Keywords
Tissue Plasminogen Activator
Nursing Care
Clinical Competence
Thrombolytic Therapy
Accidente Cerebrovascular
Activador de Tejido Plasminógeno
Atención de Enfermería
Competencia Clínica
Terapia Trombolítica
Acidente Vascular Cerebral
Ativador de Plasminogênio Tecidual
Cuidados de Enfermagem
Competência Clínica
Terapia Trombolítica
How to Cite
Abstract
Introduction: Ischemic stroke is treated with thrombolytic therapy, applied even in the acute phase, promoting a significant improvement in the after-effects caused by this condition. Considering the complexity of thrombolytic therapy, it is necessary for nurses to understand the skills required to assist in care.
Objective: To identify scientific evidence about the competencies of nurses in the care of patients with stroke who are eligible for thrombolytic therapy.
Methodology: An integrative review consisting of six stages (elaboration of the question, literature review, data collection, analysis, discussion, and presentation), conducted in MEDLINE, LILACS, BDENF, IBECS, PubMed, Scopus, Web of Science, Embase, and CINAHL databases. The search was carried out between August and September 2022 using primary studies as the inclusion criteria: free of charge, fully available electronically, published in English, Portuguese, or Spanish. Initially, 2.830 studies were obtained, which underwent a selection process that included only those studies that met the previously established criteria.
Results: Based on the twelve studies included in this review, competencies focused on three care activities were identified: care management such as teamwork; codes; flows and protocols; patient care before, during, and after the use of thrombolytic therapy; and education health education for staff, patients, and families.
Conclusion: The findings of this review highlighted the nurses' competencies in the care of patients eligible for thrombolytic therapy, which encompass different areas of the nurse's work. For this study, assistance competencies prevailed, followed by management competencies.
References
Hui C, Tadi P, Patti L. Ischemic Stroke. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2022. Disponível em: https://www.ncbi.nlm.nih.gov/books/NBK499997/
Schmidt MH, Selau CM Soares PS Franchi EF, Piber VD, Quatrin LB. Acidente vascular cerebral e diferentes limitações: uma análise interdisciplinar. Arq. Ciênc. Saúde UNIPAR. 2019;23(2):139-144. Disponível em: https://ojs.revistasunipar.com.br/index.php/saude/article/view/6404/3778
Feigin VL, Stark BA, Johnson CO, Roth GA, Bisignano C, Abady GG, et al. Global, regional, and national burden of stroke and its risk factors, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol. 2021; 20:795-820. doi: https://doi.org/10.1016/s1474-4422(21)00252-0
GBD Compare [site]. Seattle, WA: IHME. University of Washington, 2019. Disponível em: http://vizhub.healthdata.org/gbd-compare
Liang X, Gao W, Xu J, Saymuah S, Wang X, Wang J, et al. Triage Nurse-Activated Emergency Evaluation Reduced Door-to-Needle Time in Acute Ischemic Stroke Patients Treated with Intravenous Thrombolysis. Evidence-Based Complementary and Alternative Medicine. 2022; 2022:7. doi: https://doi.org/10.1155/2022/9199856
Liu C, Xie J, Sun S, Li H, Li T, Jiang C, et al. Hemorrhagic Transformation After Tissue Plasminogen Activator Treatment in Acute Ischemic Stroke. Mol Neurobiol. 2020; 42(3):621-646. doi: https://doi.org/10.1007/s10571-020-00985-1
Powers WJ, Rabinstein AA, Ackerson T, Adeoye OM, Bambakidis NC, Becker K, et al. Guidelines for the Early Management of Patients With Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke. 2019; 50(12):344-418. doi: https://doi.org/10.1161/STR.0000000000000211
Rodgers ML, Fox E, Abdelhak T, Franker LM, Johnson BJ, Kirchner-Sullivan C, et al. Care of the Patient With Acute Ischemic Stroke (Endovascular/Intensive Care Unit-Postinterventional Therapy): Update to 2009 Comprehensive Nursing Care Scientific Statement: A Scientific Statement From the American Heart Association. Stroke. 2021; 52(5):198-210. doi: https://doi.org/10.1161/STR.0000000000000358
Brasil. Lei 7.498, de 25 de junho de 1986. Dispõe sobre a Regulamentação do Exercício da Enfermagem e dá outras providências. Brasília: Ministério da Saúde; 1986. Disponível em: https://www.planalto.gov.br/ccivil_03/leis/l7498.htm
Conselho Federal de Enfermagem (COFEN). Resolução COFEN nº 358/2009. Dispõe sobre a Sistematização da Assistência de Enfermagem e a implementação do Processo de Enfermagem em ambientes, públicos ou privados, em que ocorre o cuidado profissional de Enfermagem, e dá outras providências [Internet]. Brasília: COFEN; 2009. Disponível em: http://www.cofen.gov.br/resoluocofen-3582009_4384.html
Lopes OCA, Henriques SH, Soares MI, Celestino LC, Leal LA. Competências dos enfermeiros na estratégia Saúde da Família. Esc. Anna. Nery. 2019; 24(2):1-8. doi: https://doi.org/10.1590/2177-9465-EAN-2019-0145
Mendes KDS, Silveira RCCP, Galvão CM. Revisão integrativa: método de pesquisa para a incorporação de evidências na saúde e na enfermagem. Texto Contexto Enferm. 2008; 17(4):758-764. doi: https://doi.org/10.1590/S0104-07072008000400018
Cardoso V, Trevisan I, Cicolella DA, Waterkemper R. Revisão sistemática de métodos mistos: método de pesquisa para a incorporação de evidências na enfermagem. Texto Contexto Enferm 2019; 28:e20170279. doi: https://dx.doi.org/10.1590/1980-265X-TCE-2017-0279
Ouzzani M, Hammady H, Fedorowicz Z, Elmagarmid A. Rayyan: a web and mobile app for systematic reviews. Syst Rev. 2016; 5:210. doi: https://doi.org/10.1186/s13643-016-0384-4
Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group. Preferred Reporting Items for Systematic Reviews and MetaAnalyses: The PRISMA Statement. PLoS Med. 2009; 6(7):e1000097. doi: https://doi.org/10.1371/journal.pmed.1000097
Romanzini AE. Recuperação cirúrgica retardada: análise do conceito. [Dissertação]. Ribeirão Preto: Escola de Enfermagem de Ribeirão Preto da Universidade de São Paulo. 2013. Disponível em: https://www.teses.usp.br/teses/disponiveis/22/22132/tde-26092013-180326/publico/ADILSONEDSONROMANZINI.pdf
Fineout-Overholt E, Stillwell SB. Asking compelling, clinical questions. In: Melnyk BM, Fineout-Overholt E. Evidence-based practice in nursing & healthcare. A guide to best practice. 2nd. ed. Philadelphia: Wolters Kluwer, Lippincot Williams & Wilkins, p. 25-39, 2011.
