Related Experiment Video
Updated: Jan 2, 2026
Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Published on: January 20, 2019
Improving Compliance With Protocol-Driven Care in Adult Traumatic Brain Injury Patients by Implementing an Electronic
Kimberly M Gorman1, Dawn Drahnak, Russell D Dumire
1Kimberly M. Gorman, DNP, RN, AG-ACNP-BC, CNL, CCRN, CNRN, TCRN, is the principle investigator and a staff ICU nurse in an Intensive Care unit at Memorial Medical Center, Johnstown, Pennsylvania. She recently received her DNP from the University of Pittsburgh, School of Nursing in the Adult-Gerontology Acute Care Nurse Practitioner program. Currently a Certified Registered Nurse Practitioner working with the Trauma department. Dawn Drahnak, DNP, RN, CCNS, CCRN, is an assistant professor, University of Pittsburgh School of Nursing, Pennsylvania. Russell D. Dumire, MD, FACS, is the director of Trauma and the Surgical Residency training program at the Memorial Medical Center, Johnstown, Pennsylvania. Jodi Noon, RN, CCRN, is a staff nurse in the Intensive Care Unit at Memorial Medical Center, Johnstown, Pennsylvania. Richard Nahouraii, MD, FACS, is a trauma surgeon and medical director at the Surgical Critical Care Unit, Memorial Medical Center, Johnstown, Pennsylvania. Shawna Morrissey, DO, FACS, is a trauma surgeon, Memorial Medical Center, Johnstown, Pennsylvania. Cheryl Kieta, BSN, RN, CCRN, was the clinical educator in the Intensive Care Unit. Currently she works in Risk Management as a Quality Specialist at Memorial Medical Center, Johnstown, Pennsylvania. Jane Guttendorf, DNP, RN, CRNP, ACNP-BC, CCRN, is an assistant professor at the University of Pittsburgh, School of Nursing, Adult-Gerontology Acute Care Nurse Practitioner Program; and an acute care nurse practitioner with the Department of Critical Care Medicine at UPMC Presbyterian, Surgical and Cardiothoracic Intensive Care Units, Pittsburgh, Pennsylvania.
Abstract:
Traumatic brain injury (TBI) remains a major cause of death and disability each year in the United States. Implementation of preestablished evidence-based guidelines has been associated with a decrease in overall TBI mortality and disability.
Objectives:
An electronic clinical monitoring tool was developed for monitoring compliance with evidence-based TBI treatment protocols to improve the overall care and outcomes in this patient population.
Methods:
This project was designed as a process improvement project. For the preimplementation cohort of TBI patients, aggregate compliance data (by patient) were obtained from the Brain Trauma Foundation Trial patient registry maintained at Conemaugh Memorial Medical Center for the time between 2011 and 2012. The postimplementation cohort includes all patients older than 18 years who have sustained a TBI requiring clinical monitoring devices.
Results:
There was a statistical significance between groups; the TBI-2017 group demonstrated better compliance with anticonvulsant use and cerebral perfusion pressure maintenance. In addition, overall compliance was better in the TBI-2017 cohort compared with the TBI-2012 cohort.
Conclusions:
Traumatic brain injury-specific education and frequent assessments improved compliance between TBI-2012 and TBI-2017, resulting in a higher percentage in overall survivors in the latter group.
