Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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Each year more than 1.7 million people experience traumatic brain injury. This qualitative descriptive study sought to describe how surrogate decision makers for patients with severe traumatic brain injury made the decision to withdraw or continue life support, and whether they believed that the health care team could have been of greater assistance. ⋯ Eight surrogates said that they would make the same proxy decisions if they had to do it again. Surrogates used multiple inputs to make treatment decisions and described the need for support from a trauma advanced practice nurse or palliative care team.
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Comparative Study
Comparing rural ground and air emergency medical services: a level I trauma center's experience.
We sought to compare differences in patients transported by ground and air emergency medical services directly from the scenes of their injuries to a rural level I trauma facility. Variables examined included age, gender, vital signs, Glasgow Coma Scale score, discharge location, length of stay, and survival metrics. ⋯ Generally, length of stay was longer in air-transported patients, who also had poorer survival metrics with negligible risk of death. Significant differences exist in the markers of physiology such as vital signs, expected survival, and degree of injury.
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An electronic dashboard can enhance compliance with a specific checklist of indicators with daily management of injured patients in a trauma intensive care unit effectively. A performance management electronic dashboard monitored 24 indicators in the trauma intensive care unit over a 3-year period. Over a 3-year period, utilization of the electronic dashboard improved from 64% to 100% and mean compliance rose from 94.8% to 97.4%. Implementation of an electronic dashboard enhances compliance in managing trauma patients in a sustainable manner, allows immediate correction of deficiencies, monitors trends, and facilitates performance improvement/patient safety initiatives of a trauma program.
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Study purpose was to describe critical care nurses' levels of moral distress and the effects of that distress on their professional practice environment. A descriptive, correlational, prospective, survey design was used. ⋯ It is important to monitor the frequency of moral distress. Strategies to improve the nurse's sense of control over practice, teamwork, communication, and autonomy need to be developed and tested in future research.
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Trauma programs that are verified by the American College of Surgeons are required to have a multidisciplinary committee that examines trauma-related patient care operations. To facilitate a potentially large number of issues relevant to patient care, the Trauma Performance Improvement and Patient Safety Committee can apply team principles to promote success. ⋯ Eleven principles were identified as essential for developing an effective committee that can properly respond to and resolve performance issues in complex trauma care. This article describes and applies these 11 principles to the Trauma Performance Improvement and Patient Safety Committee.