Challenges developing evidence-based algorithms for the trauma reception and resuscitation project.

Abstract: A project based at the Alfred Emergency and Trauma Centre in Melbourne, Australia aimed to standardise trauma resuscitation, documentation and interventions by developing best practice algorithms. The primary study objective was to demonstrate a reduction in management errors using a real-...

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Publicado en:International Emergency Nursing Vol. 21; no. 2; pp. 129 - 136
Autores principales: Lee, Geraldine A., Murray, Angela, Bushnell, Rosie, Niggemeyer, Louise E.
Formato: pictorial research tables/charts randomized controlled trial Journal Article
Publicado: Elsevier B.V. Apr2013
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Elsevier B.V.
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        2012147022
        10.1016/j.ienj.2012.01.005
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        atl: Challenges developing evidence-based algorithms for the trauma reception and resuscitation project.
      aug:
        au:
          Lee, Geraldine A.
          Murray, Angela
          Bushnell, Rosie
          Niggemeyer, Louise E.
        affil: Division of Nursing & Midwifery, Latrobe University, Bundoora, Melbourne, Victoria, Australia
      sug:
        subj:
          Professional Practice, Evidence-Based
          Resuscitation
          Trauma Therapy
          Decision Trees
          Decision Making, Clinical
          Emergency Care
          Treatment Errors Prevention and Control
          Trauma Centers
          Human
          Funding Source
          Victoria
          Randomized Controlled Trials
          Emergency Nursing
          Physicians, Emergency
          Multidisciplinary Care Team
          Emergency Service Information Systems
          Emergency Patients
          Airway Management
          Resuscitation, Cardiopulmonary
          Shock Therapy
          Severity of Illness Indices
          Descriptive Statistics
          Algorithms
          Change Management
          Nursing Records
          Outpatients
      ab: Abstract: A project based at the Alfred Emergency and Trauma Centre in Melbourne, Australia aimed to standardise trauma resuscitation, documentation and interventions by developing best practice algorithms. The primary study objective was to demonstrate a reduction in management errors using a real-time computer based algorithm (the study group) compared to the control group in an open randomised controlled interventional study. A baseline control group was also used for comparison with usual (current) practice. In order to examine the existing evidence and algorithms in trauma care, nine teams of emergency nurses and doctors were formed. Specific literature searches performed by each team revealed a paucity of evidence supporting clinical practice in the trauma setting for procedures. Subsequently, the multidisciplinary teams worked together and developed algorithms based on best practice. The process revealed three main areas of challenges in the development of algorithms: (i) clinical, (ii) research and (iii) nursing challenges. The completion of the project demonstrated benefits in the real-time computer based algorithm with a reduction in the error rate per patient from the baseline control group to the intervention study group (2.30 vs. 2.13, p =0.04) and error-free resuscitations increasing from 16% to 21.8% (p =.049). This project supported the implementation of a real-time computer based algorithm system with improved protocol compliance and reduced errors and morbidity.
      pubtype: Academic Journal
      doctype:
        pictorial
        research
        tables/charts
        randomized controlled trial
        Journal Article
      ougenre: Article
    language: English
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