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A Novel Approach to Explore How Nursing Care Affects Intracranial Pressure
DaiWai M Olson1, Camille Parcon2, Aljean Santos2
1DaiWai M. Olson is an associate professor, neurology and therapeutics, Sonja E. Stutzman is research program manager, and Guilla Santos is staff nurse, University of Texas Southwestern Medical Center, Dallas, Texas. Camille Parcon is a staff nurse, Baylor University Medical Center, Dallas, Texas. Aljean Santos is a registered nurse, Texas Woman's University, Denton, Texas. Ryan Delabar is a medical resident, Washington University, St Louis, Missouri. DaiWai.Olson@UTSouthwestern.edu.
Background:
Intracranial pressure is measured continuously, and nursing behaviors have been associated with variations in the measurements.
Methods:
A prospective pilot observational study was done to develop a comprehensive list of nursing behaviors that affect patients' intracranial pressure. Data on nurses were obtained by self-reports and video recording. Patient-level data were collected via chart abstraction, video recording, and patients' monitors.
Results:
Data on 9 patients and 32 nurses were analyzed. A total of 6244 minutes of data were video recorded. Intracranial pressure was changed because of a nursing intervention during 3394 observations. Compared with baseline levels, intracranial pressure was significantly higher if a nursing intervention was performed (odds ratio, 1.96; 95% CI, 1.71-2.24; P < .001).
Conclusion:
Studying nursing behaviors is feasible. Synchronizing and analyzing mutually exclusive and exhaustive behaviors indicated that nursing behaviors have an effect on patients' intracranial pressure.
