The development of clinical nursing practice guideline for initial assessment in multiple injury patients admitted to trauma ward

摘要

Background: Missed diagnoses are very common in patients with multiple injuries. To help nurses identify missed injuries, this study aimed to develop and evaluate a clinical nursing practice guideline (CNPG) for the initial assessment of multiply injured patients admitted to the trauma ward in a provincial hospital in southern Thailand. Method: The CNPG was developed using evidence-based knowledge of trauma assessment and the Advanced Trauma Life Support guideline. The CNPG was used by 18 nurses working in the trauma ward. They implemented the CNPG with 34 multiply injured patients. The outcome measures of the CNPG use were the nurses' self-reported compliance with the use of the CNPG, the nurses' satisfaction with using the CNPG, and the percentage of missed injuries detected as a result of the use of the CNPG. Results: Most nurses (83.33%) reported complying with the CNPG and 72.2% of them indicated that their satisfaction with using the CNPG was at a high level. Missed injuries were discovered at a rate of 14.6% of the total injuries diagnosed in the injured patients within 24 h of ward admission. Conclusion: Further research needs to be conducted to establish if the CNPG could be more widely applied to improve the quality of care and increase the safety of those with multiple injuries.