Document Type

DNP - Open Access

Award Date


Degree Name

Doctor of Nursing Practice (DNP)


Graduate Nursing

First Advisor

Robin Arends


Background: The focus of this Doctor of Nursing Practice Project surrounds the need for an evidence-based clinical nursing protocol to augment nurse competency and therefore streamline care to patients with an external ventricular drain (EVD).
Methods: A clinical protocol alongside tailored education was used to promote nurse competency for EVD management. A pre-implementation survey was completed evaluating the nurses’ baseline competency when managing an EVD. The nursing protocol was then implemented for bedside use. After 2 months, the survey was completed once again and paired for statistical analysis.
Results: Statistical analysis using the Wilcoxon signed-rank nonparametric test with dependent matched pairs was used. Results revealed no statistical significance at the 5% level after the implementation of a bedside clinical nursing protocol for EVD care as each statement from the completed surveys revealed a p-value of 0.173 or above.
Discussion: Although the results of this project were not statistically significant, it highlights the need for more studies or projects analyzing the potential effectiveness of a bundled-approach nursing protocol on competency for EVD management in its entirety, as previous literature suggests great benefit in other aspects of neurocritical patient care.
Implications for Practice: Further research is needed into nursing competency of neurocritical patient care. Improving nurse knowledge and skill via an evidence-based clinical protocol improves the possibility of improved competency with EVD bedside management, therefore stimulating superior patient clinical outcomes.

Library of Congress Subject Headings

Nursing care plans.
Clinical competence.
Drainage, Surgical.
Brain -- Ventricles -- Surgery.
External ventricular drain

Number of Pages



South Dakota State University


Copyright © 2023 Lauren Orson

Available for download on Thursday, May 15, 2025