The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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Head-of-bed (HOB) elevation is the standard of care for patients with intracranial pressure monitoring at risk for intracranial hypertension. Measurement of cerebral perfusion pressure (CPP) based on HOB elevation and arterial transducer position has not been adequately studied. ⋯ The difference in CPP when ABP is referenced at the Tg versus PA is not consistently attributed to HOB elevation.
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To enhance nursing staff retention and ensure a consistently high standard of care, a study was conducted to determine an appropriate nurse staffing model for a neurocritical care unit. In addition to being critically ill, these patients often require extensive diagnostic testing to determine treatment. Nurses traveling with patients leave higher nurse-patient ratios remaining on the unit. ⋯ Significant time was spent every day off the floor, in addition to the documentation and performance of frequent assessments. These results advocate for a staffing position without a dedicated patient assignment but to assist with traveling and high-acuity patients so that safe and attentive care can be consistently given.
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In 2018, the American Association of Neuroscience Nurses will celebrate its 50th anniversary as the premier member organization for neuroscience nurses. In recent decades, one of the highest rated member benefits has been the ability for members to join special focus groups (SFGs). ⋯ In this anniversary edition, the neurotrauma SFG presents a review of trends in the publication of articles in the Journal of Neuroscience Nursing related to neurotrauma. Findings from this article illustrate how these publications have impacted the nursing care of patients who have sustained traumatic injuries of the central and peripheral nervous system and the integral role of neuroscience nurses throughout the decades.
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The disease and treatment trajectory of patients with high-grade glioma is a burdensome period for the patients' closest relatives who become informal caregivers. Caregivers experiencing this demanding shift in role are at risk of developing symptoms such as depression. Few studies have explored the needs and experiences of bereaved caregivers, and there is lack of evidence-based practice. This study explores the perspectives of newly bereaved caregivers to patients with high-grade glioma on end-of-life caregiving and bereavement. ⋯ Late-stage caregiving is a difficult and challenging experience at the end of an already burdening treatment trajectory. Caregivers prefer to actively share responsibility and practical tasks with professionals, family, and friends. The bereaved caregivers' key areas of concern indicate the need for additional research in advance care planning within neuro-oncology caregiving to establish evidence-based practice guidelines and recommendations.
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In the setting of acute traumatic brain injury (TBI), an abnormal pupil assessment may suggest a worsening intracranial lesion. Early detection of pupillary changes may expedite emergent care to improve outcomes. Automated, handheld pupillometers have been commercially available for 20 years, and several studies suggest that their use may facilitate early recognition of worsening injury and intracranial hypertension. ⋯ Data were available for 22 nurses at 4 separate time points. Staff were positive about their ability to use and understand the device (µ = 8.7 and 9.1, respectively, on a 10-point scale) and reported that it added value to patient care and critical decision-making. Use of automated pupillometry is acceptable to nursing staff in a neurotrauma intensive care unit, and staff believed that pupillometry results enhanced clinical decision-making.