PURPOSE:To compare the thermal efficiency of 3 methods of heat-loss prevention in trauma patients undergoing resuscitation in the emergency department and the nurses' attitude toward the use of each method.DESIGN:A quasi-experimental design was used to compare 3 interventions for heat-loss prevention: 3 prewarmed cotton blankets, a reflective blanket with a head covering over 1 prewarmed cotton blanket, and a forced-warm-air inflatable blanket. All patients (n = 298) admitted in trauma-alert status and who were not hypothermic at the time of admission were randomly assigned to 1 of the interventions. Temperatures were recorded every 15 minutes for the first hour, then hourly until the patient was transferred from the emergency department. Nurses were asked to comment on and rate each method for ease of use, convenience, and access to the patient during care.FINDINGS:Analysis of variance results showed no significant differences in temperature change among the groups. Nurses significantly preferred the prewarmed cotton and reflective blankets to the warm-air inflatable blanket.CONCLUSIONS:The 3 modes of temperature conservation equally maintained body temperature in trauma patients who were not hypothermic on admission. The nurses surveyed had a preference for not using the more mechanical intervention.
This article provides an overview of the history and current practice of trauma nursing in the German health care system. A description of nursing education, skills, duties, and responsibilities of the nursing workforce is complemented by a brief description of the trauma system. As current demographic developments, structural changes, and medical progress result in a rapidly changing health care environment, tasks for nurses are becoming increasingly complex. The development of academic programs and extended nursing tasks are expected to help manage the upcoming changes and challenges in the manifold processes of patient-centered-nursing-care delivery. (Int J Trauma Nurs 2002;8:9-14.)
Child abuse continues to go undetected by hospital-based health care providers because clues may exist exclusively in the child's home. Emergency personnel are in the unique position of being able to assess the home environment. An educational intervention was developed to increase the prehospital providers' awareness of how to assess, report, and document suspected child maltreatment based on findings in the home. (Int J Trauma Nurs 2002;8:81-3.)
Trauma can cause visible, often profound physical injuries for patients. The emotional and social drain that families and health care providers experience can also be life-altering. REBUILD is a program designed by a level 1 trauma center that incorporates former patients and their families in a support group to aid previous and new patients, their families, and care providers by sharing mutual experiences and learning from each other. Health care providers have found that participating in the program has been personally gratifying and professionally beneficial by preventing burn-out.
Failure to rapidly identify high-value information due to inappropriate output may alter user acceptance and satisfaction. The information needs for different intensive care unit (ICU) providers are not the same. This can obstruct successful implementation of electronic medical record (EMR) systems. We evaluated the implementation experience and satisfaction of providers using a novel EMR interface—based on the information needs of ICU providers—in the context of an existing EMR system.This before–after study was performed in the ICU setting at two tertiary care hospitals from October 2013 through November 2014. Surveys were delivered to ICU providers before and after implementation of the novel EMR interface. Overall satisfaction and acceptance was reported for both interfaces.A total of 246 before (existing EMR) and 115 after (existing EMR + novel EMR interface) surveys were analyzed. 14% of respondents were prescribers and 86% were non-prescribers. Non-prescribers were more satisfied with the existing EMR, whereas prescribers were more satisfied with the novel EMR interface. Both groups reported easier data gathering, routine tasks & rounding, and fostering of team work with the novel EMR interface. This interface was the primary tool for 18% of respondents after implementation and 73% of respondents intended to use it further. Non-prescribers reported an intention to use this novel interface as their primary tool for information gathering.Compliance and acceptance of new system is not related to previous duration of work in ICU, but ameliorates with the length of EMR interface usage. Task-specific and role-specific considerations are necessary for design and successful implementation of a EMR interface. The difference in user workflows causes disparity of the way of EMR data usage.
The Ebola virus produces one of Africa's most lethal viral hemorrhagic fever (VHF) infections. Statistically, Ebola fever is at the bottom of Africa's list of infectious diseases, but the speed with which it induces agonizing death puts Ebola fever at the top of Africa's emergencies. Many aspects of the virus are unknown and have eluded medical scientists for 3 decades. Hence enormous difficulties may be encountered in treating, preventing, and controlling Ebola fever. In this article, the origin of the disease is traced, followed by a description of the Ebola fever triad, with some insights into the perspectives that may complicate treatment and control of the disease. The clinical manifestations are described in relation to the progression of the disease. Patients with the Ebola virus are admitted to the hospital as an emergency with the activation of a disaster-type plan of action.
Trauma centers are challenged to share beds with a larger hospital population of critical care patients. Often, this means that patients may be shifted between units when beds are not immediately available in the specialty unit that fits their diagnosis. They are admitted to the first intensive care unit bed that becomes available. This practice results in patients with special care needs being cared for by nursing staff who do not perceive themselves as trained to provide those needs. This practice is referred to as displaced specialty unit (DSU) admission. A review of 2-year data from one large trauma center revealed a total of 1072 DSU patients, of whom 50% were medical patients. A questionnaire given to intensive care unit nurses found that caring for DSU patients did affect their perceptions of their ability to care for such patients and affected their sense of job satisfaction. Strategies to improve nurses' comfort level and competency in treating diverse critical care patients were recommended and implemented.
