Simulation exercises, when organised with the aim of developing insight and empathy can result in positive outcomes for those who take part. Simulation exercises as an integrated learning tool for staff within healthcare settings should be provided.
INTRODUCTION
Neurocritical care has become increasingly subspecialized. However, due to a lack of bed availability in neurocritical care units (NCCUs), sometimes patients may need to be boarded in other intensive care units (ICUs). Several academic centers do not have access to dedicated NCCUs. We hypothesized that general ICU and postanesthesia care unit (PACU) nurses may not feel as comfortable managing neurocritical care patients. In this survey-based quality improvement (QI) study, we explored the self-reported knowledge of ICU and PACU nurses at a comprehensive stroke center in recognizing and managing some common neurological emergencies such as stroke, status epilepticus, and raised intracranial pressure.
METHODS
We engaged the nursing managers of 8 units in this QI project, which included medical, surgical, neurocritical care, cardiac and cardiothoracic units as well as PACU and interventional radiology units. Using institutional RedCap, anonymized surveys were sent to the nurses in January 2019. We collected information on demographic and critical care work experience. All participants answered questions on a Likert-type scale based on their knowledge of several common neurological emergencies.
RESULTS
A total of 240 nurses (199 females, 41 males) participated in the survey. Out of which, 112 (58%) had been working in an ICU for 3 yr or longer. Their self-reported level of knowledge in managing neurological emergencies have been summarized below. More than half the participants did not feel comfortable managing patients with EVDs, ICH, SAH, raised intracranial pressure, and TBI and traumatic spine injury patients. More than 70% of nurses were not satisfied with their current level of training to deal with neuroemergency and supported the need for dedicated training/study time.
CONCLUSION
ICU and PACU nurses report gaps in knowledge in recognizing and managing common neuroemergencies. With an increasing cohorting of patients in subspecialized units, it is important to provide ongoing education to ICU and PACU nurses to help them maintain fundamental neurocritical knowledge.
*According to the article, four out of every five Americans-about 200 million people-are afflicted with low-back pain sometime in their lives; injured backs are the most common work-related disability; and insurance companies shell out over $15 billion a year for back-care costs. Out of curiosity, I checked the card catalog at my local library and found 37 titles listed under back pain and therapy. What surprised me was that none of these books focused on yoga as therapy
*The following interview took place in April 1994, in Madras India, between Mala Srivatsan, the managing editor of Darsanam and student of Professor T. Krishnamacharya, and Sonia Nelson (the American distributor for Darsanam), a yoga teacher and student of T.K.V. Desikachar.
*Several visits to India over a short period of time have transformed my secularist reserve on the topic of Hindu mythology into a keen fascination for this subject. The Hindu goddess, having already become a prime influence in my life, is now the central character in my Ph.D. dissertation research.
It was therefore with a sense of delighted affinity for the material and a keen interest in what a sister sadhika had learnt about her emissaries that I seized on the chance to read and review this book.
*Shoosh's video is designed for anyone with limited mobility, including seniors, people with multiple sclerosis, arthritis or other limitations as well as those who are overweight or temporarily limited. Intended to be used independently, instructions are both given and demonstrated for those working with a teacher or an assistant. A small chart with stick figures and helpful hints is included with the video.
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