Brasil. Lei n. 9.610, de 19 de fevereiro de 1998. Altera, atualiza e consolida a legislação sobre direitos autorais e dá outras providencias. Disponível em: http://www.planalto.gov.br/ccivil_03/leis/l9610.htm
Innes K, IST-3 Stroke Nurse Collaborative Group. Thrombolysis for acute ischaemic stroke: core nursing requirements. Br J Nurs. 2003; 12(7):416-24. doi: https://doi.org/10.12968/bjon.2003.12.7.11262
Maniva SJCF, Freitas CHA. Uso de alteplase no tratamento do acidente vascular encefálico isquêmico agudo: o que sabem os enfermeiros?. Revista Brasileira de Enfermagem. 2012; 65(3):474-481. doi: https://doi.org/10.1590/S0034-71672012000300012
Moran JL, Nakagawa K, Asai SM, Koenig MA. 24/7 Neurocritical Care Nurse Practitioner Coverage Reduced Door-to-Needle Time in Stroke Patients Treated with Tissue Plasminogen Activator. J Stroke Cerebrovasc Dis. 2016; 25(5):1148-1152. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.01.033
Alexandrov AW, Coleman KC, Palazzo P, Shahripour RB, Alexandrov AV. Direct stroke unit admission of intravenous tissue plasminogen activator: safety, clinical outcome, and hospital cost savings. Therapeutic Advances in Neurological Disorders. 2016; 9(4):304-309. doi: http://dx.doi.org/10.1177/1756285616648061
Nonnenmacher CL, Ávila CW, Mantovani VM, Vargas MAO, Echer IC, Lucena AF. Cross Mapping Between the Priority Nursing Care for Stroke Patients Treated With Thrombolytic Therapy and the Nursing Interventions Classification (NIC). Int J Nurs Knowl. 2016; 28(4):171-177. doi: https://doi.org/10.1111/2047-3095.12147
Mainali S, Stutzman S, Sengupta S, Dirickson A, Riise L, Jones D, et al. Feasibility and Efficacy of Nurse-Driven Acute Stroke Care. Journal of Stroke and Cerebrovascular Diseases. 2017; 26(5):987-991. doi: https://doi.org/10.1016/j.jstrokecerebrovasdis.2016.11.007
Tahtali D, Bohmann F, Rostek P, Wagner M, Steinmetz H, Pfeilschifter W. Setting Up a Stroke Team Algorithm and Conducting Simulation-based Training in the Emergency Department - A Practical Guide. J. Vis. Exp. 2017; 119:e55138. doi: https://doi.org/10.3791/55138
Zhou Y, Xu Z, Liao J, Feng F, Men L, Xu L, He Y, Li G. New standardized nursing cooperation workflow to reduce stroke thrombolysis delays in patients with acute ischemic stroke. Neuropsychiatr Dis Treat. 2017; 13:1215-1220. doi: https://doi.org/10.2147/NDT.S128740
Liu Z, Zhao Y, Liu D, Guo ZN, Jin H, Sun X, et al. Effects of Nursing Quality Improvement on Thrombolytic Therapy for Acute Ischemic Stroke. Frontiers in Neurology. 2018; 9: 1-7. doi: https://doi.org/10.3389/fneur.2018.01025
Hamilton H, Dale S, McElduff B, Craig LE, Fasugba O, McInnes E, et al. The role of stroke nurses in thrombolysis administration in Australia and the United Kingdom: A cross-sectional survey of current practice. Journal of Clinical Nursing. 2021; 31:158-166. doi: https://doi.org/10.1111/jocn.15892
Yin C, Qi L, Jing X. Effect of standardized nursing cooperation on intravenous thrombolysis with recombinant tissue plasminogen activator in acute ischemic stroke. Am J Transl Res. [internet]. 2021; [cited 2022 sep 15];13(10):11925-11931. PMID: 34786123; PMCID: PMC8581870. Available from: https://europepmc.org/article/pmc/pmc8581870
Olson DM, Provencher M, Stutzman SE, Hynan LS, Novakovic S, Guttikonda S, et al. Outcomes From a Nursing-Driven Acute Stroke Care Protocol for Telehealth Encounters. Journal of Emergency Nursing. 2022; 48(4):406 - 416. doi: https://doi.org/10.1016/j.jen.2022.01.013
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Copyright (c) 2023 Michele Marcon Fochesatto, Cléton Salbego, Tamiris Ferreira Pacheco, Patrícia Bitencourt Toscani Greco, Samuele Verza Bertelli, Letícia Bibiana de Oliveira Tedesco, Leonardo Borges