Development of a screening tool and clinical pathway for adults with acute mild traumatic brain injury (mTBI) in the Emergency Department.
Ashtyn Cowie1, Julia Murray1, Amy Spencer1 1Fiona Stanley Fremantle Hospital Group, Murdoch, WA, Australia
Abstract
Development of a screening tool and clinical pathway for adults with acute mild traumatic brain injury (mTBI) in Emergency Department
Background: Increased presentations of mTBI in the emergency department (ED) at Fiona Stanley Hospital (FSH) placed an increased demand on the occupational therapy (OT) service for assessment and disposition planning. The aim of this project was to develop a clinical management pathway with appropriate assessment tools to optimise patient care.
Method:
A screening tool was developed based on a literature review between June 2020 of appropriate assessment tools, benchmarking across Australian tertiary emergency OT departments and a working group of six senior FSH OTs.
An initial trial of the screening tool and pathway was conducted between June 2020 to December 2021 in ED, Acute Medical Unit and multi trauma. The outcome measures were time taken to assess and occasions of service and therapist confidence.
Results:
The screening tool reduced assessment time from an average of 119.5 minutes to 72.5 minutes.
The clinical pathway improved and increased clinical efficacy with occasion of services reducing from an average of 3 to 1.
Increased OT confidence in assessment and interventions with this patient cohort was captured with a survey.
Discussion:
Our study developed a novel OT mTBI assessment tool and an evidence-based clinical pathway. It improved clinical efficacy to optimise patient care for treating mTBI patients presenting to ED and acute medical wards. Further evaluation into the validity and reliability of the screening tool and clinical trials of the management pathway are planned.
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