1.Expert consensus on safety management of inpatients with Alzheimer's disease
Yuchen QIAO ; Hong CHANG ; Hong SUN ; Kaiting FAN ; Xuan YANG ; Siying TIAN
Chinese Journal of Modern Nursing 2024;30(8):981-988
Objective:To develop an expert consensus on safety management of inpatients with Alzheimer's disease (AD) (referred to as the " Consensus") and standardize safety management strategies for AD inpatients. Methods:The evidence on safety management of AD inpatients was searched, evaluated, and summarized, with a search period from database establishment to July 31, 2023. This study conducted methodological quality evaluation and evidence extraction on the included article to form a consensus draft. A total of 24 experts from 15 hospitals across the country were selected for two rounds of Delphi expert consultation to analyze, revise, and improve their opinions, forming the final draft of the Consensus. Results:The positive coefficients for both rounds of expert consultation were 100.00% (24/24). In the second round of consultation, the expert judgment basis coefficient was 0.925, familiarity level was 0.846, authority coefficient was 0.886, Kendall harmony coefficient was 0.044 ( P<0.01). The Consensus elaborated on five common safety problems (loss, falling, aspiration/choking, self-injury/other injury, and medication errors in AD inpatients) from three aspects (assessment, identification of risk factors, and nursing strategies) . Conclusions:The Consensus is scientific and practical to a certain extent, providing guidance and reference for the safety management practice of AD inpatients.
2.Clinical observation and nursing management of infusion-related reactions induced by lecanemab in Alzheimer disease patients
Kaiting FAN ; Yuchen QIAO ; Rui WANG ; Bingxin XIE
Adverse Drug Reactions Journal 2024;26(12):720-725
Objective:To explore the occurrence and clinical characteristics of infusion-related reactions (IRRs) caused by lecanemab in Chinese patients with Alzheimer disease, and summarize the nursing management experience of IRRs.Methods:This study was a single center retrospective study and the subjects were Alzheimer′s disease patients who received lecanemab (10 mg/kg, once every 2 weeks) in the Department of Neurology, Xuanwu Hospital, Capital Medical University from June 26 to August 18, 2024. The occurrence, clinical characteristics, severity, and outcome of IRRs that occurred during the treatment of lecanemab in these patients were descriptively analyzed.Results:A total of 45 patients were included in the study, including 15 males (33.3%) and 30 females (66.7%); the age ranged from 52 to 82 years, with a median age of 62 years. Among the 45 patients, 15 (33.3%) developed IRRs, including 6 males and 9 females, and 2 of them had a previous history of allergy. In the 15 patients, there were 3, 8, 1 and 3 patients with 1, 2, 3 and 4 treatment cycles, respectively; 13 patients were pretreated with diphenhyd-ramine 30 minutes before lecanemab treatment; 14 patients had IRRs in the first cycle of lecanemab treatment, and 1 in the second cycle; IRRs occurred within 5 hours after finishing the intravenous infusion of lecanemab in 13 patients and on the second day after the administration in 2 patients. The main manifestations of IRRs were fever and chills; some patients had headache, nausea, and vomiting symptoms, and only 1 patient developed rash and itching. After symptomatic treatments, these symptoms in the 13 patients were relieved soon, and IRRs did not recur after the continued treatment of lecanemab according to the regime. The severity of IRRs was grade 1, 2, and 3 in 5, 9, and 1 patient, respectively. The incidence of severe IRRs was 2.2% (1/45).Conclusions:IRRs are common adverse reactions of lecanemab, mainly characterized by fever and chills, with mild severity. Generally, lecanemab-related IRRs occurs after the first administration, and may not occur again in the continued treatments. Vital signs should be routinely monitored in lecanemab treatment. Once IRRs occur, timely treatments should be given according to the severity, and the prognosis is usually good.
