1. Saban, Karen L. PhD RN APRN CNRN

Article Content

AACN-AANN Protocols for Practice: Monitoring Technologies in Critically Ill Neuroscience Patients

L. Littlejohns & M. Bader (Editors), Sudbury, MA: Jones and Bartlett Publishers, 2009, 197 pages, $99.95, ISBN 13:978-0-7637-4156.


This book is an essential resource for neuroscience nurses practicing in critical care as well as nurse educators and researchers. The AACN-AANN Protocols for Practice: Monitoring Technologies in Critically Ill Neuroscience Patients offers a comprehensive reference of the latest research practice protocols in a format that is well organized and easy to understand. Readers will recognize the editors and the contributors and reviewers of this book as being premier, well-respected experts in the field of neuroscience nursing.


Each chapter focuses on a specific critical care technology protocol related to the care of critically ill neuroscience patients including (a) ventilator management, (b) intracranial pressure management, (c) cerebrospinal drainage systems, (d) brain oxygen monitoring, (e) cerebral blood flow monitoring, and (f) electroencephalograph-derived monitoring. Within each chapter, a case study, general description of the technology, accuracy of the technology, competency required to use the technology, future research, clinical recommendations, and an annotated bibliography are provided. The annotated bibliographies are especially valuable because they succinctly and clearly describe supporting research studies. When appropriate, ethical considerations related to the use of the technology are also included. For example, the chapter on ventilator management discusses the challenges of mechanical ventilation for patients with end-stage amyotrophic lateral sclerosis.


The protocols outline how to use the latest critical care technology supported by current recommendations and research. Level of recommendation ratings is provided based upon the strength of the evidence of the recommendation. For example, level I indicates that the recommendation is a manufacturer's recommendation only, whereas a level VI recommendation is based on the support of well-designed clinical studies in a variety of patient populations. Each protocol includes a table with the recommendation, rationale for recommendation, level of recommendation, supporting references, and comments. Although some of the tables are very lengthy, they provide a comprehensive and valuable reference for both novice and expert nurse clinicians.


One drawback of the book is that the content may become outdated quickly. However, the editors address this weakness by referring the reader to practice alerts posted on the AACN Web site which provide the latest, most current guidance.


This book is one of the few publications available to neuroscience nurses that bridges the gap between research and clinical practice. It is an indispensable resource for neuroscience nurses who want to ensure that they are using the latest evidence to guide and support their practice.


Reviewed by Karen L. Saban, PhD RN APRN CNRN, Assistant Professor, Marcella Niehoff School of Nursing, Loyola University Chicago.