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Maine Medical Center; Nursing; Critical Care


Background: Traumatic brain injury (TBI) occurs when an external force causes brain dysfunction. TBI management in the critical care setting focuses on treating the initial, or primary brain injury, as well as secondary injuries, caused by hypoxia, hypotension, and swelling. Due to the lack of consensus within the literature, in addition to numerous attending and resident physicians at Maine Medical Center (MMC), variability in care often occurs. Nursing staff within the neuro-intensive care unit at MMC noticed this variability, and approached leadership within the surgical-trauma service to create an order set focused on TBI management.

Purpose: In the TBI population, does development and implementation of an order set decrease variability in care among providers?

Methods: A literature search was conducted regarding TBI management using PubMed and the Cochrane Review. Practice guidelines from the Brain Trauma Foundation and the United States Military Joint Trauma System were also examined. Further, other trauma centers within the United States were contacted to obtain TBI management order sets used in practice. An interdisciplinary team met in order to review and create a TBI order set for MMC. A second meeting is being scheduled to discuss the remainder of items within the future order set.

Results: Results are ongoing at this time.

Timeframe: The project began after a meeting with Dr. Rappold on April 12, 2017. Our end date is to be determined.