Book contents
- Neurocritical Care
- Neurocritical Care
- Copyright page
- Contents
- Contributors
- Preface
- Chapter 1 The Neurological Assessment of the Critically Ill Patient
- Chapter 2 Cerebral Blood Flow Physiology and Metabolism in the Neurocritical Care Unit
- Chapter 3 Cerebral Edema and Intracranial Pressure in the Neurocritical Care Unit
- Chapter 4 Hypothermia in the Neurocritical Care Unit: Physiology and Applications
- Chapter 5 Analgesia, Sedation, and Paralysis in the Neurocritical Care Unit
- Chapter 6 Airway Management and Mechanical Ventilation in the Neurocritical Care Unit
- Chapter 7 Neuropharmacology in the Neurocritical Care Unit
- Chapter 8 Intracranial Monitoring in the Neurocritical Care Unit
- Chapter 9 Electrophysiologic Monitoring in the Neurocritical Care Unit
- Chapter 10 The Role of Transcranial Doppler as a Monitoring Tool in the Neurocritical Care Unit
- Chapter 11 Ischemic Stroke in the Neurocritical Care Unit
- Chapter 12 Intracerebral Hemorrhage in the Neurocritical Care Unit
- Chapter 13 Management of Cerebral Venous Thrombosis in the Neurocritical Care Unit
- Chapter 14 Subarachnoid Hemorrhage in the Neurocritical Care Unit
- Chapter 15 Status Epilepticus in the Neurocritical Care Unit
- Chapter 16 Neuromuscular Disorders in the Neurocritical Care Unit
- Chapter 17 Management of Head Trauma in the Neurocritical Care Unit
- Chapter 18 Management of Autoimmune Encephalitis in the Neurocritical Care Unit
- Chapter 19 Management of Cerebral Salt-Wasting Syndrome and Syndrome of Inappropriate Antidiuresis in the Neurocritical Care Unit
- Chapter 20 Brain Death in the Neurocritical Care Unit
- Chapter 21 Neuroterrorism and Drug Overdose in the Neurocritical Care Unit
- Chapter 22 Infections of the Central Nervous System in the Neurocritical Care Unit
- Chapter 23 Management of the Spinal Cord Injury in the Neurocritical Care Unit
- Chapter 24 Postoperative Management in the Neurocritical Care Unit
- Chapter 25 Ethical Considerations in the Neurocritical Care Unit
- Chapter 26 Pulmonary Consult: Management of Severe Hypoxia in the Neurocritical Care Unit
- Chapter 27 Management of Refractory Arrhythmias in the Neurocritical Care Unit
- Chapter 28 An Infectious Diseases Consult in the Neurocritical Care Unit
- Chapter 29 A Nephrology Consult in the Neurocritical Care Unit
- Chapter 30 Management of Hepatic Encephalopathy in the Neurocritical Care Unit
- Chapter 31 Hypoxic Encephalopathy in the Neurocritical Care Unit
- Chapter 32 Management of Delirium in the Neurocritical Care Unit
- Chapter 33 Generalized Weakness in the Neurocritical Care Unit
- Chapter 34 Management of Severely Brain-Injured Patients Recovering from Coma in the Neurocritical Care Unit
- Chapter 35 Acute Demyelinating Disorders in the Neurocritical Care Unit
- Chapter 36 Building a Case for a Neurocritical Care Unit
- Chapter 37 Neurointensive (NCCU) Care Business Planning
- Index
- References
Chapter 37 - Neurointensive (NCCU) Care Business Planning
Published online by Cambridge University Press: 24 July 2019
Edited by
Book contents
- Neurocritical Care
- Neurocritical Care
- Copyright page
- Contents
- Contributors
- Preface
- Chapter 1 The Neurological Assessment of the Critically Ill Patient
- Chapter 2 Cerebral Blood Flow Physiology and Metabolism in the Neurocritical Care Unit
- Chapter 3 Cerebral Edema and Intracranial Pressure in the Neurocritical Care Unit
