Trauma Center Research Paper

 please check that attachment and read the rubric. it has all the required information, some of them that you need to look up. make sure to write about disaster and triage protocol in the first part.  

TRAUMA / EMERGENCY CENTER 1

TRAUMA CENTER RESEARCH PAPER 2

Trauma / Emergency Center

Nursing process IV

09/28/2020

Trauma / Emergency Center

The emergency department (ED) is a vital section of the hospital that determines the survival of critically ill patients. More specifically, it constitutes a fast-paced environment where physicians respond to situations where any delays decrease the chances of recovery. In fact, hospital have guidelines that define the standard procedures and safety protocols that nurses must observe to ensure the plan of quality care.

Triage protocol

ED analysis patients according to urgency and type of condition to ensure that they are taken at the right place and care. In Hendrick Medical Center (HMC) triage protocol apply a color system based on the severity of their condition. Nurses assign red, yellow, or green color after begin short assessment. For example, red represents life-threatening conditions that need to be seeing immediately, such as shock or cardiorespiratory issues. While yellow indicate that treatment may be delayed for limited time without significant mortality.

Conversely, nurses give the color green for those with stabilizes situation and minor injuries. In addition, for disaster protocol, nurses apply blue and black color. Blue for those unlikely to survive or who need extensive care within minutes, while black is applied for dead or severely injured and not expected to survive. the HMC is equipped to handle a wide variety of injuries that disaster victims might be express. The coloring system in the triage protocol at HMC is a critical element to ensures that patients receive appropriate care and increase their chances of recovery.

Safety guidelines or practices

Among developed nations, injuries have emerged to be the leading cause of death among middle-aged traumatic patients. Despite the significant strides in preventing injuries over the past decades, trauma centers still register deaths resulting from injuries. Implementation of safety guidelines towards protecting nurses, physician , patients, and the support staff in trauma care centers is based on the public and private section response . Therefore safety guidelines specific to the trauma center include the use of a plain-language , initiating emergency calls, emergency operations and command center calls.

Hendrick trauma center (HMC) utilizes the plain language policy in alerting various parties in an emergency based on the hospital colors. Once an emergency notification is made in plain language, relevant additional guidance is given to patients, doctors, nurses, and visitors (Hendrick Health System, nd). Plain language plays a vital role in crror reduction , improved transparency of safety protocols, and prevents confusion among staff working in other facilities. 

Physicians who issue patient care in the trauma unit must meet every credential that needs to belong to the hospital medical department and such extra requirements must be important for sustaining the trauma designation. The criteria must be provided in the laws of the medical professionals and applicable personal privilege documents. The TMD would ensure and supervise the cooperation of the medical employers’ operations to the rules. The medical management board, the PIPS board as well as TSRC

Trauma nursing oversight

The trauma cooperation in association with the Department of Nursing, the Chief Nursing Officer, concerned Unit Nurse Managers as well as Educators has to oversee the placement, certification, and continuing competency needs for the nurses giving care for Trauma patients. Specific orientation is done to the department, procedures, schemes, recording, functions, and duties relation to health care of the trauma patients are established and every licensed and unregistered worker in the emergency department. Asses and apply suitable equipment and resources. The Emergency Department Nurses Association like TNCC together with approving that in every situation of patient care the particular clinical situation of the patient dictates the kind and the level of concern.

Steps beyond standard precaution

Measures observed to protect Trauma patients

Every multisystem patient’s Concern of the trauma patients always begins in the health center with witnesses as well as progress through the whole acute concern, followed by the retrieval duration inclusion of rehabilitation and going back. Oversight of the concern given, variation limitation, advancement applications and efficiency, learning, and injury avoidance are administered through TMO, TAMD together with Trauma cooperation in association with all sectors and societies served.

Incorporation of additional disciplines is included. There is an application of respiratory counseling, Pharmacy, radiology services, Nursing, pastoral concern, patient relations, surrounding services, surgical services, pastoral care, rehabilitation services, law enforcement, food services, transport, emergency medical services, occupational counseling, and wound counseling.

The “Critical Hour” Concept in the ED

Critical hour entails the first sixty minutes after traumatic damage which is the most important golden hour. This perception that resuscitative trauma concerns must be applied within this early period is known, learned, and exercised in the whole world for many years. Ms. DG, a woman aged 34 years, came to the health center at 11:00 in the morning using the EMC, reporting of seizure episode with experiencing of headache, fever as well as nausea. She revealed not experiencing any pain or head injury. Ms. DG was upset and cried based on what she went through. Based on the signs, I gathered Ms. DG’s medical history to establish a suitable treatment mechanism. She has had an experienced seizure before and weakness in the right side of the body, and was receiving medical care to manage the situation.

