Journal of Trauma Nursing最新文献

{"title":"Be Someone's Betsy!","authors":"Linda Kate Reinhart","doi":"10.1097/JTN.0000000000000728","DOIUrl":"10.1097/JTN.0000000000000728","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 4","pages":"191-192"},"PeriodicalIF":1.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10020254","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":"Postintensive Care Syndrome: Feasibly Bridging Care at a Tertiary Trauma Center.","authors":"Timothy J Stevens,&nbsp;Donna B Lee","doi":"10.1097/JTN.0000000000000735","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000735","url":null,"abstract":"<p><strong>Background: </strong>Advancements in critical care management have improved mortality rates of trauma patients; however, research has identified physical and psychological impairments that remain with patients for an extended time. Cognitive impairments, anxiety, stress, depression, and weakness in the postintensive care phase are an impetus for trauma centers to examine their ability to improve patient outcomes.</p><p><strong>Objective: </strong>This article describes one center's efforts to intervene to address postintensive care syndrome in trauma patients.</p><p><strong>Methods: </strong>This article describes implementing aspects of the Society of Critical Care Medicine's liberation bundle to address postintensive care syndrome in trauma patients.</p><p><strong>Results: </strong>The implementation of the liberation bundle initiatives was successful and well received by trauma staff, patients, and families. It requires strong multidisciplinary commitment and adequate staffing. Continued focus and retraining are requirements in the face of staff turnover and shortages, which are real-world barriers.</p><p><strong>Conclusions: </strong>Implementation of the liberation bundle was feasible. Although the initiatives were positively received by trauma patients and their families, we identified a gap in the availability of long-term outpatient services for trauma patients after discharge from the hospital.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 4","pages":"242-248"},"PeriodicalIF":1.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029423","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":"Bringing Trauma Education to the Frontier: Overcoming Distance Barriers Utilizing a Virtual Platform.","authors":"Elizabeth L McCotter,&nbsp;Alexa L Peterson,&nbsp;Tessa C Savell,&nbsp;Lanny C Orr,&nbsp;Jamie M Besel,&nbsp;Simon J Thompson","doi":"10.1097/JTN.0000000000000734","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000734","url":null,"abstract":"<p><strong>Background: </strong>The American College of Surgeons and state regulations mandate that trauma facilities offer trauma-specific continuing education throughout the region they serve. These requirements come with unique challenges when serving a rural and sparsely populated state. A novel approach to providing education was necessitated by the coronavirus disease 2019 pandemic, travel distance, and limited local specialists.</p><p><strong>Objective: </strong>The purpose of this article is to describe the development of a virtual educational program used to improve access to quality trauma education and decrease barriers to obtaining continuing education hours inherent in the region.</p><p><strong>Methods: </strong>This article describes the development and implementation of the Virtual Trauma Education program, which provided one free continuing education hour per month from October 2020 to October 2021. The program reached more than 2,000 viewers and established a method to provide continuous monthly educational offerings throughout the region.</p><p><strong>Results: </strong>After the Virtual Trauma Education program implementation, monthly educational attendance increased from an average of 55 to 190. Viewership data indicate that trauma education across our region is far more robust, available, and accessible using a virtual platform. With more than 2,000 views from October 2020 to October 2021, Virtual Trauma Education offerings have spread far beyond regional borders, reaching 25 states and 169 communities.</p><p><strong>Conclusion: </strong>Virtual Trauma Education delivers easily accessible trauma education and is a program that has proven its sustainability.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 4","pages":"235-241"},"PeriodicalIF":1.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10029422","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":"Identification of Seniors at Risk Score to Determine Geriatric Evaluations on Trauma Patients With Hip Fractures.","authors":"","doi":"10.1097/JTN.0000000000000726","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000726","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 3","pages":"E5"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9421992","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":"Massive Transfusion Protocol Adherence: Relationship to Trauma Patient Outcomes.","authors":"Alexander M Margolin,&nbsp;Susan G Silva,&nbsp;Kasey E T McLaughlin,&nbsp;Katherine C Pereira,&nbsp;Adam M Flowe,&nbsp;Jessica L Poisson","doi":"10.1097/JTN.0000000000000722","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000722","url":null,"abstract":"<p><strong>Background: </strong>Ongoing evaluation of massive transfusion protocol adherence is critical to ensure better trauma patient outcomes.</p><p><strong>Objective: </strong>This quality improvement initiative aimed to determine provider adherence to a recently revised massive transfusion protocol and its relationship to clinical outcomes among trauma patients requiring massive transfusion.