Bronson Hospital/Western Michigan University, Kalamazoo (Dr Schieman); and Bronson Hospital, Kalamazoo, Michigan (Mss Cowles and Hoeve).
J Trauma Nurs. 2020 May/Jun;27(3):151-154. doi: 10.1097/JTN.0000000000000504.
Trauma patients are unique in their potential for exposure to dangerous chemicals or material, placing staff in the emergency department (ED) or trauma unit at risk for exposure themselves. The purpose of this study was to describe one centers' trauma nursing experience with decontamination and to identify opportunities for improvement. This was a cross-sectional descriptive study of decontamination practices using an anonymous online survey of trauma nurses at a single Midwestern verified Level I trauma center and burn center. A total of 82 nurses completed the survey with a 48% response rate. Overall, 57% reported having had some previous decontamination training, with ED and air transport nurse's training, knowledge, and comfort level reported as the highest and inpatient trauma nurses the lowest. A significant association was found between ED nurses and feeling the surest about their safety when caring for exposed patients (χ = 19.908, p = .018) and between hazardous materials training and receiving communication about the patient's decontamination procedures during care (χ = 8.879, p = .031). Our results show that trauma nurse decontamination training and communication, as well as confidence in knowledge and safety, vary by nursing unit. The relatively low-volume high-risk scenario of trauma decontaminations likely contributes to inpatient nurses reporting of inadequate preparedness. This requires administrative commitment to ensure that all trauma nurses receive decontamination training in orientation, as well as ongoing continuing education, skill competency checks, and simulation training. Decontaminate communication is an essential requirement of all ED trauma team handoffs and medical record documentation.
创伤患者可能接触到危险化学品或物质，这使急诊部（ED）或创伤病房的工作人员面临暴露风险。本研究旨在描述一家中心的创伤护理人员在去污方面的经验，并确定改进的机会。这是一项横断面描述性研究，使用创伤护士在中西部地区的一个验证的一级创伤中心和烧伤中心的匿名在线调查来描述去污实践。共有 82 名护士完成了调查，回复率为 48%。总体而言，57%的护士报告说之前接受过一些去污培训，ED 和空中运输护士的培训、知识和舒适度水平最高，住院创伤护士最低。ED 护士在照顾暴露患者时对自己安全的信心（χ=19.908，p=0.018）和危险材料培训与在护理过程中收到有关患者去污程序的沟通（χ=8.879，p=0.031）之间存在显著关联。我们的结果表明，创伤护士去污培训和沟通以及对知识和安全的信心因护理单元而异。创伤去污的相对低容量高风险情况可能导致住院护士报告准备不足。这需要行政部门的承诺，以确保所有创伤护士在入职培训中接受去污培训，以及持续的继续教育、技能能力检查和模拟培训。去污沟通是 ED 创伤团队交接和医疗记录文档的基本要求。
