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.

Number of Pages



South Dakota State University


Copyright © 2023 Lauren Orson

Available for download on Thursday, May 15, 2025