The journal of trauma and acute care surgery
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J Trauma Acute Care Surg · Oct 2013
Randomized Controlled TrialPerioperative supplemental oxygen to reduce surgical site infection after open fixation of high-risk fractures: a randomized controlled pilot trial.
Higher concentrations of fraction of inspired oxygen (FIO2) have been shown to be associated with lower risk for surgical site infection in multiple studies outside the domain of orthopedic surgery. We evaluated the efficacy of high FIO2 administered during the perioperative period to reduce the rate of surgical site infection after open fixation of lower-extremity fractures at high risk of infection. ⋯ Therapeutic study, level III.
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J Trauma Acute Care Surg · Oct 2013
Contemporary trends in the immediate surgical management of renal trauma using a national database.
The National Trauma Data Bank was used to analyze open surgical management of renal trauma during the first 24 hours of hospital admission, excluding those who were treated with conservative measures. A descriptive analysis of initial management trends following renal trauma was also performed as a secondary analysis. ⋯ Epidemiologic study, level III.
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J Trauma Acute Care Surg · Oct 2013
Can the reduction of pediatric injury rates be sustained using a community-based approach?
Injuries are the leading cause of morbidity and mortality in US residents aged 1 to 44 years. Community-based interventions are effective in reducing injuries. Using this approach, investigators significantly reduced injuries in Avondale, Ohio, between 1999 and 2004 compared with three control communities (42 vs. 15%, respectively). The objective of this study was to determine if injury reduction was sustained through the 5 years after initial implementation of injury prevention (IP) efforts in Avondale compared with the same three control communities. ⋯ Community-based strategies to prevent injuries to children in high-risk communities can be successful in reducing overall injury rates. These efforts can result in sustained injury reduction over time despite no new interventions being introduced.
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J Trauma Acute Care Surg · Oct 2013
Can nurse education in the postpartum period reduce car seat misuse among newborns?
Despite national, state, and hospital policies that require newborns to be transported in correctly used child safety seats (CSSs), significant CSS misuse frequently occurs among newborn infants. The objective of this study was to evaluate a comprehensive educational CSS training program for nurses and parents in a maternal/newborn unit. ⋯ Car safety seat misuse did not improve following implementation of a comprehensive nursing education and training program. CSS misuse in our study population was frequent and may increase injury risk in the event of a motor vehicle crash. Future work is needed to develop novel approaches and identify appropriate settings to reduce newborn CSS misuse.
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J Trauma Acute Care Surg · Oct 2013
Measurable outcomes of quality improvement using a daily quality rounds checklist: two-year prospective analysis of sustainability in a surgical intensive care unit.
The use of a "quality rounds checklist" (QRC) is an effective tool for improving compliance with evidence-based preventative measures and outcomes in the surgical intensive care unit (SICU). Our aim was to evaluate the long-term sustainability and outcome impact of this quality improvement strategy. ⋯ Therapeutic study, level IV.