Journal of Trauma NursingPub Date : 2024-05-01Epub Date: 2024-05-09DOI: 10.1097/JTN.0000000000000787
Gordon L Gillespie, Holly A Meyer, Margot Daugherty, Delinda Puthoff, Lisa J Fryman, Patricia Kunz Howard
{"title":"Stress and Coping in Emergency Nurses Following Trauma Patient Care: A Qualitative Grounded Theory Approach.","authors":"Gordon L Gillespie, Holly A Meyer, Margot Daugherty, Delinda Puthoff, Lisa J Fryman, Patricia Kunz Howard","doi":"10.1097/JTN.0000000000000787","DOIUrl":"10.1097/JTN.0000000000000787","url":null,"abstract":"<p><strong>Background: </strong>Experiencing symptoms of traumatic stress may be the cost of caring for trauma patients. Emergency nurses caring for trauma patients are at risk for traumatic stress reactions.</p><p><strong>Objective: </strong>This study explored the stress and coping behaviors experienced by emergency nurses who provide trauma care.</p><p><strong>Methods: </strong>Focus groups were held at three urban trauma centers in the Midwestern United States: a Level I pediatric trauma center, a Level I adult trauma center, and a Level III adult trauma center. Data were collected between December 2009 and March 2010. Data analysis was guided by the principles of grounded theory. Line-by-line coding and constant comparative analysis techniques were used to identify recurring constructs.</p><p><strong>Results: </strong>A total of 48 emergency nurses participated. Recurring constructs emerged in the data analysis and coding, revealing four major themes: care of the trauma patient, professional practice, personal life, and support.</p><p><strong>Conclusions: </strong>Nurse job engagement, burnout, and professional and personal relationships are influenced by trauma patient care. The study's resulting themes of care of the trauma patient, professional practice, personal life, and support resulted in the development of the \"trauma nursing is a continual experience theory\" that can be used as a framework to address these effects. Intentional support and timely interventions based on this new theory can help mitigate the effects of traumatic stress experienced by trauma nurses.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 3","pages":"136-148"},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923753","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}
Journal of Trauma NursingPub Date : 2024-05-01Epub Date: 2024-05-09DOI: 10.1097/JTN.0000000000000793
{"title":"Stress and Coping in Emergency Nurses following Trauma Patient Care: A Qualitative Grounded Theory Approach.","authors":"","doi":"10.1097/JTN.0000000000000793","DOIUrl":"10.1097/JTN.0000000000000793","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 3","pages":"E6"},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923757","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}
Journal of Trauma NursingPub Date : 2024-05-01Epub Date: 2024-05-09DOI: 10.1097/JTN.0000000000000790
Kellie M Liersch, Kellie M Gumm, David J Read
{"title":"Prevalence and Risk Factors of Constipation in Trauma Patients: A Prospective Cohort Study.","authors":"Kellie M Liersch, Kellie M Gumm, David J Read","doi":"10.1097/JTN.0000000000000790","DOIUrl":"10.1097/JTN.0000000000000790","url":null,"abstract":"<p><strong>Background: </strong>Hospitalized patients are well described as having a high prevalence of constipation. While the risks associated with constipation in trauma patients are well known, the prevalence rate is not.</p><p><strong>Objective: </strong>This study aims to measure the prevalence of constipation and associated risk factors in trauma patients.</p><p><strong>Methods: </strong>This study is a single-center analytic cross-sectional study on constipation in hospitalized trauma patients aged 18-65 years, admitted from January 2021 to July 2021 to the trauma service at The Royal Melbourne Hospital, a Level I major trauma and teaching hospital servicing the state of Victoria, Australia. Exclusion criteria include patients with traumatic brain injury, blunt or penetrating abdominal or spinal injuries, pregnancy, and gastrointestinal comorbidities.</p><p><strong>Results: </strong>A total of N = 99 patients were studied, of which n = 78 (78.8%) were male with a median (interquartile range) age of 46 years (33-58). The overall prevalence of constipation was 76%. The univariate analysis demonstrated higher constipation rates in males and patients with multisystem injuries. However, in the multivariate analysis, mode of toileting and mobility were not associated with constipation after adjusting for confounding factors.</p><p><strong>Conclusion: </strong>This study demonstrated a high prevalence of constipation in all trauma patients. There is a strong association between the development of constipation in patients with multisystem injuries when compared to those with single system.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 3","pages":"164-170"},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923740","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}
