Journal of Trauma Nursing最新文献

{"title":"On Their Shoulders: Clara Barton.","authors":"Michael A Glenn","doi":"10.1097/JTN.0000000000000860","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000860","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Delirium in Critically Ill Geriatric Surgical Patients: A Systematic Review of Screening, Risk Factors, Diagnosis, and Management.","authors":"Zackary Yates, Philip Lee, Nikita Nunes Espat, Ruth Zagales, Nickolas Hernandez, Quratulain Amin, Andrew Ford, Caitlin Tweedie, Adel Elkbuli","doi":"10.1097/JTN.0000000000000859","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000859","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aims to evaluate optimal early screening strategies, significant risk factors, and effective diagnostic and management approaches for delirium in critically ill geriatric surgical patients.</p><p><strong>Data sources: </strong>A comprehensive search was conducted across five databases: PubMed, Google Scholar, ProQuest, Embase, and Cochrane.</p><p><strong>Study selection: </strong>Studies were included based on their relevance to early screening, risk factors, diagnostic accuracy, and management strategies for delirium in critically ill geriatric surgical patients. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.</p><p><strong>Data extraction: </strong>A total of 31 studies met the inclusion criteria. Outcomes of interest included effective early screening/prevention strategies, significant risk factors, sensitive diagnosis tools, and effective management strategies.</p><p><strong>Data synthesis: </strong>Early screening strategies, including advanced neural networks and E-PROD-NS, demonstrated high sensitivity and specificity (area under the receiver operating characteristic curve >0.76). Key risk factors included advanced age, renal dysfunction, cognitive impairment, prolonged intensive care unit length of stay (ICU-LOS), and mechanical ventilation time. Diagnostic tools such as the 4A's test and serum biomarkers exhibited superior accuracy compared to the ICU Confusion Assessment Method and Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) criteria. Management strategies effectively reduced delirium duration, including acetaminophen, environmental modifications, and family involvement.</p><p><strong>Conclusions: </strong>E-PROD-NS and the 4A's test were associated with early delirium detection and intervention. Risk factors for delirium included advanced age, renal dysfunction, and existing cognitive dysfunction. Mitigating mechanical ventilation and ICU-LOS duration, treatment with acetaminophen, and environmental modifications reduced delirium duration in critically ill geriatric surgical patients.</p><p><strong>Registration: </strong>PROSPERO #CRD42025632279.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Volume and Fluid Resuscitation Strategies for Critically Ill Geriatric Trauma Patients: A Systematic Review.","authors":"Zackary Yates, Phillip Lee, Ruth Zagales, Caitlin Tweedie, Kirk Dourvetakis, Ariel Hus, Quratulain Amin, Logan Rogers, Adel Elkbuli","doi":"10.1097/JTN.0000000000000861","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000861","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to evaluate fluid resuscitation strategies including volume assessment measures, conservative versus aggressive fluid resuscitation, and multifocal fluid resuscitation protocols in critically ill geriatric trauma patients.</p><p><strong>Data sources: </strong>A comprehensive search was conducted across five databases including PubMed, Google Scholar, ProQuest, Embase, and Cochrane.</p><p><strong>Study selection: </strong>Studies were included based on their relevance to volume assessment measures, conservative versus aggressive fluid resuscitation, and multifocal fluid resuscitation protocols in critically ill geriatric trauma patients.</p><p><strong>Data extraction: </strong>A total of 14 studies met the inclusion criteria. Outcomes of interest included mortality, intensive care unit length of stay, ventilator days, and in-hospital complications.</p><p><strong>Data synthesis: </strong>The initial query identified 1,257 studies, and after inclusion/exclusion criteria, a total of 14 studies were evaluated. On average, serum lactate levels above 2.5 mmol/L were found to be significantly associated with mortality. Conservative approaches to fluid resuscitation that were on average <1,500 cc were also found to decrease mortality and incur no increase in in-hospital complications. Additionally, goal-oriented geriatric fluid resuscitation protocols utilizing multiple measures for hemodynamic stability were found to reduce mortality in patients following the implementation of the protocol.</p><p><strong>Conclusion: </strong>Serum lactate level kept on average below 2.5 mmol/L has shown to be an effective volume assessment measure and associated with decreased mortality. Additionally, conservative fluid resuscitation with volume maintained on average <15,000 cc was also associated with decreased mortality compared to aggressive fluid resuscitation measures. Lastly, goal-oriented geriatric fluid resuscitation protocols that aimed to maintain multiple volume assessment measures were associated with decreased mortality and complication rates. Implementation of these protocols has the potential to significantly improve outcomes in this vulnerable population.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":" ","pages":""},"PeriodicalIF":0.7,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144163628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical Restraint Reduction in the Trauma Intensive Care Unit: A Quality Improvement Initiative.","authors":"Briana R Miller, Lauren M Leppert, Elisabeth D Tucker, Bethany Webster, Kimberly A Maye, Nancy M Steffan","doi":"10.1097/JTN.0000000000000854","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000854","url":null,"abstract":"<p><strong>Background: </strong>Physical restraints are linked to adverse patient outcomes, yet there is limited research examining effective strategies to reduce restraint use in trauma intensive care units.</p><p><strong>Objective: </strong>This study aims to assess the impact of a multicomponent physical restraint reduction initiative on restraint use in trauma intensive care unit patients.</p><p><strong>Methods: </strong>This quality improvement project used a survey and a pre- and post-intervention methodology. The study compared restraint data from matching four-month periods in 2023 and 2024 in an 885-bed level I trauma center intensive care unit in the Southeastern United States. The study inclusion criteria were adult trauma patients (age > 18) and intensive care unit registered nurses. The exclusion criteria included pediatric patients and those requiring physical restraints for violent behavior. The project was conducted in five phases: (1) baseline staff survey of restraint use perceptions, (2) targeted education on restraint reduction strategies, (3) comparison of pre- and post-intervention restraint hours, (4) follow-up staff perception survey, and (5) analysis of restraint episodes and duration to measure impact.