Effectiveness of Care Bundle on Hemodynamic, Oxygenation, level of Consciousness and Pupil Reactivity among Traumatic Brain Injury Patients

Document Type : Original Article

Authors

1 Lecturer of Critical Care and Emergency Nursing, Faculty of Nursing, Menoufia University, Egypt

2 Assistant Professor of Critical Care and Emergency Nursing, Faculty of Nursing, Menoufia University, Egypt

3 Lecturer of Medical, Surgical Nursing Faculty of Nursing, Menoufia University, Shebin El-Kom, Egypt

Abstract

Background: Care Bundle is an effective way in minimizing morbidity and mortality among critically ill patients with traumatic brain injury by enhancing hemodynamics, improving oxygenation, level of consciousness and pupil reactivity. Purpose of the study: to examine the effectiveness of care bundle on hemodynamic, oxygenation, level of consciousness and pupil reactivity among traumatic brain injury patients. Setting: Current research was conducted at Trauma ICU, Menoufia University Hospital, Egypt. Sample: A convenient sample of 60 patients admitted to Trauma ICU. Design: A Quasi-experimental design was used (study and control). Instruments: 1) Demographic and Medical Data Sheet; 2) Hemodynamic Parameters Measurements; 3) Oxygenation Parameters Measurements; 4) Glasgow Coma Scale (GCS) and 5) Pupil Reactivity and Pupil Size Assessment Scale. Results: There was a statistically improvement in hemodynamic parameters in the study group compared to the control group post intervention (p < 0.001). There was a statistically significant improvement in the oxygenation (paO2, saO2) of the study group who received care bundle intervention compared to the control group post intervention (p <0.001). Additionally, the level of consciousness was statistically higher in the study group (8.66± 0.85) than the control group (5.57± 1.48) (p < 0.001). Pupil reactivity also, exhibited a highly statistically significant difference between study and control groups post intervention (P = 0.001). Conclusion: Implementation of a care bundle demonstrated enhanced hemodynamic parameters, improved oxygenation, elevated level of consciousness, and enhanced pupil reactivity in traumatic brain injury patients. Recommendation: Integration of care bundle into clinical practice setting will improve clinical outcomes for TBI patients in the Trauma ICU.

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