title: Nurses' perceptions of using an evidence-based care bundle for initial emergency nursing management of patients with severe traumatic brain injury: A qualitative study.
abstract: Evidence to guide initial emergency nursing care of patients with severe traumatic brain injury (TBI) in Thailand is currently not available in a useable form. A care bundle was used to summarise an evidence-based approach to the initial emergency nursing management of patients with severe TBI and was implemented in one Thai emergency department. The aim of this study was to describe Thai emergency nurses' perceptions of care bundle use. A descriptive qualitative study was used to describe emergency nurses' perceptions of care bundle use during the implementation phase (Phase-One) and then post-implementation (Phase-Two). Ten emergency nurses participated in Phase-One, while 12 nurses participated in Phase-Two. In Phase-One, there were five important factors identified in relation to use of the care bundle including quality of care, competing priorities, inadequate equipment, agitated patients, and teamwork. In Phase Two, participants perceived that using the care bundle helped them to improve quality of care, increased nurses' knowledge, skills, and confidence. Care bundles are one strategy to increase integration of research evidence into clinical practice and facilitate healthcare providers to deliver optimal patient care in busy environments with limited resources.
authors.affiliation: School of Nursing and Midwifery, Deakin University, Burwood, Victoria, Australia; Faculty of Nursing, Prince of Songkla University, Songkhla, Thailand. Electronic address: jintana.d@psu.ac.th.
authors.forename: Jintana
authors.initials: J
authors.lastname: Damkliang
authors.affiliation: Eastern Health, Midwifery Research Centre, Centre for Quality and Patient Safety Research, Deakin University Nursing, Burwood, Victoria, Australia.
authors.forename: Julie
authors.initials: J
authors.lastname: Considine
authors.affiliation: School of Nursing and Midwifery, University of Plymouth, Plymouth, UK.
authors.forename: Bridie
authors.initials: B
authors.lastname: Kent
authors.affiliation: Eastern Health, Midwifery Research Centre, Centre for Quality and Patient Safety Research, Deakin University Nursing, Burwood, Victoria, Australia.
authors.forename: Maryann
authors.initials: M
authors.lastname: Street
mesh_terms: D000070642:Brain Injuries, Traumatic / Q000451:nursing* / Q000628:therapy; D016529:Emergency Nursing / Q000706:statistics & numerical data*; D055318:Evidence-Based Nursing / Q000379:methods*; D006801:Humans; D064872:Patient Care Bundles / Q000523:psychology* / Q000706:statistics & numerical data*
keywords: Brain injury; Care bundle; Emergency nursing; Evidence-based practice; Neurotrauma; Thailand; Trauma