The Effects of Clinical Nursing Practice Guideline Development on Nursing Outcomes in Patients with Traumatic Brain Injury

Abstract

Delayed medical care for patients with moderate to severe traumatic brain injury (TBI) could consequently cause deformity and death. This study aimed to develop Clinical Nursing Practice Guidelines for Patients with Traumatic Brain Injury (CNPG-TBI) and examine the effects of the CNPG-TBI on nursing outcomes and the satisfaction of registered nurses (RNs) with the guidelines. The sample consisted of 100 persons with moderate to severe TBI, with 50 assigned to the experimental and 50 to the comparison group, and 67 RNs. The research instruments were composed of 1) the CNPG-TBI (Cronbach alpha coefficient of .89, 2) a demographic data form, 3) the nursing outcomes records, and 4) the satisfaction questionnaire (Cronbach alpha coefficient of .80). Data were analyzed using descriptive statistics, Chi-squared test, Fisher's exact test, and Mann–Whitney U test. The findings showed that 1) The CNPG-TBI consisted of 2 phases, including pre-hospital management and in-hospital management and that its quality was more than 60 percent for all domains which were acceptable. After implementing the CNPG-TBI, we found that the length of stay in the hospital and average time in the emergency room of patients in the experimental group were statistically significantly less than those in the comparison group (Z = -2.01, p = .04 and Z = -2.72, p = .007, respectively). In addition, the RNs had a high level of satisfaction with the guidelines (M = 3.21, SD = 0.60) level, although the lowest mean score was related to the having clear content aspect (M = 3.13, SD = 0.67). Based on the research results, the developed CNPG-TBI should be continue to be employed to care for TBI patients and while it is rewritten to further clarify the content.