Please see attachment that is named (week 1 assignment Capstone Project) for detailed instructions for the assignment. This assignment consist of 3 parts. The other 2 attachments are just to use as references to complete this assignment. Please let me know if you need further clarification.
|Paper Type||Research Paper|
|Number of Pages||3 (825 words)|
Nursing Capstone Project
Nursing Capstone Project
Part 1-Development of the PICOT Question
After a series of research and studies, it is evident that multiple cases of minor head injuries and subsequent intracranial hemorrhages [blur] in head injury went undiagnosed hence untreated. A majority of the health care institutions were using X-ray computed tomography commonly referred to as CT scans. Due to the unnoticed nature of the minor head injuries and undiagnosed cases of intracranial hemorrhages in children, there was increased the number of patients being admitted to the institutions’ trauma emergency department. Similarly, the number of child deaths due to brain injuries is relatively high recording an unnecessarily high rate of mortality and morbidity. My proposal focuses on identifying the limitations of using CT scans over other emerging methods of diagnosing head injuries. Evaluation of hospital documents and records indicated that there were chances that CT scans missed identifying minor head injuries whether inflicted or non-inflicted. In this proposal, the study will be rooted in a Diagnosis Clinical question using the following PICOT question:
PICOT: Among victims of minor head [/blur] injuries (P) does use of MRI and DTI (I) compared to contemporary scanning methods (C) improve timely diagnosis of minor head injuries (O)?
Problem Observation Settings
The problem of misdiagnosed and untimely late diagnosis of minor head injuries that can [blur]result in intracranial hemorrhages (ICH) is a challenge to many hospitals that provide maternity and nursery services. In the case of traumatic births, most head injuries go unnoticed or undiagnosed. A lot of people sustain minor head injuries that do not pose any significant health problem at first. The injuries [/blur] later lead to the development of ICH increasing the populations’ mortality and morbidity rate because of untimely diagnosis of the minor injuries.
Diagnosis and treatment of minor head injuries in children pose some challenges to health care providers. Head injuries, particularly intracranial [blur] hemorrhage (ICH), are diffuse and subtle in nature and. Therefore, it is common for available neuroimaging techniques to show little or no evidence of the anticipated injury. Without proper diagnosis and subsequent treatment, the injuries can advance to concussions.
Currently, the available imaging techniques do not fully address the problem we have at hand. A CT Scan is the most common method of identifying minor head injuries. However, the efficiency and effectiveness of these technologies are not in congruence with what is expected of them in the medical arena. With poor diagnosis and treatment of minor head injuries victims, the rate of mortality in this age bracket is wanting. My project will come up with reasonable procedures and technologies to address the problem. The outcome of the project will be entirely based on empirical data obtained from the qualitative and descriptive research I conducted regarding the problem in question. By using MRI’s as the intervention tool, I will be able to prove that mortality due to intracranial hemorrhages can be reduced by adopting the new and sophisticated[/blur] technologies. Results from Functional Magnetic Resonance Imaging (FMRI) and Diffuse Tensor Imaging (DTI) for four months will be compared with those from the previous diagnostic procedures.
Impact of the Problem
If the minor head injury is not treated, the concussions will cause disruption of normal functioning of the brain just as any other physical body injury does. Retrospective [blur]studies indicate that chances of ICH occurring in children are 3.4% to 4%. About 41% of children intracranial hemorrhages occur during the first week of delivery, and the condition is highly linked to traumatic deliveries. Statistics estimates that 20% of victims with the condition die therefore the need for timely diagnosis and subsequent treatment. Data from CDC indicates that children with [/blur] inhibitors and below the age of ten have a significant chance of developing ICH sometime later in their life.
