Cluster Care or Don't?

[sergel02, BSN]

There was something I was curious about when it comes to clustering care and ICP and hopefully you guys can help me out. I was told by one nurse that they cluster care to keep the ICP low, but another nurse in a different hospital said that they (or she), avoids clustering care, since some research shows that clustering care causes spikes in ICP due to so many activities going on at once, while doing them throughout the day will allow for less spikes, but a higher baseline ICP.

Do both methods have their merits, or is one more beneficial than the other? Not a neuro nurse myself or anything, which is why I wanted to ask.

[Ladyscrubs]

We don't cluster care. There are recommendations (EBP) that suggests rest periods between care. Since the brain can't store O2 each spike or rise in the ICP can the lead to interruption of cerebral blood flow (oxygen) by reduction of the perfusion pressure or sort of like putting a choke hold on the brain aka potential ischemia, so that ain't good.

How much care I do varies from patient to patient, and day to day. Those patients that are hypotensive are more sensitive to any minor increase in ICP, but it is the perfusion pressure we try to maintain. Look first at your environment, eliminate noxious stimuli.

When it comes to people with brain trauma, do the Goldilocks method of nursing: not too long or too short, too much or too little, too fast or too slow, too hot or too cold, too loud or too piercing.

My patients bath consists of face, pits, and crotch...rest... turning and linen change...rest. You also can do a lot of your assessment by just being. Hope this helps.