Lewis-O'Connor Annie, Olson Rose, Grossman Samara, Nelson Derek, Levy-Carrick Nomi, Stoklosa Hanni, Banning Stephanie, Rittenberg Eve
Division of Women's Health, Department of Medicine Brigham and Women's Hospital Boston Massachusetts USA.
Harvard Medical School Boston Massachusetts USA.
J Am Coll Emerg Physicians Open. 2023 Jul 17;4(4):e13001. doi: 10.1002/emp2.13001. eCollection 2023 Aug.
To describe factors that influence interprofessional staff decisions and ability to implement trauma-informed care (TIC) in a level-one emergency department (ED) trauma center.
This qualitative research study consisted of semi-structured interviews and quantitative surveys that were conducted between March and December 2020 at an urban trauma center. Eligible participants were staff working in the ED. Interview questions were developed using the Theoretical Domains Framework (TDF), which is designed to identify influences on health professional behavior related to implementation of evidence-based recommendations. Interview responses were transcribed, coded using Atlas software, and analyzed using thematic analysis.
Key themes identified included awareness of TIC principles, impact of TIC on staff and patients, and experiences of bias. Participants identified opportunities to improve care for patients with a trauma history, including staff training, more time with patients, and efforts to decrease bias toward patients. Most participants (85.7%) felt that a TIC plan, tiered trauma inquiry, and warm handovers would be easy or very easy to implement.
We identified key interprofessional staff beliefs and attitudes that influence implementation of TIC in the ED. These factors represent potential individual, team-based, and organizational targets for behavior change interventions to improve staff response to patient trauma and to address secondary trauma experienced by ED staff.
描述在一级急诊科创伤中心影响跨专业工作人员做出实施创伤知情护理（TIC）决策及实施能力的因素。
这项定性研究包括2020年3月至12月在一家城市创伤中心进行的半结构化访谈和定量调查。符合条件的参与者是急诊科工作人员。访谈问题是使用理论领域框架（TDF）制定的，该框架旨在确定对与实施循证建议相关的卫生专业人员行为的影响。访谈回复被转录，使用阿特拉斯软件编码，并使用主题分析进行分析。
确定的关键主题包括对TIC原则的认识、TIC对工作人员和患者的影响以及偏见经历。参与者确定了改善对有创伤史患者护理的机会，包括工作人员培训、与患者相处更多时间以及减少对患者偏见的努力。大多数参与者（85.7%）认为TIC计划、分层创伤询问和热情交接很容易或非常容易实施。
我们确定了影响急诊科实施TIC的关键跨专业工作人员信念和态度。这些因素代表了行为改变干预的潜在个人、团队和组织目标，以改善工作人员对患者创伤的反应，并解决急诊科工作人员经历的继发性创伤。
