RESUMO
Ischemic stroke remains the fifth leading cause of death in the United States. Nurses play a pivotal role in the care of patients throughout the continuum. With the advances in stroke care, including mechanical thrombectomy, the American Heart Association/American Stroke Association charged the writing panel to complement the 2009 clinical practice guideline, "Comprehensive Overview of Nursing and Interdisciplinary Care of the Acute Ischemic Stroke Patient," with current evidence-based nursing care. This update is 1 of a 3-part series focusing on emergency medical services/emergency care, endovascular/intensive care unit care, and postacute care. The aim of this scientific statement is to review and present current evidence, complications, best practices, and clinical practice strategies to provide current comprehensive scientific information for nursing care in the neuroendovascular area and intensive care unit in conjunction with medical treatments, including intravenous thrombolysis and mechanical thrombectomy.
Assuntos
Enfermagem Baseada em Evidências , Unidades de Terapia Intensiva , AVC Isquêmico/terapia , Cuidados de Enfermagem , Cuidados Semi-Intensivos , American Heart Association , Humanos , Estados UnidosRESUMO
Surgical-site infections (SSI) contribute to increased hospital length of stay, readmission rates, cost, and morbidity and mortality rates. The spine service line at a suburban Level II trauma center encountered 2 SSIs among the spine fusion population within a 6-month period. This did not meet the organization's internal benchmark of zero. A pilot quasi-experimental design was used to determine whether preoperative cleansing with 2% chlorhexidine gluconate (CHG)-impregnated cloths versus current practice of bathing with 4% CHG solution would reduce SSIs. Infection rates were measured using simple percentages. Level of significance was p < .05. Outcome data showed a reduction in SSIs from 3.9% to 1.9% with use of 2% CHG-impregnated cloths. There was no significant difference found between the use of 2% CHG-impregnated cloths and 4% CHG solution (p = .524). This quality improvement change, combined with a strengthened preoperative bundle approach, has permanently been adopted within the spine service line. From October 2017 to March 2021, the spine service line has had zero SSIs within the spine fusion population.