Date of Award

2023

Degree Name

Doctor of Philosophy (School of Nursing and Midwifery)

Schools and Centres

Nursing and Midwifery

First Supervisor

Kylie Russell

Second Supervisor

Tracey Coventry

Abstract

A neurological assessment is performed on a patient to determine their neurological function and to establish a differential diagnosis should deficits be identified. Not all patients require the same neurological assessment, and a comprehensive assessment can be very time-consuming and lead to patient fatigue. However, the ability to identify and manage neurological decline and emergencies is singularly the most important skill required for the care of neurosurgical patients by their nurses. Consequently, neurosurgery nurses remain forever vigilant for neurological changes, assessing and recording their observations over time and at the bedside. Neurosurgery patients would benefit from a neurological assessment tool that goes beyond an assessment of consciousness via the Glasgow Coma Scale or stroke scales (such as the National Institutes of Health Stroke Scale), which primarily focus on anterior brain circulation. Instead, the neurosurgical patient requires a whole-brain assessment to appropriately measure common salient neurosurgical sequela at the bedside. This thesis presents a multiphase mixed-methods approach for the development of an abbreviated neurological assessment tool for the conscious neurosurgical patient and provides appropriate clinical pathways for nursing management. The Mini-Neurosurgical Assessment tool has been developed as an ancillary neurological assessment tool to the Glasgow Coma Scale. A review of international neurological assessment tools and expert feedback drawn from four states of Australia was used to establish the tool’s validity via a Knowledge-to-Action Framework.

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