- Chapter 4 Hypothermia in the Neurocritical Care Unit: Physiology and Applications
- Chapter 5 Analgesia, Sedation, and Paralysis in the Neurocritical Care Unit
- Chapter 6 Airway Management and Mechanical Ventilation in the Neurocritical Care Unit
- Chapter 7 Neuropharmacology in the Neurocritical Care Unit
- Chapter 8 Intracranial Monitoring in the Neurocritical Care Unit
- Chapter 9 Electrophysiologic Monitoring in the Neurocritical Care Unit
- Chapter 10 The Role of Transcranial Doppler as a Monitoring Tool in the Neurocritical Care Unit
- Chapter 11 Ischemic Stroke in the Neurocritical Care Unit
- Chapter 12 Intracerebral Hemorrhage in the Neurocritical Care Unit
- Chapter 13 Management of Cerebral Venous Thrombosis in the Neurocritical Care Unit
- Chapter 14 Subarachnoid Hemorrhage in the Neurocritical Care Unit
- Chapter 15 Status Epilepticus in the Neurocritical Care Unit
- Chapter 16 Neuromuscular Disorders in the Neurocritical Care Unit
- Chapter 17 Management of Head Trauma in the Neurocritical Care Unit
- Chapter 18 Management of Autoimmune Encephalitis in the Neurocritical Care Unit
- Chapter 19 Management of Cerebral Salt-Wasting Syndrome and Syndrome of Inappropriate Antidiuresis in the Neurocritical Care Unit
- Chapter 20 Brain Death in the Neurocritical Care Unit
- Chapter 21 Neuroterrorism and Drug Overdose in the Neurocritical Care Unit
- Chapter 22 Infections of the Central Nervous System in the Neurocritical Care Unit
- Chapter 23 Management of the Spinal Cord Injury in the Neurocritical Care Unit
- Chapter 24 Postoperative Management in the Neurocritical Care Unit
- Chapter 25 Ethical Considerations in the Neurocritical Care Unit
- Chapter 26 Pulmonary Consult: Management of Severe Hypoxia in the Neurocritical Care Unit
- Chapter 27 Management of Refractory Arrhythmias in the Neurocritical Care Unit
- Chapter 28 An Infectious Diseases Consult in the Neurocritical Care Unit
- Chapter 29 A Nephrology Consult in the Neurocritical Care Unit
- Chapter 30 Management of Hepatic Encephalopathy in the Neurocritical Care Unit
- Chapter 31 Hypoxic Encephalopathy in the Neurocritical Care Unit
- Chapter 32 Management of Delirium in the Neurocritical Care Unit
- Chapter 33 Generalized Weakness in the Neurocritical Care Unit
- Chapter 34 Management of Severely Brain-Injured Patients Recovering from Coma in the Neurocritical Care Unit
- Chapter 35 Acute Demyelinating Disorders in the Neurocritical Care Unit
- Chapter 36 Building a Case for a Neurocritical Care Unit
- Chapter 37 Neurointensive (NCCU) Care Business Planning
- Index
- References
Summary
Historically, neurology has been primarily an outpatient specialty. The advent of modern neurosurgical techniques, as well as more elegant means of artificial ventilation in the 1960s, brought increasing numbers of neurologic patients to the intensive care units (ICUs). Although these patients were primarily managed by medical and surgical-anesthesiologist intensivists, occasional consults for neurophysiologic testing, management of neuromuscular failure, and, more commonly, prognostication, would bring a neurologist to the ICU. In the 1980s and 1990s, the surge in new neurosurgical procedures created an interest by some neurologists in cerebrovascular disease, while others ventured into the ICUs and carved a niche for a new subspecialty: neurocritical care [1].