Journal of Trauma NursingPub Date : 2024-05-01Epub Date: 2024-05-09DOI: 10.1097/JTN.0000000000000791
Lakyn Webb, Kelly Urban, Natalie Capps
{"title":"Hospital Based Violence Intervention Programs Using Peer Support Specialists: A Concise Review.","authors":"Lakyn Webb, Kelly Urban, Natalie Capps","doi":"10.1097/JTN.0000000000000791","DOIUrl":"10.1097/JTN.0000000000000791","url":null,"abstract":"<p><strong>Background: </strong>Interpersonal violence remains a significant public health problem in the United States. The toll of violence has spurred the development of hospital-based violence intervention programs that use peer support specialists or navigators. Yet, their effectiveness remains uncertain. This study aims to concisely review the recent literature on the effectiveness of hospital-based violence intervention programs using the peer support specialist role.</p><p><strong>Methods: </strong>A systematic search of articles from PubMed, OVID, and Google Scholar was performed for this review. Peer reviewed studies addressing hospital-based violence intervention programs using peer support specialists between 2017 and 2022 were selected. Key data points were extracted and analyzed by consensus of the authors.</p><p><strong>Results: </strong>Eight of the 232 studies reviewed met eligibility requirements. Across these studies, the recidivism rate was reduced between 43% and 95% in victims participating in hospital-based violence intervention programs with peer support specialists.</p><p><strong>Conclusion: </strong>The peer support specialist (navigator) role is central to the success of the violence intervention programs. This role guides and coordinates health services for victims of violence, extending after discharge into the community. Programs showed the most success with helping victims reach short-term goals focused on immediate basic needs but are more challenged meeting longer-term goals, such as education or relocation. This review reveals that hospital-based violence intervention programs using peer support specialists (navigators) lead to the achievement of meeting victim goals and reduce recidivism rates.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 3","pages":"171-177"},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923727","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}
Journal of Trauma NursingPub Date : 2024-05-01Epub Date: 2024-05-09DOI: 10.1097/JTN.0000000000000792
{"title":"Impact of Bedside Laparotomy Simulation and Microlearning on Trauma Nurse Role Clarity, Knowledge, and Confidence.","authors":"","doi":"10.1097/JTN.0000000000000792","DOIUrl":"10.1097/JTN.0000000000000792","url":null,"abstract":"","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 3","pages":"E5"},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923703","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":"Nurse-Initiated Protocol to Improve Timely Antibiotic Administration in Pediatric Open Fractures.","authors":"Kylie Scallon, Jessica Lee, Meghan Spencer, Makayla Schissel, Zebulon Timmons, Angela Hanna, Hannah Sneller","doi":"10.1097/JTN.0000000000000789","DOIUrl":"10.1097/JTN.0000000000000789","url":null,"abstract":"<p><strong>Background: </strong>Early administration of antibiotics in the presence of open fractures is critical in reducing infections and later complications. Current guidelines recommend administering antibiotics within 60 min of patient arrival to the emergency department, yet trauma centers often struggle to meet this metric.</p><p><strong>Objectives: </strong>This study aims to evaluate the impact of a nurse-initiated evidence-based treatment protocol on the timeliness of antibiotic administration in pediatric patients with open fractures.</p><p><strong>Methods: </strong>A retrospective pre-post study of patients who met the National Trauma Data Standard registry inclusion criteria for open fractures of long bones, amputations, or lawn mower injuries was performed at a Midwestern United States Level II pediatric trauma center. The time of patient arrival and time of antibiotic administration from preimplementation (2015-2020) to postimplementation (2021-2022) of the protocol were compared. Patients transferred in who received antibiotics at an outside facility were excluded.</p><p><strong>Results: </strong>A total of N = 73 participants met the study inclusion criteria, of which n = 41 were in the preimplementation group and n = 32 were in the postimplementation group. Patients receiving antibiotics within 60 min of arrival increased from n = 24/41 (58.5%) preimplementation to n = 26/32 (84.4%) postimplementation (p< .05).</p><p><strong>Conclusions: </strong>Our study demonstrates that initiating evidence-based treatment orders from triage helped decrease the time from arrival to time of antibiotic administration in patients with open fractures. We sustained improvement for 24 months after the implementation of our intervention.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 3","pages":"158-163"},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923708","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}
