Updated research priorities for neuroscience nursing.

In 2007, the Neuroscience Nursing Foundation (NNF) convened a research panel to update NNF's research priorities used to guide funding. The research panel identified leaders in neuroscience nursing and conducted a review of neuroscience nursing research literature and an American Association of Neuroscience Nurses membership survey on research priorities. A workgroup of leaders in neuroscience nursing was then convened to draft and set priorities on the basis of the review of the literature and the membership survey. The updated priorities were submitted to the NNF Board of Trustees for approval. The revised document reviews the mission of NNF and outlines six strategies and five program areas (including specific subareas) that represent priorities for NNF research funding. The purpose of the updated priority document is to provide guidelines for the systematic development of knowledge in neuroscience nursing through the encouragement of selected neuroscience nursing research activities.

The role of the advanced practice nurse in neuroscience nursing: results of the 2006 AANN membership survey.

The need for a scope of practice for advanced practice neuroscience nurses was identified by the American Association of Neuroscience Nurses (AANN) in 2006. A task force consisting of advanced practice nurses (nurse practitioners and clinical nurse specialists) was commissioned by AANN and charged with the development of the document. Current information regarding the practices of advanced practice neuroscience nurses was needed as the task force began to develop this document. To best obtain this information, an electronic survey was created and distributed to advanced practice nurses within the AANN database. The survey questions included basic demographic data and sought information regarding activities and procedures performed by the advanced practice nurse. The results of this survey clearly reflect the diversity in practice and the integral role advanced practice neuroscience nurses play in the management of patients' care.

Subarachnoid clot volume correlates with age, neurological grade, and blood pressure.

OBJECTIVE: Cerebral vasospasm after aneurysmal subarachnoid hemorrhage (SAH) is associated with the volume and location of subarachnoid blood clots. Factors that influence the volume of SAH have seldom been studied. METHODS: Two independent sets of data were analyzed. Data from 3028 patients with SAH enrolled in four clinical trials of the drug tirilazad were analyzed in addition to data from 74 patients with SAH who underwent digital volumetric analysis of admission computed tomographic scans to determine the subarachnoid clot volume. In the smaller sample of 74 patients, aneurysm width, length, neck size, aspect ratio, and volume were measured on diagnostic cerebral angiograms. Statistical inference bearing on the question of what factors are associated with clot volume was derived by univariate methods, including analysis of variance, chi and t tests, and polytomous logistic regression. RESULTS: Of 22 clinical parameters examined by univariate analysis of the tirilazad dataset, age, World Federation of Neurological Surgeons (WFNS) clinical grade, time from SAH to admission, history of hypertension or diabetes mellitus, aneurysm location, and admission diastolic and systolic blood pressure were correlated with the subarachnoid clot volume (P < 0.05). Polytomous logistic regression found that only age, WFNS grade, time to admission, admission systolic blood pressure, and history of hypertension were higher in patients with larger subarachnoid clots (P < 0.05). Analysis of 74 patients with quantitative subarachnoid clot volumes also found that age and WFNS grade were higher in patients with larger subarachnoid clots (P < 0.05). No aneurysm location or measurement of aneurysm size showed a statistically significant relationship to clot volume in either dataset. CONCLUSION: SAH volume is correlated with clinical characteristics, including age, history of hypertension, admission systolic blood pressure, and WFNS grade. Anatomic aneurysm characteristics such as size and location do not reliably predict clot volume.

Clot volume and clearance rate as independent predictors of vasospasm after aneurysmal subarachnoid hemorrhage.

OBJECT: This study was conducted for two purposes. The first was to determine whether a combination of measurements of subarachnoid clot volume, clearance rate, and density could improve prediction of which patients experience vasospasm. The second was to determine if each of these three measures could be used independently to predict vasospasm. METHODS: Digital files of the cranial computerized tomography (CT) scans obtained in 75 consecutive patients admitted within 24 hours of subarachnoid hemorrhage (SAH) were analyzed in a blinded fashion by an observer who used quantitative imaging software to measure the volume of SAH and its density. Clot clearance rates were measured by quantifying SAH volume on subsequent CT scans. Vasospasm was defined as new onset of a focal neurological deficit or altered consciousness 5 to 12 days after SAH in the absence of other causes of deterioration, diagnosed with the aid of or exclusively by confirmatory transcranial Doppler ultrasonography and/or cerebral angiography. Univariate analysis showed that vasospasm was significantly associated with the SAH grade as classified on the Fisher scale, the initial clot volume, initial clot density, and percentage of clot cleared per day (p < 0.05). In multivariate analysis, initial clot volume and percentage of clot cleared per day were significant predictors of vasospasm (p < 0.05), whereas Fisher grade and initial clot density were not. CONCLUSIONS: Quantitative analysis of subarachnoid clot shows that vasospasm is best predicted by initial subarachnoid clot volume and the percentage of clot cleared per day.