• DaiWai M Olson, Molly M McNett, Lisa S Lewis, Kristina E Riemen, and Cynthia Bautista.
• Duke University Medical Center, Durham, NC, USA. DaiWai.Olson@UTSouthwestern.edu
• Am. J. Crit. Care. 2013 Sep 1;22(5):431-8.

BackgroundIntracranial pressure is a frequent target for goal-directed therapy to prevent secondary brain injury. In critical care settings, nurses deliver many interventions to patients having intracranial pressure monitored, yet few data documenting the immediate effect of these interventions on intracranial pressure are available.ObjectiveTo examine the relationship between intracranial pressure and specific nursing interventions observed during routine care.MethodsSecondary analysis of prospectively collected observational data.ResultsDuring 3118 minutes of observation, 11 specific nursing interventions were observed for 28 nurse-patient dyads from 16 hospitals. Family members talking in the room, administering sedatives, and repositioning the patient were associated with a significantly lower intracranial pressure. However, intracranial pressure was sometimes higher, lower, or unchanged after each intervention observed.ConclusionResponse of intracranial pressure to nursing interventions is inconsistent. Most interventions were associated with inconsistent changes in intracranial pressure at 1 or 5 minutes after the intervention.

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