Abstract

The purpose of the current study was to identify the variables associated with the risk of closed head injury (CHI) in children under age two with suspected minor head injuries based on age-appropriate, or near age-appropriate, mental status on exam, as defined by a Glascow Coma Score (GCS) of 15 or 14, respectively. The goal was to propose a set of variables that, when considered together, have a high degree of predictive accuracy in identifying CHI in this population. This set of variables could eventually be used to inform a clinical decision rule which may help triage nurses make acuity decisions in a more evidence-based manner. The study was guided by Donabedian's Structure, Process, Outcome model that allows for the assessment of the various factors that inform and influence the ED triage process. The current study was a secondary data analysis of the public-use dataset from the largest prospective, multi-center pediatric head injury study found in the current literature. As part of the secondary analysis, an existing clinical decision rule by Greenes and Schutzman (2001) (Greenes and Schutzman Risk Scoring System [the Scalp Score]), was examined using a sample of 3,329 children under age two to determine whether it, or the individual variables within it, could be utilized alone, or in conjunction with other variables to accurately predict the risk of underlying CHI in this population.

Description

This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 10977906; ProQuest document ID: 2175723522. The author still retains copyright.

Author Details

Elizabeth L. Stone, PhD, MSN, CHSE, FAEN, Assistant Dean

Sigma Membership

Non-member

Lead Author Affiliation

The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

Type

Dissertation

Format Type

Text-based Document

Study Design/Type

Other

Research Approach

Other

Keywords:

Head Injuries, Pediatrics, Triage

Advisor

Leslie Davis

Second Advisor

Thomas McCoy

Third Advisor

Debbie Travers

Fourth Advisor

Elizabeth Van Horn

Degree

PhD

Degree Grantor

The University of North Carolina at Greensboro

Degree Year

2018

Rights Holder

All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.

All permission requests should be directed accordingly and not to the Sigma Repository.

All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.

Review Type

None: Degree-based Submission

Acquisition

Proxy-submission

Date of Issue

2024-08-29

Full Text of Presentation

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