Mild traumatic brain injury: a survey of perceived knowledge and learning preferences of military and civilian nurses.

Early case recognition and intervention by nurses for patients with mild traumatic brain injury (mTBI) can significantly improve outcomes for civilian and military patients. The "Concussion/mTBI Learning Needs Assessment for Registered Nurses Survey" was developed to evaluate bedside nurses' knowledge related to the assessment and care of patients with mTBI as well as their preferences for learning in order to develop a targeted curriculum. An anonymous, self-administered, Web-based survey was available from February to August 2009. A series of invitational e-mails were sent to nurses at a convenience sample of civilian, federal, and military institutions. A total of 1,224 nurses meeting the inclusion criteria of being bedside care providers and nonadvanced practice responded and were included in the analysis (civilian, n = 731; military, n = 494). Most respondents (91.3%) considered knowledge of mTBI to be important or very important to their practice, and 44.5% saw mTBI patients at least monthly. Despite this perception of importance and exposure to the patients, nurses' self-reported knowledge levels were very low. Overall, 39.8% expressed a high knowledge level (score of 4 [a lot] or 5 [expert] on a 1-5 scale) of the causes of mTBI. Fewer than 25% expressed high knowledge level in the skills needed for the identification and assessment of mTBI patients, and less than 15% had high knowledge in the treatment and prognosis of these patients. The nurses' preferred learning method was shadowing another provider (37%), but the most often used method was Internet searches (80.3%). There was minimal difference between military and civilian nurses. Although nurses recognize the importance of familiarity with mTBI for their practice and most clearly self-identify knowledge deficits in all aspects of care of the mTBI patients, a broad but succinct curriculum for the nonadvanced practice bedside nurse could provide a cost-effective, quickly accessible way to provide the needed education.