New Beginnings

Huntington’s Australia

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<p>Apomorphine is generally a safe and well tolerated therapy used in acute and intermittent treatment of the motor symptoms, the ‘off’ motor state in Parkinson’s disease, and there is growing evidence supporting its clinical value in non-motor symptoms. It has an excellent efficacy profile in clinical practice, though the use of the agent continues to be underutilised. One of the most common reasons of this is most likely the perception of how difficult it is to use the agent, and the management of the adverse events (AE’s). The discontinuation due to AE’s is not as common as it has been believed. Apomorphine is generally well tolerated by most patients and if AE’s do develop, they are manageable in most cases.</p>
<p>The objective of this literature review was to examine the body of literature regarding the risk of Electrocardiogram (ECG) changes, and cardiac arrest in apomorphine challenges; and to look for safety parameters for people commencing and continuing apomorphine therapy. There is evidence that apomorphine can prolong a QTc interval, leading to cardiac arrhythmias. During the apomorphine challenge the drug domperidone is widely used to combat the side effects of nausea and vomiting, and vasodilation side effects of postural hypotension from the apomorphine. Domperidone has also been identified and studied as a medication with risks of QTc prolongation.</p>
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Apomorphine and Domperidone Review

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<p>The Parkinson’s passport is a compact document consisting facts and tips about managing PD. The aim of the study was to examine the impact of ‘The Parkinson’s Passport booklet’ on the care and management of patients with Parkinson’s admitted to an Australian hospital. The results suggest the implementation of the Parkinson’s passport booklet does not improve the care and the management of a patient with PD who present to hospital which in turn challenges the efficacy of the document. However, the major unexpected finding during the course of the study was a high incidence of cognitive impairment in PD patients (85%) presenting to hospital.</p>
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High Prevalence of cognitive impairment in patients with Parkinson’s disease presenting to hospital

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<h3>Background</h3>
<p>Neuroscience patients can present with agitation due to a number of factors such as the presence of cerebral abnormalities, tumours, trauma, or medications. Agitation among neuroscience patients that escalates to violence and aggression appears to be increasing and highly challenging for neuroscience nursing practice across Australasia. Neuroscience wards or units endeavour to effectively manage patients who are affected by agitation and provide appropriate training for clinical and non-clinical staff. Following a workshop through Australasian Neuroscience Nurses’ Association (ANNA), a group of neuroscience nurses, passionate about improving the care of neuroscience patients presenting with agitation and the safety of the staff; collaborated and researched the most effective prevention and management strategies that can be used to ensure that care delivery for these patients is therapeutic and effective.</p>
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<h3>Purpose</h3>
<p>The purpose of this paper is to share recommendations that can guide the prevention and management of agitation among neuroscience patients from the perspective of neuroscience nurses in Australasia.</p>
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<h3>Discussion</h3>
<p>These recommendations have been discussed from hospitals across Australasia including Perth, Brisbane, Sydney, Canberra, Melbourne, and Wellington in the hope that other cities can make changes in their own hospitals to inform neuroscience nurses and allied clinicians, improve guidelines and provide effective education for staff members that interact with neuroscience patients.</p>
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Prevention and management of agitation in the neuroscience patient: Recommendations from Australasia

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<p>This review examined the body of evidence to determine the efficacy of an apomorphine challenge. Its primary objective is to identify the dose of the most common adverse events involved with apomorphine challenges. The secondary objective is to determine whether a titration challenge is warranted prior to commencing Apomorphine therapy or an alternate option, such as slow titration, is more efficacious.</p>
<p>Results: The literature review was developed using the Cochrane handbook of systematic reviews. The search yielded 157 results, only 23 were included in the final analysis. Evidence is largely lacking and traditionally anecdotal and based on clinician experience. Studies inadequately control for reporter and rater bias, have small sample sizes; high level evidence is lacking.</p>
<p>Continuous rates range between 2-4mg/hr (<xref ref-type="bibr" rid="j_ajon-2023-005_ref_008">Deleu, 2004</xref>) and an intermittent dose range between 4mg- 6 mg (<xref ref-type="bibr" rid="j_ajon-2023-005_ref_020">Pahwa et al 2007</xref>); doses higher than this are likely to induce side effects. QT interval prolongation is linked with both apomorphine and domperidone use and an electrocardiogram (ECG) should be performed prior to commencing both medications.</p>
<p>A positive result for an apomorphine challenge is determined when there is a 20% improvement from baseline score in part III of the Movement Disorder Society – Unified Parkinson’s Disease Rating Scale (MDS- UPDRS), 30 minutes after a dose is given.</p>
<p>Lastly, review examines a theoretical way to titrate patients using the Tomlinson levodopa conversion.</p>
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Apomorphine subcutaneous titration in Parkinson’s disease - the effectiveness and safety of apomorphine challenges: A Literature Review

