Introduction: Caring for patients with different medical and surgical needs and different physician teams can be challenging. Therefore, subspecialty nursing training also poses a challenge, one which requires technical in-service and didactic education, and allocation of resources.

Methods: To encourage medical-surgical nurses to become more engaged and confident in subspecialty patient care the authors developed an at-hand bedside neurosurgical nursing guide to allow for independent procedure related education. They hypothesized that this would enable nurses to better predict adverse outcomes and respond appropriately. Objective parameters were not assessed; this was a quality improvement project.

Results: Familiarization with the neurosurgical nursing guide had a positive impact on the confidence of medical-surgical nurses caring for neurosurgical patients. Medical-surgical nurses were more comfortable taking care of neurosurgical patients.

Conclusions: Medical-surgical nurses felt the guide helped improve skills, and noted improved knowledge regarding involvement of physician oversight.

Patient Care: Further quality improvement research is of paramount importance to improve value in healthcare; a freely accessible neurosurgical nursing guide improves nursing confidence which has been shown to affect outcomes.

Learning Objectives: By the conclusion of this session, participants should understand: 1. A poignant example of how to construct a helpful subspecialized nursing guide. 2. The impact of improving nursing confidence using a manual supplement for subspecialized neurosurgical care.

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