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Frequency of neuro checks in Neuro ICU

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by Soleil72 Soleil72 (New) New

Just wondering how frequently nurses do neuro checks in the neuro ICU. We do hourly neuro checks for weeks. To me it seems excessive when patient's have not had a neuro change in days. Often when we ask the Attending if we can change to q2 we get shot down. I understand patients with SAH with vasospasm risks need to be monitored more closely but strokes, SDH, tumor resections? Of course patients who received TPA we do the standard q15, q30, q 1... I have worked at other facilities where neuro checks were done q1 X12 then q2 then changed to q4 when appropriate. Thanks in advance, Diane

Here.I.Stand, BSN, RN

Specializes in SICU, trauma, neuro. Has 16 years experience.

We do the q15/30/60 min post-tPA. We do them q 1 hr for unstable bleeds or if there's other specific cause for concern, but most of our pts are q 2 hrs. If they have an EVD or a Camino we check an ICP q 1 hr at least, but don't necessarily wake them up for a neuro check.

Q 1 hr neuro checks for weeks in relatively stable pts is a recipe for delirium. :no:

HouTx, BSN, MSN, EdD

Specializes in Critical Care, Education. Has 35 years experience.

My guess? The frequency may be tied to admission/discharge criteria & they want to avoid the 'why is this person still in ICU?' issues that may arise if those q 1h checks are stopped... but then, I am a self-admitted cynic.