A Guideline for Parkinson’s Disease Nurse Specialists, with Recommendations for Clinical Practice

Lennaerts, Herma; Groot, Marieke; Rood, Berna; Gilissen, Koen; Tulp, Hella; Wensen, Erik van; Munneke, Marten; Laar, Teus van; Bloem, Bastiaan R.

doi:10.3233/jpd-171195

Cited by 46 publications

(69 citation statements)

References 22 publications

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“…Specialized nurse [80] (i) Nurse specialized in Parkinson's Disease (ii) Often central coordination role in multidisciplinary team (iii) Usually in closest contact with the patient and his family (iv) Participates in clinical monitoring and adjustment of medicines (v) May be a reliable source of information about clinical and social matters of concern to the attending neurologist Physiotherapist [81] (i) Uses a range of techniques and strategies to help in maintaining good posture, balance and fitness through exercise (ii) Trains the patient in external cueing for improving gait and balance, helping to prevent falls: Individual rehabilitation session 2-3 times weekly may reduce the risk of falls (iii) Trains the patient for maintaining effective breathing and helping with pain relief Speech therapist (i) Should be involved as soon as the patient starts experiencing difficulties with communication and/or swallowing (ii) May provide intensive and efficient interventions, e.g. :…”

Section: Resultsmentioning

confidence: 99%

Update on the Management of Parkinson’s Disease for General Neurologists

Pirtošek

Băjenaru

Kovács

et al. 2020

Parkinson's Disease

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Management of Parkinson’s disease (PD) is complicated due to its progressive nature, the individual patient heterogeneity, and the wide range of signs, symptoms, and daily activities that are increasingly affected over its course. The last 10–15 years have seen great progress in the identification, evaluation, and management of PD, particularly in the advanced stages. Highly specialized information can be found in the scientific literature, but updates do not always reach general neurologists in a practical and useful way, potentially creating gaps in knowledge of PD between them and neurologists subspecialized in movement disorders, resulting in several unmet patient needs. However, general neurologists remain instrumental in diagnosis and routine management of PD. This review provides updated practical information to identify problems and resolve common issues, particularly when the advanced stage is suspected. Some tips are provided for efficient communication with the members of a healthcare team specialized in movement disorders, in order to find support at any stage of the disease in a given patient, and especially for a well-timed decision on referral.

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Section: Resultsmentioning

confidence: 99%

Update on the Management of Parkinson’s Disease for General Neurologists

Pirtošek

Băjenaru

Kovács

et al. 2020

Parkinson's Disease

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“…A similar multidisciplinary team "on timeevery time" approach in an Australian hospital increased the proportion of PD patients who received their medication "on time". 21 There was a reduction in the use of contraindicated medications and this was associated with a reduction in length of stay as well as cost savings to the hospital budget. Additional improvements can be expected when timely prompts can be sent by a hospital's eMeds system.…”

Section: Discussionmentioning

confidence: 99%

“…Designated PD nurse navigators could co-ordinate with the medical staff, pharmacy and nursing to ensure that PD medications are administered "on time". 20,21…”

Section: Guidelines To Improve Pd Medication Use In Hospitalmentioning

confidence: 99%

“…The successful strategies above need to be integrated into a single framework (Table 2) and delivered by a multidisciplinary team led by a dedicated PD nurse. 20,21 By coordinating patient care across a range of service providers, PD nurse navigators can focus on the patient's health care journey as well as their health care needs. 20,21 A previously successful, three stage process developed to address issues with insulin dosing in hospitals, 22 has been adopted as the best framework to improve levodopa use in hospitals.…”

Section: An Integrated Approach To Improve "On Time" Levodopa Adminismentioning

confidence: 99%

“…20,21 By coordinating patient care across a range of service providers, PD nurse navigators can focus on the patient's health care journey as well as their health care needs. 20,21 A previously successful, three stage process developed to address issues with insulin dosing in hospitals, 22 has been adopted as the best framework to improve levodopa use in hospitals. Two hospital admission pathways are proposed so that the PD nurse navigator can interact with PD patients as early as possible (Stage 1 for scheduled and Stage 2 for unscheduled admissions).…”

Section: An Integrated Approach To Improve "On Time" Levodopa Adminismentioning

confidence: 99%

See 2 more Smart Citations

“On time ‐ every time” A new strategy for dosing levodopa in hospital

Ortiz

2020

Pharmacy Practice and Res

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Most Parkinson’s Disease (PD) patients are hospitalised for reasons other than their PD. Their PD symptoms are usually under control before admission, however, too many seem to experience medication‐related problems in hospital. Hospitalised PD patients should receive their levodopa within 30 min of the scheduled time (“on time”) and not miss doses (“every time”). Hospital staff should avoid prescribing and administering contraindicated dopamine antagonists to PD patients in their care. Multiple studies have shown the failure to deliver levodopa “on time” to PD patients, with less than 50% of doses being “on time” and an average 0.7 of doses missed each day. The evidence points to hospital medication administration systems (HMAS) as the likely cause of late and missed levodopa doses. PD medication administration guidelines were reviewed to find strategies that reduced late and missed doses. An integrated “on time – every time” medication administration approach is proposed. PD patients should be encouraged to self‐administer their medication in hospital. More PD nurse navigators will be needed to facilitate PD patient care in Australian hospitals.

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Development of a New Care Pathway for Depression and Anxiety in Adult‐Onset Isolated Dystonia

Martino

Nosratmirshekarlou

Cothros

et al. 2023

Movement Disord Clin Pract

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Background Recently, we identified barriers and facilitators to the screening and treatment of depressive and anxiety symptoms in adult‐onset isolated dystonia (AOID). These symptoms are common, functionally impairing, and often underdetected and undertreated. Objectives To develop a care pathway for mood symptoms in AOID. Methods We used a multistep modified Delphi approach to seek consensus among healthcare professionals with experience of AOID on the screening, diagnosis, and treatment of mood symptoms. A combination of face‐to‐face meetings and online surveys was performed from 2019 to 2020. We created the survey and then reviewed with stakeholders before 2 rounds of Delphi surveys, all of which was finally reviewed in a consensus meeting. A purposive sample of 41 expert stakeholders from 4 Canadian provinces, including neurologists, nurses, psychiatrists, psychologists, and family physicians, was identified by the research team. Results The Delphi process led to consensus on 12 statements that operationalized a pathway of care to screen for and manage depression and anxiety in people with AOID. Key actions of the pathway included yearly screening with self‐rated instruments, multidisciplinary involvement in management involving local networks of providers coordinated by movement disorders neurologists, and access to educational resources. The Delphi panel indicated the 2 core steps as the documentation of the most recent screening outcome and the documentation of a management plan for patients who were positive at the last screening. Conclusions This new care pathway represents a potentially useful intervention that can be used to build an integrated model of care for AOID.

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A Guideline for Parkinson’s Disease Nurse Specialists, with Recommendations for Clinical Practice

Abstract: This guideline provide ground to harmonize care delivery by PDNS in clinical practice, and offer a foundation for future research.

Cited by 46 publications

References 22 publications

Update on the Management of Parkinson’s Disease for General Neurologists

Update on the Management of Parkinson’s Disease for General Neurologists

“On time ‐ every time” A new strategy for dosing levodopa in hospital

Development of a New Care Pathway for Depression and Anxiety in Adult‐Onset Isolated Dystonia

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