surgery among older adults

Por: Johnson · C. E. · Brooke · B. S. — Diciembre 15th 2023 at 10:25

Commentary on: Goeddel L, Murphy Z, Owodunni O, et al. Domains of Frailty Predict Loss of Independence in Older Adults after Non-Cardiac Surgery. Ann Surg. 2022 Sep 20. doi: 10.1097/SLA.0000000000005720. Epub ahead of print.

Implications for practice and research

  • Frailty screening with the Edmonton Frailty Scale can be used to identify risk factors for loss of independence after surgery, including a patient’s functional performance, functional dependence, social support and urinary incontinence.

  • Prospective studies are needed to test whether risk factors can be modified before surgery to prevent loss of independence among frail patients.

  • Context

    Frailty is a common syndrome of physiological decline among older adults characterised by vulnerability to adverse outcomes and loss of functional independence after major surgery.1 The study by Goeddel et al2 examined 11 geriatric domains associated with frailty that were collected before surgery using the Edmonton...

    ☐ ☆ ✇ Evidence-Based Nursing

    Early rehabilitation of patients in the ICU may reduce long-term healthcare costs

    Por: Al Qadire · M. · Abdelrahman · H. — Diciembre 15th 2023 at 10:25

    Commentary on: Murooka Y, Sasabuchi Y, Takazawa T, Matsui H, Yasunaga H, Saito S. Long-Term Prognosis Following Early Rehabilitation in the ICU: A Retrospective Cohort Study. Crit Care Med. 2023 Mar 29. doi: 10.1097/CCM.0000000000005862. Epub ahead of print.

    Implications for practice and research

  • Rehabilitation programmes if introduced early after admissions to intensive care unit could be beneficial to patients and healthcare systems.

  • Prospective studies are needed to confirm the long-term impacts of early introduction of rehabilitation programmes on healthcare outcomes in terms of, quality of life and physical functions, the optimal timing, duration, and intensity of rehabilitation.

  • Context

    Early rehabilitation is a promising treatment for postintensive care syndrome. Studies have demonstrated the benefits of rehabilitation, such as early exercise and mobilisation, which improve short-term physical and functional outcomes and reduce intensive care unit (ICU) and hospital stay durations for critically ill patients.1...

    ☐ ☆ ✇ Evidence-Based Nursing

    Innovative and evidence-informed technology-based assessment can facilitate comprehensive cancer rehabilitation by improving cancer care outcomes through personalised nurse-led follow-up interventions

    Por: Ghassemi · A. E. — Diciembre 15th 2023 at 10:25

    Commentary on: Skorstad M, Vistad I, Fegran L, et al. Nurse-led consultation reinforced with eHealth technology: a qualitative study of the experiences of the patients with gynecological cancer. BMC Nurs 2022;21:326. doi: 10.1186/s12912-022-01104-9.

    Implications for practice and research

  • To improve continuity and quality of cancer care (QoCC) and patients’ adherence to the oncological treatments, it is necessary to develop innovative, digitalised, personalised and evidence-informed follow-up interventions that enhances patients’ quality of life (QoL).

  • Future research should focus on developing clear guidance and efficient technology-based assessment measures that are necessary for providing individualised early palliative care and post-treatment interventions.

  • Context

    A surge in the ageing population and the rising incidence of cancer risk factors have resulted in the increase in the occurrence of cancer in women worldwide, which requires careful treatment planning and innovations in post-treatment follow-up interventions.1–3 Several...

    ☐ ☆ ✇ Evidence-Based Nursing

    Nurse-driven patient empowerment intervention reduces patients anxiety and depression during the discharge from critical care units

    Por: Al Qadire · M. — Septiembre 26th 2023 at 16:14

    Commentary on: Cuzco C, Castro P, Marín Pérez R, Ruiz García S, Núñez Delgado AI, Romero García M, Martínez Momblan MA, Benito Aracil L, Carmona Delgado I, Canalias Reverter M, Nicolás JM, Martínez Estalella G, Delgado-Hito P. Impact of a Nurse-Driven Patient Empowerment Intervention on the Reduction in Patients' Anxiety and Depression During ICU Discharge: A Randomized Clinical Trial. Crit Care Med. 2022 Dec 1;50(12):1757-1767. doi: 10.1097/CCM.0000000000005676. Epub 2022 Sep 30.

