The Development of Nurse-led Integrated Care Model for Patients with Traumatic Brain Injury
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Abstract
This research and development aimed to 1) develop an integrated care model led by nurses for patients with traumatic brain injury (TBI) regarding prevention of catheter-associated urinary tract infection (CAUTI), prevention of ventilator-associated pneumonia (VAP) and nutritional management; and 2) pilot-test by using the developed integrated care model at the neurosurgical ward, Vachira Phuket Hospital. The study was conducted during March to November 2019. The development of the Nurse-led Integrated Care Model (NL-ICM) for patients with TBI composed of three components: 1) policy regarding integration of research findings in care of patients with TBI; 2) practice guidelines; and 3) enhancing nurses' competency. Results showed that clinical outcomes including, length of stay, mortality rate, rate of CAUTI and VAP and nutritional management indicators when compared between the groups before and after using the NL-ICM were not different significantly (p > .05). Regarding family’s satisfaction, family members of the group after using the NL-ICM showed significantly more satisfied than the before group (p < .01). For the process outcomes after using the NL-ICM, nurses had practiced for prevention of CAUTI and VAP, as well as, nutritional management significantly more than before the NL-ICM was launched (p < .01). They also rated higher satisfaction than before using the NL-ICM (p < .01). The follow-up study and expansion of the integrated care model to other groups of patients are recommended.
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