The relationship of selected nursing activities to ICP

Study of a number of routine nursing care activities has suggested a relationship between activities and intracranial pressure (ICP). The purpose of this study was to focus on the relationship between nursing care activities and variations in ICP. A case study method was used to study ICP in five brain-injured patients with a Glasgow Coma Scale (GCS) score of 4 or more. Each patient's condition warranted continuous ICP monitoring with a fiberoptic catheter in a neurological intensive care unit (ICU) of two hospitals in the Upper Midwest. Selected nursing measures--turning, suctioning and bathing--were recorded on the data collection tool as they occurred. Suctioning and turning were noted to be associated with an increase in ICP; however, a sustained increase in ICP was not observed. During the bathing procedures only two baths elicited an ICP greater than 20 mm Hg. All other bathing procedures elicited minimal increases in ICP. These findings further support the need for nurses to be aware of the patient's ICP prior to turning and suctioning.