Journal of trauma nursing : the official journal of the Society of Trauma Nurses
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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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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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One of the leading causes of mortality in the intensive care unit is Acute Respiratory Distress Syndrome (ARDS). Acute Respiratory Distress Syndrome can occur as a result from multiorgan dysfunction syndrome and sepsis. In the trauma population, ARDS accounts for an increase in mortality as well as morbidity and disability. ⋯ Respiratory treatments such as airway pressure release ventilation and chest physiotherapy are utilized often for ARDS treatment. A lesser used therapy, intermittent prone positioning has also been found to be effective in increasing the pulmonary gas exchange in trauma patients. This article will explain the nursing roles and responsibilities in the initiation, continuation, and cessation of intermittent prone positioning.
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Injured patients are especially prone to developing complications. Using a multidisciplinary standardized approach to complication review is an effective method of evaluating quality improvement in patients on the trauma service. ⋯ Using this consistently, quality improvement strategies can be put in place and tracked for outcomes. This has allowed for better quantification of the problem as well as any change that may result from applying this formal review process and subsequent intervention.
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The purpose of the present study was to determine (1) the prevalence and degree of hypothermia in patients on emergency department admission and (2) the effect of hypothermia and rate of rewarming on patient outcomes. ⋯ Hypothermia on admission is correlated with worse outcomes in brain-injured patients. Patients with traumatic brain injury who are rapidly rewarmed may be more likely to have worse outcomes. Trauma protocols may need to be reexamined to include controlled rewarming at rates 0.25°C/h or less.