Zhu Thein Hlaing, Hollister Lisa, Scheumann Christopher, Konger Jennifer, Opoku Dazar
Parkview Adult and Pediatric Level 2 Trauma Center, Fort Wayne, Indiana.
J Trauma Nurs. 2016 Jan-Feb;23(1):13-22. doi: 10.1097/JTN.0000000000000176.
The study evaluates (1) health care provider perception of the Rural Trauma Team Development Course (RTTDC); (2) improvement in acute trauma emergency care knowledge; and (3) early transfer of trauma patients from rural emergency departments (EDs) to a verified trauma center. A 1-day, 8-hour RTTDC was given to 101 nurses and other health care providers from nine rural community hospitals from 2011 to 2013. RTTDC participants completed questionnaires to address objectives (1) and (2). ED and trauma registry data were queried to achieve objective (3) for assessing reduction in ED time (EDT), from patient arrival to decision to transfer and ED length of stay (LOS). The RTTDC was positively perceived by health care providers (96.3% of them completed the program). Significant improvement in 13 of the 19 knowledge items was observed in nurses. Education intervention was an independent predictor in reducing EDT by 28 minutes and 95% confidence interval (CI) [-57, -0.1] at 6 months post-RTTDC, and 29 minutes and 95% CI [-53, -6] at 12 months post-RTTDC. Similar results were observed with ED LOS. The RTTDC is well-perceived as an education program. It improves acute trauma emergency care knowledge in rural health care providers. It promotes early transfer of severely injured patients to a higher level of care.
（1）医疗服务提供者对农村创伤团队发展课程（RTTDC）的看法；（2）急性创伤急救知识的改善情况；以及（3）创伤患者从农村急诊科（ED）早期转至经认证的创伤中心的情况。2011年至2013年期间，为来自9家农村社区医院的101名护士和其他医疗服务提供者提供了为期1天、共8小时的RTTDC课程。RTTDC参与者完成了问卷调查，以实现目标（1）和（2）。查询了急诊科和创伤登记数据，以实现目标（3），即评估从患者到达至决定转院的急诊科时间（EDT）以及急诊科住院时间（LOS）的缩短情况。医疗服务提供者对RTTDC给予了积极评价（96.3%的参与者完成了该课程）。护士对19项知识条目中的13项有显著改善。教育干预是RTTDC课程结束后6个月时将EDT缩短28分钟的独立预测因素，95%置信区间（CI）为[-57, -0.1]；在RTTDC课程结束后12个月时，将EDT缩短29分钟，95%CI为[-53, -6]。急诊科住院时间也观察到了类似结果。RTTDC作为一项教育项目得到了很好的评价。它提高了农村医疗服务提供者的急性创伤急救知识。它促进了重伤患者早期转至更高水平的护理机构。