Journal of Trauma NursingPub Date : 2024-05-01Epub Date: 2024-05-09DOI: 10.1097/JTN.0000000000000785
Esther H Shim, Satyam K Ghodasara, Justin S Roskam, Amanda G Gaccione, Louis T DiFazio, Gary Lombardo, Zoltan H Nemeth
{"title":"Effects of COVID-19 Status on Hip Fracture Surgical Outcomes: An ACS NSQIP Study.","authors":"Esther H Shim, Satyam K Ghodasara, Justin S Roskam, Amanda G Gaccione, Louis T DiFazio, Gary Lombardo, Zoltan H Nemeth","doi":"10.1097/JTN.0000000000000785","DOIUrl":"10.1097/JTN.0000000000000785","url":null,"abstract":"<p><strong>Background: </strong>Studies have indicated that patients infected with the SARS-CoV-2 virus fare worse clinically after a traumatic injury, especially those who are older and have other comorbidities.</p><p><strong>Objective: </strong>This study aims to understand the effects of Corona Virus Disease 19 (COVID-19) diagnosis on patients undergoing surgery for hip fractures.</p><p><strong>Methods: </strong>This is a retrospective review of the 2021 American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) Targeted Hip Fracture database for patients who underwent surgery. Two cohorts were formed based on patients' preoperative COVID-19 status, as tested within 14 days prior to the operation. Several clinical factors were compared.</p><p><strong>Results: </strong>The COVID-positive cohort consisted of 184 patients, all of whom had a laboratory-confirmed or clinically suspected SARS-CoV-2 infection, while the COVID-negative cohort consisted of 12,211 patients with no infection. A lower proportion of COVID-positive patients had an emergent operation compared to the COVID-negative cohort (58.70% vs. 73.09%, p < .001). Preoperatively, the COVID-positive cohort showed higher rates of coagulopathy/bleeding disorders (22.83% vs. 14.12%), congestive heart failure (16.30% vs. 9.84%), diabetes mellitus (28.26% vs. 19.24%), and dementia (42.39% vs. 28.07%), with p ≤ .005 for all. Postoperatively, a higher proportion of COVID-positive patients died (9.78% vs. 5.40%) or had pneumonia (8.70% vs. 3.65%), hospital readmission within 30 days (10.87% vs. 6.76%), and pressure sores (8.15% vs. 4.55%), with p ≤ .033 for all.</p><p><strong>Conclusion: </strong>The diagnosis of COVID-19 in hip fracture patients was associated with higher rates of postoperative complications, including mortality, when compared to COVID-negative patients, indicating the severity of the viral infection.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 3","pages":"123-128"},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923695","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}
Journal of Trauma NursingPub Date : 2024-05-01Epub Date: 2024-05-09DOI: 10.1097/JTN.0000000000000786
Jonathan A Messing, Kathleen Russell-Babin, Deborah Baker, Rita D'Aoust
{"title":"Impact of Bedside Laparotomy Simulation and Microlearning on Trauma Nurse Role Clarity, Knowledge, and Confidence.","authors":"Jonathan A Messing, Kathleen Russell-Babin, Deborah Baker, Rita D'Aoust","doi":"10.1097/JTN.0000000000000786","DOIUrl":"10.1097/JTN.0000000000000786","url":null,"abstract":"<p><strong>Background: </strong>The care of patients undergoing low-volume, high-risk emergency procedures such as bedside laparotomy (BSL) remains a challenge for surgical trauma critical care nurses.</p><p><strong>Objectives: </strong>This study evaluates simulation and microlearning on trauma nurse role ambiguity, knowledge, and confidence in caring for patients during emergency BSL.</p><p><strong>Methods: </strong>The study is a single-center, prospective pretest-posttest design conducted from September to November 2022 at a Level I trauma center in the Mid-Atlantic United States using simulation and microlearning to evaluate role clarity, knowledge, and confidence among surgical trauma intensive care unit (STICU) nurses. Participants, nurses from a voluntary convenience sample within a STICU, attended a simulation and received three weekly microlearning modules. Instruments measuring role ambiguity, knowledge, and confidence were administered before the simulation, after, and again at 30 days.</p><p><strong>Results: </strong>From the pretest to the initial posttest, the median (interquartile range [IQR]) Role Ambiguity scores increased by 1.0 (1.13) (p < .001), and at the 30-day posttest, improved by 1.33 (1.5) (p < .001). The median (IQR) knowledge scores at initial posttest improved by 4.0 (2.0) (p < .001) and at the 30-day posttest improved by 3.0 (1.75) (p< .001). The median (IQR) confidence scores at initial posttest increased by 0.08 (0.33) (p = .009) and at the 30-day posttest improved by 0.33 (0.54) (p = .01).</p><p><strong>Conclusions: </strong>We found that simulation and microlearning improved trauma nurse role clarity, knowledge, and confidence in caring for patients undergoing emergency BSL.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 3","pages":"129-135"},"PeriodicalIF":1.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923732","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}
