Introduction

Acquired brain injury (ABI), represented by a range of cognitive, emotional and physical challenges, provides healthcare professionals with an arduous mission to address its management. Even though ABI is a unique, multi-dimensional condition that requires an interdisciplinary approach to care and incorporates the essential elements of nursing science principles, including patient assessment, prioritisation methodology followed by nursing diagnosis formulation and clinical reasoning. Also such a plan is crucial for the ABI individuals and must assist in effective recovery, rehabilitation as well as improved life quality. The cornerstone of this care plan is the development of a well-defined system which makes it easy to conduct in-depth evaluations and identify patients’ needs. Moreover, the plan focuses on patient-centric outcomes by characterising SMART (Specific Measurable Achievable Relevant Time-Bound) Goals, which ensure realistic and measurable results. The latter is supported by modern research, and recognised assessment tools including the Glasgow Coma Scale (GCS) and Montreal Cognitive Assessment (MoCA), aimed at providing a personalised treatment plan. Therefore, through such evidence-based methodologies, the nursing care plan for ABI patients is a critical tool in guiding an individual patient’s journey towards recovery.

Assessment Baseline

The sensitivity with which MoCA can detect cognitive dysfunctions following ABI makes it an irreplaceable part of the process, giving a synoptic representation of one’s cognitions and helping define the areas that require precise therapeutical intervention according to Hilgeman et al. (2019). On the other hand, in assessing baseline level of brain injury; evaluation begins at seconds elapsed since any GCS is also supportive. According to Barakat and Greene-Chandos (2019), based on verbal, motor and eye-opening stimuli, the GCS allows immediate clinical decisions and extended monitoring of neurological status. The tools used in conjunction offer an all-rounded resource for assessing ABI patients, enabling such practitioners to make generalisations from detailed knowledge of the exact patient condition. These analyses included in the rehabilitation plan base can be considered for a proper adaption to the patient’s specific needs.

Need/Diagnosis

Tools such as the Glasgow Coma Scale (GCS) and Montreal Cognitive Assessment(MoCA), among others, can be used to carry out complete exams that enable nurses to determine what two primary requirements and diagnoses an ABI patient has. First, the concept of cognitive impairment involving memory processes, brain functions, and attention is characterised by the inability to perform daily activities, which requires an individual approach that provides a unique rehabilitation program (Pavlovic et al., 2019). Thus, MoCA supports the above diagnosis, comprehensively analysing cognitive domains. Secondly, emotional dysregulation presents itself as either sadness or anxiety, which makes one more likely to self-harm and have suicidal thoughts (Hitchens, 2021). Cognitive behavioural therapy (CBT) and other types of psychological support may be used as the presence was diagnosed to help control emotional disturbance, thereby contributing to improving his efficiencies. Such a patient-centred care plan meets these needs to ensure faster recovery and better independence among ABI patients with improved quality of life.

SMART Goals

• Making SMART goals is valuable to ensure that the focal point of implemented care for an acquired brain injury occurs. The first aim is to restore cognitive functioning by 20% on the MoCA in three months. This objective is specialised to the cognitive performance functions such as memory and executive skills. It can be obtained with the help of MoCA scores, reached through individualised cognitive activities associated with the patient’s need for cognitive recovery and has a three-month limit.
• The second objective, which is aimed at the enhancement of mental stability, HADS will be utilised to reduce depressive episodes by about 30% over six months. The only objective here is enhancing mental health, which applies score measurement in the HADS. The goal of this kind of treatment is particular therapy and psychological support, as well as there are six months prescribed for it.

Rationale/Evidence-based

Cognitive Rehabilitation Therapy (CRT) has several studies supporting it as an effective intervention in recovering and restoring cognitive functions such as memory, attention and executive processes after ABI. Despite the above, systematic reviews and meta-analyses, including those from Carmichael et al. (2019), have demonstrated that some