Improving Ventriculostomy Management: Risk and Cost Reduction Through a Multidisciplinary Approach

Angulo, Melissa; Springer, Lauren; Behbahani, Mandana; Fagaragan, Lolita; Tabbilos, Snyder John; Alaraj, Ali; Testai, Fernando D.; Amin‐Hanjani, Sepideh

doi:10.1016/j.wneu.2018.11.025

Cited by 6 publications

(2 citation statements)

References 19 publications

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“…PubMed search for “external ventricular drain nursing management” yielded 16 results, with 12 relevant to our discussion but did not specifically address zero-calibration procedure 4,6–16 . Additional known literature was included in our evaluation; however, it also did not specifically address the process for zeroing an EVD 17–22 .…”

Section: Resultsmentioning

confidence: 99%

“…PubMed search for "external ventricular drain nursing management" yielded 16 results, with 12 relevant to our discussion but did not specifically address zerocalibration procedure. 4,[6][7][8][9][10][11][12][13][14][15][16] Additional known literature was included in our evaluation; however, it also did not specifically address the process for zeroing an EVD. [17][18][19][20][21][22] An Internet search including "guidelines for external ventricular drain nursing management" found practice guidelines from the American Association of Neuroscience Nurses and the American Association of Critical-Care Nurses.…”

Section: Resultsmentioning

confidence: 99%

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Zero-Calibrating External Ventricular Drains: Exploring Practice

Pratt

Peacock²,

Yost³

et al. 2021

Journal of Neuroscience Nursing

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BACKGROUND: Guidelines call for the removal of the nonvented cap (NVC) on the flushless transducer applied to the external ventricular drain (EVD) to zero the device to atmospheric pressure. Some hospitals have abandoned this practice to prevent opening the system to air. No data exist to determine the safest, most effective method of EVD zero-calibration. METHODS: A multidisciplinary team was assembled to use reflective practice to evaluate current zero-calibration of EVD practice. RESULTS: Clinical Nursing Focus showed recommendations largely out of date without detailed rationale or a high level of evidence. Manufacturer recommendations were fragmented and did not address rationale for technique. Bedside trial showed equivalence when comparing intracranial pressure (ICP) tidal, ICP after EVD zero with NVC removal, and ICP after EVD zero without NVC removal. CONCLUSION: Institutional guidelines were changed to reflect zero-calibration of EVD without NVC removal in systems that are amendable to this procedure. Further study is needed to determine best practice.

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Section: Resultsmentioning

confidence: 99%