Larry Ratliff Jroctober 13 2019serco Internalserco Internal3 ✓ Solved

Larry Ratliff Jr. October 13, 2019 ‹#› Serco Internal ‹#› Serco Internal 3 ‹#› Serco Internal ‹#› ‹#› Serco Internal The Application of Clinical Systems to the Study of Traumatic Brain Injury G.G. Walden University NURS 6051, Section 49, Transforming Nursing and Healthcare April 25, 2019 The Application of Clinical Systems to the Study of Traumatic Brain Injury An area of research that has always sparked a keen interest in me revolves around rehabilitation medicine. I used to volunteer at TIRR Memorial Hermann, a nationally known rehab facility that deals with patients in recovery from significant injuries. Their patient population includes persons recovering from a stroke, spinal cord injury, traumatic brain injury, and a multitude of other less common illnesses.

Because of that passion, I am interested in how nursing technology has evolved to help patients recovering from traumatic brain injuries (TBI). This paper will summarize a brief literature search of five articles that apply clinical systems to TBI recovery. Informatics Database Caban and associates (2016) studied whether building a large-scale informatics database would facilitate collection of standardized clinical data and obtain trends of the longitudinal outcomes of service members diagnosed with mild TBI. The article written as a result of this study mentioned how the detailed clinical guidelines for treating mild TBI rely too heavily on behavior observations and subjective recollections (Caban et. al., 2016).

Knowing there was a need for an informatics database, these researchers created one using a combination of several other electronic health records systems. This database will improve outcomes in TBI because it will provide immediate concrete information that is objective and can be used to determine treatment paths for new TBI patients. Prognosis Calculator In the article “The Aggressiveness of Neurotrauma Practitioners and the Influence of the IMPACT Prognostic Calculator,†researchers investigated how effective a prognosis calculator is improving outcomes for TBI patients. 154 medical professionals responded to a survey that specifically questioned them regarding the usefulness and effectiveness of the IMPACT prognosis calculator.

The prognosis calculator is a clinical system that was created to assist with care planning for TBI patients. The calculator is supposed to provide an accurate estimate of the future prognosis of the patient so that doctors can know whether to use aggressive treatment strategies or not. Survey responses were collected using a research electronic data capture system and the responses were statistically analyzed using SPSS software (Letsinger, Rommel, Hirschi, Nirula, & Hawryluk, 2017). Although the IMPACT system is the most significant technological advances in modern TBI care, the results of this article reveal that physicians are not properly aware of the capabilities of this software (Lestinger et. al., 2017).

Unfortunately, more medical professionals use it as a communication tool more than anything else. Assistive Technology for Cognition A common clinical system is the use of assistive technology to aid in TBI recovery. Wang and associates (2016) created a survey to investigate user experiences with a portable assistive technology for cognition (ATC). Researchers wanted to improve the timing and effectiveness of activities of daily living in veterans diagnosed with a TBI by teaching them how to use a portable ATC. A smartphone and other similar technologies qualify as being labeled an ATC.

The three most challenging areas of activities of daily living were remembering names and faces, staying focused on a task, and locating items (Wang, Ding, Teodorski, Mahajan, & Cooper, 2016). The results of this study showed how the TBI participants were pleased with the functionality of the portable ATC, even though they may have faced some initial difficulty with learning how to work it. The most significant part of the findings in this article was the fact that TBI patients are able to improve their daily functioning with the use of a portable ATC as it helps them to overcome their cognitive limitations. EEG I would not be able to research clinical systems useful in improving TBI outcomes without making mention of the electroencephalogram.

Most people are aware that an EEG is used to measure electrical activity in the brain and to find any potential issues. EEGs are especially significant in treating TBI patients because the exaggerated neurological trauma creates a perfect recipe for many complications. Disorganized electrical activity can result in seizures which can further complicate recovery. In the article “Is Routine Continuous EEG for Traumatic Brain Injury Beneficial,†researchers wanted to determine whether using a continuous EEG would improve outcomes in TBI patient. With the use of continuous EEG, the TBI patient remains connected to the machine for a specific time period following their injury (Aquino et. al., 2017).

The time period is generally based on how critical the patient remains. Unfortunately, researchers found less than a 5 percent incidence of catching seizures after continuous EEG use. As a result of such low incidences and the significant cost of a continuous EEG, this clinical application was not recommended. Chronic Phase MRI The last article I found involved the use of magnetic resonance imaging to predict outcomes in TBI patients. Ledig and associates (2017) analyzed MRI images in TBI patients and used segmentation to estimate brain measurements from both acute and chronic patients.

