Journal of Trauma Nursing最新文献_第10页

Trauma Registry Professionals' Perspectives on the Secondary Traumatic Stress Component of Compassion Fatigue: A Qualitative Study. 创伤登记处专业人员对 "同情疲劳 "中 "二次创伤压力 "部分的看法：定性研究。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2024-03-01 DOI: 10.1097/JTN.0000000000000783

引用次数: 0

Trauma Patient-Centered Discharge Plan Form: A Pilot Study. 以创伤患者为中心的出院计划表：试点研究。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-03-01 DOI: 10.1097/JTN.0000000000000770

Lisa G Stricker, Alice Running, Amanda H Lucas, Barry A McKenzie

{"title":"Trauma Patient-Centered Discharge Plan Form: A Pilot Study.","authors":"Lisa G Stricker, Alice Running, Amanda H Lucas, Barry A McKenzie","doi":"10.1097/JTN.0000000000000770","DOIUrl":"10.1097/JTN.0000000000000770","url":null,"abstract":"Background: Comprehensive and multidisciplinary discharge planning can improve trauma patient throughput, decrease length of hospitalization, increase family and patient support, and expedite hospital discharge.Objective: This study aimed to assess the feasibility and acceptability of implementing a patient-centered discharge plan form for adult trauma patients.Methods: A single-center pilot study was conducted with adult trauma patients on a neurosurgical medical-surgical floor at a Level II trauma center in the Western United States from January to February 2023. The study had three phases: observation, pilot intervention, and follow-up. The key pilot intervention was the development of a standardized patient-centered discharge plan form, pilot tested by a trauma advanced practice provider and an inpatient discharge nurse. The primary outcome was the frequency of discharge orders being written before noon on the day of discharge. Qualitative and quantitative outcomes are reported.Results: The discharge form was used for eight patients during the pilot intervention phase; an advanced practice provider and an inpatient discharge nurse each completed the forms for four patients. Five of eight observed patients had discharge orders before noon; the incidence of orders before noon was slightly higher when the form was completed by the discharge nurse (three of four patients) than by the advanced practice provider (two of four patients).Conclusions: The pilot study found that the patient-centered discharge plan form was feasible and acceptable to help improve the discharge process for trauma patients. Additional work to further refine the form's content and administration is warranted.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 2","pages":"104-108"},"PeriodicalIF":1.0,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133232","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}

引用次数: 0

Misplaced Evidence, Missed Opportunities: Protocols for Handling Ballistic Evidence in Pediatric Patients. 放错证据，错失良机：处理儿科患者弹道证据的规程。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2024-01-01 DOI: 10.1097/JTN.0000000000000761

Derek Marlor, Miriam Crandall, Meredith Elman, Shai Stewart, Nelimar Cruz-Centeno, Dae Kim, Maria Ginger-Wiley, David Juang

{"title":"Misplaced Evidence, Missed Opportunities: Protocols for Handling Ballistic Evidence in Pediatric Patients.","authors":"Derek Marlor, Miriam Crandall, Meredith Elman, Shai Stewart, Nelimar Cruz-Centeno, Dae Kim, Maria Ginger-Wiley, David Juang","doi":"10.1097/JTN.0000000000000761","DOIUrl":"10.1097/JTN.0000000000000761","url":null,"abstract":"Background: Gun-related injury is now the number one cause of death in pediatric trauma patients. Many hospitals lack dedicated forensic nurses or updated protocols for handling ballistic evidence. Evidence not collected, handled improperly, or misplaced may deny a victim the basic human right to justice.Objective: This article aims to describe an initiative to highlight the importance of proper management of ballistic evidence and to educate medical providers on best practices for the documentation, handling, removal, and transfer of ballistic evidence.Methods: After discovering 24 \"orphaned\" bullets and bullet fragments in our hospital that had not been turned over to law enforcement, we sought to turn in evidence to the proper authorities and implement protocols to prevent this error in the future. New protocols were written by forensic staff, and education on new protocols was provided via in-person training, grand rounds, emails, and other collaborative initiatives.Results: Evidence was matched to police reports using the patient name and date of birth on evidence labels. The median (interquartile range [IQR]) time of lost ballistic evidence was 1,397 (903, 1604) days, with the oldest bullet removed in 2015. All bullets were successfully returned to law enforcement with a median (IQR) time from bullet discovery to collection of 78 (78, 174) days.Conclusions: Ballistic evidence handling protocols are essential for all hospitals. Dedicated, trained forensic staff should be employed to ensure proper evidence handling.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 1","pages":"40-48"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405175","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}

