Training to meet the pandemic's challenges in neuroscience nursing

All health services and specialities, including neuroscience, are facing an uncertain future as the pandemic's impact continues to be felt throughout 2021. Emily Spence highlights the importance of continuing professional development and education in meeting these challenges.

Oxford Handbook of Neuroscience Nursing

The field of neuroscience nursing practice relates to a wide range of neurological disorders, many of which are progressive, deteriorating, life-changing, and life-limiting conditions affecting not only the patient but their families and carers. At the same time, the care of the patient following acute-onset injury and trauma presents different challenges in terms of support in critical care and ongoing rehabilitation. Brain damage and injury, irrespective of the causative factors, invariably can have a devastating effect on an individual’s physical, psychological, and cognitive functioning impairing their ability for self-autonomy and independence. The Oxford Handbook of Neuroscience Nursing begins to equip the practitioner with a basic knowledge of the complex needs and specialist management of this group of patients. It gives some insight into the patient’s perspective of living with a neurological condition and presents the best available evidence to inform practice and nursing care.

Confidentiality in professional practice

Practitioners of neuroscience nursing are likely to come by knowledge of a delicate nature concerning their patients, and having such knowledge may play an essential part in treatment. It is critical to disentangle confidentiality from the related notions of privacy, secrecy and tact in professional practice. John Finch provides his analysis

Consent conundrums: patient consent in neuroscience nursing

In BJNN 15(4) and BJNN 15(5), John Finch looked in detail at the role of the Mental Capacity Act 2005 and its accompanying Code in the practice of neuroscience nurses. He concluded, as have others, that the guidance offered by the Act and the Code falls short of what neuroscience nurses need in their practice. In this article, he turns his attention to the treatment of patients who can and do consent to proposed treatment. The law relating to such patients in this matter offers neither an act nor a code. The law is to be found in court decisions. It might, at first sight, appear that a practice situation in which a patient with undoubted mental capacity or, at least, sufficient mental capacity to understand and accept what is proposed, presents no legal problem. But a closer examination of mental processes encountered in patients who may be in pain, distress and pressing need reveals that communication between the treater and the treated may be subtle and complex, and that the meeting of minds required in law to ensure that a patient has genuinely agreed to a detailed proposal is anything but simple.

Abstract TP381: Impact of a Staff Led Neuroscience Nursing Committee on Quality of Care, Staff Education, Staff Morale and Empowerment, and Health Outcomes in the Neuro-Intensive Care Unit

Background: An ICU Neuroscience Nursing Committee was formed to function as a unit-based council, empowering nurses to impact unit decision-making and problem-solving. The committee members serve as neuroscience leaders in the Neuro ICU (NICU). Purpose: To determine the impact of the ICU Neuroscience Nursing Committee on staff education, quality of care, staff morale and empowerment, and health outcomes in a large NICU. Methods: Staff-led committee interventions include: A quarterly comprehensive neuroscience newsletter Curriculum development for an annual Neuroscience Symposium and other education eventsAnnual neurological competency review for unit staffNew employee neurological orientation and educationICU protocol, pathway, process, and policy development and reviewParticipation in neuro patient roundsReal-time hands-on education in response to unit-specific needs and identified opportunities. Results: Mixed methodology was used to evaluate the impact of the committee. External Ventricular Drain infections less than 1% for the last 3 years Improved stroke symptom recognition and inpatient stroke alert times Best practice recognition from The Joint Commission on nursing knowledge and expertise in caring for complex stroke patients Improved collaboration between nursing and physicians Increase in national neuroscience nursing certifications Decrease in nurse-sensitive events Abstract submission and poster presentations at premier conferences Improved neurocritical care physician satisfaction with nursing care Enhanced nurse morale and empowerment Improved patient satisfaction Input and development of new policy and procedures Duplication of neuroscience committee efforts in other departments. Conclusion: Establishment of the ICU Neuroscience Nursing Committee has proven to have a significant impact in improving the quality of care, patient health outcomes and enriching staff morale.