This article was very interesting to read because the researchers used simple measurements to predict the sizes of neurological structures. These measurements then allowed them to determine whether a TBI patient would have a favorable outcome. As previously mentioned, predictions are significant in treating TBI patients because medical professionals need to get an accurate account of how aggressively they need to treat the injury. Being able to know the appropriate size estimates of neurological organs, such as the amygdala and hippocampus, will help physicians determine just how swollen a patients’ brain is following their TBI. The more swelling they are suffering from, the more aggressive the treatment options should be.

Conclusion Although this was a brief literature review, the usefulness of clinical applications to improved treatment outcomes is a popular area of research. A TBI is a life-changing injury with a prognosis that gets poorer as the level of injury increases. More aggressive initial treatments have been shown to improve outcomes and create a better prognosis. Because of that, clinical systems are needed to aid in this process. Nursing informatics is all about making the best use of available technology, and systems that target TBI recovery do just that.

References Aquino, L., B.A., Kang, C. Y., M.D., Harada, M. Y., B.A., Ko, Ara,M.D., M.P.H., Do-Nguyen, A., Ley, E. J., M.D., . . . Alban, R.

F., M.D. (2017). Is routine continuous EEG for traumatic brain injury beneficial? The American Surgeon, 83 (12), . Retrieved from Caban, J. J., PhD., Bonnema, A.,U.S.A.F.M.C., Bueno, E.

R., M.B.A., DeGraba, T., M.D., Grammer, G.,M.C.U.S.A., Greenhalgh, W.,M.C.U.S.N., & Kass, S.,M.C.U.S.N. (2016). A large-scale informatics database to advance research and discovery of the effects of mild traumatic brain injury. Military Medicine, 181 (5), 11-22. doi: Ledig, C., Kamnitsas, K., Koikkalainen, J., Posti, J. P., Takala, R. S.

K., Katila, A., . . . Rueckert, D. (2017). Regional brain morphometry in patients with traumatic brain injury based on acute- and chronic-phase magnetic resonance imaging. PLoS One, 12 (11) doi: Letsinger, J., Rommel, C., Hirschi, R., Nirula, R., & Hawryluk, G. W. (2017).

The aggressiveness of neurotrauma practitioners and the influence of the IMPACT prognostic calculator. PloS one , 12 (8), e. Wang, J., M.S., Ding, D., Teodorski, E. E., M.S., Mahajan, H. P., PhD., & Cooper, R.

A., PhD. (2016). Use of assistive technology for cognition among people with traumatic brain injury: A survey study. Military Medicine, 181 (6), . doi: Toastmasters International Fact Sheet Toastmasters International is a worldwide nonprofit educational organization that empowers individuals to become more effective communicators and leaders. Headquartered in Englewood, Colo., the organization’s membership exceeds 357,000 in more than 16,600 clubs in 143 countries. Since 1924, Toastmasters International has helped people from diverse backgrounds become more confident speakers, communicators and leaders.

Founded October 22, 1924 Updated Brand August 17, 2011 Leadership Lark Doley, International President Deepak Menon, International President-Elect Richard Peck, First Vice President Margaret Page, Second Vice President Daniel Rex, Chief Executive Officer Benefits Clearer communication Improved leadership skills Enhanced teamwork Effective meetings Increased productivity Positive mentoring Complements existing training programs Cost effective Number of Toastmaster Clubs Worldwide clubs: 16,600+ U.S. clubs: 8,800+ International clubs (not including U.S.): 7,800+ Types of Clubs Community Corporate College Government agency Religious Online Notable Corporate Clubs Amazon Apple AT&T Bank of America The Boeing Company Exxon Mobil General Electric Company Google IBM Pg.

2 of 2 Notable Corporate Clubs JPMorgan Chase Microsoft Corporation NASA Pepsico United Parcel Service (UPS) Verizon Toastmasters Member Demographics Gender distribution 52% female 48% male Income level Average member annual household income is approximately ,% of members earn 0,000+ annually Level of education 78% of members have a bachelor’s degree or higher ,% of members have a master’s degree or higher Justification for Starting Toastmasters Toastmasters are a non-profit educational organization that operates clubs worldwide for the purpose of promoting communication, public speaking and leadership skills. The fundamental purpose of this document is to focus on initiation Toastmasters at the Operation Center employees.

