Intensive Care Unit Nurse Characteristics Impacting Judgments About Secondary Brain Injury

Abstract

Although intensive care unit nurses have an integral role in preventing secondary brain injury when caring for critically ill traumatic brain injury patients, nursing practice varies and little research has examined if individual nurse characteristics affect judgments about secondary brain injury. The purpose of this study was to investigate how intensive care unit nurse characteristics influence judgments when managing secondary brain injury. A factorial survey research design was used to administer surveys to intensive care nurses from 2 level I trauma centers. Nursing shift and number of years in the intensive care unit were significant predictors of judgments. Understanding the role of nurse characteristics is important in future educational and research efforts aimed at evidence-based management of secondary brain injury.

Nursing Interventions for Critically Ill Traumatic Brain Injury Patients

“…The study survey had three parts: Part A contained a series of questions about the last TBI patient nurses cared for in their unit and interventions typically performed when caring for these patients, part B contained case scenarios in which nurses were asked to indicate judgments they were most likely to make, and part C gathered demographic information about nurse respondents. Findings from the latter two survey sections have been previously reported (McNett, 2009). In this article, findings from survey part A (nurse interventions) are presented.…”

“…The findings presented here are part of a larger study investigating ICU nurse judgments about secondary brain injury using a prospective factorial survey research design (McNett, 2009;McNett et al, 2009). Approval for the study was obtained from the institutional review boards and nursing administration at both study sites.…”

“…The presence of external factors can influence nursing interventions performed with neurologically impaired patients (Cook, Deeny, & Thompson, 2004;McNett, 2009;McNett, Doheny, Sedlak & Ludwick, 2009). Nursing judgments about appropriate interventions when managing secondary brain injury in critically ill TBI patients are influenced by worsening values for oxygen saturation, intracranial pressure (ICP), cerebral perfusion pressure (CPP), and nursing shift.…”

“…Nurses are less likely to rely solely on nursing interventions and more likely to consult another member of the healthcare team as values for oxygen saturation, ICP, and CPP fall farther from recommended parameters. In addition, nurses working day shift are more likely to rely solely on nursing interventions and less likely to consult other healthcare team members than are their night shift colleagues (McNett, 2009).…”

Nursing Interventions for Patients with Intracranial Hypertension: Integrative Literature Review

“…O enfermeiro deve ser muito cauteloso, já que a realização de procedimentos rotineiros pode agravar o quadro neurológico, em decorrência da elevação da PIC e da diminuição da pressão de perfusão cerebral. Para tanto, o profissional deve ser capacitado para prestar uma assistência segura e qualificada aos pacientes críticos, uma vez que há necessidade de atenção constante na aplicação das intervenções para a sua recuperação (20,33,(55)(56)(57)(58)(59).…”