Journal of Trauma Nursing最新文献_第2页

Physical Restraint Reduction in the Trauma Intensive Care Unit: A Quality Improvement Initiative. 减少创伤重症监护病房的物理约束：一项质量改进倡议。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000854

Briana R Miller, Lauren M Leppert, Elisabeth D Tucker, Bethany Webster, Kimberly A Maye, Nancy M Steffan

{"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":"Background: 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.Objective: This study aims to assess the impact of a multicomponent physical restraint reduction initiative on restraint use in trauma intensive care unit patients.Methods: 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.Results: 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.Conclusion: 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.","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}

引用次数: 0

Effect of Early Vasopressin Administration in Refractory Hemorrhagic Shock. 早期加压素治疗难治性失血性休克的效果。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000853

Michaelia D Cucci, Matthew Palmer, Carli Bower, Farjad Siddiqui, Daniel Vazquez, Jessica Krizo

{"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":"Background: 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.Objective: This study aims to evaluate the efficacy of early vasopressin administration in trauma patients with refractory hemorrhagic shock.Methods: 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.Results: 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).Conclusion: 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.","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}

引用次数: 0

Replies Letter to the Editor. 给编辑的回信。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000849

Mauro Mota, Madalena Cunha, Margarida Reis Santos

引用次数: 0

Optimizing Mental Health Referral and Follow-Up for Pediatric Trauma Patients. 优化儿童创伤患者的心理健康转诊和随访。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000857

引用次数: 0

Non-Battle Injuries in Military Settings: Impacts on Health-Related Quality of Life and Service Capability. 军事环境中的非战斗伤害：对健康相关生活质量和服务能力的影响

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000851

Yedidiah Samson, Jacob Rotschield, Julie Benbenishty

{"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":"Background: Non-battle injuries significantly impact military readiness and individuals' quality of life, yet research on their effects on soldiers remains inadequate.Objective: This study examines relationships between non-battle injury characteristics, perceptions, health-related quality of life (HRQOL), and service capability in the Israel Defense Forces.Methods: 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).Results: 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.Conclusion: 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.","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}

引用次数: 0

Letter to the Editor: Mota et al. 给编辑的信：Mota等人。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000848

Nicole S Cook

引用次数: 0

Effect of Early Vasopressin Administration in Refractory Hemorrhagic Shock. 早期加压素治疗难治性失血性休克的效果。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000865

引用次数: 0

Optimizing Mental Health Referral and Follow-Up for Pediatric Trauma Patients. 优化儿童创伤患者的心理健康转诊和随访。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000855

Jennifer K York, Derek Krinock, Lesa Slaughter, Mallory Onarecker, Deidre Wyrick

{"title":"Optimizing Mental Health Referral and Follow-Up for Pediatric Trauma Patients.","authors":"Jennifer K York, Derek Krinock, Lesa Slaughter, Mallory Onarecker, Deidre Wyrick","doi":"10.1097/JTN.0000000000000855","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000855","url":null,"abstract":"Background: Level I trauma centers are required to screen at-risk patients for mental health concerns and provide appropriate intervention and referral. However, there is limited guidance on implementing these recommendations in the pediatric trauma population.Objective: This study aims to evaluate a multicomponent initiative to improve mental health referral and follow-up in pediatric trauma patients.Methods: We conducted a retrospective cohort study evaluating a multicomponent initiative aimed at improving mental health referral and follow-up in admitted pediatric trauma patients aged 8-17 years with a positive inpatient mental health screen. The study was conducted in a Level I pediatric trauma center in the Southern United States between December 2022 and March 2024. Outcomes included the provision of inpatient resources and outpatient follow-up.Results: A total of N = 120 patients were included, of which 77 (64.2%) received a clinic appointment. Patients who had an inpatient social work consultation (n = 69, 89.6%, p = .023) or were discharged from the trauma service (n = 24, 55.8%, p = .002) were more likely to receive a clinic appointment. Of those scheduled, 51 (66.2%) attended their appointment. Factors associated with appointment adherence included White race (n = 32, 62.7%, p = .034) and higher Injury Severity Score (21.6 vs. 15.2, p = .010). Among attendees, over 50% of patients and 20% of parents continued to screen positive for posttraumatic stress, with 67% receiving mental health resources or referrals.Conclusions: Our screening and resource provision process effectively identifies pediatric trauma patients at risk for psychosocial distress. However, improvements are needed to enhance referral completion and ensure follow-up care.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"157-164"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025060","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