</p><p><strong>Methods: </strong>A retrospective, descriptive, correlational design was used to determine the association between provider adherence to a recently revised massive transfusion protocol and clinical outcomes in trauma patients with hemorrhage treated at a Level I trauma center from November 2018 to October 2020. Patient characteristics, provider massive transfusion protocol adherence, and patient outcomes were assessed. Patient characteristics and massive transfusion protocol adherence associations with 24-hr survival and survival to discharge were determined using bivariate statistical methods.</p><p><strong>Results: </strong>A total of 95 trauma patients with massive transfusion protocol activation were evaluated. Of the 95, 71 (75%) survived the initial 24 hr following massive transfusion protocol activation and 65 (68%) survived to discharge. Based on protocol applicable items, the median massive transfusion protocol overall adherence rate per patient was 75% (IQR = 57.1-85.7) for the 65 survivors and 25% (IQR = 12.5-50.0) for the 21 nonsurvivors to discharge whose death occurred at least 1 hr after massive transfusion protocol activation (p < .001).</p><p><strong>Conclusion: </strong>Findings indicate the importance of ongoing evaluations of adherence to massive transfusion protocols in hospital trauma settings to target areas for improvement.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 3","pages":"164-170"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9424537","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":"Under the Lens: Team Perception of Trauma Video Review.","authors":"Marinda G Scrushy,&nbsp;Madhuri Nagaraj,&nbsp;Kristen Burke,&nbsp;Kali Kuhlenschmidt,&nbsp;Shannon Jeter,&nbsp;Della Johnson,&nbsp;Kristie Brown,&nbsp;Courtney Edwards,&nbsp;Alexander Marinica,&nbsp;Michael A Vella,&nbsp;Daniel N Holena,&nbsp;Caroline Park,&nbsp;Ryan P Dumas","doi":"10.1097/JTN.0000000000000723","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000723","url":null,"abstract":"<p><strong>Background: </strong>Video-based assessment and review are becoming increasingly common, and trauma video review (TVR) has been shown to be an effective educational, quality improvement, and research tool. Yet, trauma team perception of TVR remains incompletely understood.</p><p><strong>Objective: </strong>We evaluated positive and negative perceptions of TVR across multiple team member groups. We hypothesized that members of the trauma team would find TVR educational and that anxiety would be low across all groups.</p><p><strong>Methods: </strong>An anonymous electronic survey was provided to nurses, trainees, and faculty during weekly multidisciplinary trauma performance improvement conference following each TVR activity. Surveys assessed perception of performance improvement and anxiety or apprehension (Likert scale: 1 \"strongly disagree\" to 5 \"strongly agree\"). We report individual and normalized cumulative scores (average of responses for each positive [n = 6] and negative [n = 4] question stem).</p><p><strong>Results: </strong>We analyzed 146 surveys over 8 months, with 100% completion rate. Respondents were trainees (58%), faculty (29%), and nurses (13%). Of the trainees, 73% were postgraduate year (PGY) 1-3 and 27% were PGY 4-9. Of all respondents, 84% had participated previously in a TVR conference. Respondents reported an improved perception of resuscitation education quality and personal leadership skills development. Participants found TVR to be more educational than punitive overall. Analysis of team member types showed lower scores for faculty for all positive stemmed questions. Trainees were more likely to agree with negative stemmed questions if they were a lower PGY, and nurses were least likely to agree with negative stemmed questions.</p><p><strong>Conclusions: </strong>TVR improves trauma resuscitation education in a conference setting, with trainees and nurses reporting the greatest benefit. Nurses were noted to be the least apprehensive about TVR.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 3","pages":"171-176"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9424538","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":"Standardizing Child Passenger Safety Screening in the Emergency Department: A Quality Improvement Study.","authors":"Heidi L Almodovar,&nbsp;Chad M Thorson,&nbsp;Christina R Cardy","doi":"10.1097/JTN.0000000000000724","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000724","url":null,"abstract":"<p><strong>Background: </strong>Motor vehicle collisions remain a leading cause of death and injury in children in the United States. Our Level I trauma center found that 53% of children ages 1-19 years are improperly restrained or unrestrained. Our center employs a Pediatric Injury Prevention Coalition with nationally certified child passenger safety technicians who are active in the community yet remain underutilized in the clinical setting.</p><p><strong>Objective: </strong>The purpose of the quality improvement project was to standardize child passenger safety screening in the emergency department to increase referrals to a Pediatric Injury Prevention Coalition.</p><p><strong>Methods: </strong>This quality improvement project utilized a pre-/postdesign of data collected before and after implementing the child passenger safety bundle. Using the Plan-Do-Study-Act model, organizational change processes were identified, and quality improvement interventions implemented from March to May 2022.