According to Roquski et al. (2015), MRI is highly recommended as an alternative to CT. It can be used to diagnose Traumatic Head Injury (THI) and intracranial hemorrhage. A study [blur] was conducted to evaluate how sensitive MRI was to head minor undiagnosed minor head injuries that had been missed by the X-ray computed tomography. By focusing on the review of all the patients who underwent both CT and MRI over a period of 5 days, a sample group of 35 patients with the total was obtained. MRI scans results of the 35 patients were availed. Experts reviewed the images for the presence of traumatic head injuries, intracranial hemorrhages, and axonal injuries. Radiologists found that CT scan had recorded 14 negative results for minor head injuries that were clearly imaged when [/blur] the MRI scan was used.
The implication of these results further confirms the necessity of adopting new diagnostic imaging methods. Ultrasound imaging and MRIs are considered as the best alternatives to CT [blur] scans. Ultrasound uses sound to construct images while MRI uses magnetic fields to do the same. Unlike the two, CT scan uses beams of X-rays. Critics argue that continuous and prolonged exposure to these magnetic fields can lead to cancer. Although these findings have never been substantiated scientifically, it is worth noting and appreciating such possibility. According to a medical journal also [/blur] indicates that multiple exposures to the scan procedures increased chances of developing brain tumors and leukemia.
Part 3: Critical Appraisal Peer Reviewed Journals
According to Cooper et al. (2000), inflicted Traumatic Brain Injury (TBI) is considered the second biggest cause of death in infants after TBI. To ascertain this, Gibbs (2010) research findings [blur] indicated that the number of misdiagnosis of head injuries, particularly in the brain, is very common. Evidence confirming cases of misdiagnosis using ordinary CT scans indicated the need for health care profession to adopt effective diagnostic methods. Bradley et al. (2013) determined how efficient MRI scans were when used to diagnose head injuries via a study was conducted on 98 children to In the study, all the infants had no trauma history. However, they presented with symptoms that were nonspecific in nature. CT scans carried out. 6.4% of the infants were identified having minor head injuries. Benson et al. (2013) noted that one of the children was recorded having ICH. 65.8% of the minor health injury cases were self-inflicted but had been unnoticed. The rest were non-inflicted. When the test was conducted using Magnetic Resonance Imaging (MRI), the results were different. 16% of the children were diagnosed with Inflicted Brain Injury. The two tests are clinically accepted as an imaging solution, but they presented contrasting results (Dearholt, 2012). All the children fell under the 0 to 2 year age bracket. The results indicated that X-ray computed tomography was not efficient in diagnosing minor head injuries that were inflicted long ago. An online database journal by Sietsema (2010) on CT and MRI recommendation requirement indicated that CT scan is mostly recommendable when the brain injury occurred between 24 hours to 48 hours. In the case of MRI, a positive diagnosis is not limited by time span implying that it is better suited for minor head injuries[/blur] that have gone for a long time undiagnosed. Strand et al. (2015) study on MRI application recommended the diagnostic procedure in minor head injuries /brain traumas.
According to Gibbs et al. (2015), MRI is highly recommended as an alternative to CT. It can be used to diagnose Traumatic Head Injury (THI) and intracranial hemorrhage. A [blur]study was conducted to evaluate how sensitive MRI was to head minor undiagnosed minor head injuries that had been missed by the X-ray computed tomography. Crookes et al. (2015) results were based on a ten-year study of 574 admissions to level 1 trauma center. By focusing on the review of all the patients who underwent both CT and MRI over a period of 5 days, a sample group of 35 patients with the total was obtained (Gean, 2014). MRI scans results of the 35 patients were availed. Experts for the presence of traumatic head injuries, intracranial hemorrhages, and axonal injuries reviewed the [/blur] images. Gerrish peer-reviewed journal (2010) found that CT scan had recorded 14 negative results for minor head injuries that were clearly imaged when the MRI scan was used.
