EVD nursing management – exploring the differences in Australasia

Abstract Background: Infection is a significant risk for neurosurgical patients undergoing external ventricular drain (EVD) insertion. Nurses are well placed in the care of the patient with an EVD and in the role of infection prevention. Aim: This article aims to explore evidence-based practices and variations in nursing management of EVDs across Australasia, explored through questionnaires at the 2024 Australasian Neuroscience Nurses Association (ANNA) conference and compared with the literature. Methods: A written questionnaire containing 10 pre-determined questions were provided to participants who signed up for an EVD session at the ANNA 2024 conference workshops. Results from this survey along with data from conference discussions and existing research though a librarian, with thanks to the university of Otago the search were analysed to highlight effective prevention strategies and risk factors for external Ventriculostomy drain Associated Infections (VAIs). Results: A final sample of 9 neurosurgical nurses from Australasia and Canada completed the questionnaire although more nurses attended the workshop (n = 25). Combined with findings from the literature, the survey data identified several modifiable risk factors for VAIs, including cerebrospinal fluid sampling frequency, catheter duration, and site care. Effective practices—such as tunnelling EVDs, using antimicrobial-impregnated catheters, and implementing evidence-based maintenance protocols—were consistently highlighted. Ongoing education and adherence to best-practice guidelines were recognised as key strategies to reduce infection risk. Conclusion: Standard guidelines do not necessarily need extensive changes but should be regularly reviewed and adjusted to improve practices. Continuous education is crucial for reducing VAIs. Collaborative efforts among neuroscience nurses can significantly enhance patient care and outcomes. Focus areas for nurses could include wound dressing, cleaning and sampling technique.