Development of a White Paper on the Neurological Assessment of the Hospitalized Adult.

R ELEC IO N S A ll hospitalized adult patients have the potential to experience a neurological event. It is important for nurses caring for those patients to be familiar with basic neurological assessment so subtle changes can be detected early, allowing prompt intervention to prevent further decline or irreversible damage. Nurses do not need an order to assess their patients' health status, because they are educated in the science of nursing assessment and required by state law to maintain competence. However, some nurses perceive the adult neurological examination as challenging because there is no established standard, leading to confusion and a piecemeal approach. The American Association of Neuroscience Nurses (AANN) Board of Directors recognized the importance of developing a standard neurological assessment for adult hospitalized patients that nurses from all specialties can use. They charged the Clinical Science Committee with the task of developing a white paper to describe essential components of the examination so nurses could identify early changes and intervene. It was not intended to be a detailed assessment for all neurological conditions; it was meant to describe a basic neurological assessment that can be used on any hospitalized adult, whether they have a neurological diagnosis. Working with the Clinical Science Committee, a task force of 6 experienced neuroscience nurses developed a white paper describing the essential components of a neurological assessment of the hospitalized adult. Awhite paper communicates the recommendations of an organization on a topic, which helps educate readers about an issue of interest, a good fit for the task. A clinical practice guideline was considered; however, after a review of the literature, there was not enough evidence to support and meet clinical practice guideline recommendations for the document.