ABSTRACT 912

Abstract

Background and aims: A neurological critical care physician specialist, Dr.Tasker, was hired with the objective of educating nurses and physicians in advance of initiating a new neurological critical care program. Education sessions were established to instruct the nurses in the medical –surgical ICU. Sessions transitioned from physician led presentations to nurse led case studies. Aims: To increase nursing knowledge in the care of the complex neurological patient population. Methods: Initial education started with physician led lectures, which transitioned to nurse driven patient presentations facilitated by DR. Tasker. Each session focused on the ICU course of the patient, summarized in a logical pattern allowing thoughtful pauses to encourage critical thinking along with review of scans/treatment regiments. Diagnoses included: traumatic brain injury, meningitis, metabolic disorder, and brain tumor, right parietal/temporal subdural hematoma and head bleed secondary to familial intrahepatic cholestasis II. Results: A formalized nurse led monthly discussion of complex neurological patients has been achieved. The formal discussion includes, patient’s initial presentation, first 24hours symptoms and management, ongoing ICU care, treatment, and follow up status of the patient. Discussions were supplemented with CT/MRI scans, medications and treatment regimes, along with discussion of what went well and what could we have done differently. Conclusions: Nurse led patient presentations led to the recognition of gaps in unit based nursing guidelines. Creation of algorithms and scamps to coordinate care and enhance team communication was accomplished once the need was recognized.