Factors Relating to Disposition Status in Children With Severe Traumatic Brain Injury

2.50
Hdl Handle:
http://hdl.handle.net/10755/157650
Type:
Presentation
Title:
Factors Relating to Disposition Status in Children With Severe Traumatic Brain Injury
Abstract:
Factors Relating to Disposition Status in Children With Severe Traumatic Brain Injury
Conference Sponsor:Western Institute of Nursing
Conference Year:2009
Author:Taha, Asma A., RN, PhD, (C)
P.I. Institution Name:Loma Linda University Medical Center, Advance Practice Nursing
Title:Nurse Practitioner
Contact Address:111234 Anderson Street, Loma Linda, CA, 92354, USA
Contact Telephone:951-522-1431
Purpose: Published traumatic brain injury (TBI) treatment guidelines for children are not in complete agreement with the adult guidelines.  The areas of discord include the fluid management for cerebral edema and the initiation and achievement of full calorie intake.  As not all trauma centers have a pediatric intensive care unit (ICU), the ICU type may relate to utilization of the guidelines and the patient outcomes.  There is insufficient literature to inform these treatment questions.  Therefore, the purpose of this study was to investigate the relationship between treatment modalities [fluid management for cerebral edema (hyperosmolar therapy), time to initiation and achievement of full calorie intake, ICU type] and the outcome (disposition at discharge from the hospital) of children (age 8-18) with severe TBI. Rational/Conceptual Basis: King's conceptual model, provided the framework for describing the relationships among the interpersonal and the social systems variables and patient's health. The interpersonal system encompasses all hospital course transactions which include fluid management and nutritional supplementation. The social system is the type of ICU setting where the child is receiving treatment.  Attaining health is the goal of nursing and the desired outcome.  This outcome will be measured by the patient disposition status on discharge from the hospital. Method: A retrospective, descriptive, chart review, design will be used to determine the relationship of three hospital course independent variables {fluid management for cerebral edema (hyperosmolar therapy- mannitol, NaCl 3%, other), time of initiation and achievement of full calorie intake in hours, & ICU type (pediatric or adult ICU)} with patient's outcomes (disposition status at discharge from the hospital).  Patient outcome, the dependent variables will be measured using the pediatric cerebral performance category scale (Fiser, 1992) to quantify the disposition status upon discharge from the hospital. The scale includes six categories, which are as follows: normal = 1; mild disability = 2; moderate disability = 3; severe disability = 4; coma or vegetative state = 5; and brain death = 6. Results: Univariate descriptive statistics will be used to present the characteristics of the patient population.  A bivariate correlation matrix will be used first to determine the relationships between the variables of interest.  The variables with a significant correlation (r > .30) will be used in a multivariate analysis to determine the contribution of each variable in predicting the outcomes.  Data Collection and statistical analysis are in progress. Implication: Findings will identify treatment modalities that may optimize discharge disposition status thereby potentially reducing the burden of disease on the individual, family, and the society for children with severe TBI.  Also, findings may serve to guide in the amendment of the treatment guidelines for the pediatric TBI population.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Western Institute of Nursing

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleFactors Relating to Disposition Status in Children With Severe Traumatic Brain Injuryen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157650-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Factors Relating to Disposition Status in Children With Severe Traumatic Brain Injury</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Western Institute of Nursing</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Taha, Asma A., RN, PhD, (C)</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Loma Linda University Medical Center, Advance Practice Nursing</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Nurse Practitioner</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">111234 Anderson Street, Loma Linda, CA, 92354, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">951-522-1431</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">ataha@llu.edu, atah@apu.edu</td></tr><tr><td colspan="2" class="item-abstract">Purpose: Published traumatic brain injury (TBI) treatment guidelines for children are not in complete agreement with the adult guidelines.&nbsp; The areas of discord include the fluid management for cerebral edema and the initiation and achievement of full calorie intake.&nbsp; As not all trauma centers have a pediatric intensive care unit (ICU), the ICU type may relate to utilization of the guidelines and the patient outcomes.&nbsp; There is insufficient literature to inform these treatment questions.&nbsp; Therefore, the purpose of this study was to investigate the relationship between treatment modalities [fluid management for cerebral edema (hyperosmolar therapy), time to initiation and achievement of full calorie intake, ICU type] and the outcome (disposition at discharge from the hospital) of children (age 8-18) with severe TBI. Rational/Conceptual Basis: King's conceptual model, provided the framework for describing the relationships among the interpersonal and the social systems variables and patient's health. The interpersonal system encompasses all hospital course transactions which include fluid management and nutritional supplementation. The social system is the type of ICU setting where the child is receiving treatment.&nbsp; Attaining health is the goal of nursing and the desired outcome.&nbsp; This outcome will be measured by the patient disposition status on discharge from the hospital. Method: A retrospective, descriptive, chart review, design will be used to determine the relationship of three hospital course independent variables {fluid management for cerebral edema (hyperosmolar therapy- mannitol, NaCl 3%, other), time of initiation and achievement of full calorie intake in hours, &amp; ICU type (pediatric or adult ICU)} with patient's outcomes (disposition status at discharge from the hospital).&nbsp; Patient outcome, the dependent variables will be measured using the pediatric cerebral performance category scale (Fiser, 1992) to quantify the disposition status upon discharge from the hospital. The scale includes six categories, which are as follows: normal = 1; mild disability = 2; moderate disability = 3; severe disability = 4; coma or vegetative state = 5; and brain death = 6.&nbsp;Results: Univariate descriptive statistics will be used to present the characteristics of the patient population.&nbsp; A bivariate correlation matrix will be used first to determine the relationships between the variables of interest.&nbsp; The variables with a significant correlation (r &gt; .30) will be used in a multivariate analysis to determine the contribution of each variable in predicting the outcomes.&nbsp; Data Collection and statistical analysis are in progress. Implication: Findings will identify treatment modalities that may optimize discharge disposition status thereby potentially reducing the burden of disease on the individual, family, and the society for children with severe TBI.&nbsp; Also, findings may serve to guide in the amendment of the treatment guidelines for the pediatric TBI population.</td></tr></table>en_GB
dc.date.available2011-10-26T20:04:23Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T20:04:23Z-
dc.description.sponsorshipWestern Institute of Nursingen_GB
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