Improving Compliance With Protocol-Driven Care in Adult Traumatic Brain Injury Patients by Implementing an Electronic Clinical Compliance Monitoring Tool
| Autor: | Dawn Drahnak, Jodi Noon, Cheryl Kieta, Shawna Morrissey, Richard Nahouraii, Russell Dumire, Kimberly M. Gorman, Jane Guttendorf |
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| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Traumatic brain injury Monitoring Ambulatory Emergency Nursing Critical Care Nursing 03 medical and health sciences 0302 clinical medicine Injury Severity Score Patient Education as Topic Statistical significance Medicine Humans Cerebral perfusion pressure Cause of death Protocol (science) 030504 nursing business.industry Process Assessment Health Care 030208 emergency & critical care medicine Middle Aged medicine.disease Quality Improvement nervous system diseases Compliance Monitoring Compliance (physiology) nervous system Brain Injuries Emergency medicine Cohort Patient Compliance Female Guideline Adherence 0305 other medical science business |
| Zdroj: | Dimensions of critical care nursing : DCCN. 39(1) |
| ISSN: | 1538-8646 |
| Popis: | Traumatic brain injury (TBI) remains a major cause of death and disability each year in the United States. Implementation of preestablished evidence-based guidelines has been associated with a decrease in overall TBI mortality and disability. OBJECTIVES An electronic clinical monitoring tool was developed for monitoring compliance with evidence-based TBI treatment protocols to improve the overall care and outcomes in this patient population. METHODS This project was designed as a process improvement project. For the preimplementation cohort of TBI patients, aggregate compliance data (by patient) were obtained from the Brain Trauma Foundation Trial patient registry maintained at Conemaugh Memorial Medical Center for the time between 2011 and 2012. The postimplementation cohort includes all patients older than 18 years who have sustained a TBI requiring clinical monitoring devices. RESULTS There was a statistical significance between groups; the TBI-2017 group demonstrated better compliance with anticonvulsant use and cerebral perfusion pressure maintenance. In addition, overall compliance was better in the TBI-2017 cohort compared with the TBI-2012 cohort. CONCLUSIONS Traumatic brain injury-specific education and frequent assessments improved compliance between TBI-2012 and TBI-2017, resulting in a higher percentage in overall survivors in the latter group. |
| Databáze: | OpenAIRE |
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