Underestimation of Pupil Size by Critical Care and Neurosurgical Nurses.

Background: Early detection of pupillary changes in patients with head injuries can alert the care team to increasing intracranial pressure. Previous research has shown inconsistencies in pupil measurement that are most likely due to the subjective nature of measuring pupils without the assistance of technology.

Objectives: To evaluate nurses' abilities to assess pupil diameter accurately and detect unequal pupils.

Infrequent assessment of pain in elderly trauma patients.

There are inherent difficulties in assessing and managing pain in elderly trauma patients, especially those with chronic health conditions or diminished capacities for self-reporting pain. This retrospective study identifies and describes patterns of pain assessment for a trauma population of older adults (age ≥65 years). Gaps between patient assessments existed in all phases of hospitalization and did not meet hospital guidelines for frequency of assessment.