Model System:

TBI

Reference Type:

Journal

Accession No.:

J77261

Journal:


Brain Injury

Year, Volume, Issue, Page(s):

, 30, 11, 1343-1349

Publication Website:

Abstract:

Study developed and provided initial validation of a measure for accurately determining the need for constant visual observation (CVO) in patients with traumatic brain injury (TBI) admitted to inpatient rehabilitation. An internally consistent measure of the need for CVO was developed and confirmed using Rasch analysis; the concurrent validity of the measure was assessed in relation to subjective clinical judgement recorded using the Levels of Risk scale (LoR) and the current level of supervision as measured by the Supervision Rating Scale (SRS). One hundred thirty-four individuals with moderate-to-severe TBI were studied in seven inpatient brain rehabilitation units associated with the National Institute for Disability, Independent Living and Rehabilitation Research TBI Model System. Participants were rated on the preliminary version of the CVO Needs Assessment (CVONA) and, by independent raters, on the LoR and SRS at four time points during inpatient rehabilitation: admission, days 2–3, days 5–6, and days 8–9. After pruning misfitting items, the CVONA showed satisfactory internal consistency (Person Reliability = 0.85–0.88) across time points. With reference to the LoR and SRS, low false negative rates (sensitivity > 90 percent) were associated with moderate-to-high false positive rates (29 to 56 percent). The CVONA may be a useful objective metric to complement clinical judgement regarding the need for CVO; however, additional prospective studies are needed to further assess its utility in identifying at-risk patients, reducing adverse events, and decreasing CVO costs.

Author(s):


Moessner, Anne, Malec, James F., Beveridge, Scott, Reddy, Cara C., Huffman, Tracy, Marton, Julia, Schmerzler, Audrey J.

Participating Centers: