title: The practice of out-lying patients is dangerous: a multicentre comparison study of nursing care provided for trauma patients.
abstract: Pressure for acute hospital beds is a national problem with many acute trauma patients being admitted to non-trauma wards. This prospective multicentre questionnaire study of 220 qualified trauma and non-trauma nurses aims to compare the quality of nursing care that trauma patients receive when admitted to trauma wards and non-trauma wards. The questions included the nursing management of common fractures and post-operative conditions. The completed questionnaires were scored and the results analysed. Hundred percent of the questionnaires were completed and returned. The trauma nurses conveyed the importance of ice (85%) and elevation (97%) in the initial management of limb fractures. This compares with ice (10%) and elevation (50%) on the outlying wards. Trauma nurses correctly monitor for potentially devastating post-operative complications and compartment syndrome 87% of the time compared with 42% on outlying wards. Spinal injuries are managed appropriately 88% of the time on trauma wards compared with 36% on outlying wards. Trauma patients receive better nursing care when admitted to a trauma ward and are nursed by trauma nurses. Many of the out-lying wards provide sub-optimal trauma nursing care and a few are positively dangerous. We suggest that trauma patients should not be nursed on outlying wards.
authors.affiliation: Royal Gwent Hospital, Newport, South Glamorgan, UK. jmlloydl@btopenworld.com
authors.forename: J M
authors.initials: JM
authors.lastname: Lloyd
authors.forename: S
authors.initials: S
authors.lastname: Elsayed
authors.forename: A
authors.initials: A
authors.lastname: Majeed
authors.forename: S
authors.initials: S
authors.lastname: Kadambande
authors.forename: D
authors.initials: D
authors.lastname: Lewis
authors.forename: R
authors.initials: R
authors.lastname: Mothukuri
authors.forename: R
authors.initials: R
authors.lastname: Kulkarni
mesh_terms: D000208:Acute Disease; D002983:Clinical Competence; D003161:Compartment Syndromes / Q000451:nursing; D017679:Cryotherapy; D050723:Fractures, Bone / Q000451:nursing; D019538:Health Care Surveys; D006742:Hospital Bed Capacity; D006760:Hospitalization; D006801:Humans; D011183:Postoperative Complications / Q000451:nursing; D011187:Posture; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards*; D013124:Spinal Injuries / Q000451:nursing; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000451:nursing*