Main Article Content
Background: Moderate to severe brain injury is a leading cause of injury-related death and disability.
Objectives: The aim was to develop a care model for moderate to severe trauma patients using case management and to evaluate the effect of the model.
Methods: This research and development study included 4 phases, including to: 1) analyzing the situation using a review of medical records and conducting focused groups, 2) development of care by synthesizing the results from phase 1 by using case management and nursing practice guidelines, 3) testing the tentative model, and 4) implementing and evaluating the results. The sample consisted of a 12-person multidisciplinary team, 40 registered nurses, 30 patients with moderate to severe brain injury and caregivers. The data were collected using the following questionnaires: knowledge related of nursing care of traumatic brain injury, nursing performance in accordance with the care model, satisfaction of multidisciplinary staff and caregivers, and a record of clinical outcomes. Data were analysed with descriptive statistics and Paired t-tests, whereas qualitative data were analysed using content analysis.
Results: After using the development of care model for patients with moderate to severe traumatic brain injury, the level of knowledge among nurses was significantly higher significant (p<.01). The nurses were able to perform and agree in accordance with the care model at highest level (M = 120.27, SD = 3.87), (M = 4.51, SD = 0.44), respectively, and were most satisfied with the model implementation (M = 4.68, SD = 0.30). The caregivers’ satisfaction was at high level (M = 4.48, SD = 0.30). The clinical outcomes revealed that complications had decreased.
Conclusions: Caring for patients with moderate to severe brain injury using case management and nursing practice guidelines can reduce mortality and the incidence of complications.
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