The Journal of neuroscience nursing : journal of the American Association of Neuroscience Nurses
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The contributions and perceptions of staff regarding nurse practitioners (NPs) and physician assistants (PAs) in neuroscience intensive care units (ICUs) throughout the country are not well known. The objectives of this study were to determine the impact of neuroscience NPs and PAs and assess demographics of ICUs. ⋯ Additional responsibility of NPs and PAs has strong potential to improve staff, patient, and family satisfaction and safety and prevent neurological deterioration. Thus, NPs and PAs should be utilized to the full extent of their role.
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The purpose of this article is to explore the management of coexisting brain insult and acute lung injury to help guide clinicians in balancing what may appear to be competing goals. First, contemporary management of mechanically ventilated patients with either brain or lung injury diagnoses is reviewed, followed by a review of intracranial pressure and acute lung injury/acute respiratory distress syndrome. The article ends with a discussion of a literature review regarding possible treatment balance when the two conditions coexist.
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The Full Outline of UnResponsiveness (FOUR) Score is a coma scale that consists of four components (eye and motor response, brainstem reflexes, and respiration). It was originally validated among the adult population and recently in a pediatric population. To enhance clinical assessment of pediatric intensive care unit patients, including those intubated and/or sedated, at our children's hospital, we modified the FOUR Score Scale for this population. ⋯ Our hypothesis was that the PFSS and PCPC should highly correlate and the GCS and PCPC should correlate lower. Study results show that the PFSS is excellent for interrater reliability for trained nurse-rater pairs and prediction of poor outcome and in-hospital mortality, under various situations, but there were no statistically significant differences between the PFSS and the GCS. However, the PFSS does have the potential to provide greater neurological assessment in the intubated and/or sedated patient based on the outcomes of our study.
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Observational Study
Assessment of satisfaction with care among family members of survivors in a neuroscience intensive care unit.
Many prior nursing studies regarding family members specifically of neuroscience intensive care unit (neuro-ICU) patients have focused on identifying their primary needs. A concept related to identifying these needs and assessing whether they have been met is determining whether families explicitly report satisfaction with the care that both they and their loved ones have received. The objective of this study was to explore family satisfaction with care in an academic neuro-ICU and compare results with concurrent data from the same hospital's medical ICU (MICU). ⋯ Parents of patients were more likely than other relatives to feel very included and supported in the decision-making process. Future studies may focus on evaluating strategies for neuro-ICU nurses and physicians to provide better decision-making support and to implement more frequent family meetings even for those patients who may not seem medically or socially complicated to the team. Determining satisfaction with care for those families whose loved ones passed away during their neuro-ICU admission is another potential avenue for future investigation.