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<p>Parkinson’s disease is a common neurological condition. Patients benefit from patient centred care provided by a Parkinson’s disease or movement disorder nurse specialist. This study is the second in a series of annually recurring publications to progressively monitor the growth and development of the PDMDNS profession in Australia. Results will firstly; provide evidence to support the PDMDNS professional body in Australia to advocate for adequate resources, sufficient training and appropriate levels of qualifications and pay grades, secondly; assist in identifying gaps in the provision of services to people living with PD.</p>
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Parkinson’s Disease Movement Disorder Nurse Specialist Demographic Survey 2021

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<p>Concussion awareness became a priority for the Northern Sydney Local Health District as the increase in children, teenagers, and young adults with concussion, had an effect on emergency department (ED) presentations, follow-up, schooling and sports-related activities. Education in some of the local schools from the Neuroscience Clinical Nurse Consultant had been occurring, but the need far outweighed the in-person approach. Therefore, it was decided that the development of an educational concussion video for schools was required.</p>
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<h3>AIM</h3>
<p>To produce a 5-minute educational video for use in schools in the PDHPE Program / Sport sessions, that could then be broken down into shorter 1-minute versions for social media bursts.</p>
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<h3>METHOD</h3>
<p>A focus group was established and the process of devising and parenting this video took approximately 11months. It is pitched at a 12-year-old and combines animation and realistic scenes.</p>
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<h3>OUTCOME</h3>
<p>The video can be found at - <ext-link ext-link-type="uri" xmlns:xlink="http://www.w3.org/1999/xlink" xlink:href="https://vimeo.com/674645370">https://vimeo.com/674645370</ext-link></p>
<p>It has been sent to and accessed by schools within the Northern Sydney Local Health District and has been integrated into the NSW Education Department teacher training as a tool for teachers and students. It has been accessed throughout NSW, other Australian states and accepted for use in the New Zealand schooling system.</p>
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Concussion Video—Educating Schools

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<h3>Background statement</h3>
<p>Accurate completion of a Neurological Assessment including the Glasgow Coma Scale (GCS) is of the upmost importance in identifying and escalating neurological deterioration. This assessment must be standardised to ensure patient safety and quality care.</p>
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<h3>Aim</h3>
<p>This paper aims to review the standardisation of the GCS inclusive of a comprehensive Neurological Assessment in metropolitan hospitals in Australia. Existing literature on this tool in clinical practice, will be further explored in this review. It will primarily focus on efficacy, standardisation and accuracy of completing a Neurological Assessment on an Adult.</p>
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<h3>Methods</h3>
<p>A comprehensive review of the topic was undertaken, to reveal literature that supports the aim of this paper. Medline and Embase were accessed, with the use of Boolean operators to ensure literature met the inclusion and exclusion criteria.</p>
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<h3>Results</h3>
<p>Five articles were selected as appropriate and relevant to meet the needs and expectations of this review. Research suggests inconsistency and validity of the tool, which may affect patient safety.</p>
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Neurological Assessment: Practice Review’

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<h3>Background</h3>
<p>A correlation exists between staff retention, staff and patient safety and effective prevention of violence and aggression in neuroscience nursing. Workplace violence leads to a lack of productivity amongst nurses and legally a hospital is required to provide a safe working environment. This literature review aims to determine the themes within the literature and effective patient management of agitation leading to violence and aggression.</p>
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<h3>Aim</h3>
<p>A literature review of articles was conducted using CINAHL, PubMed, Cochrane database and Google Scholar between 2007-2022.</p>
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<h3>Discussion</h3>
<p>The common themes within the literature included assessment of the patient to identify an unmet need, early referrals to members of the interdisciplinary team, effective communication, verbal de-escalation techniques and an understanding of restraint and pharmaceutical management, even though these should be the last resort. Education for staff is fundamental and should include effective communication, warning signs, triggers for aggression, simulation in the clinical context, and verbal de-escalation techniques. Debriefing should take place after an incidence of violence and aggression and effective hospital management should be considered with guidelines and systems in place to support and protect staff and patients.</p>
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A literature review of Patient care in the management of agitation leading to violence and aggression in neuroscience nursing

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<p>Huntington’s disease (HD) is a rare, progressive, neuropsychiatric disorder that is inherited. Although there are treatment options for some of the symptoms, currently there is no cure, despite much research. In addition to medical, nursing and allied health care, a person with HD needs a great deal of support. Until now, this support, for individuals and their families, has been facilitated by Huntington’s Disease Associations in each Australian state and territory. It has been a long-held dream to merge these Associations to form a national body, so as to provide better and more equitable support, increased resources, greater sustainability and create consistent educational material for everyone impacted by HD. The ultimate goal is to help people impacted by the condition live their best life. This dream is about to be realised as 5 states and 2 territories will merge to create Huntington’s Australia, planning to begin operations later this year. The journey over the last 3 years towards this dream is described in this paper.</p>
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Huntington’s Australia – a New National Association to Support the Huntington’s Community

AHEAD OF PRINT

Volume 34 (2024): Issue 1 (May 2024)

Volume 33 (2023): Issue 2 (October 2023)

Volume 33 (2023): Issue 1 (May 2023)

Volume 32 (2022): Issue 2 (October 2022)

Volume 32 (2022): Issue 1 (May 2022)