- Type
- Chapter
- Information
- Neurocritical Care , pp. 430 - 441Publisher: Cambridge University PressPrint publication year: 2019
References
References
Zakaria, A, Provencio, JJ, Lopez, GA. (2008). Emerging subspecialties in neurology: neurocritical care. Neurology, 70(18): 68–69.CrossRefGoogle ScholarPubMed
Hodgson, T, Brorson, J, Ardelt, AA, Lukas, R. (2013). Accrediting neurology fellowships accelerates subspecialization. Front Neurol, 4: 94.Google Scholar
Berry, T. (2014). What is a Business Plan? http://articles.bplans.com/writing-a-business-plan/what-is-a-business-plan/33 (accessed December 2018).Google Scholar
Graduate School of the Business Center for Entrepreunial Studies (2015). Business plans. www.gsb.stanford.edu/ces/resources/business_plans.html (accessed December 2018).Google Scholar
Wasserman, E. (n.d.). Financial Analysis: How to Write the Financial Section of a Business Plan. www.inc.com/guides/business-plan-financial-section.html (accessed December 2018).Google Scholar
Goren, L. (2014). Integration and physician issues. www.beckershospitalreview.com/hospital-physician-relationships/ (accessed December 2018).Google Scholar
Higashida, R. (2013). Interactions within stroke systems of care: a policy statement from the American Heart Association/American Stroke Associations. Stroke, 44(10): 2961–2984.CrossRefGoogle Scholar
Sherry, SP. (2012). Integrating advanced practice providers in the ICU. www.sscm.org/communications/critical-connections/archives/pages/integrating-advanced-practice-providers-in-the-ICU (accessed December 2018).Google Scholar
Kleinpell, R, Ward, NS, Kelso, LA, Mollenkopf, FP, Houghton, D. (2015). Provider to patient ratios for nurse practitioners and physician assistants in critical care units. Am J Crit Care Nurses, 24(3): e16–e21.Google Scholar
National Council of State Boards of Nursing (2008). Concensus model for APRN regulation: licensure, accreditation, certification and education. https://www.ncsbn.org/Consensus_Model_Report.pdf (accessed December 2018).Google Scholar
Stanely, JM, Crabtree, MK. (2010). Adult-gerontology primary care nurse practitioner competencies. https://cdn.ymaws.com/www.nonpf.org/…/competencies/adult-geropccomps2010.pdf (accessed December 2018).Google Scholar
Crabtree, MK, Stanley, J, Werner, KE, Schmid, E. (2002). Nurse practitioner primary care competencies in specialty areas: adult, family, gerontological, pediatric, and women’s health. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/competencies/primarycarecomps02.pdf (accessed December 2018).Google Scholar
Thomas, A. (2013). Population-focused nurse practitioner competencies: family/across the lifespan, neonatal, pediatric acute care, pediatric primary care, psychiatric-mental health, women’s health/gender-related. https://cdn.ymaws.com/www.nonpf.org/resource/resmgr/Competencies/CompilationPopFocusComps2013.pdf (accessed December 2018).Google Scholar
Becker, D, Amba, K, Hardin, S, et al. (2012). AACN scope and standards for acute care nurse practitioner practice. www.aacn.org/nursing-excellence/standards/aacn-scope-and-standards-for-acute-care-nurse-practitioner-practice (accessed December 2018).Google Scholar
Haut, C, Madden, M. (2015). Hiring appropriate providers for different populations: acute care nurse practitioners. Crit Care Nurse, 35(3):e1–e8.CrossRefGoogle ScholarPubMed
Gutsche, J, Raiten, JM. (2013). Staffing models for the ICU: open, closed, MD, NP or telemedicine. Curr Anesthesiol Rep, 3(2): 65–72.CrossRefGoogle Scholar