</p><p><strong>Results: </strong>The total number of families referred was 199, representing 230 children, which was 3.8% of the eligible population. A significant relationship was found between child passenger safety screening and referral to the Pediatric Injury Prevention Coalition in 2019 and 2021, χ2 (1, n = 230) = 239.98, p < .001, and χ2 (1, n = 230) = 240.78, p < .001, respectively. Forty-one percent of the referred families established contact with the Pediatric Injury Prevention Coalition.</p><p><strong>Conclusion: </strong>Standardizing child passenger safety screening in the emergency department increased referrals to a Pediatric Injury Prevention Coalition and resulted in improved child safety seat distribution and child passenger safety education.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 3","pages":"177-185"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10019705","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":"Virtual Rural Trauma Team Development Course: Trying to Zoom in on a Solution.","authors":"Jennifer Koontz,&nbsp;Thomas Causer,&nbsp;Jami Zipf,&nbsp;Jill Dillman-Stull,&nbsp;Russell Dumire","doi":"10.1097/JTN.0000000000000725","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000725","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic prevented centers from providing in-person interactive training programs such as the Rural Trauma Team Development Course. Adapting the course to a virtual platform is an option, yet little is known regarding the feasibility of using this format.</p><p><strong>Objective: </strong>This study aimed to evaluate the feasibility of providing a virtual rural trauma development course during COVID-19.</p><p><strong>Methods: </strong>This is a descriptive study of emergency medical technicians, nurses, emergency department technicians, and physicians from four rural community health care facilities and local emergency medical services who participated in a virtual Rural Trauma Team Development Course held in November 2021 which was transformed into a virtual platform using live remote interactive lectures, recorded case-based scenarios, and interactive virtual-based questions. The course was evaluated by the changes instituted at the centers based on program recommendations and a participant survey.</p><p><strong>Results: </strong>A total of 41 participants were studied, of whom 31 (75%) returned the emailed postprogram survey. The majority (>75%) of respondents rated the activity as very good, with course objectives met. All four facilities instituted changes following the program, including enhancing policy and procedures, guidelines, advancing performance improvement triggers, and equipment acquisition. Individual-reported participant satisfaction was very high.</p><p><strong>Conclusion: </strong>The Rural Trauma Team Development Course can be provided virtually and is a feasible option for trauma centers to provide initial trauma management in the rural community in a safe pandemic-restrictive atmosphere.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 3","pages":"186-190"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9424534","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":"Sanguine.","authors":"Emilie S Gardner","doi":"10.1097/JTN.0000000000000717","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000717","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 3","pages":"133-134"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9421986","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":"Role of Serial Phlebotomy in the Management of Blunt Solid Organ Injury in Adults.","authors":"Mohammad A Frotan,&nbsp;Philip Edmundson,&nbsp;Christopher Cooper,&nbsp;Brian Tibbs,&nbsp;Laura Garlow,&nbsp;Kaeli Vandertulip,&nbsp;Amy Miller,&nbsp;Subhash Aryal,&nbsp;Jacob W Roden-Foreman,&nbsp;G Tom Shires","doi":"10.1097/JTN.0000000000000718","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000718","url":null,"abstract":"<p><strong>Background: </strong>The management of blunt spleen and liver trauma has become increasingly nonoperative. There is no consensus on timing or duration of serial hemoglobin and hematocrit monitoring in this patient population.</p><p><strong>Objective: </strong>This study examined the clinical utility of serial hemoglobin and hematocrit monitoring. We hypothesized that most interventions occur early in the hospital course, based on hemodynamic instability or physical examination findings rather than serial monitoring.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study of adult trauma patients with blunt spleen or liver injury from November 2014 through June 2019 at our Level II trauma center. Interventions were classified as no intervention, surgical intervention, angioembolization, or packed red blood cell transfusion. Demographics, length of stay, total blood draws, laboratory values, and clinical triggers preceding intervention were reviewed.</p><p><strong>Results: </strong>A total of 143 patients were studied, of whom 73 (51%) received no intervention, 47 (33%) received an intervention within 4 hr of presentation, and 23 (16%) had interventions beyond 4 hr. Of these 23 patients, 13 received an intervention based on phlebotomy results alone. Most of these patients (n = 12, 92%) received blood transfusion without further intervention. Only one patient underwent operative intervention based on serial hemoglobin results on hospital day 2.</p><p><strong>Conclusion: </strong>The majority of patients with these injury patterns either require no intervention or declare themselves promptly after arrival. Serial phlebotomy after initial triage and intervention may add little value in the management of blunt solid organ injury.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"30 3","pages":"135-141"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9424536","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}