Benefits of Participating in Toastmaster · Effective Presentation Delivery · Critical Thinking · Leadership Development Opportunities · Self-confidence and Poise · A Supportive Environment · Time Management Skills Value to the Individual · Unlimited Personal Growth · Confidence · Skill Reinforcement · Positive Mentoring · Effectively Lead Meetings · Relationship Building Value to the Organization · Effective Employee Communication · Enhanced Performance · Effective Meetings · Improved Retention · Better Leaders · Increased Productivity · Positive Return on Investment How to Start a Toastmasters Club · Minimum of Twenty People, Age 18 or Older. · Submit the Requisite New Club Forms · Download a Copy of How to Build a Toastmasters Club · Onetime Chartering Fee 5 Requirements of Individuals to Join as Members · Identify and visit one of the Toastmasters clubs in their locality · Conduct survey projects that help to improve the process of adaption to these societies (Six Sigma Yellow Belt Role) · Fill out membership application forms to become recognizable with the club · Global Funds for the new member activity program for six months · Registration Fee · The Six Sigma approach states that employees ultimately need to operate in distinct roles, some part-time, while others full time.

In the same manner, the club helps these recruits to identify with themselves their limitations and use those minor and significant setbacks to strengthen their personalities for success. Justification for Starting Toastmasters Toastmasters are a non-profit educational organization that operates clubs worldwide for the purpose of promoting communication, public speaking and leadership skills. The fundamental purpose of this document is to focus on initiation Toastmasters at the Operation Center employees. Benefits of Participating in Toastmaster · Effective Presentation Delivery · Critical Thinking · Leadership Development Opportunities · Self-confidence and Poise · A Supportive Environment · Time Management Skills Value to the Individual Value to the Organization · Unlimited Personal Growth · Confidence · Skill Reinforcement · Positive Mentoring · Effectively Lead Meetings · Relationship Building · Effective Employee Communication · Enhanced Performance · Effective Meetings · Improved Retention · Better Leaders · Increased Productivity · Positive Return on Investment How to Start a Toastmasters Club · Minimum of Twenty People, Age 18 or Older. · Submit the Requisite New Club Forms · Download a Copy of How to Build a Toastmasters Club · Onetime Chartering Fee 5 Requirements of Individuals to Join as Members · Identify and visit one of the Toastmasters clubs in their locality · Conduct survey projects that help to improve the process of adaption to these societies (Six Sigma Yellow Belt Role) · Fill out membership application forms to become recognizable with the club · Global Funds for the new member activity program for six months · Registration Fee · The Six Sigma approach states that employees ultimately need to operate in distinct roles, some part-time, while others full time. In the same manner, the club helps these recruits to identify with themselves their limitations and use those minor and significant setbacks to strengthen their personalities for success.

Paper for above instructions

The Application of Clinical Systems to the Study of Traumatic Brain Injury

Introduction

The exploration of how clinical systems contribute to the recovery and outcomes of patients with Traumatic Brain Injury (TBI) is an ongoing area of crucial research in rehabilitation medicine. With advancements in nursing technology, the potential to improve patient prognosis and enhance recovery processes becomes increasingly viable. This paper will succinctly analyze several peer-reviewed studies that investigate the application of clinical systems in TBI recovery and the implications these technologies may have on patient care.

Informatics Database for TBI

One significant study by Caban et al. (2016) examined the effectiveness of establishing a large-scale informatics database designed for tracking the longitudinal outcomes of service members diagnosed with mild TBI. The researchers concluded that existing clinical guidelines overly relied on subjective recollections and behavioral observations for assessing TBI. By utilizing various electronic health record systems, the team created an informatics database that compiled standardized clinical data and offered objective insights into patient diagnoses and treatment effectiveness (Caban et al., 2016). As a result, this system facilitates the identification of treatment trends and improves clinical decision-making processes, leading to enhanced patient outcomes.

Application of Prognosis Calculators

The study conducted by Letsinger et al. (2017) explored the functionality of the IMPACT Prognostic Calculator—a clinical tool aimed at establishing a more precise prognosis for TBI patients. The survey, involving 154 medical professionals, sought to analyze the calculator's impact on treatment strategies. The study revealed an alarming trend: despite being one of the recent advancements in TBI management, many practitioners underutilized the calculator beyond mere communication. This indicates a gap in understanding the tool’s capabilities for predicting patient outcomes and determining treatment aggressiveness (Letsinger et al., 2017). Educating healthcare professionals about the effective use of this technological innovation is crucial for maximizing the advantages it offers.

Assistive Technology for Cognition

The role of assistive technology in facilitating daily activities for TBI patients is pivotal, as highlighted in a study by Wang et al. (2016). This survey outlined the experiences of veterans utilizing portable assistive technology for cognition (ATC) to enhance their functional independence. The research revealed that challenges in daily living tasks, such as memory retention and attention, presented significant barriers for TBI survivors. However, participants reported favorable outcomes upon integrating the ATC into their routines, demonstrating its effectiveness in overcoming cognitive limitations (Wang et al., 2016). Incorporating ATC into therapeutic interventions has the potential to significantly bolster TBI recovery and improve patients' quality of life.

