Toward Solving the Sedation-Assessment Conundrum: Neurofunction Monitoring

The Cue-Response Theory and Nursing Care of the Patient With Acquired Brain Injury

The cue-response theory is herewith proposed to replace the coma cue-response conceptual framework as a nursing theory for care of patients with acquired brain injury (ABI). After ABI, nurses assess patients and develop an understanding of their condition by interpreting meaning from physiologic and observational or behavioral cues. These interpretations form the basis for optimizing the timing of discrete nursing interventions; the outcome of which influences the trajectory toward recovery or toward secondary brain injury. The cue-response theory applies specifically for nurses' use to determine which interventions should be used and when those interventions should be carried out. The theory recognizes the knowledge potential and knowledge produced in the context of nursing care of all patients with ABI, not just those with coma, and broadens our understanding of how the timing of nursing interventions directly impacts secondary brain injury and the brain entropy state.