Strategies nurses use when caring for patients with moderate-to-severe traumatic brain injury who have cognitive impairments.
AIMS AND OBJECTIVES
Adults with moderate-to-severe traumatic brain injury (TBI) may have immediate and chronic cognitive impairments that require use of specific nursing strategies. Nurses must be knowledgeable about strategies to use to accommodate these impairments. However, available clinical guidelines and research lack information to direct nonacute nursing management of cognition, limiting guidance for nurses when developing their care plans. The purpose of this study was to investigate strategies nurses use when caring for patients with moderate-to-severe TBI who have cognitive impairments.


DESIGN
Cross-sectional, exploratory study.


METHODS
A total of 692 nurses from three hospitals answered the following open-ended question via electronic survey: "Imagine you are caring for a patient with moderate-to-severe TBI who has problems with cognition (e.g., issues with memory, attention, and executive function). Please state your typical nursing routine to care for this type of patient." Data were analysed using summative content analysis. Methods are reported using COREQ guidelines (See File S1).


RESULTS
Most respondents were female (89%), middle-aged (40.3 years), staff registered nurses (77%) practicing on an inpatient unit (51%) with prior experience caring for patients with moderate-to-severe TBI (95%). Nurses described 189 strategies used in their care plan when caring for patients with TBI who have cognitive impairments, including the following: (a) cognitive techniques; (b) communication techniques; (c) patient safety techniques; (d) agitation and behaviour management techniques; and (e) education techniques.


CONCLUSIONS
Findings have implications for education and training of nurses, direction for future research aimed at determining the effectiveness of nursing strategies with this patient population, and for development of clinical guidelines for nonacute nursing management of patients with moderate-to-severe TBI who have cognitive impairments.


RELEVANCE TO CLINICAL PRACTICE
Findings provide foundational knowledge on strategies nurses use when caring for patients with TBI who have cognitive impairments, which could be used to direct evidence-based nursing care of this patient population.
['Oyesanya|Tolu O|TO|https://orcid.org/0000-0001-8821-4510', 'Thomas|Mitchell A|MA|']
D000328:Adult D000070642:Brain Injuries, Traumatic D060825:Cognitive Dysfunction D003430:Cross-Sectional Studies D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D009741:Nursing Staff, Hospital D011795:Surveys and Questionnaires
strategies nursing traumatic brain injury cognitive impairments care plan