The practice of out-lying patients is dangerous: a multicentre comparison study of nursing care provided for trauma patients

Injury. 2005 Jun;36(6):710-3. doi: 10.1016/j.injury.2004.11.006. Epub 2005 Mar 24.

Abstract

Pressure for acute hospital beds is a national problem with many acute trauma patients being admitted to non-trauma wards. This prospective multicentre questionnaire study of 220 qualified trauma and non-trauma nurses aims to compare the quality of nursing care that trauma patients receive when admitted to trauma wards and non-trauma wards. The questions included the nursing management of common fractures and post-operative conditions. The completed questionnaires were scored and the results analysed. Hundred percent of the questionnaires were completed and returned. The trauma nurses conveyed the importance of ice (85%) and elevation (97%) in the initial management of limb fractures. This compares with ice (10%) and elevation (50%) on the outlying wards. Trauma nurses correctly monitor for potentially devastating post-operative complications and compartment syndrome 87% of the time compared with 42% on outlying wards. Spinal injuries are managed appropriately 88% of the time on trauma wards compared with 36% on outlying wards. Trauma patients receive better nursing care when admitted to a trauma ward and are nursed by trauma nurses. Many of the out-lying wards provide sub-optimal trauma nursing care and a few are positively dangerous. We suggest that trauma patients should not be nursed on outlying wards.

Publication types

  • Comparative Study
  • Multicenter Study

MeSH terms

  • Acute Disease
  • Clinical Competence
  • Compartment Syndromes / nursing
  • Cryotherapy
  • Fractures, Bone / nursing
  • Health Care Surveys
  • Hospital Bed Capacity
  • Hospitalization*
  • Humans
  • Postoperative Complications / nursing
  • Posture
  • Prospective Studies
  • Quality of Health Care / standards*
  • Spinal Injuries / nursing
  • Trauma Centers*
  • Wounds and Injuries / nursing*