Journal of Trauma Nursing最新文献

Background: Post-traumatic stress disorder (PTSD) significantly impacts post-injury quality of life; however, many injured patients struggle to access necessary psychosocial care. A brief intervention, Talk, Listen, Communicate to Recover (TLC to Recover), may facilitate access to psychosocial care in low resource trauma centers.

Objective: This study assessed staff and patient perceptions regarding the feasibility and acceptability of implementing TLC to Recover at a Level I trauma center.

Methods: This study used a mixed methods approach to examine the implementation of a brief dyadic intervention intended to mitigate the effect of potential post-injury mental health sequelae. The study took place from April 2021 to April 2024. Participants included adult patients who received post-injury care and were at risk for post-injury PTSD and/or depression. Outpatient trauma clinic staff participated in formative and summative evaluations of the intervention. Recruitment, retention rates, and engagement were assessed. Symptom measurements were administered to patients at baseline, two week follow-up, and one month to measure the effectiveness of TLC to Recover. Semistructured interviews and focus groups explored the acceptability of TLC to Recover among staff and patients. Summative template analysis was utilized to analyze qualitative data and integrated with the theoretical framework of acceptability.

Results: A total of N = 26 participants were included in the summative and formative evaluations, of which n = 15 were patients and n = 11 were clinic staff. The surgical clinic was an acceptable and feasible context to deliver a brief intervention to patients at risk for post-injury PTSD and/or depression.

Conclusion: This study offers insight into opportunities for implementation of brief post-injury psychosocial interventions in a surgical context.

Background: Motorcycle and equestrian accidents can share similar trauma mechanisms and can result in serious injuries.

Objective: This study aims to analyze variations in injuries and safety standards through types, severity, and outcomes of traumatic injuries in both motorcycle and equestrian riders.

Methods: Using the 2020 ACS TQIP database, we split patients into two groups based on their primary injury. We chose codes V28 and V80.0 to identify non-collision fall or throw injuries for motorcycle and equestrian accidents respectively. A total of 17,730 motorcycle and 5,461 equestrian patients were identified.

Results: Motorcyclists were more likely to experience external/superficial injuries (41.34% vs. 29.08%, p < .001) and chest trauma (5.15% vs. 3.18%, p < .001), while equestrian trauma resulted in more injuries to the abdomen and pelvic content (24.07% vs. 15.75%, p < .001), extremities and pelvic girdle (9.85% vs. 4.98%, p < .001), and head/neck (15.57% vs. 12.16%, p < .001) comparatively. Motorcyclists also had a higher average length of inpatient stay (6.06 (8.03) vs. 4.32 (4.23) days, p < .001). Helmet use was more common among motorcyclists than horseback riders (57.79% vs. 24.24%, p < .001). The average injury severity score between the two groups was not significantly different.

Conclusion: These data show the different injuries observed between both activities and the need for increased safety equipment, especially in the case of hip and pelvic injuries among equestrians. The low rate of helmet, especially among equestrian riders, is concerning despite broad education regarding their benefits.

Background: Tennis is a globally popular sport offering physical benefits but poses a high risk of injury due to its demands and prolonged gameplay. While injuries are common among professional players, detailed injury data for this group is limited.

Objective: This review aims to analyze trends in the incidence, type, region, and onset of injuries in professional tennis players, with particular attention to gender distribution, to improve guidelines and reduce injury impacts on performance and career longevity.

Data sources: PubMed, Google Scholar, Cochrane, ProQuest, and Embase were reviewed for relevant literature.

Study selection: Included studies evaluated various features of injuries in professional tennis players.

Data extraction: Studies were selected and included by agreement among the authors. The extracted data included incidence, type, affected body regions, and timing of onset of injuries in professional tennis players.

Data synthesis: Tennis is widely popular and physically beneficial but carries a high injury risk, with limited detailed data on professional players.

Conclusion: The findings indicate a high incidence of acute lower limb, muscle, and tendon injuries among professional tennis players, with significant gender differences in injury patterns. These insights highlight the need for improved injury prevention strategies and further research into gender-specific injury mechanisms.

Background: Contemporary research has shown that acellular dermal matrices can benefit adult lower extremity traumatic injuries; however, its use in children has not been explored.

Objective: This study aims to explore the use of acellular dermal matrices in pediatric complex lower extremity trauma.

Methods: This single-center retrospective observational cohort study of children with complex lower extremity trauma treated with Pelnac™, commercial acellular dermal matrices, was conducted at a tertiary hospital in South Africa from 2010 to 2017. Demographic and clinical data were collected from medical records. The primary outcome was the rate and type of acellular dermal matrices-related complications. Secondary outcomes included the usage of negative pressure wound therapy.

