Effect of Designed Practice Guidelines on Nurses’ Performance and Outcome of Children with Head Injuries

Abstract

Contexts Acute head injury resulting from a trauma to the head, leading to brain injury or bleeding within the brain, can cause edema and hypoxia. Head injury is the leading cause of death in the first four decades of life. Effective nursing management strategies for children with severe traumatic brain injury are still a remarkable issue and a difficult task for neurologists, neurosurgeons, and nurses. Aim: To evaluate the effect of designed practice guidelines on nurses' performance regarding the care of children with head injuries. Methods: A quasi-experimental research design was utilized to conduct the current study on pediatric neurosurgery departments of Benha University Hospital and Benha Teaching Hospital. A purposive sample of 72 children with head injuries and a convenient sample of all available nurses. They were 62 nurses who are working in the previously mentioned study settings. Four tools were used to collect data in this study. A structured interviewing questionnaire sheet was developed to assess the personal characteristic of the studied nurses and nurses' knowledge regarding head injuries. Child medical data records were developed to assess children's personal and head injuries characteristics for them. Glasgow coma scale was adopted to assess the child's conscious level. Observational checklists to assess the actual nurses' practices regarding the care of children with head injuries.

Results: There was a statistically significant improvement in nurses' knowledge and practice regarding the care of children with head injuries before and after implementing designed practice guidelines (p˂0.001). There was a statistically significant improvement regarding the occurrence of convulsion after the implementation of the program.
Conclusion: The study concluded that implementing designed practice guidelines for nurses improved their knowledge and practice and reduced the occurrence of frequency, duration, and timing of convulsion, which supports the current research hypotheses. The study emphasizes the importance of implementing designed practice guidelines for nurses caring for children with a head injury to reduce head injury complications, which is an effective and safe non-invasive intervention in neurosurgery and emergency departments as a standard of care for all head-injured children.