Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 26, 2021; 9(36): 11265-11275
Published online Dec 26, 2021. doi: 10.12998/wjcc.v9.i36.11265
Application effect for a care bundle in optimizing nursing of patients with severe craniocerebral injury
Ying Gao, Li-Ping Liao, Peng Chen, Ke Wang, Cui Huang, Ying Chen, Shao-Yu Mou
Ying Gao, Li-Ping Liao, Peng Chen, Ke Wang, Cui Huang, Ying Chen, Department of Neurosurgery, Chongqing Emergency Medical Center, Chongqing 400014, China
Shao-Yu Mou, School of Nursing, Chongqing Medical University, Chongqing 400016, China
Author contributions: Gao Y and Mou SY were responsible for conceptualization and methodology; Gao Y collected the data and wrote the original draft; Liao LP, Chen P, Wang K and Huang C were responsible for visualization and software and edited the manuscript; Chen Y and Mou SY were responsible for validation and supervision; all authors approved the final submission.
Institutional review board statement: This study was approved by the Ethics Committee of Chongqing Emergency Medical Center.
Informed consent statement: The data were not involved in the patients’ privacy information, so the informed consent was waived by the Ethics Committee of Chongqing Emergency Medical Center.
Conflict-of-interest statement: All authors have no conflict of interest related to this manuscript.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shao-Yu Mou, BMed, Professor, School of Nursing, Chongqing Medical University, No. 1 Medical College Road, Yuzhong District, Chongqing 400016, China. m13594360198@163.com
Received: August 26, 2021
Peer-review started: August 26, 2021
First decision: September 29, 2021
Revised: October 17, 2021
Accepted: November 14, 2021
Article in press: November 14, 2021
Published online: December 26, 2021
Processing time: 119 Days and 3.4 Hours
Abstract
BACKGROUND

Severe craniocerebral injury (STBI) is a critical physical trauma caused by a sudden external force acting on the head. The condition is complex and changeable, and disability and mortality rates are high. Although the life of STBI patients can be saved through treatment, the sequelae of consciousness, speech, cognitive impairment, stiffness, spasm, pain and abnormal behavior in the early rehabilitation stage can be a heavy burden to a family. In the past, routine nursing was often used to treat/manage STBI; however, problems, such as improper cooperation and untimely communication, reduced therapeutic effectiveness.

AIM

To investigate the effect of a proposed care bundle to optimize the first aid process and assess its effectiveness on the early rehabilitation nursing of patients with STBI.

METHODS

From January 2019 to December 2020, 126 STBI patients were admitted to the emergency department of Chongqing Emergency Medical Center. These patients were retrospectively selected as the research participants in the current study. The study participants were then divided into a control group (61 cases) and a study group (65 cases). The control group was treated with routine nursing. The study group adopted the proposed care bundle. The National Institutes of Health Stroke Scale/Score and Glasgow Coma Scale (GCS) were used to evaluate neurological function before and after emergency treatment. After 3 mo of rehabilitation, experimental outcomes were assessed. These included the GCS, Barthel Index, complication rate, muscle strength grade and satisfaction.

RESULTS

There was no significant difference in gender, age, cause of injury and GCS between the two groups. After emergency, the National Institutes of Health Stroke Scale/Score of the study group (10.23 ± 3.26) was lower than that of the control group (14.79 ± 3.14). The GCS score of the study group (12.48 ± 2.38) was higher than that of the control group (9.32 ± 2.01). The arrival time of consultation in the study group was 20.56 ± 19.12, and the retention time in the emergency room was 45.12 ± 10.21, which were significantly shorter than those in the control group. After 3 mo of rehabilitation management, the GCS and Barthel Index of the study group were 14.56 ± 3.75 and 58.14 ± 12.14, respectively, which were significantly higher than those of the control group. The incidence of complications in the study group (15.38%) was significantly lower than that in the control group (32.79%). The proportion of muscle strength ≥ grade III in the study group (89.23%) was significantly higher than that in the control group (50.82%). The satisfaction of patients in the study group was significantly higher than that in the control group.

CONCLUSION

Care bundles are used to optimize the nursing process. During first-aid, care bundles can effectively improve the rescue effect and improve neurological function of STBI patients as well as shorten the treatment time. In early rehabilitation, they can effectively improve the consciousness of STBI patients, improve the activities of daily living, reduce the risk of complications, accelerate the recovery of muscle strength and improve their satisfaction.

Keywords: Severe craniocerebral injury; Care bundle; Emergency treatment; Early rehabilitation; Clinical application

Core Tip: Bundle of care have become a widely implemented new concept/strategy in the field of critical care. When we applied it to patients with severe craniocerebral injury in optimizing the first aid process and early rehabilitation nursing, we found that it can effectively improve the problems existing in routine nursing, reduce complications and improve the quality of life of patients. In subsequent studies, it is necessary to increase the sample size, add evaluation indicators and improve the nursing process to evaluate its effectiveness and feasibility.