Impact of a Novel Level III Trauma Activation Protocol Utilizing Trauma Nurse Clinicians. 利用创伤护士临床医生的新型III级创伤激活方案的影响。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000850

Cindy Austin, Katherine Kelley, Oluwafolaranmi Sodade, Brian Draper

{"title":"Impact of a Novel Level III Trauma Activation Protocol Utilizing Trauma Nurse Clinicians.","authors":"Cindy Austin, Katherine Kelley, Oluwafolaranmi Sodade, Brian Draper","doi":"10.1097/JTN.0000000000000850","DOIUrl":"https://doi.org/10.1097/JTN.0000000000000850","url":null,"abstract":"Background: Tiered trauma activation protocols help physicians prioritize the severely injured but may delay care for those with less severe injuries. While trauma nurse clinicians (TNCs) have been shown to provide efficient trauma care, their impact as primary responders for Level III trauma activations has not been studied.Objective: This study aims to evaluate the impact of TNC response to Level III trauma activations on patient outcomes.Methods: This pre- and postintervention study was conducted at a Midwestern United States Level I trauma center from July 1, 2023, to October 10, 2023, and included adult and pediatric trauma patients. In July 2022, we implemented a protocol where TNCs replaced physicians responding to Level III trauma activations. Data from the trauma registry and electronic medical records were analyzed before and after implementation. The primary outcome was time to computed tomography within 30 minutes. Secondary outcomes were emergency department (ED) time, hospital length of stay (LOS), and 30-day readmissions.Results: The final analysis included 812 post-intervention patients (562 with TNCs, 250 without TNCs), of which 53% were male. Groups were comparable in age and Injury Severity Score at baseline. Patients seen by TNCs were more likely to receive computed tomography (CT) within 30 minutes (56% vs 35%, p < .0001), while ED and hospital LOS and readmission rates showed no significant difference between groups.Conclusions: This study showed that trauma nurse clinicians' response to third-tiered activations is feasible and improves timely access to CT within 30 minutes, but it showed no effect on ED time, hospital LOS, or hospital readmissions.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"120-125"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994098","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

Effect of Stress Ball Use on Fear and Anxiety During Pediatric Casting Procedures. 压力球使用对儿童铸型过程中恐惧和焦虑的影响。

IF 0.7 4区医学

Journal of Trauma Nursing Pub Date : 2025-05-01 Epub Date: 2025-05-07 DOI: 10.1097/JTN.0000000000000852

Sultan Esra Sayar, Zülbiye Demir Barbak, Orhan Delice

{"title":"Effect of Stress Ball Use on Fear and Anxiety During Pediatric Casting Procedures.","authors":"Sultan Esra Sayar, Zülbiye Demir Barbak, Orhan Delice","doi":"10.1097/JTN.0000000000000852","DOIUrl":"10.1097/JTN.0000000000000852","url":null,"abstract":"Background: Pediatric trauma patients are often exposed to treatments that can result in pain, fear, and anxiety. While nonpharmacological distraction techniques like stress balls have been increasingly used in pediatric care, their effectiveness during casting procedures remains unexplored.Objective: This study aims to evaluate the impact of stress ball distraction on fear and anxiety in pediatric extremity fracture patients during casting procedures.Methods: This randomized controlled trial, with a parallel group design, was conducted from February to May 2023 in a hospital in Erzurum, Turkey, to evaluate stress ball distraction on fear and anxiety in children aged 6-12 years presenting to the emergency department with extremity fracture.Results: Among 66 children randomized to the stress ball (n = 33) or control (n = 33) group during casting procedures (mean age 8.5 years, 47% female), both groups were comparable at baseline. The stress ball group showed decreased fear scores (mean [SD], 2.24 [1.25] to 1.30 [1.07], p < .001), while controls showed increases (2.42 [1.02] to 3.15 [1.08], p < .001). State anxiety scores decreased in the stress ball group (mean [SD], 4.97 [2.52] to 3.09 [1.79], p < .001) but remained unchanged in controls (3.93 [0.32] to 3.91 [0.29], p = .487).Conclusion: Our findings show that stress ball distraction reduced fear and anxiety in children during the casting procedures and is an easy and cost-effective intervention.","PeriodicalId":51329,"journal":{"name":"Journal of Trauma Nursing","volume":"32 3","pages":"134-140"},"PeriodicalIF":0.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065236","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