Strategies to Increase Identification of Unexpected Trauma Survivors in the Emergency Department

2.50
Hdl Handle:
http://hdl.handle.net/10755/162548
Type:
Presentation
Title:
Strategies to Increase Identification of Unexpected Trauma Survivors in the Emergency Department
Abstract:
Strategies to Increase Identification of Unexpected Trauma Survivors in the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2009
Author:Snavely, Terry, RN, BSN
P.I. Institution Name:Penn State Milton S. Hershey Medical Center
Title:Trauma Program Manager
Contact Address:500 University Drive, Hershey, PA, 17033-0850, USA
Contact Telephone:717-531-7013
[Annual Conference Research Poster]
Purpose: TRISS is the Trauma Injury Severity Score combined with the revised Trauma Score which indicates the likelihood of patient survival. TRISS scores are used to evaluate trauma outcomes and provide ED quality performance analysis. Only patients with complete documentation can be included in the TRISS population analysis. The number of Unexpected Trauma Survivors (UTS) is one quality indicator of a Level 1 Trauma center performance analysis which may be under reported indicating a falsely lower performance. This study identified methods to capture a higher rate of UTS in a hospital Trauma Registry Database. Changes in nursing care and documentation in the Emergency Department had a positive impact on identifying an increase in UTS over a 4 year period.

Design: This was a quasi-experimental design using retrospective data analysis to note changes in identification of UTS as a result of nursing care and documentation in the Emergency Department.

Setting: An Academic Tertiary level 1 Trauma Center located in south central Pennsylvania.

Sample: A sample size of 4600 trauma patients over a 4 year period was obtained from the Trauma Registry Data for this hospital.

Methodology: TRISS is the Trauma Injury Severity Score plus the revised Trauma Score which predicts the likelihood of patient survival. TRISS scores are used to evaluate trauma outcomes. Only patients with complete documentation can have their TRISS score calculated and included in statics for a hospitals quality performance analysis. A retrospective review identified Trauma patients with very high injury severity scores who survived but had inadequate nursing documentation to calculate a full TRISS score. Based on these findings, various strategies and processes were implemented to increase ED nurses documentation of GCS, systolic BP, and spontaneous respirations.
Results: As a result of more accurate and consistent documentation by ED nurses, more UTS were identified. In 2004, TRISS suitable submissions were 76% with 2 reported UTS. In 2005, scores rose to 90% TRISS suitable and 22 UTS identified. Over the last 4 years, there has been steady documented improvement ending with a 2008 TRISS suitability rate of 99% and 49 identified UTS.
Conclusions: ED nurses can make a significant contribution to the identification of UTS by implementing accurate and consistent documentation of GCS, systolic BP, and spontaneous respirations. This improvement in documentation by ED nurses allowed the hospital to capture a more realistic number of UTS which has a positive impact on performance analysis and quality outcomes.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleStrategies to Increase Identification of Unexpected Trauma Survivors in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162548-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Strategies to Increase Identification of Unexpected Trauma Survivors in the Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Snavely, Terry, RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Penn State Milton S. Hershey Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Trauma Program Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">500 University Drive, Hershey, PA, 17033-0850, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">717-531-7013</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">Tsnavely1@hmc.psu.edu</td></tr><tr><td colspan="2" class="item-abstract">[Annual Conference Research Poster] <br/>Purpose: TRISS is the Trauma Injury Severity Score combined with the revised Trauma Score which indicates the likelihood of patient survival. TRISS scores are used to evaluate trauma outcomes and provide ED quality performance analysis. Only patients with complete documentation can be included in the TRISS population analysis. The number of Unexpected Trauma Survivors (UTS) is one quality indicator of a Level 1 Trauma center performance analysis which may be under reported indicating a falsely lower performance. This study identified methods to capture a higher rate of UTS in a hospital Trauma Registry Database. Changes in nursing care and documentation in the Emergency Department had a positive impact on identifying an increase in UTS over a 4 year period.<br/><br/>Design: This was a quasi-experimental design using retrospective data analysis to note changes in identification of UTS as a result of nursing care and documentation in the Emergency Department.<br/><br/>Setting: An Academic Tertiary level 1 Trauma Center located in south central Pennsylvania.<br/><br/>Sample: A sample size of 4600 trauma patients over a 4 year period was obtained from the Trauma Registry Data for this hospital.<br/><br/>Methodology: TRISS is the Trauma Injury Severity Score plus the revised Trauma Score which predicts the likelihood of patient survival. TRISS scores are used to evaluate trauma outcomes. Only patients with complete documentation can have their TRISS score calculated and included in statics for a hospitals quality performance analysis. A retrospective review identified Trauma patients with very high injury severity scores who survived but had inadequate nursing documentation to calculate a full TRISS score. Based on these findings, various strategies and processes were implemented to increase ED nurses documentation of GCS, systolic BP, and spontaneous respirations.<br/>Results: As a result of more accurate and consistent documentation by ED nurses, more UTS were identified. In 2004, TRISS suitable submissions were 76% with 2 reported UTS. In 2005, scores rose to 90% TRISS suitable and 22 UTS identified. Over the last 4 years, there has been steady documented improvement ending with a 2008 TRISS suitability rate of 99% and 49 identified UTS. <br/>Conclusions: ED nurses can make a significant contribution to the identification of UTS by implementing accurate and consistent documentation of GCS, systolic BP, and spontaneous respirations. This improvement in documentation by ED nurses allowed the hospital to capture a more realistic number of UTS which has a positive impact on performance analysis and quality outcomes.</td></tr></table>en_GB
dc.date.available2011-10-27T10:30:03Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:30:03Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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