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Geriatric Trauma Protocol

Cortez, Renee, DNP, ARNP, ACNP-BC, MSN, CCRN, BSN

doi: 10.1097/JTN.0000000000000376
GERIATRICS
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Study design for a quality improvement project. Objective was to implement a geriatric trauma protocol (GTP) based on American College of Surgeons recommendations to improve patient outcomes. Geriatric trauma patients comprise a vulnerable and high-risk trauma population, and must be treated with specific protocols that take into account physiological, psychosocial, environmental, and pharmacological needs. A growing body of research and organizations such as the American College of Surgeons and the Eastern Association for the Surgery of Trauma recommend that a specific trauma protocol for geriatric adults must be utilized in hospitals and trauma centers. A retrospective chart review was conducted to assess geriatric patient outcomes prior to GTP implementation. Surgical residents then received training on the GTP, including performing additional diagnostics, referrals, and discussing goals of care early in treatment. The GTP was then implemented for 8 weeks and monitored to determine its effects on patient outcomes. The training for surgical residents in the GTP yielded a 9.2% increase in provider knowledge. The results of the GTP showed a reduced length of stay and increased geriatric consultations. More patients received a full evaluation by the trauma team, contributing the reduced length of stay. The use of a GTP shows promise in being able to improve patient outcomes, including morbidity and mortality. The principles of the GTP can be applied in all clinical settings, especially emergency rooms, which are on the frontlines of initial evaluations. In order to improve health care delivery to an aging population, organizations and clinicians should adopt a specialized GTP into their practices.

U.S. Department of Veterans Affairs, Orlando VA Medical Center, Florida.

Correspondence: Renee Cortez, DNP, ARNP, ACNP-BC, MSN, CCRN, BSN, U.S. Department of Veterans Affairs, Orlando VA Medical Center, 13800 Veterans Way, Orlando, FL 32827 (renee.corteznp@gmail.com; renee.cortez@va.gov).

The author declares no conflict of interest.

Copyright © 2018 by the Society of Trauma Nurses.