Efficacy of Severe Head Injury Nursing Care Plan Development

Abstract

Background: Severe head injury is an important health, social and economic problem which results in mortality, physical and mental disability, standard nursing practice with participation of multidisciplinary team will increase the effectiveness of nursing care, decrease complications and improve quality of life.
Objective: to determine the efficacy of nursing care plan development in severe head injury patient
Methods: An action research comprised of three phases; 1) Preliminary study 2) operation and 3) outcome assessment. The operation phase was two PDCA cycles (plan - do - check -act), study period was conducted from October 1^st 2001 to December 31^st 2003. Sample group was 30 cases of severe head injury patient and their key caregivers including 92 cases of multidisciplinary professionals providing care to these patients. Research instrument was practice guideline for severe head injury care, caregiver education plan, caregiver comprehensive test, quality of care assessment form and caregiver/multidisciplinary team satisfaction assessment form.
Results: Care plan development consisted of four processes; 1) patient admission at emergency department, 2) patient care at ward 3) discharge plan 4) referral and continuum of care. Compliance rate to care plan practice was 99.1%. Rate of complication, pressure sore, urinary tract infection and length of hospital stay were decreased. The average knowledge score of key caregiver was significantly increased (p < 0.001) after caregiver education. Caregivers had patient care ability in “good level” consequently the patient had good health status and absence of readmission within 28 days. The key caregiver and multidisciplinary team had high level of satisfaction
Conclusion: Development of patient care plan resulted in convenient and practical guideline to practice. The rate of practitioner’s satisfaction to the care plan was high as 99.1% therefore the patient care was achieved goal of treatment and participation of key caregiver enhanced patient’s quality of life.