3.Clinical observation and nursing management of infusion-related reactions induced by lecanemab in Alzheimer disease patients
Kaiting FAN ; Yuchen QIAO ; Rui WANG ; Bingxin XIE
Adverse Drug Reactions Journal 2024;26(12):720-725
Objective:To explore the occurrence and clinical characteristics of infusion-related reactions (IRRs) caused by lecanemab in Chinese patients with Alzheimer disease, and summarize the nursing management experience of IRRs.Methods:This study was a single center retrospective study and the subjects were Alzheimer′s disease patients who received lecanemab (10 mg/kg, once every 2 weeks) in the Department of Neurology, Xuanwu Hospital, Capital Medical University from June 26 to August 18, 2024. The occurrence, clinical characteristics, severity, and outcome of IRRs that occurred during the treatment of lecanemab in these patients were descriptively analyzed.Results:A total of 45 patients were included in the study, including 15 males (33.3%) and 30 females (66.7%); the age ranged from 52 to 82 years, with a median age of 62 years. Among the 45 patients, 15 (33.3%) developed IRRs, including 6 males and 9 females, and 2 of them had a previous history of allergy. In the 15 patients, there were 3, 8, 1 and 3 patients with 1, 2, 3 and 4 treatment cycles, respectively; 13 patients were pretreated with diphenhyd-ramine 30 minutes before lecanemab treatment; 14 patients had IRRs in the first cycle of lecanemab treatment, and 1 in the second cycle; IRRs occurred within 5 hours after finishing the intravenous infusion of lecanemab in 13 patients and on the second day after the administration in 2 patients. The main manifestations of IRRs were fever and chills; some patients had headache, nausea, and vomiting symptoms, and only 1 patient developed rash and itching. After symptomatic treatments, these symptoms in the 13 patients were relieved soon, and IRRs did not recur after the continued treatment of lecanemab according to the regime. The severity of IRRs was grade 1, 2, and 3 in 5, 9, and 1 patient, respectively. The incidence of severe IRRs was 2.2% (1/45).Conclusions:IRRs are common adverse reactions of lecanemab, mainly characterized by fever and chills, with mild severity. Generally, lecanemab-related IRRs occurs after the first administration, and may not occur again in the continued treatments. Vital signs should be routinely monitored in lecanemab treatment. Once IRRs occur, timely treatments should be given according to the severity, and the prognosis is usually good.
4.Research progress of assessment tools for stroke-related sleep disorders
Mengjiao CHEN ; Jie ZHAO ; Kaiting FAN ; Hong CHANG ; Hui YAO
Chinese Journal of Modern Nursing 2021;27(22):3071-3076
Stroke-related sleep disorder is a common clinical manifestation after stroke, which has a greater impact on the prognosis and recovery of patients, but it is often overlooked in actual clinical work. Therefore, it is necessary to quantitatively evaluate the severity of stroke-related sleep disorders through relevant assessment scales in order to facilitate clinical intervention and improve patient prognosis. This article reviews the subjective and objective assessment tools of stroke-related sleep disorders, so as to provide certain theoretical support and a reference basis for the diagnosis, intervention and effect evaluation of stroke-related sleep disorders.
5.A qualitative study on nursing practice of intravenous thrombolysis in acute ischemic stroke
Wenya CAO ; Hong CHANG ; Jie ZHAO ; Kaiting FAN ; Hui YAO
Chinese Journal of Modern Nursing 2020;26(26):3639-3643
Objective:To understand the current situation and existing problems of nursing practice of intravenous thrombolysis in acute ischemic stroke and to reflect on and put forward specific suggestions, so as to provide reliable practical basis for improving nursing practice level of acute ischemic stroke.Methods:Using the phenomenological method of qualitative research, 12 nurses attended in an advance studies from different area of China who participated in in-hospital treatment of acute ischemic stroke in Xuanwu Hospital of Capital Medical University were selected as the research objects from October to November 2019, and they were interviewed by semi-structured in-depth interview. Data were collected by notes and recordings, and Colaizzi content analysis was used for data analysis.Results:The nurses' experience of intravenous thrombolysis nursing for acute ischemic stroke included: full awareness of participating in the in-hospital treatment of intravenous thrombolysis for acute ischemic stroke, but lack of professional knowledge of venous thrombolysis for acute ischemic stroke and easy confusion of thrombolytic nursing practice knowledge and basic first aid knowledge. In terms of nursing management, nurses had low cognition and enthusiasm for quality control of intravenous thrombolysis nursing practice.Conclusions:The organized treatment mode of ischemic stroke is still in the practice stage. The training of stroke specialists and the quality control of intravenous thrombolysis nursing practice is an important part of improving the level of medical treatment in the hyperacute phase of ischemic stroke.

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