Epilepsy is the fourth leading neurologic disorder in the United States and affects the quality of life of approximately 2.9 million Americans. Despite modern progress in medicine and technology, the disease may prove to be drug resistant, a condition that serves as a primary indication to consider invasive treatment modalities. Current evidence supports the efficacy of early surgical intervention for patients with drug-resistant epilepsy, although this approach continues to be underused. The positive outcomes of epilepsy surgery are a result of multidisciplinary efforts, and perioperative nurses play a vital role in the continuum of care for this patient population. In the effort to optimize nursing care for patients with epilepsy, this article provides a clinical review of epilepsy as a neurologic disorder and specifically focuses on surgical interventions and perioperative nursing considerations.

Creutzfeldt-Jakob disease (CJD) is a rare but lethal prion disease. The worldwide mortality rate of CJD is 1.67 per one million people, although 90% of cases will lead to death within one year of symptom onset. Rapid, progressive dementia is the cardinal sign of CJD. Other early symptoms include deterioration of muscle coordination, memory, judgment, and vision, as well as personality changes, insomnia, and depression. It occurs in two types, classic and new variant, and classic CJD can be further divided into three subtypes: sporadic, familial (ie, genetic), and iatrogenic (ie, health care associated). Surgery often requires using instruments that come in contact with high-infectivity tissue, especially during neurosurgical procedures and diagnostic biopsies. To reduce the risk of disease transmission, infection control practices should include identification of the risk of infection, implementation of safety protocols (eg, use of personal protective equipment), proper selection and use of instrumentation, and adequate disinfection and sterilization practices. Silent carriers, risks of iatrogenic infection, and the possibility of inadvertent exposure of healthy patients may carry great liability to public health and hospital stability.

Since 2006, the Centers for Disease Control and Prevention (CDC) has recommended routine HIV screening in primary care settings for people ages 13 to 64, regardless of individual risk factors. However, an extensive body of research has identified several barriers to primary care providers' (PCPs) adherence to the CDC recommendations. Employing a pre–postintervention design, this study provided an assessment of barriers among 11 PCPs and implemented an evidence-based continuing education program adapted to the specific individual barriers they identified. The study found that PCPs were initially providing HIV testing using risk-based criteria but that the continuing education program increased intentions to perform routine HIV testing (e.g., during annual wellness examinations and new patient visits). Results of the study inform individual quality improvement projects and legislative or policy actions to increase HIV screening in sites providing primary care. [ J Contin Educ Nurs. 2018;49(12):563–574.]

New Jersey is projected to be one of the top three states to experience a nursing shortage. The current practice of health care organizations providing their own education and training in the perioperative setting leads to variability in the degree of staff readiness and competence to address the complexities encountered in this setting. This may result in increased perioperative nursing orientation costs. The Center for Professional Development at Rutgers School of Nursing partnered with members of the region's surgical facilities to design and implement an accelerated immersion perioperative training model. This academic–clinical practice partnership resulted in a model that equips nurses with the competencies to better fulfill workforce demands while reducing costs. [ J Contin Educ Nurs. 2019;50(8):363–366.]

No abstract