The Role of Nursing Care in the Management of External Ventricular Drains on the Neurosurgical Ward: A Quality Improvement Project

Abstract

The management of external ventricular drains (EVD) is a critical aspect of patient care in intensive care settings. However, nurses on the general floor are not commonly exposed to patients with EVD, and therefore may lack the necessary knowledge and skills to manage and troubleshoot EVDs effectively. The aim of this study was to evaluate the level of knowledge, comfort, and impact of EVD management among nurses on the floor following the implementation of a Quality Improvement (QI) tool. This is a cross-sectional study conducted among registered nurses working on the neurosurgical floors of the Montreal Neurological Institute. Data were collected using a questionnaire based on the Plan-Do-Study-Act model. A survey assessing the level of knowledge and comfort with EVD management was conducted before and after the implementation of the QI tool. Seventy-six nurses completed the questionnaire regarding their knowledge and comfort level in EVD management. Results showed that only 42% of the nurses reported feeling "comfortable" while 37% reported feeling "uncomfortable" in caring for patients with an EVD. Additionally, only 6.5% reported being "comfortable" in troubleshooting a malfunctioning EVD. However, the level of comfort significantly improved after using the QI project. The results of this study highlight the need for continued training and education to support the care of patients with EVDs in the ward setting. The implementation of a QI tool can significantly improve nurses' knowledge and comfort level in EVD management, leading to improved patient outcomes and overall quality of care.