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June 10-11, 2019 | Edinburgh, Scotland
Central Nervous System and Therapeutics
2nd International Conference on
Journal of Neurology and Neurorehabilitation Research | Volume 4
allied
academies
Evidence-Based practice nursing interventions for improved functional and cognitive
outcomes in the Traumatic Brain Injury Patient
Judith Kutzleb
Fairleigh Dickinson University, USA
Problem: Traumatic brain injury (TBI) results in a combination
of physical, cognitive, and behavioral impairments with
an estimated 1.5 million Americans sustaining a TBI every
year. The overall purpose of this program was to implement
evidence-based practice protocols for clinical management
of traumatic brain injury patients. The routine integration
of the EBP protocols of: pulse oximetry and blood pressure
monitoring every two hours; toileting and limited distance
ambulation (10 to25 feet) every twohours during the patients
wakeful state; baseline Orientation-Log assessment (O-Log)
on admission then on a daily basis; physical therapy and
speech/cognitive therapy evaluations within 24 to 48 hours
of admission were implemented to improve the functional
and cognitive outcomes; and reduce bedside patient sitters in
the acute care setting.
Data Source: This was an exploratory pilot program that
implemented RBP protocols for the clinical management of
TBI patients. An analysis of trends (pre-EBP of 58 TBI patients
Vs. post-EBP of 50 TBI patients) was utilized to evaluate
whether change in practice made a significant difference in
improving patient’s outcome.
Conclusion: The EBP protocols decreased sitter sessions by
80% and enabled TBI patients to achieve states of functional
and cognitive well-being with a structured approach to
clinical management. The finding for sitter session usage
showed a reduction from 30 sessions 3 months before
program implementation to 6 sessions during program
implementation, with a continued sitter session reduction
of 0 sessions for 6 months post program implementation.
The results of this program established a structured and
sustainable approach to the clinical management of TBI
patients. Through the strategic cycle of patient assessment,
ambulation, toileting, and hemodynamic status evaluation,
patients became less apt to develop confused agitated states,
which supported a safer patient environment and reduced
the need for sitter sessions.
Implications for Practice: Results indicate that the EBP
protocol created a structured approach to clinical patient
management for the nursing staff. The continuous repetition
of patient interventions supported by the protocols in concert
with staff education on TBI and its consequences, created skill
development in the nursing staff for assessing and managing
altered states in this patient population.
Speaker Biography
Judith Kutzleb, is working in the Fairleigh Dickinson University and in Holy
Name Medical center from October 2009. Previously she has worked in
Hackensack University Medical Center fromMay 2006 to March 2010. She
has hold Doctorate of Nursing Practice and currently she is doing research
in Traumatic Brain Injury.
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