The examination of a patient’s pupils is an essential practice to detect neurological deterioration and the need for changes in a patient’s plan of care. A pupil examination consists of the inspection of pupils to assess size, shape, reactivity to light, and symmetry. Previous research has confirmed that serial pupil examinations are a crucial component in evaluating neurological status among critically ill patients. However, inconsistencies and inaccuracies in pupil assessments by critical care nurses can contribute to failure to recognize clinically significant changes in pupil size that are linked to neurological deterioration. This can lead to delays in time-sensitive interventions needed to minimize the progression of neurological injury.

In an effort to describe the inconsistencies among critical care nurses performing pupil examinations, the authors conducted a 3-phase descriptive study to determine the accuracy of critical care and neurosurgical nurses’ pupil examinations.

In phase 1, the study investigators recruited 30 critical...

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