The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, Australia; Trauma Quality Improvement Sub-Committee, Royal Australasian College of Surgeons, Australia; Australasian Trauma Society, Australia; Australian Trauma Quality Improvement Program (AusTQIP), Australia; Illawarra Shoalhaven Local Health District, NSW, Australia; University of Wollongong, Faculty of Science, Medicine and Health, Wollongong, Australia.
The University of Sydney, Faculty of Medicine and Health, Susan Wakil School of Nursing and Midwifery, Sydney, Australia.
Injury. 2020 Sep;51(9):2053-2058. doi: 10.1016/j.injury.2020.07.033. Epub 2020 Jul 15.
Injury is a leading cause of death and disability world-wide. Little is known about the day-to-day challenges the trauma clinicians face in their practice that they feel could be improved through an increased evidence base. This study explored and ranked the trauma clinical practice research priorities of trauma care professionals across Australia and New Zealand.
A modified-Delphi study was conducted between September 2019 and January 2020. The study employed two rounds of online survey of trauma professionals from relevant Australia and New Zealand professional organisations using snowballing method. Participants were asked to rank the importance of 29 recommendations, each corresponding to a key challenge in trauma care delivery. Decisions on the priorities of the challenges were determined by a consensus of >70% of respondents ranking the challenge as important or very important.
One hundred and fifty-five participants completed Round One, and 106 participants completed Round Two. A total of 15 recommendations reached >70% in Round One. Nine recommendations also reached >70% consensus in Round Two. Recommendations ranked highest were 'Caring for elderly trauma patients', 'Identifying and validating key performance indicators for trauma system benchmarking and improvement', and 'Management of traumatic brain injury'.
This study identified the priority areas for trauma research as determined by clinician ranking of the most important for informing and improving their practice. Addressing these areas generates potential to improve the quality and safety of trauma care in Australian and New Zealand.
在全球范围内，伤害是导致死亡和残疾的主要原因。人们对创伤临床医生在实践中每天面临的挑战知之甚少，他们认为这些挑战可以通过增加证据基础来改善。本研究探讨并对澳大利亚和新西兰创伤护理专业人员的创伤临床实践研究重点进行了排名。
采用改良德尔菲法，于 2019 年 9 月至 2020 年 1 月对相关澳大利亚和新西兰专业组织的创伤专业人员进行了两轮在线调查。研究采用滚雪球法对创伤专业人员进行了两轮在线调查。参与者被要求对 29 项建议的重要性进行排名，每项建议对应创伤护理提供方面的一个关键挑战。通过 >70%的应答者将挑战评为重要或非常重要，来确定对挑战的优先次序的决策。
155 名参与者完成了第一轮，106 名参与者完成了第二轮。第一轮有 15 项建议达到了 >70%的共识。第二轮也有 9 项建议达到了 >70%的共识。排名最高的建议是“照顾老年创伤患者”、“确定和验证创伤系统基准和改进的关键绩效指标”和“创伤性脑损伤的管理”。
本研究通过临床医生对最重要的实践信息进行排名，确定了创伤研究的优先领域。解决这些问题有可能提高澳大利亚和新西兰创伤护理的质量和安全性。
