title: Effects of nursing interventions on intracranial pressure.
abstract: BACKGROUND
  Intracranial pressure is a frequent target for goal-directed therapy to prevent secondary brain injury. In critical care settings, nurses deliver many interventions to patients having intracranial pressure monitored, yet few data documenting the immediate effect of these interventions on intracranial pressure are available.
  
  
  OBJECTIVE
  To examine the relationship between intracranial pressure and specific nursing interventions observed during routine care.
  
  
  METHODS
  Secondary analysis of prospectively collected observational data.
  
  
  RESULTS
  During 3118 minutes of observation, 11 specific nursing interventions were observed for 28 nurse-patient dyads from 16 hospitals. Family members talking in the room, administering sedatives, and repositioning the patient were associated with a significantly lower intracranial pressure. However, intracranial pressure was sometimes higher, lower, or unchanged after each intervention observed.
  
  
  CONCLUSIONS
  Response of intracranial pressure to nursing interventions is inconsistent. Most interventions were associated with inconsistent changes in intracranial pressure at 1 or 5 minutes after the intervention.
authors.affiliation: Duke University Medical Center, Durham, NC, USA. DaiWai.Olson@UTSouthwestern.edu
authors.forename: DaiWai M
authors.initials: DM
authors.lastname: Olson
authors.forename: Molly M
authors.initials: MM
authors.lastname: McNett
authors.forename: Lisa S
authors.initials: LS
authors.lastname: Lewis
authors.forename: Kristina E
authors.initials: KE
authors.lastname: Riemen
authors.forename: Cynthia
authors.initials: C
authors.lastname: Bautista
mesh_terms: D000328:Adult; D001930:Brain Injuries / Q000451:nursing / Q000517:prevention & control*; D003422:Critical Care / Q000379:methods*; D016638:Critical Illness / Q000451:nursing*; D005260:Female; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods / Q000451:nursing*; D009741:Nursing Staff, Hospital