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TBIs in U.S. Veterans Nearly Tripled in Last Decade
According to a new Institute of Medicine report, Cognitive Rehabilitation Therapy for Traumatic Brain Injury: Evaluating the Evidence, traumatic brain injury (TBI) among U.S. veterans increased nearly threefold between 2000 and 2010. Causes include repeated and prolonged deployments to Iraq and Afghanistan. A strong focus on cognitive—not just physical—rehabilitation is essential to improving survivors' functionality. While the evidence for the efficacy of cognitive rehabilitation therapies is limited, the authors emphasize that such therapies often still have "meaningful benefit."

Nurse-Led Follow-up Helps Reduce Sequelae for Patients with TIA
Based on evidence that urgent intervention reduces short-term stroke risk after transient ischemic attack (TIA), Danish researchers constructed a prospective study to test measures aimed at further risk reductions. These included intervention by an acute TIA team (ATT) and follow-up telephone counseling by nurses after 7 and 90 days. The primary outcome was stroke, myocardial infarction, or vascular death at one year. The cumulated stroke risk was found to be 2% after 90 days, compared with an expected risk of 7.5%. Reporting in the European Journal of Neurology, the researchers concluded that a specialized ATT approach combined with nurse-led follow-up is feasible and associated with substantially reduced risk of stroke during the 90 days after a TIA.

A Hospital Task Force Seeks to Reduce Perioperative Complications in Obese Patients
When the staff of a community hospital in California realized that patients with a high body mass index (BMI) were difficult to intubate and position, they created an interdisciplinary task force to address the problem. Four areas were targeted for improvement: communication among perioperative staff, potential respiratory care issues, staff education, and equipment issues. The project's success was evaluated by chart audits. Reporting in the AORN Journal, the authors noted that no positioning incidents or intubation emergencies have occurred in patients with high BMIs since January 1, 2009.

Quick Takes

• Winkler County physician Rolando G. Arafiles, Jr. has pled guilty to charges of retaliation and misuse of official information in a plea agreement that includes two months' jail time, five years' probation, and loss of his medical license.
• Military sources tell AJN that Major General Patricia D. Horoho, the first woman and first nurse to be appointed as the Surgeon General and Commander of the U.S. Army Medical Command, will assume her duties early next month. Her appointment was confirmed by the Senate in September.
• Parent behavior training is an effective, low-risk approach to addressing attention deficit hyperactivity disorder in children younger than 6 years, according to this Comparative Effectiveness Review from the Agency for Healthcare Research and Quality.

"Original Research: Documentation of Screening for Perpetration of Intimate Partner Violence in Male Veterans with PTSD," a November CE feature, details the findings of a retrospective cohort study investigating how often such screening occurs and why it's important for health care providers to improve screening rates. A podcast interview with the lead author can be found here.

In a related article, "Ask a Few More Questions," the authors explain how nurses can identify and respond to perpetrators of intimate partner violence in the clinical setting.

"The 'Graying' of Trauma Care: Addressing Traumatic Injury in Older Adults," another CE feature, describes the mechanisms of traumatic injury in this population, reviews the effects of aging and comorbidities, discusses strategies for preventing trauma-related complications, and offers evidence-based approaches for improving outcomes.

"Teaching Essential Skills to Family Caregivers," part two of a three-part series on Supporting Family Caregivers, explores how nurses can best make use of "teachable" moments to help families transition from hospital to home. Don't miss the accompanying video.

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Coming up in the December issue of AJN...