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Comprehensive review of a neuro progressive care unit : a thesis submitted to the faculty of the Milwaukee School of Engineering in partial fulfillment of the requirements for the degree of Master of Science in Nursing / by Abigail J. Vogt.

by Vogt, Abigail J. author., Normington, Dr. Havilah thesis advisor , Powell, Rhonda committee member , committee member , Milwaukee School of Engineering

[Milwaukee School of Engineering], [2018]

Neurological intensive care.

Nervous system--Surgery

Hospital--Admission and Discharge

neurosurgical progressive care unit

neuroscience progressive care unit

intermediate care unit

39 leaves : 29 cm

Comprehensive review of a neuro progressive care unit -- Problem statement -- Purpose statement -- Definition of variables -- Neuro progressive care unit -- Literature review -- Search parameters -- Quality assessment -- Data extraction -- Search results -- Theoretical and conceptual framework -- Methods -- Results -- Cardiac monitoring and infusions -- Resperatory monitoring and abilities -- Neurological assessments -- Diagnoses and interventions -- Stroke -- Drains -- Surgery -- Nurse ratios -- Discussion -- Recommendations -- Hospital A's NCPU -- Inclusion criteria -- Monitoring -- Staffing ratios -- Conclusion -- References -- Appendix A: Rapid critical appraisal of qualitative evidence -- Appendix B: Rapid critical appraisal checklist for descriptive studies -- Appendix C: Rapid critical appraisal of evidence-based guidelines -- Appendix D: Rapid critical appraisal questions for cohort studies -- Appendix E: Evidence table -- Appendix F: Patient characteristics, nurse competencies, and recommendations.

The objective of this comprehensive review is to analyze the current state of the neuro progressive care unit (NPCU) in Hospital A, and evaluate it in comparison to evidence-based practice recommendations of typical patient characteristics and associated nurse staffing and competencies in progressive care units of other hospitals. The current state is defined by the published 'NPCU Guidebook' of Hospital A in which patient characteristics and nurse competencies are outlined. The current healtcare environment operates under pressures of limited and expensive resources, constrained budgets, and a looming nurse shortage. Critical care expenditures can be reduced by effectively utilizin progressive care units to provide clinically appropriate, high quality, and cost-effective patient care. Underutilization of a neuro progressive care unit prompts this review. English-language articles published on NPCUs were retrieved using electrinic databases and manual screening of titles and abstracts. Rapid critical appraisal and data extraction were completed for the first six articles found. This review features recommendations on (1) inclusion and exclusion criteria for the typical patient population admitted to Hospital A's MPCU, (2) necessary monitoring, appropriate medications, and interventions, and (3) appropriate staffing ratios and nursing competencies. It features evidence to support recommendations that influence an increase in appropriate utilization of Hospital A's NPCU. This will allow patients to be managed at an appropriate level of care outside of the ICU, where acute changes are still able to be identified and managed, readmissions to the ICU are minimized, and critical care costs are decreased.

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