Engaging all staff, encouraging ownership and stability of management are key factors in the successful implementation and maintenance of IR. IR is flexible and robust enough to accommodate different patient types and acuity.
Routine ward admission for patients undergoing elective craniotomies with selective ICU admission appears safe; however, approximately 2% of patients may require a direct postoperative unplanned ICU admission. Patients with anticipated long operation times, extensive blood loss, and high anesthetic risks should be selected for postoperative ICU admission, but further study is needed to determine the preoperative factors that can aid in identifying and caring for these groups of patients.
These initial studies highlight the potential of employing an integrated multi-tiered intervention based on a Behavioural Consultancy model to manage CBs after PBT.
The findings showed how audits may be used to promote best practice in healthcare and that focused education and provision of relevant resources can have an immediate and positive impact on clinical practice. Some of the measured criteria improved to a moderate degree, leaving room for improvement; however, by the end of the project attitudes toward nursing clinical handover had been "transformed" from a passive routine "must do" task to an active process with a focus on safety and patient/carer engagement. Future audits are planned to ensure sustainability.
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