Secondary Logo

Institutional members access full text with Ovid®

Cohorting Trauma Patients in a Medical/Surgical Unit at a Level I Pediatric Trauma Center to Enhance Interdisciplinary Collaboration and Documentation

Meyer, Loreen K., MSN; Nanassy, Autumn D., MA; Lavella, Heather, BSN; Arthur, L. Grier, MD; Grewal, Harsh, MD

doi: 10.1097/JTN.0000000000000418
INNOVATIONS AND OPERATIONS
Buy
SDC

Medical errors are a significant issue in health care that may be avoided through enhanced communication and documentation. This study examines interdisciplinary communication and compliance with trauma standards of care demonstrated through following the implementation of cohorting trauma patients to one medical/surgical unit and instituting daily interdisciplinary trauma patient rounds. Potential benefits include enhanced communication, improved nursing satisfaction, and increased compliance with trauma standards of care demonstrated through documentation, which the literature suggests improves quality of care. Pre- and postcohorting surveys related to safety attitudes, comfort with caring for trauma patients, and the efficacy of cohorting were administered to the nursing staff. As a marker for increased compliance with trauma standards of care, medical records were reviewed for completion of substance abuse screening upon admission and Functional Independence Measure screening at discharge. The results were compared after the cohorting initiative with 2 years prior. The rate of compliance with substance abuse screening increased from an average of 62.5% in 2015 and 2016 to 84% in 2017. Functional Independence Measure compliance increased from an average of 72.5% in 2015 and 2016 to 94% in 2017 following the cohorting intervention. Nursing perceptions of teamwork, safety climate, and staff support significantly improved (p < .05) from pre- to postcohorting surveys. Improvements were noted in comfort with performing tasks associated with caring for trauma patients but were not statistically significant. Cohorting trauma patients to one medical/surgical unit resulted in positive perceptions of professional relationships, improved communication, and compliance with trauma standards of care for documentation.

St. Christopher's Hospital for Children, Philadelphia, Pennsylvania (Mss Meyer, Nanassy, and Lavella and Drs Arthur and Grewal); and Drexel University College of Medicine, Philadelphia, Pennsylvania (Drs Arthur and Grewal).

Correspondence: Autumn D. Nanassy, MA, St. Christopher's Hospital for Children, 160 E. Erie Ave, Philadelphia, PA 19134 (autumndnanassy@gmail.com).

Author Contributions: Loreen K. Meyer helped conceptualize and design the work, acquire data, and draft and revise the manuscript, approved the version submitted, and agrees to be accountable for all aspects of the work. Autumn D. Nanassy helped conceptualize and design the work, acquire, analyze, and interpret the data, and draft and revise the manuscript, approved the version submitted, and agrees to be accountable for all aspects of the work. Heather Lavella helped conceptualize and design the work, acquire data, and draft and revise the manuscript, approved the version submitted, and agrees to be accountable for all aspects of the work.

L. Grier Arthur helped conceptualize and design the work and draft and revise the manuscript, approved the version submitted, and agrees to be accountable for all aspects of the work.

Harsh Grewal helped conceptualize and design the work and draft and revise the manuscript, approved the version submitted, and agrees to be accountable for all aspects of the work.

Conflicts of Interest: None.

Copyright © 2019 by the Society of Trauma Nurses.