The implication of these results further confirms the necessity of adopting new diagnostic imaging methods (Huang, 2013). Ultrasound imaging and MRIs are considered as the[blur] best alternatives to CT scans (Levin et al. 2013). Ultrasound uses sound to construct images while MRI uses magnetic fields to do the same. Unlike the two, CT scan uses beams of X-rays. Marincek et al. 2015 argue that continuous and prolonged exposure to these magnetic fields can lead to cancer. According to a medical journal, The Marshall’s Journal (2015) minor head injury misdiagnosis by CT scan can lead to repeated scan over a short period. Mendelsohn’s et al. (2014) Journal also indicates that multiple exposures to the scan procedures increased chances of developing brain tumors [/blur] and leukemia. Another study in 2013 by Rodrigo et al. (2014) suggested that 43% of those cancer cases can be prevented if 25% of the highest doses were reduced.
Benson, Carolyn M, & Young, G Bryan. (2013). New guidelines for [blur] the initial management of head injury. (BioMed Central Ltd.) BioMed Central Ltd.
Bradley, PB, Harding, SG, Pena, A, Chatfield, DA, Pickard, JD, Carpenter, TA, & Menon, DK. (2003). Diffusion weighted magnetic resonance imaging in early moderate and severe head injury. (BioMed Central Ltd.) BioMed Central Ltd.
Cooper, P. R., & Golfinos, J. G. (2000). Head injury. New York: McGraw-Hill, Medical Pub. Division.
Crookes, P., & Davies, S. (2014). Research into practice: Essential skills for reading and applying research in nursing and health care. Edinburgh: Baillière Tindall.
Dearholt, S., Dang, D., Sigma Theta Tau International,, & Institute for Johns Hopkins Nursing,. (2012). Johns Hopkins nursing evidence-based practice: Models and guidelines.
Gibbs, R, Walker, R, & Thomas, E. (2010). Impact of regional imaging guidelines for head injury and unconscious polytrauma patients. (BioMed Central Ltd.) BioMed Central Ltd.
Gean, A. D. (2014). Imaging of head trauma. New York: Raven Press.
Gerrish, K., & Lacey, A. (2010). The research process in nursing. Chichester, West Sussex, U.K: Wiley-Blackwell.
Huang, D. (2013). Retinal imaging. Philadelphia, PA: Mosby Elsevier.
Levin, H. S., Eisenberg, H. M., & Benton, A. L. (2013). Mild head injury. New York: Oxford University Press.
Marincek, B., & Dondelinger, R. F. (2015). Emergency radiology: Imaging and intervention. Berlin: Springer.
Marshall, K. W., Koch, B. L., Egelhoff, J. C., University of Michigan., & Children’s Hospital Medical Center (Cincinnati, Ohio). (January 01, 2011). Air bag-related deaths and serious injuries in children: Injury patterns and imaging findings. American Journal of Neuroradiology, 19, 9, 1599-1607.
Mendelsohn, D., & Lilly, M. A. (January 01, 2014). Tower of lond Reider-Groswasser, I. I., Groswasser, Z., Ommaya, A. K., Schwab, K., Pridgen, A., Brown, H. R., Cole, R., … Salazar, A. M. (January 01, 2002). Quantitive imaging in late traumatic brain injury. Part I: late imaging parameters in closed and penetrating head injuries. Brain Injury, 16, 6, 517-25.on performance in relation to magnetic resonance imaging following closed head injury in children.Neuropsychology, 8, 2.
Rodrigo, R. M., Martel, J., Vilanova, J. C., & SpringerLink (Online service). (2014).Sports Injuries in Children and Adolescents: A Case-Based Approach. (Springer eBooks.) Berlin, Heidelberg: Springer Berlin Heidelberg
Sietsema, D. L., & Grand Valley State University. (2010). A comparison of critical thinking ability and clinical judgement skills in associate and baccalaureate senior nursing students. (Masters Abstracts International, 31-3.)
Strand, Ingrid, Solheim, Ole, Moen, Kent, & Vik, Anne. (2012). Evaluation of the Scandinavian guidelines for head injuries based [/blur] on a consecutive series with computed tomography from a Norwegian university hospital. (BioMed Central Ltd.) BioMed Central Ltd.
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