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Using an evidence‐based care bundle to improve initial emergency nursing management of patients with severe traumatic brain injury
Author(s) -
Damkliang Jintana,
Considine Julie,
Kent Bridie,
Street Maryann
Publication year - 2015
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.12923
Subject(s) - traumatic brain injury , medicine , emergency department , emergency medicine , emergency nursing , acute care , nursing care , medical emergency , nursing , health care , psychiatry , economics , economic growth
Aims and objectives To test the feasibility of an evidence‐based care bundle in a Thai emergency department. The specific objective of this study was to examine the impact of the implementation of the care bundle on the initial emergency nursing management of patients with severe traumatic brain injury. Background A care bundle approach is one strategy used to improve the consistency, quality and safety of emergency care for different patients groups, however, has not been tested in patients with severe traumatic brain injury. Design A pretest/post‐test design was used. The study intervention was an evidence‐based care bundle for initial emergency nursing management of patients with severe traumatic brain injury. Methods Nonparticipant observations were conducted between October 2012–June 2013 at an emergency department of a 640 bed regional hospital in Southern Thailand. The initial emergency nursing care was observed in 45 patients with severe traumatic brain injury: 20 patients in the pretest period and 25 patients in the post‐test period. Results There were significant improvements in clinical care of patients with severe traumatic brain injury after implementation of the care bundle: (1) use of end‐tidal carbon dioxide monitoring, (2) frequency of respiratory rate assessment, (3) frequency of pulse rate and blood pressure assessment, and (4) patient positioning. Conclusion This study demonstrated that implementation of an evidence‐based care bundle improved specific elements of emergency nurses' clinical management of patients with severe traumatic brain injury. Relevance to clinical practice The study suggests that a care bundle approach can be used as a strategy to improve emergency nursing care of patients with severe traumatic brain injury.