Continuous intra-arterial BP moni- toring should be considered in patients receiving intravenous vasoactive medications. Nursing Care The specific nursing care required for ICH patients in inten- sive care units may include (1) surveillance and monitoring of ICP, cerebral perfusion pressure (CPP), and hemody- namic function; (2) titration and implementation of protocols for management of ICP, BP, mechanical ventilation, fever, and serum glucose; and (3) prevention of complications of immobility through positioning, airway maintenance, and mobilization within physiological tolerance. The consensus document from the Brain Attack Coalition on comprehensive stroke centers delineates these as specific areas of monitor- ing and complication prevention in which nurses should This document also recommends that nurses be trained in detailed assessment of neurological function, including standardized scales such as the NIHSS, GCS, and the Glasgow Outcome Scale. In a Canadian study of 49 hospitals that included ICH patients, a higher proportion of registered nurses at the hos- pital and better nurse-physician communication were inde- pendently associated with lower 30-day mortality even after adjustment for disease severity, comorbidities, and hospital Hemphill et al Management of Spontaneous ICH 2041 In a Swedish study of 86 hospitals, stroke unit care was associated with a lower risk of death or institu- tional living after 3 months in patients with ICH (OR, 0.60; General Monitoring and Nursing Care: Recommendation Initial monitoring and management of ICH patients should take place in an intensive care unit or dedi- cated stroke unit with physician and nursing neu- roscience acute care expertise (Class I; Level of Evidence B). 