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Effect of an Educational Intervention on Nursing Staff Knowledge, Confidence, and Practice in the Care of Children With Mild Traumatic Brain Injury

Cook, Rebecca S.; Gillespie, Gordon L.; Kronk, Rebecca; Daugherty, Margot C.; Moody, Suzanne M.; Allen, Lesley J.; Shebesta, Kaaren B.; Falcone, Richard A. Jr.

Journal of Neuroscience Nursing: April 2013 - Volume 45 - Issue 2 - p 108–118
doi: 10.1097/JNN.0b013e318282906e
Article

Background: Nurses are key providers in the care of children with mild traumatic brain injury (mTBI). New treatment recommendations emphasize symptom assessment and brain rest guidelines to optimize recovery. This study compared pediatric trauma core nurses’ knowledge, degree of confidence, and perceived change in practice following mTBI education.

Methods: Twenty-eight trauma core nurses were invited to participate in this voluntary quasiexperimental, one-group pretest–posttest study. Multiple choice questions were developed to assess knowledge, and self-report Likert scale statements were used to evaluate confidence and change in practice. Baseline data of 25 trauma core nurses were assessed and then reassessed 1 month postintervention.

Results: Paired samples analysis showed significant improvement in knowledge (mean pretest: 33.6% vs. mean posttest score: 79.2%; 95% CI [35.6, 55.6]; t = 9.368; p < .001). All but two test questions yielded a significant increase in the number of participants with correct responses. Preintervention confidence was low (0–32% per question) and significantly increased postintervention (26%–84% per question). Despite increased administration of the symptom assessment and identification of interventions for symptom resolution posteducation (χ2 = 6.125, p = .001), these scores remained low.

Conclusion: Findings demonstrate that educational intervention effectively increased trauma core nurses’ knowledge and confidence in applying content into practice. Postintervention scores did not uniformly increase, and not all trauma core nurses consistently transferred content into practice. Further research is recommended to evaluate which teaching method and curriculum content are most effective to educate trauma core nurses and registered nurses caring for patients with mTBI and to identify barriers to incorporating this knowledge in practice.

Questions or comments about this article may be directed to Rebecca S. Cook, DNP RN CNP-PC, at becky.cook@cchmc.org. She is a Pediatric Trauma Nurse Practitioner at Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Gordon L. Gillespie, PhD RN PHCNS-BC CEN CPEN FAEN, is an Assistant Professor at the College of Nursing, University of Cincinnati, Cincinnati, OH.

Rebecca Kronk, PhD MSN RN CRNP, is an Assistant Professor at the School of Nursing, Duquesne University, Pittsburgh, PA.

Margot C. Daugherty, MSN MEd RN EMT-P, is the Trauma Education Specialist at Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Suzanne M. Moody, MPA, is the Clinical Research Coordinator at Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Lesley J. Allen, MSN RN CRNP, is a Pediatric Trauma Nurse Practitioner at Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Kaaren B. Shebesta, MSN CRNP-AC/PC, is a Pediatric Trauma Nurse Practitioner at Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

Richard A. Falcone, Jr., MD MPH, is an Associate Professor of Surgery and the Medical Director of Trauma Services at Cincinnati Children’s Hospital Medical Center, Cincinnati, OH.

This study was fulfilled as a requirement of the Doctor of Nurse Practice Program at Duquesne University School of Nursing.

The authors declare no conflicts of interest.

© 2013 American Association of Neuroscience Nurses