DEVELOPMENT OF NURSING PRACTICES STANDARDS FOR EMERGENCY TRAUMA PATIENTS

Abstract

The field of traumatology has come to be recognized as a specialized branch of health care. Concurrently, because of the uniqueness and complexity of patients with multiple traumas, trauma nursing also has evolved in its own right as a specialized field of nursing. Moreover, the multiple trauma patients present a great challenge to the emergency nurse or trauma team. Failure to recognize and correctly treat traumatic injuries promptly will have a detrimental effect on early and delayed mortality and morbidity. A careful and thorough assessment must be made as quickly as possible, 2 9 supported by life- saving interventions < • >.

One of the most challenging aspects of caring for trauma patients is the development of a plan of care that address every component of the patient's needs in a logical, organized fashion to ensure continuity and coordination of all health disciplines. Formulation of such a plan of care requires incorporation of five components of the nursing process: assessment, diagnosis, planning, implementation, and evaluation. However, the complex nature of the trauma patient makes the development of such plans often difficult for many reasons (I4>.

First and foremost, time may be a constraint. The ideal situation exists if nursing administration has the financial ability to provide nurses with paid time for writing the care plan aside from their actual patient' care time. However, with the increased emphasis on decreasing health care costs, this is typically not possible. The emergency nurse must provide time during patients' care hours to formulate plans and make the needed changes. Documentinf. a complex plan is often difficult when the patient in the critical care area is unstable (I • 16>.

Development of ready standard nursing care plans including management pf the most common problems encountered by trauma patients has a several advantages. They conserve valuable nursing time, ensure that patients with a specific nursing diagnosis receive the highest standard of care, and promote continuity of care. Nursing practice standard defines the professional role and performance responsibilities of the nurse. Therefore, it is imperative to develop nursing practices standards that are facilitating the implementation of patients care and ensuring the accountability in practice by achieving competence in performance (I 7 20>.

The aim of this study is to develop nursing practices standards for management of trauma patients. Descriptive design was used to conduct this research. The setting used in this study comprised emergency care department in Alexandria Main University Hospital. The sample comprised two groups. The first group consisted of hospital head nurse and her assistance, all head nurses of the selected units and their assistants, nursing and medical educators, medical specialists serving in the ED (n = 50). As for the second group, it consisted of nurses who are providing direct patient care (n = 85).

Three tools were used in this study. Tool one consisted of a structured interview schedule developed in order to elicit opinions of specialists (in service & education) as