Kerry's story: the challenges of facing a recurrent craniopharyngioma.

Craniopharyngiomas account for approximately nine per cent of pediatric brain tumours and one to two per cent of adult brain tumours. Though considered benign, the compressive nature of these relentless tumours can produce catastrophic sequelae. This case study pays tribute to a 33-year-old woman who faced numerous surgeries, adjuvant therapy, and many of the complications associated with a craniopharyngioma. The interdisciplinary neuroscience team, along with colleagues from neuroradiology, ophthalmology, and endocrinology, joined together to care for Kerry and her family to meet their complex health and psychosocial needs. However, it was Kerry who taught us about perseverance, strength, and the power of an unconquerable human spirit.

Clinical indicators contributing to I.C.U. length of stay in elective craniotomy patients with brain tumour.

The immediate purposes of this study are (a) to indicate the I.C.U. and hospital length of stay in elective craniotomy patients with brain tumour, and (b) to identify the clinical indicators that contribute to the I.C.U. length of stay. The ultimate purpose is to contribute to a growing body of knowledge in providing quality and cost effective patient outcomes by creating appropriate vehicles for further research in the field of neuroscience. The following clinical indicators are identified: pre-op patient admission to ward or same day admit unit, O.R. cancellations, type of tumour, nursing staff availability, intubation on admission, I.C.U. length of stay, and post-op complications. The results of this pilot study, with sample size of 55 patients, could assist us in the nursing profession to develop an appropriate Care Map for craniotomy patients with brain tumour.

Nursing intervention scoring system in management of a surgical intensive care unit.

Hospital cost containment and nursing shortages have diminished resources available in surgical intensive care units (SICU). To provide a more quantitative approach to management of these resources, the nursing intervention scoring system (NISS) devised by Greenburg et al was instituted in the SICU at the VA Medical Center, Gainesville, Fla. The NISS scores for patients in the SICU were calculated without computer support. During a four-month study period, 725 NISS evaluations on 70 patients were collected. Characteristic curves of NISS scores versus postoperative days were generated from the data and were predictive of workloads in the unit. In addition, NISS patient scores provided a basis for day-to-day bed control and provided an effective tool for management of nursing service staffing. The hospital administrators responded positively to quantitative documentation of SICU resource requirements by providing additional personnel, equipment, and intermediate care facilities. We have concluded that the NISS is an effective means of providing optimal day-to-day use of SICU beds. In addition, the NISS also provides the data needed to quantitate unit needs for nursing service and administration.