Alteration in cerebral perfusion: clinical concept or nursing diagnosis?

Nursing diagnosis was introduced into the neuroscience intensive care unit (NSICU) of the Medical College of Virginia in 1984 as a framework for naming the problems nurses treat. During this process, there was concern about using nursing diagnosis terminology to describe common NSICU problems. Of particular concern was increased intracranial pressure (ICP). The staff concluded that "alteration in cerebral perfusion" was the nursing diagnosis from the North American Nursing Diagnosis Association (NANDA) list that best described the patient with increased ICP. A descriptive study of patients who received this nursing diagnosis in our NSICU was designed and implemented one year later. This study identified patient characteristics and independent and interdependent nursing interventions.