引用次数: 0

A New Year's Resolution. 新年愿望

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-01-01 DOI: 10.1097/JTN.0000000000000764

Linda K Reinhart

引用次数: 0

Alcohol Misuse Screening Performance Improvement Initiative. 酒精滥用筛查绩效改进倡议。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2024-01-01 DOI: 10.1097/JTN.0000000000000766

Todd Hightower, Sheri Stucke, Katherine Specht, Jennifer Bertolani, Cheryl Malone, Krishna Dhanyamraju, Nancy Rivera, Rodrigo Rodriguez

{"title":"Alcohol Misuse Screening Performance Improvement Initiative.","authors":"Todd Hightower, Sheri Stucke, Katherine Specht, Jennifer Bertolani, Cheryl Malone, Krishna Dhanyamraju, Nancy Rivera, Rodrigo Rodriguez","doi":"10.1097/JTN.0000000000000766","DOIUrl":"10.1097/JTN.0000000000000766","url":null,"abstract":"Background: A trauma registry review of our trauma center's alcohol misuse screening compliance noted inconsistent screening and data collection methods, putting our American College of Surgeons trauma center reverification at risk for a deficiency.Objective: The objective of this study was to evaluate an alcohol misuse screening improvement initiative on screening compliance in trauma patients.Methods: This before and after analysis of a quality improvement initiative to improve alcohol misuse screening was conducted from 2019 to 2021 at a Southwestern U.S. Level II trauma center on admitted trauma patients aged 13 years and older. The multicomponent initiative included a change in the screening instrument and timing of application, implementing electronic medical record documentation screens, and educating staff. The primary outcome measure was screening adherence.Results: A total of n = 4,734 patients were included in the study period. Alcohol misuse screening improved from 2.9% to 87.4% and remained sustained for over a year after the initiative's implementation.Conclusion: The performance improvement initiative improved the alcohol misuse screening process, resulting in consistent screenings exceeding the American College of Surgeons standards of 80% for verified trauma centers.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 1","pages":"30-33"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405172","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}

引用次数: 0

Emergency Department Pediatric Readiness: A Trauma Center Quality Improvement Initiative. 急诊科儿科准备就绪：创伤中心质量改进计划。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2024-01-01 DOI: 10.1097/JTN.0000000000000765

Amy Tucker, Teresa Bailey, Courtney Edwards, Amy Stewart

{"title":"Emergency Department Pediatric Readiness: A Trauma Center Quality Improvement Initiative.","authors":"Amy Tucker, Teresa Bailey, Courtney Edwards, Amy Stewart","doi":"10.1097/JTN.0000000000000765","DOIUrl":"10.1097/JTN.0000000000000765","url":null,"abstract":"Background: Most pediatric patients present to general emergency departments, yet maintaining pediatric equipment, skilled staff, and resources remains a challenge for many hospitals. Pediatric readiness assessment is now a requirement for trauma center verification.Objective: This study aims to assess the impact of a quality improvement initiative to improve emergency department pediatric readiness.Methods: A pre- and poststudy design was used to evaluate a quality improvement initiative to improve the National Pediatric Readiness assessment survey results conducted at a Southwestern United States adult Level I trauma center from September 2022 to April 2023. The multicomponent initiative included implementing a pediatric emergency care coordinator, pediatric-specific policies and procedures, identifying pediatric-specific quality and performance indicators, and educating pediatric-specific staff. Study inclusion criteria were all patients younger than 18 years who presented to the emergency department. The primary outcome measure was the improvement in the weighted Pediatric Readiness Score. Secondary outcomes were throughput, nursing documentation of vital signs, and pain scores.Results: A total of N = 2,356 patients met inclusion, of which n = 1,158 (49.2%) were in the preintervention group and n = 1,198 (50.8%) postintervention group. The weighted Pediatric Readiness Score improved by 45.4%. Transfers to a pediatric hospital increased from 4.1% to 8.6% (p = .016). Blood pressure documentation improved slightly from 88.3% to 88.6%. Pain score documentation decreased from 83.9% to 63.1% (p = .008). Pain medication and administration improved from 19.8% to 26.7% (p = .046).Conclusion: We found that participation in the quality improvement initiative was associated with emergency department pediatric readiness improvements.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 1","pages":"23-29"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139405174","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}

引用次数: 0

Misplaced Evidence, Missed Opportunities: Protocols for Handling Ballistic Evidence in Pediatric Patients. 放错证据，错失良机：处理儿科患者弹道证据的规程。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-01-01 DOI: 10.1097/JTN.0000000000000772

