TY - JOUR
T1 - 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
AU - Bosch, Marije Caroline
AU - McKenzie, Joanne Ellen
AU - Mortimer, Duncan Stuart
AU - Tavender, Emma Jane
AU - Francis, Jill J
AU - Brennan, Sue Ellen
AU - Knott, Jonathan C
AU - Ponsford, Jennie Louise
AU - Pearce, Andrew C
AU - O'Connor, Denise Ann
AU - Grimshaw, Jeremy M
AU - Rosenfeld, Jeffrey Victor
AU - Gruen, Russell Lindsay
AU - Green, Sally Elizabeth
AU - Bayley, Mark Theodore
AU - Buchan, Heather A
AU - Cameron, Peter
AU - Cooper, David James
AU - Ellis, Niki
AU - Fitzgerald, Mark
AU - Huckson, Sue D
AU - Joseph, Anthony
AU - Morley, Peter
AU - Khan, Farees
AU - Lavis, John N
AU - Marshall, Shawn C
AU - Michie, Susan
AU - Rushworth, Nick
AU - Sherry, Lisa
AU - Clavisi, Ornella Maria
AU - Cooksley, David G
AU - Harris, Claire
AU - Kaye, Andrew H
AU - McDonald, Steven
AU - Morokoff, Andrew
AU - Zobel, Justin
AU - Goergen, Stacy Kellan
AU - Meares, Susanne
AU - Smyth, Tracy
AU - Chau, Marisa
AU - Varanelli, Laura
PY - 2014
Y1 - 2014
N2 - 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
AB - 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
U2 - 10.1186/1745-6215-15-281
DO - 10.1186/1745-6215-15-281
M3 - Article
VL - 15
SP - 1
EP - 20
JO - Trials
JF - Trials
SN - 1745-6215
IS - 281
ER -