Sports Medicine Research: In the Lab & In the Field: Nurses’ Views on Interprofessional Concussion Management Teams (Sports Med Res)


Wednesday, October 4, 2017

Nurses’ Views on Interprofessional Concussion Management Teams

School nurses’ perceptions and experiences with an interprofessional concussion management team in the secondary school setting

Welch Bacon CE, Erickson CD, Kay MC, Weber ML, Valovic McLeod TC. Journal of Interprofessional Care. 2017; ahead of print.

Take Home Message: Nurses understand that they play a key role in the interprofessional concussion management team for secondary school students; however, the lack of agreement on the roles of team members suggest that protocols may be needed to foster role delineation and communication.

Students commonly need academic accommodations following a concussion to ease back into full cognitive load in a classroom. These accommodations would be best implemented by an interprofessional concussion management team that uses a collaborative, multifaceted approach to permit the safe return to activity and classroom. However, there is little research to address who should be involved and how academic accommodations would be effectively carried out. The school nurse may offer insight on the best approach to facilitate a team approach to academic accommodations. Therefore, the authors explored the school nurses’ perceptions and experiences of an interprofessional concussion management team for adolescents following a concussion in the secondary school setting. Fifteen school nurses who had at least 5 years’ experience and at least 1 concussed adolescent that needed academic accommodations in the past year were randomly selected from 296 potential individuals. Each school nurse completed a semi-structured interview by answering 12 open-ended questions (with follow up questions as needed). In brief, in addition to a nurse, the participants suggested that the concussion management team should include physician, athletic trainer, school counselor, teacher, and other members (parents, school administrators). Though nurses seem to agree on who should be involved, there was a lack of agreement on each member’s roles. Another concern was how each team member would be able to communicate with each other since not everyone on the concussion management team would be present during school and after school activities. 

The authors found that the nurses believe the return-to-learn process is important, and that there are several professionals that need to work together to make sure the plan is being implemented and carried out appropriately. The nurses typically agreed on who should be part of the concussion management team; however, access and understanding of how each person will fulfill their role varied. School nurses placed a larger emphasis on the role they play along with teachers due to the ease of contact taking place during school hours. However, the nurses also stated that they would like more education focused on concussion management. The nurses also noted that counselors and administrators were important to influence the success of a plan, but due to other responsibilities they may not have time to be sufficiently involved. Interestingly, school nurses did not highlight the athletic trainer or physician as having a large role in the concussion management process, which could be due to the conflicting schedules. Overall, nurses agreed that the physicians prescribe the accommodations, but they struggled with the lack of consistency of the accommodations. Currently, medical professionals should consider developing protocols to foster interprofessional collaboration for focused and successful implementation of return-to-learn and play guidelines. These protocols need to indicate the role of each team member and develop a strategy to foster communication between nurses, athletic trainers, and other team members.

Question for Discussion: Do you have a concussion team in place at your setting? If so, who is in the team and what roles do they play? How do you overcome the communication barriers to implement the return-to-learn policy?

Written by: Jane McDevitt, PhD
Reviewed by: Jeff Driban

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