    Implications for practice and research

  • Critical care nurses are advised to implement a nurse-driven patient empowerment intervention (NEI) in their daily practice to aid discharged patients.

  • The long-term effects of NEI on patients with varying diseases need further evaluation.

  • Context

    Several studies have indicated that a significant proportion of patients who have been admitted or discharged from an intensive care unit (ICU) experienced high levels of anxiety and depression.1 2

    ☐ ☆ ✇ Evidence-Based Nursing

    Oxygen supplementation above a low-flow nasal cannula in patients with COVID-19 may improve arterial oxygen levels but not breathlessness

    Por: Prakash · J. · Sahay · N. — Septiembre 26th 2023 at 16:14

    Commentary on: Poncin W, Baudet L, Braem F, Reychler G, Duprez F, Liistro G, Belkhir L, Yombi JC, De Greef J. Systems on top of nasal cannula improve oxygen delivery in patients with COVID-19: a randomized controlled trial. J Gen Intern Med 2022;37(5):1226–32. doi: 10.1007/s11606-022-07419-2. Epub 8 Feb 2022.

    Implications for practice and research

  • The adverse consequences of continuous exposure to high concentrations of oxygen must be considered before instituting prolonged oxygen therapy in patients with COVID-19.

  • Hypoxaemia is significant in patients with COVID-19, and isolated arterial oxygen pressure (PaO2) improvement may not necessarily translate into any significant survival benefit nor relieve the distress of breathlessness.

  • Context

    Oxygen therapy is important in COVID-19 management. The low-flow nasal cannula (NC) has some drawbacks. The patient’s peak inspiratory flow rate requirements are not met due to significant leakage around the source. A need to improve oxygen...

    ☐ ☆ ✇ Evidence-Based Nursing

    Early mobilisation in the intensive care unit randomised controlled trial: a need to look beyond the surface

    Por: Anekwe · D. · Spahija · J. — Septiembre 26th 2023 at 16:14

    Commentary on: TEAM Study Investigators and the ANZICS Clinical Trials Group; Hodgson CL, Bailey M, Bellomo R, Brickell K, Broadley T, Buhr H, Gabbe BJ, Gould DW, Harrold M, Higgins AM, Hurford S, Iwashyna TJ, Serpa Neto A, Nichol AD, Presneill JJ, Schaller SJ, Sivasuthan J, Tipping CJ, Webb S, Young PJ. Early active mobilization during mechanical ventilation in the ICU. N Engl J Med 2022;387(19):1747–58. doi:10.1056/NEJMoa2209083. Epub 26 Oct 2022.

    Implications for practice and research

  • Early mobilisation may improve patient outcomes; however, starting with a higher dosage at the early stage of critical illness may not provide any added benefit.

  • Future research should explore the intensity, timing, duration and level of activity required to optimise physical rehabilitation of critically ill patients.

  • Context

    Early mobilisation (EM) refers to the practice of initiating physical activity that is of sufficient intensity to elicit acute physiological effects...

    ☐ ☆ ✇ Evidence-Based Nursing

    Home-based model is an important cost-effective alternative to centre-based cardiac rehabilitation

    Por: Batalik · L. · Su · J. J. — Septiembre 26th 2023 at 16:14

    Commentary on: Shields GE, Rowlandson A, Dalal G, Nickerson S, Cranmer H, Capobianco L, Doherty P. Cost-effectiveness of home-based cardiac rehabilitation: a systematic review. Heart. 2023 Feb 27:heartjnl-2021-320459. doi: 10.1136/heartjnl-2021-320459. Epub ahead of print.

    Implications for practice and research

  • Home-based cardiac rehabilitation (CR) is a cost-effective alternative/supplementary model to increase CR accessibility, improve health benefits and reduce health service use.

  • More robust clinical trials are needed as the heterogeneity in design, particularly the intervention dosage, staffing models, telehealth features, hybrid approach and individual costs, challenges the evidence base.

  • The psychological care component is missing in the current cost-effectiveness analysis of home-based CR.

  • Context

    Despite evidence that exercise-based cardiovascular rehabilitation (CR) is an effective intervention, patient uptake and adherence are uncertain. Recent research suggests that home-based CR interventions are as effective and safe as those supervised in a centre.1 Therefore, home-based telemedicine...

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