Ms. DG used to take at home 50 mg of Dilantin every day. I investigated serious symptoms and noted the temperature of 98 degrees Fahrenheit. Her pulse rate was 90 beats/minute. Continuing with the diagnosis I ascertained oxygen was 99% at room air, respiratory rate was 14 breath/ minute and blood pressure was at 136/78. The assessment I conducted on Ms. DG discovered that she was alert and oriented of her surroundings. She was aware of people, time, location, and circumstances. MS DG had a regular and symmetric heartbeat in which the S1 and S2 present. Further investigation demonstrated lung sound clear, regular, and symmetric breathing pattern. When I carried an examination on Mrs. DG, she has no other medical history, and never smoked.

MS DG conscious condition and the capability of speaking was of great help because we managed to collect necessary data to continue with the treatment procedure. Based on the previous evaluation, we established that Ms. DG had a seizure. Hence when she arrived at the emergency department we placed IV cannula 20-gauge in left cephalic veins, We conducted a blood samples include: blood count using differential, ISTAT troponin, prothrombin time, INR, PTT, ECG, and chest X-ray. The physician at 11:15 am, and ordered 1 mg of oral diazepam, and 0.9 sodium chloride IV bolus.The chest X-ray results returned at 11:50 am and indicated that her heart size was normal and her lung was clear together with the absence of abnormal issues. The physician came back at 2:00 after patient stabilized and discharged her.

My nursing diagnosis was risk for trauma or suffocation related to the loss of small/ large muscles coordination. The goal is that the patient will maintain safety and treatment regimen to control seizure activity. The intervention of my diagnosis was first, teach patient and family about safety precaution before and during seizure. This could be conducted by turning the patient head to side, clear environment around the patient, nothing in the mouth, do not restrain, and stay with patient during the seizure activity. Second, take medication as prescribed 50 mg of Dilantin. The main objective is to promote patient activity. My evaluation of the experience is that the goal met, patient was stable by that time, and patient and family understand the safety precaution by the discharge 09/14/20 2:05pm

Legal / ethical dilemmas the Trauma Nurse experienced

Nurses make choices every time that should take into consideration laws and ethical norms. Hence to decide, nurses need a comprehension of means by which law as well as ethics, and nursing interface. The nurse should balance their choices associated with what evidence based operation demonstrates, what the constitution approves, and what the moral dilemma requires (Oyeniyi, Fox, Scerbo, Tomasek, Wade & Holcomb, 2017). Legal together with ethical dilemmas are present in different beliefs. Legal as well as ethical dilemmas manifest themselves when the patient circumstance calls for sudden decision making. For instance, when the patient arrives at the emergency department after excessive bleeding and they are unresponsive. The need for blood donation arises although the patient is unresponsive. The family members are also hesitant in deciding concerning blood donation to the patient. This situation puts the nurse in an ethical and legal dilemma.

Traumatic experience

In the end, my experience at the emergency department was that I learned significance of teamwork. Also, I learned that a healthy doctor-nurse relationship creates a conductive environment for both health care professional and patients. Teamwork makes coordination of activities in trauma care faster and reliable for patients and their families.

Although, I learned the autonomy of nurses in establishing quality care, I work hard to understand more concerning chief complain to reduce patients waiting time. An ethical dilemma that I faced was caused by the challenge of balancing between patients’ waiting time and satisfaction with service provided.

References

Munnangi, S., Dupiton, L., Boutin, A., & Angus, L. D. (2018). Burnout, perceived stress, and job satisfaction among trauma nurses at a level I safety-net trauma center. Journal of Trauma Nursing, 25(1), 4-13.

Paul, S. (2017, December 03). TRIAGE. Retrieved September 29, 2020, from https://www.slideshare.net/subhankarnrs/triage-83240979

Oyeniyi, B. T., Fox, E. E., Scerbo, M., Tomasek, J. S., Wade, C. E., & Holcomb, J. B. (2017). Trends in 1029 trauma deaths at a level 1 trauma center: impact of a bleeding control bundle of care. Injury, 48(1), 5-12.