Owen, DS, Danielsen, RD, Bell-Gordon, C. (2012). Administrative considerations for maximizing the integration of nurse practitioners and physician assistants into the ICU. In Kleinpell, RM, Boyle, WA, Buchman, TG (eds.) Integrating Nurse Practitioners and Physicians Assistants into the ICU Strategies for Optimizing Contributions to Care. Mount Prospect, IL: Society of Critical Care Medicine, 123.Google Scholar
D’Agostino, RP. (2010). The NP staffing model in the ICU at Memorial Sloan-Kettering Cancer Center. Crit Care Med, 26(1): 207–217.Google Scholar
Further Reading
Berkhemer, OF. (2015). A randomized trial of intraarterial treatment for acute ischemic stroke. N Engl J Med, 372(1): 1–10.CrossRefGoogle ScholarPubMed
Broderick, JP, Palesch, YY, Demchuk, A, (2013). Endovascular therapy after intravenous t-PA versus t-PA alone for stroke. N Engl J Med, 368(10): 893–903.Google Scholar
Cameron, WO. (2002). Strategic financial planning. In Cleverly, WO, Cameron, AE (eds.), Essentials of Health Care Finance. Columbus, OH: Aspen Publication, 203–221.Google Scholar
Campbell, BM. (2015). Endovascular therapy for ischemic stroke with perfusion-imaging selection. N Engl J Med, 372(11): 1–9.Google Scholar
Charles, G, Durbin, J. (2006). Team model: advocating for the optimal method of care delivery of the intensive care unit. Crit Care Med, 34(3 Suppl): S12–S17.Google Scholar
Ciccone, A, Valvassori, L, Nichelatti, M, et al. (2013). Endovascular treatment for acute ischemic stroke. N Engl J Med, 368: 904–913.Google Scholar
Dahl, D. (2011, April). How to Write a Business Plan Outline. Retrieved from inc.com: http://www.inc.com/guies/201104/how-to-write-a-business-plan-outline.htmlGoogle Scholar
Gadhia, J, Starkman, S, Ovbiagele, B, et al. (2010). Assessment and improvement of figures to visually convey benefit and risk of stroke thrombolysis. Stroke, 41(2): 300–306.CrossRefGoogle ScholarPubMed
Gershengorn, H, Johnson, MP, Factor, P. (2012). The use of nonphysician providers in adult intensive care units. Am J Respir Crit Care Med, 185(6): 600–605.CrossRefGoogle ScholarPubMed
Gershengorn, H, Wunsch, H, Wahab, R, et al. (2011). Impact of nonphysician staffing on outcomes in a medical ICU. Chest, 139(6): 1347–1353.Google Scholar
Goyal, MD (2015). Randomized assessment of rapid endovascular treatment of ischemic stroke. N Engl J Med, 72(11): 1019–1030.CrossRefGoogle Scholar
Graland, A, Gershenjorn, H. (2013). Staffing in ICUs: physicians and alternative staffing models. Chest, 143(1): 214–221.Google Scholar
Hacke, W, Kaste, M, Bluhmki, E, et al. (2008). Thombolysis with alteplase 3 to 4.5 hours after acute ischemic stroke. N Engl J Med, 359(13): 1317–1329.Google Scholar
Haupt, M, Bekes, C, Brilli, RJ, Carl, et al. (2003). Guidelines on critical care services and personnel: recommendations based on a system of categorization of three levels of care. Crit Care Med, 31(11): 2677–2683.Google Scholar
Hull, P. (2013). 10 Essential business plan components. www.forbes.com/sites/patrickhull/2013/02/21/10-essential-business-plan-components (accessed December 2018).Google Scholar
Jauch, EC, Saver, JL, Adams, HP, et al. (2013). Guidelines for the early management of patients with acute ischemic stroke: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke, 44(3): 870–947.CrossRefGoogle ScholarPubMed
Khalessi, AA, Mocco, J. (n.d.). AANS/CNS response to CTAF thrombectomy brief. Consideration of the IMS III, MR RESCUE and SYNTHESIS thrombectomy trials. www.aans.org/pdf/Legislative/AANS-CNS%20Response%20to%20IMS%20III%20MR%20RESCUE%20and%20SYNTHESIS%20Thrombectomy%20Trials%202-13.pdf (accessed 2018).Google Scholar