</p><p><strong>Results: </strong>In total, 40 clinical staff completed the surveys, and 422 patient physical restraint episodes totaling 6,606 physical restraint hours were reviewed. Compared to the same four-month period in 2023, restraint hours decreased by 13.9%, and restraint episodes decreased by 16.6% in 2024.</p><p><strong>Conclusion: </strong>This study of a multicomponent physical restraint reduction initiative reduced physical restraint use by identifying common barriers to proper application and educating staff on alternative measures. The intervention resulted in fewer restraint episodes and decreased total restraint hours.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"150-156"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Early Vasopressin Administration in Refractory Hemorrhagic Shock.","authors":"Michaelia D Cucci, Matthew Palmer, Carli Bower, Farjad Siddiqui, Daniel Vazquez, Jessica Krizo","doi":"10.1097/JTN.0000000000000853","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000853","url":null,"abstract":"<p><strong>Background: </strong>Hemorrhagic shock management includes controlling bleeding and blood product replacement; however, vasopressor therapy may be required to maintain adequate perfusion. Studies have shown the potential benefits of early vasopressin use, but there is limited evidence of its clinical utility.</p><p><strong>Objective: </strong>This study aims to evaluate the efficacy of early vasopressin administration in trauma patients with refractory hemorrhagic shock.</p><p><strong>Methods: </strong>This retrospective cohort study included adult trauma patients who received more than one blood product. The primary outcome was 28-day alive and vasopressor-free days. Secondary outcomes included blood product administration, 28-day alive and ventilator-free days, and intensive care unit and hospital length of stay (LOS). Safety outcomes included the incidence of renal replacement therapy, venous thromboembolism, and fluid overload.</p><p><strong>Results: </strong>Overall, 37 patients were included, with seven (19%) in the vasopressin group and 30 (81%) in the norepinephrine group. The study population included primarily male patients (n = 29, 78%) with blunt injuries (n = 24, 65%) and a median Injury Severity Score of 26 [IQR 17.0-34.0]. There was no difference in the primary outcome between the vasopressin and norepinephrine groups (median 25.5 [IQR 22.7-26.7] vs 26.2 days [IQR 22.7-26.7], p = .985). All secondary and safety outcomes were similar, except that the vasopressin group was associated with a longer hospital LOS (20 [IQR 18-27] vs. 13 days [IQR 8-20], p = .036).</p><p><strong>Conclusion: </strong>Early vasopressin administration was not associated with a significant difference in 28-day alive and vasopressor-free days. However, this study was limited by its small sample size, and further studies are needed.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"141-149"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144042891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Replies Letter to the Editor.","authors":"Mauro Mota, Madalena Cunha, Margarida Reis Santos","doi":"10.1097/JTN.0000000000000849","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000849","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"118-119"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143991586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Mental Health Referral and Follow-Up for Pediatric Trauma Patients.","authors":"","doi":"10.1097/JTN.0000000000000857","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000857","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"E6"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Battle Injuries in Military Settings: Impacts on Health-Related Quality of Life and Service Capability.","authors":"Yedidiah Samson, Jacob Rotschield, Julie Benbenishty","doi":"10.1097/JTN.0000000000000851","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000851","url":null,"abstract":"<p><strong>Background: </strong>Non-battle injuries significantly impact military readiness and individuals' quality of life, yet research on their effects on soldiers remains inadequate.</p><p><strong>Objective: </strong>This study examines relationships between non-battle injury characteristics, perceptions, health-related quality of life (HRQOL), and service capability in the Israel Defense Forces.</p><p><strong>Methods: </strong>This retrospective cohort study assesses relationships between injury characteristics, perception, HRQOL, and service capability among active duty soldiers at an Israel Defense Forces clinic over 12 months (February 2023-February 2024).</p><p><strong>Results: </strong>Among 85 participants, predominant injuries occurred from falls/jumps (30.6%) and sports/training (23.5%), mainly affecting lower limbs (44.7%), upper limbs (24.7%), and back/spine (11.8%). Primary diagnoses included blunt contusions (20%) and fractures (18.8%). Lower-limb injuries were associated with mobility difficulty, upper-limb injuries with self-care difficulty, and blunt contusions with improved HRQOL. Injury perception was negatively correlated with HRQOL, while penetrating injuries, particularly open cuts/wounds, were linked to reduced military service capability.</p><p><strong>Conclusion: </strong>This first comprehensive analysis of non-battle injuries in the Israel Defense Forces reveals key associations between injury characteristics, perceptions, HRQOL, and service capability. Findings highlight the need for early detection and targeted intervention to preserve soldiers' well-being and performance.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"126-133"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: Mota et al.","authors":"Nicole S Cook","doi":"10.1097/JTN.0000000000000848","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000848","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"117"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Early Vasopressin Administration in Refractory Hemorrhagic Shock.","authors":"","doi":"10.1097/JTN.0000000000000865","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000865","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"E5"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144057422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}