Nurses' Understanding and Practice of Minimal Stimulation in the Pediatric Intensive Care Unit.

ABSTRACT

BACKGROUND: Pediatric patients receiving neurologic and neurosurgical critical care undergo many procedures that result in stimulation of the sympathetic nervous system, which increases their risk of poor outcomes. Nurses typically implement a variety of interventions to minimize such stimulation; however, minimal stimulation has not been specifically defined in the literature or described as a standardized bundle of care. OBJECTIVE: To examine pediatric intensive care unit nurses' interpretation and practice of minimal stimulation in patients with neurologic and neurosurgical conditions and specifically to triangulate nurses' descriptions of this practice with related findings in the literature. METHODS: This was a qualitative, descriptive, exploratory study that used naturalistic inquiry. RESULTS: A total of 13 pediatric intensive care unit nurses participated in the study. Three primary themes were identified regarding minimal stimulation (1) new knowledge and practice, (2) communication, and (3) impact of minimal stimulation. CONCLUSIONS: The findings of this study help to establish a working definition of the nursing practice of minimal stimulation and provide a basis for future research. More detailed study is needed on the concept of a standardized minimal stimulation bundle and its impact on patient outcomes.