Volume 31 (2021): Issue 2 (October 2021)

Volume 31 (2021): Issue 1 (May 2021)

Volume 30 (2020): Issue 2 (October 2020)

Volume 30 (2020): Issue 1 (May 2020)

Volume 29 (2019): Issue 2 (May 2019)

Volume 29 (2019): Issue 1 (May 2019)

Volume 28 (2018): Issue 2 (November 2018)

Volume 28 (2018): Issue 1 (June 2018)

Volume 27 (2017): Issue 2 (November 2017)

Volume 27 (2017): Issue 1 (November 2017)

Volume 26 (2016): Issue 2 (May 2016)

Volume 26 (2016): Issue 1 (May 2016)

Volume 25 (2015): Issue 2 (October 2015)

Volume 25 (2015): Issue 1 (May 2015)

Australasian Journal of Neuroscience

Australasian Journal of Neuroscience (AJoN) Journal Scope and Aims  Published bi-annually (May and October), the Australasian Journal of Neuroscience (AJoN), the official journal of the Australasian Neuroscience Nurses Association (ANNA), has published original peer reviewed articles since 1988 making it one of the longest standing neuroscience nursing journals.  The AJoN is an international peer reviewed open access journal that aims to promote the development and exchange of knowledge that reflects the broad and emerging interests of neuroscience nursing and the neuroscience nursing profession. The AJoN is at the forefront of disseminating and communicating knowledge and through the promotion of clinically related scholarship, the AJoN supports and advances the practice and discipline of neuroscience nursing.  The mission of the AJoN is to further the neuroscience nursing profession through representation and the provision of works that best represent neuroscience nursing expertise and experience. Through this provision evidence is translated into neuroscience nursing practice to improve health outcomes for individuals, families, and populations.  Fields of nursing represented in the AJoN include, but are not limited to, neurology, movement disorders, neurosurgical, neuro-intensive, neuro-rehabilitative, neuropsychiatry, neuro-gerontology, neuro-paediatric, neuro-emergency and neuro-trauma. Contributions are also welcome from other healthcare fields on issues and developments that have a direct impact on neuroscience nursing practice.  The AJoN welcomes manuscripts from both new and experienced authors wishing to contribute neuroscience knowledge to nursing practice and research. Both National and International submissions are welcome, with the AJoN supporting the exchange of ideas and experience that represents different practices and cultures.  Submitted original articles should make a novel contribution to neuroscience nursing with examples including advances in neurosurgical and neurological nursing, patient care, complex care interventions, research, policy, professional issues, and theory. Submissions must be of a high quality and the journal accepts various article types including (but not limited to) review articles, systematic reports, case series, case studies, quantitative, qualitative, and mixed methods research articles, practice updates, guest editorials, clinical trials, quality improvement articles, letters to the editor, commentaries, and the development of new guidelines that provide a unique insight into the field of neuroscience nursing. The journal’s purpose is to advance the field of neuroscience nursing by presenting published works with an emphasis on knowledge that will influence the way neuroscience nursing is practiced, taught, researched, and administrated. This information is applicable to nurses working in clinical, administrative, educational,  leadership and research settings. Each issues contains a variety of papers, commentaries and published works resulting from the National ANNA conference. The target audience of the AJoN includes nurses, student nurses, nurse practitioners, managers, executives, administrators, educators, and higher research degree students as well as allied health professionals.  Topics relevant to the AJoN include the development of clinical research and knowledge, evidenced based practice, leadership, and scientific enquiry. Works that explore the patient and family experience, illness, and recovery within the neuroscience field. Organisational factors including governance, patient safety, role development and models of service delivery. As well as cultural comparisons and evaluations of neuroscience nursing practice across different healthcare sectors, social and geographical settings.  The AJoN offers authors the benefits of a highly respected journal in the field of neuroscience nursing, indexed in a wide range of databases including (EBSCO, Elsevier, MIAR, MtScienceWork, ReadCube, SCILIT and Semantic Scholar). The journal has a truly global readership, rapid manuscript screening and efficient editorial processes. The journal also offers a highly visual format, with full colour figures, images, and tables.  The AJoN Editor is advised and supported by a Board of Reviewers that represent all facets of neuroscience nursing. Submitted papers are reviewed by Reviewers who meet a high standard of academic and clinical expertise. The AJoN will ensure that practice and policy development is evidenced based, research is informed at an advanced level and that readers are challenged to engage in critical debate and critically reflect on the interface between practice, policy, and research. The AJoN team believes that every neuroscience nurse should have the opportunity to grow and develop their practice and career through quality education and professional development. The AJoN is essential reading for anyone with an interest in neuroscience nursing.   Archiving  Sciendo archives the contents of this journal in Portico - digital long-term preservation service of scholarly books, journals and collections.  Plagiarism Policy  The editorial board is participating in a growing community of Similarity Check System's users in order to ensure that the content published is original and trustworthy. Similarity Check is a medium that allows for comprehensive manuscripts screening, aimed to eliminate plagiarism and provide a high standard and quality peer-review process. 