Design and validation of a critical pathway for hospital management of patients with severe traumatic brain injury

被引:11
作者
Espinosa-Aguilar, Amilcar
Reyes-Morales, Hortensia [1 ,2 ]
Huerta-Posada, Carlos E.
Limon-Perez de Leon, Itzcoatl
Lopez-Lopez, Fernando
Mejia-Hernandez, Margarita
Mondragon-Martinez, Maria A.
Calderon-Tellez, Ligia M.
Amezcua-Cuevas, Rosa L.
Rebollar-Gonzalez, Jorge A.
机构
[1] Mexican Inst Social Secur, Natl Med Ctr Century 21, Epidemiol & Hlth Serv Res Unity, Mexico City, DF, Mexico
[2] Mexican Inst Social Secur, Natl Med Ctr Century 21, Epidemiol & Hlth Serv Res Unity, Mexico City, DF, Mexico
来源
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE | 2008年 / 64卷 / 05期
关键词
severe traumatic brain injury; critical pathways; health care process; nosocomial infections;
D O I
10.1097/TA.0b013e3181469ebe
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Background: Critical pathways for the management of patients with severe traumatic brain injury (STBI) may contribute to reducing the incidence of hospital complications, length of hospitalization stay, and cost of care. Such pathways have previously been developed for departments with significant resource availability. In Mexico, STBI is the most important cause of complications and length of stay in neurotrauma services at public hospitals. Although current treatment is designed basically in accordance with the Brain Trauma Foundation guidelines, shortfalls in the availability of local resources make it difficult to comply with these standards, and no critical pathway is available that accords with the resources of public hospitals. The purpose of the present study was to design and to validate a critical pathway for managing STBI patients that would be suitable for implementation in neurotrauma departments of middle-income level countries. Methods: The study comprised two phases: design (through literature review and design plan) and validation (content, construct, and appearance) of the critical pathway. Results: The validated critical pathway for managing STBI patients entails four sequential subprocesses summarizing the hospital's care procedures, and includes three components: (1) nodes and criteria (in some cases, indicators are also included); (2) health team members in charge of the patient; (3) maximum estimated time for compliance with recommendations. Conclusions: This validated critical pathway is based on the current scientific evidence and accords with the availability of resources of middle-income countries.
引用
收藏
页码:1327 / 1341
页数:15
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