Ashley N Clausen, Katherine R Meyers, Heather M Stamey, Sarah K Spilman
{"title":"Traumatic Brain Injury, Psychological Trauma Exposure, and Anxious and Depressive Symptoms in a Clinical Population.","authors":"Ashley N Clausen, Katherine R Meyers, Heather M Stamey, Sarah K Spilman","doi":"10.1097/JTN.0000000000000777","DOIUrl":"10.1097/JTN.0000000000000777","url":null,"abstract":"<p><strong>Background: </strong>Approximately 90% of adults endorse psychological trauma exposure. However, barriers to assessment of psychological trauma and sequelae include limited access to care, lack of standardized assessments in nonpsychiatric settings, and comorbid diagnoses, such as traumatic brain injury (TBI), that may mimic psychiatric syndromes.</p><p><strong>Objectives: </strong>This study aims to assess the prevalence rates of psychological trauma exposure and TBI to understand the relationship of these experiences with current psychiatric symptoms.</p><p><strong>Methods: </strong>This is a cross-sectional study of a convenience sample of adult patients (age 18 years and older) referred for outpatient evaluation at a neuropsychology clinic in the Western United States between September 2021 and October 2022. Patients completed a clinical interview to assess their history of psychological trauma, TBI, and current psychiatric symptoms.</p><p><strong>Results: </strong>A total of 118 patients met inclusion criteria. Patients in the TBI group (n = 83) endorsed significantly higher rates of childhood trauma and prior physical, emotional, and sexual abuse compared with the No TBI group (n = 35). Psychological trauma exposure and TBI significantly predicted current anxiety and depressive symptoms, but there was no interaction between these experiences in predicting current psychiatric symptoms.</p><p><strong>Conclusions: </strong>Individuals with prior TBI experienced psychological trauma, particularly childhood trauma, at a significantly higher rate than those without TBI. Psychological trauma exposure and TBI independently predicted anxious and depressive symptoms, suggesting both may be viable treatment targets. Evaluation of prior psychological trauma exposure during evaluation of TBI may provide opportunities for trauma-informed care and may allow for improved outpatient treatment planning.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 2","pages":"82-89"},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133235","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}
Kathryn S Gerber, Gemayaret Alvarez, Arsham Alamian, Victoria Behar-Zusman, Charles A Downs
{"title":"Symptoms and Functional Outcomes Among Traumatic Brain Injury Patients 3- to 12-Months Post-Injury.","authors":"Kathryn S Gerber, Gemayaret Alvarez, Arsham Alamian, Victoria Behar-Zusman, Charles A Downs","doi":"10.1097/JTN.0000000000000776","DOIUrl":"10.1097/JTN.0000000000000776","url":null,"abstract":"<p><strong>Background: </strong>Patients with traumatic brain injury (TBI) experience a variety of physical, cognitive, and affective symptoms. However, the evolution of symptoms, especially during the 3- to 12-month convalescence period (when recovery of function is still possible), is understudied.</p><p><strong>Objective: </strong>This study aims to identify symptoms and the relationships with functional outcomes that occur during the 3- to 12-month period after a TBI.</p><p><strong>Methods: </strong>Participants who were 3 to 12 months post-TBI were recruited from a South Florida TBI clinic from May 2022 to June 2023. Clinical data were obtained from the electronic health record. Participants completed the Brain Injury Association of Virginia Symptom Checklist, Neuro-Quality of Life Cognitive Function, Anxiety, Depression, and Sleep Disturbance assessments to report symptoms, and the Disability Rating Scale and Satisfaction with Life Scale. Descriptive statistics were used to characterize demographics and symptoms. Linear regression was performed to analyze the relationships between symptoms and outcomes.</p><p><strong>Results: </strong>A total of N = 39 patients participated in the study. Memory problems and difficulty concentrating were the most common symptoms. Hospital length of stay, intensive care unit length of stay, cognitive, and physical symptoms were significantly associated with the Disability Rating Scale score. Physical, cognitive, depressive, and anxiety symptoms had significant associations with the Satisfaction with Life Scale.</p><p><strong>Conclusion: </strong>Cognitive symptoms should be integrated into the clinical care of rehabilitating TBI patients. Nurses should monitor for physical, affective, and cognitive symptoms during the recovery phase of TBI.</p>","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"31 2","pages":"72-81"},"PeriodicalIF":0.7,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140133230","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}