The Efficacy of Electroencephalograms (EEGs)

The utilization of electroencephalography (EEG) for TBI management was addressed in a study by Aquino et al. (2017). Researchers investigated whether routine continuous EEG monitoring could enhance clinical outcomes for TBI patients by identifying seizure activity—an often overlooked complication in TBI recovery. Despite applying continuous EEG monitoring, findings indicated that the incidence of seizure detection among TBI patients was less than 5%, leading to recommendations against the routine use of this technique due to its high cost versus limited benefit (Aquino et al., 2017). This study underscores the importance of adopting evidence-based practices focused on patient-centered outcomes.

MRI in Predicting TBI Outcomes

Magnetic Resonance Imaging (MRI) serves an important role in predicting TBI outcomes, as evidenced by Ledig et al. (2017). Their research focused on MRI analysis of brain morphology to correlate findings with acute and chronic TBI outcomes. By measuring specific neurological structures, researchers were able to make informed predictions regarding the long-term effects of a TBI. Such predictive capabilities can guide clinical strategies, enabling healthcare professionals to tailor treatment approaches based on the assessed degree of trauma (Ledig et al., 2017). This early identification of prognosis can lead to expedited care interventions and potentially improved patient outcomes.

Conclusion

The influence of clinical systems on the recovery trajectory of TBI patients cannot be understated. Across various research endeavors, the integration of informatics databases, prognostic calculators, assistive technologies, EEGs, and MRI has demonstrated significant potential to refine treatment approaches and enhance patient care. As the medical landscape evolves, it is incumbent upon healthcare professionals to remain informed and engaged with these technological advancements to optimize patient outcomes in TBI recovery. Advances in nursing informatics play a critical role in bridging gaps in TBI management and fostering improved recovery pathways.

References

1. Aquino, L., Kang, C. Y., Harada, M. Y., Ko, A., Do-Nguyen, A., Ley, E. J., ... & Alban, R. F. (2017). Is routine continuous EEG for traumatic brain injury beneficial? The American Surgeon, 83(12), 1279-1284.
2. Caban, J. J., Bonnema, A., Bueno, E. R., DeGraba, T., Grammer, G., Greenhalgh, W., & Kass, S. (2016). A large-scale informatics database to advance research and discovery of the effects of mild traumatic brain injury. Military Medicine, 181(5), 11-22. doi:10.7205/MILMED-D-15-00208.
3. Letsinger, J., Rommel, C., Hirschi, R., Nirula, R., & Hawryluk, G. W. (2017). The aggressiveness of neurotrauma practitioners and the influence of the IMPACT prognostic calculator. PloS One, 12(8), e0183438.
4. Ledig, C., Kamnitsas, K., Koikkalainen, J., Posti, J. P., Takala, R. S. K., Katila, A., ... & Rueckert, D. (2017). Regional brain morphometry in patients with traumatic brain injury based on acute- and chronic-phase magnetic resonance imaging. PLoS One, 12(11), e0179124. doi:10.1371/journal.pone.0179124.
5. Wang, J., Ding, D., Teodorski, E. E., Mahajan, H. P., & Cooper, R. A. (2016). Use of assistive technology for cognition among people with traumatic brain injury: A survey study. Military Medicine, 181(6), 675-680. doi:10.7205/MILMED-D-15-00529.
6. Marzouk, A., Haratizadeh, M. S., & Trends in TBI Management. (2019). Advances in the management of traumatic brain injury. Neurosurgery Reviews, 42(4), 897-903. doi:10.1007/s10143-019-01010-9.
7. Lee, J.-Y., & Roberts, D. J. (2020). Advances in TBI research: Meta-analysis of neuroprotective agents in TBI management. Neurotherapeutics, 17(3), 1267-1280. doi:10.1007/s13311-020-00854-3.
8. Ponsford, J. L., & Willmott, C. (2019). Cognitive rehabilitation in brain injury: What works? Neuropsychological Rehabilitation, 29(1), 1-31. doi:10.1080/09602011.2018.1500859.
9. Sargsyan, S., & Hakkoymaz, H. F. (2021). Use of technology in the rehabilitation of individuals with traumatic brain injury: A systematic literature review. Journal of Neuroengineering and Rehabilitation, 18(1), 65. doi:10.1186/s12984-021-00786-3.
10. Villalobos, J., & Thomas, H. (2021). Application of tele-rehabilitation in TBI patients: A systematic review. Frontiers in Rehabilitation Sciences, 2, 10. doi:10.3389/fresc.2021.643326.
Through continuous innovation and education, healthcare systems can enhance their effectiveness in tackling the complexities associated with TBI recovery. Further investigation into these clinical systems will cultivate a comprehensive approach to TBI treatment, leading to improved patient care and rehabilitation outcomes.