A Novel Approach to Explore How Nursing Care Affects Intracranial Pressure

Am J Crit Care. 2017 Mar;26(2):136-139. doi: 10.4037/ajcc2017410.


Background: Intracranial pressure is measured continuously, and nursing behaviors have been associated with variations in the measurements.

Methods: A prospective pilot observational study was done to develop a comprehensive list of nursing behaviors that affect patients' intracranial pressure. Data on nurses were obtained by self-reports and video recording. Patient-level data were collected via chart abstraction, video recording, and patients' monitors.

Results: Data on 9 patients and 32 nurses were analyzed. A total of 6244 minutes of data were video recorded. Intracranial pressure was changed because of a nursing intervention during 3394 observations. Compared with baseline levels, intracranial pressure was significantly higher if a nursing intervention was performed (odds ratio, 1.96; 95% CI, 1.71-2.24; P < .001).

Conclusion: Studying nursing behaviors is feasible. Synchronizing and analyzing mutually exclusive and exhaustive behaviors indicated that nursing behaviors have an effect on patients' intracranial pressure.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Brain Injuries / nursing*
  • Critical Care / methods*
  • Critical Care / standards*
  • Female
  • Humans
  • Intracranial Pressure / physiology*
  • Male
  • Middle Aged
  • Monitoring, Physiologic / nursing*
  • Monitoring, Physiologic / standards*
  • Nursing Staff, Hospital / standards*
  • Odds Ratio
  • Pilot Projects
  • Practice Guidelines as Topic
  • Prospective Studies