Critical care nursing clinics of North America
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Crit Care Nurs Clin North Am · Dec 2000
Clinical Trial Controlled Clinical TrialUse of an acute spinal cord injury clinical pathway.
Phased outcome clinical pathways can be useful in the management of neurotrauma patients in the acute care setting. By developing multidisciplinary plans of care that focus on patient and family outcomes and not arbitrary points in time, hospitals can provide quality care to trauma patients that is both appropriate and cost effective. In fact, this type of plan for SCIs can be expanded on and used across the health care continuum from prehospital to community reintegration. Providing collaborative quality care will result in improved outcomes for both patients and health care institutions.
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A basic understanding of metabolic alterations that occur following neurotrauma is essential for addressing nutritional requirements. Interventions must be research based and must focus on the support of metabolic alterations, minimizing the effect of catabolism and optimizing caloric delivery to meet metabolic demand. ⋯ Nutritional support requires an ongoing, daily assessment of caloric goals, protein requirements, patient responses, and assessment of nutritional laboratory values. Using this strategy, neurotrauma patients will have the greatest opportunity for a positive outcome.
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Crit Care Nurs Clin North Am · Dec 2000
ReviewKeeping the brain in the zone. Applying the severe head injury guidelines to practice.
Providing care to the TBI patient population with severe injuries requires an integrated multidisciplinary approach. The team in clinical practice must be willing to examine its own practice, seek out the latest information on TBI, and critically analyze the information. Members must be open to changing their own practice when the data presented support change. ⋯ The standardization of these interventions into protocols facilitates team communication and coordination. Measuring outcomes is imperative for evaluating the effectiveness of current treatment algorithms. Changes in treatment practice should be based on the measured outcomes and advances in the scientific literature.
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Critical care nurses are essential team members during the process of determining brain death and preparing for organ donation. Using their knowledge of the criteria for brain death, they care for the dying patient, support the grieving family, and participate in the consent process for organ donation. Nurses make a critical difference in saving the lives of others through the gift of life.
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Crit Care Nurs Clin North Am · Dec 2000
ReviewIntracranial pressure monitoring and assessing intracranial compliance in brain injury.
Caring for the patient with a brain injury is a dynamic process with the goal of providing therapy to prevent secondary injury. Until practitioners have a better understanding of the pathophysiology of ischemia and the response of therapies for treating increased ICP, they must use the tools that exist. ICP monitoring gives a rough index of the relationships and the response of the intracranial contents to changes in volume that may produce increases in pressure and further damage. Understanding the information supplied by ICP monitoring is imperative to successful management of increased ICP.