The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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The Canadian Neurological Scale (CNS), a validated stroke assessment tool, was implemented for the neurological assessment of patients with stroke. The purpose of this study was to explore nurses' values and perceptions of best-practice guidelines (BPGs) and the CNS assessment, to evaluate the effect of a workshop and implementation process on nurses' self-efficacy for CNS use, to determine whether the workshop and implementation process met the needs of the nurses, and to evaluate the accuracy and appropriateness of CNS assessment documentation. Nurses reported moderate-to-strong awareness and use of BPGs and expressed the belief that BPGs were valuable; however, they had some difficulty accessing BPGs. ⋯ A chart audit demonstrated that only 69% of patients appropriate for the CNS assessment were assessed with this tool. Although nurses are aware of BPGs, translating these changes into practice takes time and may require BPG modification to best fit the needs of the areas in which they will be used. When choosing a validated stroke assessment tool, clinicians must consider how often the tool will be used for assessments, particularly in the acute phase.
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Epidural hematomas (EDHs) account for 10% of fatal injuries in patients with head trauma. Up to 35% of patients suffering EDHs develop secondary brain injury within days after the initial trauma. ⋯ This case study presents a patient who developed an EDH following severe head trauma with signs and symptoms of secondary brain injury; intravascular temperature modulation was used to treat the secondary injury for a prolonged period of 13 days. The patient showed a complete neurologic recovery with return to work 6 months after her injury.