Journal of trauma nursing : the official journal of the Society of Trauma Nurses
-
Inconsistent application of trauma service resources and underevaluation of risk and resuscitation status in elderly trauma patients are problematic. We describe a geriatric protocol that includes initial lactate determination and trauma surgery admission. Protocol compliance rates were initial lactate determination, 67.9%; trauma service admission for overt or compensated (elevated lactate) shock, 73.6%; and trauma service consultation for nonshock patients, 67.8%. Implementation of this protocol resulted in a trend toward reduced mortality and reduced potentially preventable deaths.
-
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.
-
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.
-
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.