Abstract

Purposes/Aims

This DNP project aims to enhance the care of patients with traumatic brain injury (TBI) by improving nurses’ knowledge, clinical decision-making, and early intervention strategies through the integration of brain oxygenation data into routine neurocritical care assessments. This project seeks to promote personalized patient care, reduce secondary brain injury, and improve neurological outcomes for critically ill adults with TBI by implementing an educational protocol designed to deepen understanding of brain oxygen monitoring.

Background of Problem & Description of Current Practice

TBI remains a leading cause of death and disability worldwide and continues to pose a significant public health burden. In the United States, severe TBI accounts for approximately 30% of all injury-related deaths and results in substantial economic costs. The current management of TBI on Loma Linda University Medical Center’s unit 7A, the Adult Surgical Trauma, Transplant, Neuroscience ICU consists of preventing secondary brain injuries through the management of intracranial pressure (ICP). Nursing professionals on 7A have a notable gap in knowledge regarding the implementation and clinical importance of brain oxygen monitoring.

Supporting Evidence

Although some nurses received training on the Raumedic NEUROVENT-PTO catheters during the trial period, this training session was not extended to the entire unit, resulting in many nurses remaining unfamiliar with the device setup process and associated PbtO₂ algorithms. This has led to knowledge gaps among staff, potentially impacting optimal utilization and patient care. Overall, staff overwhelmingly indicated that more structured and formal education is needed.

The EBP/QI process approach used

The project followed the Johns Hopkins Nursing Evidence-Based Model and the Promoting Action on Research Implementation in Health Services (PARiHS) framework.

Implementation

All part-time and full-time nurses on 7A participated in the mandatory TBI Care Management education at a staff meeting.

Outcomes/Measures Achieved

The data suggest the training improved participants’ confidence, was highly relevant to their work, and encouraged the integration of new knowledge and skills into clinical practice.

Conclusions

Potential applications of brain oxygen monitoring may extend beyond TBI management, providing possible advantages for patients with other neurological disorders.

Keywords: brain oxygenation, traumatic brain injury, pbt02, brain hypoxia, multimodal brain monitoring

LLU Discipline

Nursing

Department

Nursing

School

School of Nursing

First Advisor

Robin D. Pueschel

Degree Name

Doctor of Nursing Practice (DNP)

Year Degree Awarded

2026

Date (Title Page)

2026

Language

English

Library of Congress/MESH Subject Headings

Brain–1 Oxygenation—Measurement; Brain injuries—Nursing; Evidence-based nursing

Type

Doctoral Project

Page Count

100 p.

Digital Format

PDF

Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.

Collection

Loma Linda University Electronic Theses and Dissertations

Collection Website

http://scholarsrepository.llu.edu/etd/

Repository

Loma Linda University. Del E. Webb Memorial Library. University Archives

Additional Files
Alyssa Grisham - DNP Project Poster.pdf (497 kB)
Poster: Optimizing TBI Care: Brain Oxygen Monitoring in Nursing
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