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.
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
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
by: Jeff Driban
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