Nursing Interventions Effect On Traumatic Brain Injury
Problem Statement
Five common nursing interventions were studied in order to show correlation of them with increased intracranial pressure (ICP) in patients with traumatic brain injury (TBI).
Theoretical Framework
There was no mention of theory utilization in the article.
Methodology
Subjects: 25 pediatric moderate to severe TBI patients aged 2-17 with parental informed consent. If the patients were at risk for increased mortality they were not included in the study.
Data Collection: Through observation with measurements from a piloted study tool. Attending nurses while under observation noted the measurements, and no interventions were conducted within an hour to observe changes to ICP. Measurements were taken before, during and after interventions were initiated. The interventions tested were: eye and oral care, log roll, washing, and endotracheal suction with manual ventilation.
Data Analysis: Data analyzed using SPSS. Testing methods: t-test, survival curves, log-rank test, spearmen correlation, linear regression, two-tailed test, Wilcoxin rank test, and Shapiro-Wilks test were also used. The study also sought out advice from expert statisticians.
Major Findings
There was no significance to ICP changes during the hygiene portions of intervention. However, there were significant increase in baseline ICP from suction and log rolling of patients. Both suction logrolling maneuver increased ICP from baseline in 70% of patients exceeding expected pressures to over 20 mmHg. There were increases past 30 mmHg with approximately 10% of log rolled patients, 28% of patients who received suctioning. It is noted though that hospital protocol dictated the methods used for these two interventions. This leaves the possibility of decreased rise in ICP if other methods are utilized.
Relevance to Nursing
Since TBI is a major occurrence across the world with adults and children, proper care...