Table of Contents
ISRN Neurology
Volume 2012, Article ID 903954, 7 pages
Research Article

The Use of Nurse Checklists in a Bedside Computer-Based Information System to Focus on Avoiding Secondary Insults in Neurointensive Care

1Department of Neuroscience/Neurosurgery, Uppsala University, 751 85 Uppsala, Sweden
2Department of Surgical Sciences, Uppsala University, 751 85 Uppsala, Sweden

Received 18 April 2012; Accepted 23 May 2012

Academic Editors: W. D. Dietrich and A. Martinuzzi

Copyright © 2012 Lena Nyholm et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The feasibility and accuracy of using checklists after every working shift in a bedside computer-based information system for documentation of secondary insults in the neurointensive care unit were evaluated. The ultimate goal was to get maximal attention to avoid secondary insults. Feasibility was investigated by assessing if the checklists were filled in as prescribed. Accuracy was evaluated by comparing the checklists with recorded minute-by-minute monitoring data for intracranial pressure-ICP, cerebral perfusion pressure CPP, systolic blood pressure SBP, and temperature. The total number of checklist assessments was 2,184. In 85% of the shifts, the checklists were filled in. There was significantly longer duration of monitoring time at insult level when Yes was filled in regarding ICP (mean 134 versus 30 min), CPP (mean 125 versus 26 min) and temperature (mean 315 versus 120 min). When a secondary insult was defined as >5% of monitoring time spent at insult level, the sensitivity/specificity for the checklist assessments was 31%/100% for ICP, 38%/99% for CPP, and 66%/88% for temperature. Checklists were feasible and appeared relatively accurate. Checklists may elevate the alertness for avoiding secondary insults and help in the evaluation of the patients. This concept may be the next step towards tomorrow critical care.