title: Orthopaedic nursing challenges in poly-traumatised patient management: A critical analysis of an Orthopaedic and Trauma Unit.
abstract: BACKGROUND
  Trauma is the most frequent cause of death in people under 40 years old. It is an important problem not only because of the high mortality but also because of the consequential disability that can lead to serious economic consequences.
  
  
  OBJECTIVE
  This descriptive, comparative study investigates the definitive management of poly-traumatised patients in an Italian Orthopaedic Ward in order to highlight its strengths and weaknesses in comparison with the most recent literature. This has led to the development of a pre-established algorithm for evaluation, preventive care and management of the poly-trauma patient and a flow-chart for improved patient care.
  
  
  METHODS
  A five-step observational and exploratory approach was employed in this study which critically analysed the nursing management of 60 multiple trauma patients admitted to our Orthopaedic Unit from April 2013 to October 2014.
  
  
  RESULTS
  The findings highlight the need for adherence to plans of care, which can be approached by a shared management of poly-trauma patients that involves the medical team, the patient and his family/caregiver.
  
  
  CONCLUSIONS
  The protocols and guidelines in use in our Orthopaedic and Trauma Unit are in line with European standards, although there is still margin for improvement. The study has led to the development of an algorithm that allows health professionals to have reference values for the care of polytrauma patients.
  
  
  CONCLUSIONS
  This study demonstrates the use of theoretical and practical tools for the evaluation and management of poly-traumatised patients during their hospital stay. We recommend the use of both proposed tools: the general algorithm and the flow-chart for the management of the poly-trauma patient, as they allow identification of barriers and facilitators related to the implementation of international guidelines, currently well-defined for Emergency Departments but not yet for Orthopaedic Units.
authors: Orthopaedic and Traumatology Clinic, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padova, Italy; Orthopaedic and Traumatology Clinic, Padua Hospital, Padova, Italy. Electronic address: carlo.biz@unipd.it.
authors: Carlo
authors: C
authors: Biz
authors: Orthopaedic and Traumatology Clinic, Padua Hospital, Padova, Italy; Edith Cavell Campus, Bretton Gate, Peterborough, Cambridgeshire PE3 9GZ, United Kingdom.
authors: Lisa
authors: L
authors: Buffon
authors: Orthopaedic and Traumatology Clinic, Department of Surgery, Oncology and Gastroenterology (DiSCOG), University of Padua, Padova, Italy.
authors: Roberto
authors: R
authors: Marin
authors: Orthopaedic and Traumatology Clinic, Padua Hospital, Padova, Italy.
authors: Natalia
authors: N
authors: Petrova
mesh_terms: D000328:Adult; D000465:Algorithms; D003661:Decision Support Techniques; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000451:nursing*; D016530:Orthopedic Nursing; D017063:Outcome Assessment, Health Care; D057184:Practice Patterns, Nurses'; D014193:Trauma Centers; D055815:Young Adult
keywords: Injury; Management; Multiple trauma; Nursing; Polytrauma; Service improvement; Team approach; Trauma unit