Trust Me...I'm a Trauma Nurse

Abstract

<p>Poster presentation</p> <p>Session J presented Saturday, September 16, 2017</p> <p>Purpose: There is a large number of staff in the Emergency Department, high turnover rates, many different areas of focus which lead to inconsistencies in the care and documentation of care for trauma patients.&nbsp; The goal was to develop a small group of specially trained Emergency Department nurses to care for trauma patients and initiate the quality improvement process at the bedside.</p> <p>Design: Course content was researched, developed and approved by both the trauma service and the emergency department.&nbsp; The content was based on evidence-based practice found in current literature, including American College of Surgeons requirements and hospital policy.&nbsp; Highlights of the lectures included: standardization of trauma care, trauma activation criteria, damage control resuscitation, documentation, quality improvement, and communication.&nbsp; In addition, a bedside trauma quality form was developed and utilized to begin quality improvement at the bedside.</p> <p>Setting: The setting was a 408 bed metropolitan Level 1 trauma center.&nbsp; We admit over 2200 trauma patients per year.&nbsp; The Emergency Department has 85 staff nurses and 128 total staff.&nbsp; The ED has 41 beds and 3 trauma bays.</p> <p>Participants/Subjects: The participants were thirty Emergency Department nurses who work across all shifts interested in being dedicated to trauma care.</p> <p>Methods: We created and implemented a SMART goal to track and achieve our outcomes.&nbsp; Chart review was used for documentation compliance.&nbsp; The bedside trauma quality form was also used to collect data for compliance.</p> <p>Results/Outcomes: There have been dramatic improvements in trauma care since beginning the trauma nurse program.&nbsp; The standardization of care with the use of PPE and lead aprons has improved from 0% in August 2016 to above 90% compliance in December 2016.&nbsp; Charting compliance has improved.&nbsp; Specific documentation measures with improvements are:&nbsp; prehospital c-spine care from 91.1% to 97.7%, location of event from 95.8% to 97.7%, 1st set of vital signs from 94.2% to 97.7%, primary assessment from 94.2% to 100%, time to CT 90% to 100%, nursing notes from 96.3% to 100%, c-spine clearance from 85.2% to 92.9%.&nbsp; The team developed and implemented a new trauma flowsheet to improve the capture of required data elements.&nbsp; Feedback from the trauma surgeons has been that there is greater consistency with care, increasing their comfort level with the nursing staff.&nbsp; There has been an overall decrease in the turnover rate for ED staff as a whole from 14.8% to 6% and the turnover rate for the core trauma nurse team has been 0% since its inception.&nbsp; Nurses on the team have initiated projects to improve care and flow for trauma patients.</p> <p>Implications: Developing a core trauma nurse program has created a specialized group of nurses who are invested in providing high quality care for every trauma patient, every time.&nbsp; There has been increased compliance with charting, which ensures accurate data collection.&nbsp; Future plans include additional classes for nurses, development of a trauma specialty for ED techs.&nbsp; The team will continue bimonthly meetings with education provided by the trauma surgeons and residents.</p>