Results: A total of 54 children were studied; 30 (55%) were male, and the median age was six. Forty-five children healed without complications, while nine experienced complications - four acute and five chronic. Four patients had complete loss of acellular dermal matrices, and three developed acute infections. More than 30 days post-acellular dermal matrices application, five patients had hypertrophic scarring, four had joint contractures, and two had non-healing wounds. All patients who healed without complication received negative pressure wound therapy (n = 45), while those who did not (n = 5) developed complications. Three of the five patients without negative pressure wound therapy had acute acellular dermal matrices loss, compared to only one of the 49 patients who received negative pressure wound therapy.

Conclusion: Our findings suggest that acellular dermal matrices may be an effective and safe reconstructive adjunct or alternative when used with negative pressure wound therapy.

Background: As orthopedic trauma increases, the resultant use of orthopedic devices and associated pressure injuries has increased.

Objective: This study aims to systematically evaluate the incidence and risk factors for orthopedic device-related pressure injuries.

Methods: A systematic review and meta-analysis was conducted by searching PubMed, Embase, Cochrane Library, Web of Science, ClNAHL, China National Knowledge Infrastructure, Wanfang Database, and Chinese BioMedical Literature Database from their inception until November 30, 2023. The population included adult orthopedic surgery patients aged 18 and older. Studies included case-control, cohort, or cross-sectional designs reporting risk factors, incidence, or predictors of orthopedic device-related pressure injuries published in Chinese or English. Exclusion criteria included unavailable full text, duplicate publications, reviews, animal studies, and conference abstracts. Two researchers independently screened the literature, extracted the data, and assessed the quality of the literature.

Results: A total of eight papers involving 3,783 patients were included. Meta-analysis showed that the incidence of orthopedic device-related pressure injuries was 12.0%. Significant risk factors included duration of device wear [OR 1.197, 95% Cl (1.025, 1.369), p = .016] and the length of stay [OR 1.144, 95% CI (1.096, 1.199), p < .001].

Conclusion: The duration of device wear and length of stay are key factors contributing to orthopedic device-related pressure injuries. Clinicians should actively monitor and manage these factors to reduce the risk of these injuries.

Background: Nurse managers play a critical role in disaster response and management; yet research on their experiences in earthquakes remains limited.

Objective: This study aimed to explore the experiences of nurse managers in the Kahramanmaras, Turkey, earthquakes.

Methods: A phenomenological approach was used to guide this study, exploring the lived experiences of nurse managers who worked during the 2023 earthquakes in Kahramanmaras, Turkey. Purposive sampling identified participants, and data were collected 2-3 months postearthquake, from April to May 2023, via semi-structured interviews conducted via social media. Thematic analysis was applied to analyze the interview data.

Results: A total of 11 nurse managers were interviewed for the study. Fifty-five percent were between the ages of 35 and 44, 64% were female and had a bachelor's degree. Five themes emerged from the data: "being unprepared" (predisaster phase), "emotional difficulties," "communication and coordination issues," "resource shortages" (disaster event phase), and "evaluation and professional satisfaction" (postdisaster phase).

Conclusion: The study found that most nurse managers reported feeling unprepared for the earthquake despite institutional disaster management practices. They struggled with managing their emotions, resource shortages, and communication-coordination issues. These experiences underscore the need for enhanced disaster training and preparedness for nurses. Collaboration among international health organizations, nongovernmental organizations, and governments is essential to develop disaster management plans to optimize nurses as early responders.

Background: Acute care hospitalization has been associated with older adult home falls after discharge, but less is known about the effects of hospital- and patient-related factors on home fall risk.

Objectives: This study compares the effects of hospital length of stay, medical condition, history of falls, and home health care on period rates of home falls after discharge from acute care hospitalization.

Methods: This was a retrospective cohort study comparing period rates of home injury falls among older adults (age ≥ 65) occurring after discharge from an acute care hospitalization. Data were collected from state health care utilization administrative records between January 1, 2016, and December 31, 2018. We used log-linear Poisson regression to model post-discharge injury fall incidence rates as a function of days since discharge and patient-level covariates.

Results: A total of 736,230 older adults were included in the study cohort. Absolute risk for post-discharge home falls was 7%. Fall rates were highest the first week after discharge at 0.05 per 100 person-days, with a period incidence rate 74.29 times higher than the >90-day discharge period. Fall risk increased with age, with the highest risk in the ≥85 age group. Fall risk increased for a 2-day hospital stay but decreased for 5- to 30-day stays, compared to a 1-day length of stay. Discharge to home health care and history of falls were associated with increased risk.

Conclusions: Older adults are at highest risk for a home fall the first 7 days after discharge from acute care hospitalization. These findings describe patient-related risk factors that acute care hospitals can use to develop geriatric-specific discharge guidelines intended to reduce home fall risk during the early care transition to home.