Kidwell, CS, Jahan, R, Gornbein, J, et al. (2013). A trial of imaging selection and endovascular treatment for ischemic stroke. N Engl J Med, 368(10): 914–923.Google Scholar
Kleinpell, RM, Ely, EW, Grabenkort, R. (2008). Nurse practitioners and physician assistants in the intensive care unit: an evidence-based review. Crit Care Med, 36(10): 2888–2897.CrossRefGoogle ScholarPubMed
Kleinpell, RM, Hudspeth, R, Scordo, K, Magdic, K. (2012). Defining NP scope of practice and associated regulations: focus on acute care. J Am Acad Nurse Pract, 24(1): 11–18.Google Scholar
Lansberg, MG, Schrooten, M, Bluhmki, E, Thijs, VN, Saver, JL. (2009). Treatment time-specific number needed to treat estimates for tissue plasminogen activator therapy in acute stroke based on shifts over the entire range of the modifed Rankin scale. Stroke, 40(6): 2079–2084.CrossRefGoogle Scholar
Moote, M, Krsek, C, Klienpell, R, Todd, B. (2011). Physician assistant and nurse practitioner utilization in academic medical centers. Am J Med Qual, 26(6): 452–460.Google Scholar
National Institute of Neurological Disorders and Stroke rt-PA Stroke Study Group (1995). Tissue plasminogen activator for acute ischemic stroke. N Engl JMed, 333(24): 1581–1587.Google Scholar
Pastores, S, O’Connor, MF, Kleinpell, RM, et al. (2011). The Accreditation Council for Graduate Medical Education resident duty hour new standards: History, changes, and impact on staffing of intensive care units. Crit Care Med, 39(11): 2540–2549.Google Scholar
Paton, A, Stein, DE, D’Agostino, R, Pastores, SM, Halpern, N. (2013). Critical care medicine advanced practice provider model at a comprehensive care center: successes and challenges. Am J Crit Care, 22(5): 439–443.Google Scholar
Pereira, VM, Gralla, J, Davalos, A, et al. (2013). Prospective, multicenter, single-arm study of mechanical thrombectomy using solitaire flow restoration in acute ischemic stroke. Stroke, 44(10): 2802–2807.Google Scholar
Russell, D, VorderBruegge, M, Burns, SM. (2012). Effect of an outcomes-managed approach to care of neuroscience patients by acute care nurse practitioners. Am J Crit Care, 11(4): 353–362.CrossRefGoogle Scholar
Saver, JL, Jahan, R, Levy, EL, et al. (2012). Solitaire flow restoration device versus the Merci Retriever in patients with acute ischemic stroke (SWIFT): a randomised, parallel-group, non-inferiority trial. Lancet, 380(9849): 1241–1249.Google Scholar
Summers, D, Leonard, A, Wentworth, D, et al. (2009). Comprehensive overview of nursing and interdisciplinary care of the acute ischemic stroke patient: a scientific statement from the American Heart Association. Stroke, 40(8): 2911–2944.Google Scholar
The Joint Commission (2017). Requirements for Comprehensive Stroke Center Advanced Certificiation. www.jointcommission.org/advanced-certification-comprehensive-stroke-center/ (accessed December 2018).Google Scholar
Ulrich, BT, Woods, D, Hart, KA, et al. (2007). Critical care nurses’ work environments value of excellence in beacon units and magnet organizations. Crit Care Nurse, 27(3): 68–77.Google Scholar
Varelas, P, Conti, M, Spanaki, MV, et al. (2004). The impact of a neurointensivist-led team on a semiclosed neuroscience intensive care unit. Crit Care Med, 32(11): 2191–2198.Google Scholar
Varelas, P, Eastwood, D, Yun, HJ, et al. (2006). Impact of a neurointensivist on outcomes in patients with head trauma in neurosciences intensive care unit. J Neurosurg, 104(5): 713–719.Google Scholar
Varelas, PN, Schultz, L, Conti, M, et al. (2008). The impact of a neuro-intensivist on patients with stroke admitted to a neuroscience intensive care unit. Neurocrit Care, 9(3): 293–299.Google Scholar