Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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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.
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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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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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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.