Implementing evidence-based recommended practices for the management of patients with mild traumatic brain injuries in Australian emergency care departments: study protocol for a cluster randomised controlled trial

Marije Caroline Bosch, Joanne Ellen McKenzie, Duncan Stuart Mortimer, Emma Jane Tavender, Jill J Francis, Sue Ellen Brennan, Jonathan C Knott, Jennie Louise Ponsford, Andrew C Pearce, Denise Ann O'Connor, Jeremy M Grimshaw, Jeffrey Victor Rosenfeld, Russell Lindsay Gruen, Sally Elizabeth Green, Mark Theodore Bayley, Heather A Buchan, Peter Cameron, David James Cooper, Niki Ellis, Mark FitzgeraldSue D Huckson, Anthony Joseph, Peter Morley, Farees Khan, John N Lavis, Shawn C Marshall, Susan Michie, Nick Rushworth, Lisa Sherry, Ornella Maria Clavisi, David G Cooksley, Claire Harris, Andrew H Kaye, Steven McDonald, Andrew Morokoff, Justin Zobel, Stacy Kellan Goergen, Susanne Meares, Tracy Smyth, Marisa Chau, Laura Varanelli

Research output: Contribution to journalArticleOther

18 Citations (Scopus)

Abstract

Background: Mild head injuries commonly present to emergency departments. The challenges facing clinicians in emergency departments include identifying which patients have traumatic brain injury, and which patients can safely be sent home. Traumatic brain injuries may exist with subtle symptoms or signs, but can still lead to adverse outcomes. Despite the existence of several high quality clinical practice guidelines, internationally and in Australia, research shows inconsistent implementation of these recommendations. The aim of this trial is to test the effectiveness of a targeted, theory- and evidence-informed implementation intervention to increase the uptake of three key clinical recommendations regarding the emergency department management of adult patients (18 years of age or older) who present following mild head injuries (concussion), compared with passive dissemination of these recommendations. The primary objective is to establish whether the intervention is effective in increasing the percentage of patients for which appropriate post-traumatic amnesia screening is performed.Methods/design: The design of this study is a cluster randomised trial. We aim to include 34 Australian 24-hour emergency departments, which will be randomised to an intervention or control group. Control group departments will receive a copy of the most recent Australian evidence-based clinical practice guideline on the acute management of patients with mild head injuries. The intervention group will receive an implementation intervention based on an analysis of influencing factors, which include local stakeholder meetings, identification of nursing and medical opinion leaders in each site, a train-the-trainer day and standardised education and interactive workshops delivered by the opinion leaders during a 3 month period of time. Clinical practice outcomes will be collected retrospectively from medical records by independent chart auditors over the 2 month period following intervent
Original languageEnglish
Pages (from-to)1 - 20
Number of pages20
JournalTrials
Volume15
Issue number281
DOIs
Publication statusPublished - 2014

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