引用次数: 0

Seeking a Relevant Description of Major Trauma Bleeding: Comparison of Four Major Bleeding Definitions. 寻求重大创伤出血的相关描述：四种大出血定义的比较。

IF 1 4区医学

Journal of Trauma Nursing Pub Date : 2024-01-01 DOI: 10.1097/JTN.0000000000000771

引用次数: 0

Pilot Study of a Software Application to Identify Trauma Registry Inconsistencies. 识别创伤登记不一致的软件应用试点研究。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2024-01-01 DOI: 10.1097/JTN.0000000000000767

Jacob W Roden-Foreman, Laura Garlow, Kathleen M Riordan, Susie Edlund, Valerie Suarez

{"title":"Pilot Study of a Software Application to Identify Trauma Registry Inconsistencies.","authors":"Jacob W Roden-Foreman, Laura Garlow, Kathleen M Riordan, Susie Edlund, Valerie Suarez","doi":"10.1097/JTN.0000000000000767","DOIUrl":"10.1097/JTN.0000000000000767","url":null,"abstract":"Background: Trauma registries are essential to the functioning of modern trauma centers, and high-quality data are necessary to identify patient care issues, develop evidence-based practice, and more. However, institutional experience suggested existing methods to evaluate data quality were insufficient.Objective: This study aims to compare a new software application developed at our trauma center to our existing trauma registry platform on the ability to identify registry inconsistencies (i.e., potential data quality issues).Methods: We conducted a pilot retrospective cohort study of patients from September 2019 to August 2020 who underwent chart review during a Level I verification visit and had been audited several times for accuracy. Registry records were processed by both validation systems, and registry inconsistencies were recorded.Results: In registry data for 63 patients, the new software found 225 registry inconsistencies, and the registry systems found 153 inconsistencies. The most frequent inconsistencies identified by the new software were missing or unknown procedure start times, with 18/63 (28.6%) patients affected and prehospital supplemental oxygen being blank, with 29/53 (54.7%) patients with prehospital care affected. None of the 10 most common inconsistencies detected with the registry systems were true issues.Conclusions: This study found the new software application identified 47% more inconsistencies than the standard registry systems, and none of the most frequent inconsistencies detected with the registry systems were true issues pertinent to institutional practice. Centers should consider additional methods to identify registry inconsistencies as existing processes appear insufficient.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 1","pages":"15-22"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139400849","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}

引用次数: 0

Seeking a Relevant Description of Major Trauma Bleeding: Comparison of Four Major Bleeding Definitions. 寻求重大创伤出血的相关描述：四种大出血定义的比较。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2024-01-01 DOI: 10.1097/JTN.0000000000000762

Darcy L Day, Karen Ng, Richard Severino, Josh Ng-Kamstra

{"title":"Seeking a Relevant Description of Major Trauma Bleeding: Comparison of Four Major Bleeding Definitions.","authors":"Darcy L Day, Karen Ng, Richard Severino, Josh Ng-Kamstra","doi":"10.1097/JTN.0000000000000762","DOIUrl":"10.1097/JTN.0000000000000762","url":null,"abstract":"Background: The traditional definition of massive transfusion is 10 red blood cell units transfused within 24 hr. This definition has been faulted for excluding patients who die early from exsanguination. Alternative major bleeding definitions in the trauma literature include time-based (e.g., Resuscitation Intensity) and event based (e.g., Sharpe) transfusion thresholds.Objective: The study objective was to compare four definitions of major bleeding, including a modification to the Sharpe definition, on clinically relevant processes and outcomes.Methods: This is a retrospective cohort study of adult trauma patients admitted from the field to a Level I trauma center from 2014 to 2019. Data sources were the trauma registry, blood bank, and electronic medical records. Transfusion thresholds were defined as follows: Resuscitation Intensity-4 units of any combination of crystalloids, colloids, or blood products within the first 30 min of arrival; Sharpe-10 red blood cell units from trauma bay presentation to inpatient admission (a proxy for the interval of hemorrhage control); Modified Sharpe-10 units of any combination of blood products during the same interval. The study analysis consisted of descriptive statistics.Results: The cohort contained 187 subjects. Of 39 deaths, 28 (72%) occurred within 6 hr following arrival. Modified Sharpe captured 27 (96%) of these 28 subjects, whereas Resuscitation Intensity captured 20 (71%). Sharpe and the traditional definition each captured 22 subjects (79%). Modified Sharpe captured 17%-25% of deaths missed by the other definitions.Conclusion: Modified Sharpe may optimally indicate major bleeding during trauma resuscitation.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 1","pages":"7-14"},"PeriodicalIF":0.7,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139400850","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}

引用次数: 0