@article{ref1,
title="Nurse-driven universal concussion screening: a quality improvement initiative",
journal="Journal of trauma nursing",
year="2021",
author="Cunningham, Aaron and Downie, Katie and Jafri, Mubeen",
volume="28",
number="1",
pages="67-72",
abstract="BACKGROUND: The purpose of this study was to provide an evaluation of a performance improvement initiative that operationalized universal concussion screening for all  pediatric trauma admissions at a Level I pediatric trauma center. Mild traumatic  brain injury may be difficult to identify in injured children. We implemented a  screening tool to identify the risk for concussion after traumatic injury and to  improve access to cognitive evaluation and intervention in children. Prior to  implementation of our screening tool, children admitted without obvious head injury  or those younger than 12 years were not being screened for concussion risk. <br><br>METHODS:  We employed a nurse-driven screening tool, derived from the Centers for Disease  Control and Prevention Acute Concussion Evaluation, on all pediatric trauma patients  ages 0-17 years. The screening tool identifies symptoms of physical, cognitive,  sleep, or emotional deficits and prompts a cognitive evaluation with concussion  education. The tool was administered by nursing and tracked in the electronic  medical record. <br><br>RESULTS: Key stakeholders were interviewed to identify workflow  barriers and education gaps following implementation. Enhancements to the electronic  medical record and refocused nursing education improved compliance from 41% in the  first 12 months to 91% at 24 months post-implementation (p <.001). The increasing  number of evaluations additionally resulted in overall more cognitive evaluations as  an initial step in identifying and treating previously unrecognized traumatic brain  injury. <br><br>CONCLUSIONS: A pediatric concussion screening tool is simple to administer,  applies to all developmental ages, and improves diagnostic capture of traumatic  brain injury in pediatric trauma when administered by nurses with support through  the electronic medical record.<p /> <p>Language: en</p>",
language="en",
issn="1078-7496",
doi="10.1097/JTN.0000000000000559",
url="http://dx.doi.org/10.1097/JTN.0000000000000559"
}