Increasing Adherence to Brain Trauma Foundation Guidelines for Hospital Care of Patients With Traumatic Brain Injury

Author:

Saherwala Ali A.1,Bader Mary Kay2,Stutzman Sonja E.3,Figueroa Stephen A.4,Ghajar Jamshid5,Gorman April R.6,Minhajuddin Abu7,Olson DaiWai M.8

Affiliation:

1. Ali A. Saherwala is a resident physician, Department of Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center, Dallas, Texas.

2. Mary Kay Bader is a clinical nurse specialist in the surgical trauma neuro intensive care unit, Mission Hospital, Mission Viejo, California.

3. Sonja E. Stutzman is a clinical research coordinator, Department of Neurology and Neurotherapuetics, University of Texas Southwestern Medical Center.

4. Stephen A. Figueroa is assistant professor, Departments of Neurology and Neurotherapeutics and Neurosurgery, University of Texas Southwestern Medical Center.

5. Jamshid Ghajar is a clinical professor of neurosurgery and director of the Stanford Concussion and Brain Performance Center, Stanford University School of Medicine, Palo Alto, California, and president of the Brain Trauma Foundation, Palo Alto, California.

6. April R. Gorman is a biostatistical consultant III, University of Texas Southwestern Medical Center.

7. Abu Minhajuddin is an associate professor, Department of Clinical Sciences, University of Texas Southwestern Medical Center.

8. DaiWai M. Olson is an associate professor, Department of Neurology and Neurotherapuetics, University of Texas Southwestern Medical Center.

Abstract

BACKGROUNDThe Brain Trauma Foundation has developed treatment guidelines for the care of patients with acute traumatic brain injury. The Adam Williams Initiative is a program established to provide education and resources to encourage hospitals across the United States to incorporate the guidelines into practice.OBJECTIVETo explore the relationship in hospitals between participation in the Adam Williams Initiative and adherence to the Brain Trauma Foundation guidelines for patients with acute traumatic brain injury.METHODHospitals that participated in the Adam Williams Initiative entered data into an online tracking system of patients with traumatic brain injury for at least 2 years after the initial site training. Data included baseline hospital records and daily records on hospital care of patients with traumatic brain injury, including blood pressure, intracranial pressure, cerebral perfusion pressure, oxygenation, and other data relevant to the 15 key metrics in the Brain Trauma Foundation guidelines.RESULTSThe 16 hospitals funded by the Adam Williams Initiative had good overall adherence to the 15 key metrics of the recommendations detailed in the Brain Trauma Foundation guidelines. Variability in results was primarily due to data collection methods and analysis.CONCLUSIONSThe Adam Williams Initiative helps promote adherence to the Brain Trauma Foundation guidelines for hospital care of patients with traumatic brain injury by providing a platform for developing and standardizing best practices. Participation in the initiative is associated with high adherence to clinical guidelines, a situation that may subsequently improve care and outcomes for patients with traumatic brain injury.

Publisher

AACN Publishing

Subject

Critical Care Nursing,General Medicine

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