Communication, Leadership, and Decision-Making in the Neuro-ICU

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• 作者：Stephen Trevick ; Minjee Kim ; Andrew Naidech
• 关键词：Communication ; Leadership ; Neuro ; ICU ; Shared decision ; making ; Patient decision aids ; Multidisciplinary teams
• 刊名：Current Neurology and Neuroscience Reports
• 出版年：2016
• 出版时间：November 2016
• 年：2016
• 卷：16
• 期：11
• 全文大小：334 KB
• 刊物主题：Neurology; Neurosciences;
• 出版者：Springer US
• ISSN：1534-6293
• 卷排序：16

文摘

The Neuro-ICU is a multidisciplinary location that presents peculiar challenges and opportunities for patients with life-threatening neurological disease. Communication skills are essential in supporting caregivers and other embedded providers (e.g., neurosurgeons, advanced practice providers, nurses, pharmacists), through leadership. Limitations to prognostication complicate how decisions are made on behalf of non-communicative patients. Cognitive dysfunction and durable reductions in health-related quality of life are difficult to predict, and the diagnosis of brain death may be challenging and confounded by medications and comorbidities. The Neuro-ICU team, as well as utilization of additional consultants, can be structured to optimize care. Future research should explore how to further improve the composition, communication and interactions of the Neuro-ICU team to maximize outcomes, minimize caregiver burden, and promote collegiality.