Objectives

To investigate criteria acute care interdisciplinary providers use to select discharge destination for patients with traumatic brain injury (TBI).

Design

Cross-sectional, exploratory survey study.

Methods

Data were collected from interdisciplinary providers at a U.S. Level I trauma centre via electronic survey. We invited 199 providers to participate and 27 responded (13.5% response rate). Responses were received from physicians and physical, occupational, and speech therapists.

Results

Findings showed variability in standard criteria and clinical judgment criteria providers used to select discharge destination for patients with TBI receiving acute care. There was limited agreement on standard criteria used to select discharge destination. Findings showed some agreement between providers on clinical judgment criteria used to select home as discharge destination and to prevent discharge to home. Most common clinical judgment criteria included therapists’ recommendations on discharge location, patient’s level of independence in activities of daily living, planned family support and ventilator dependence. Agreement on clinical judgment criteria became more limited when stratifying by discipline, frequency of patient care and experience.

Conclusions

Findings on clinical judgment criteria providers use to select acute care discharge destination for patients with TBI are inconclusive.

中文翻译：

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中重度脑外伤患者的出院地点选择。

目标

为了研究急诊跨学科提供者用来为脑外伤（TBI）患者选择出院目的地的标准。

设计

横断面，探索性调查研究。

方法

通过电子调查从美国一级创伤中心的跨学科提供者那里收集数据。我们邀请了199位提供者参加，其中27位做出了回应（回复率为13.5％）。收到了医生以及物理，职业和言语治疗师的回应。

结果

调查结果显示，标准标准和临床判断标准的提供者存在差异，用于选择接受急诊护理的TBI患者的出院目的地。在选择排放目的地的标准标准上达成的协议有限。调查结果表明，提供者之间在临床判断标准上达成了一些共识，这些判断标准用于选择家庭作为出院目的地并防止出院。最常见的临床判断标准包括治疗师对出院位置，患者日常活动中的独立性水平，计划的家庭支持和呼吸机依赖性的建议。当按纪律，患者护理的频率和经验进行分层时，关于临床判断标准的共识变得更加有限。

结论

提供者用来为TBI患者选择急性护理出院目的地的临床判断标准的发现尚无定论。