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The Department of Trauma at a Level 1 trauma center sought to improve outcomes by enhancing the continuity of care for patients admitted to trauma services. Departmental leadership explored opportunities to improve this aspect of patient care through expansion of existing trauma Nurse Practitioner (NP) services. The restructured trauma NP service model was implemented in September 2013. A retrospective study was conducted with patients who presented at the trauma center between September 2012 and August 2015. Patients with at least a 24 hour hospital length of stay were separated into three comparator groups by 12-month increments. Twelve months pre-, 12 months during and 12 months post implementation. Data revealed improvement in hospital length of stay, Intensive Care Unit (ICU) length of stay, time to place rehabilitation consultation, 30-day readmission, missed injury(s), and placement of discharge orders before noon. A significant decline in the rate of complications including pneumonia and deep vein thrombosis were also noted. Accordingly, expansion of the trauma NP model resulted in significant improvements in patient, and process of care outcomes. This model for NP services may prove to be beneficial for acute care settings at other hospitals with high volume trauma services.

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Blunt trauma is the primary mechanism of injury seen at Charleston Area Medical Center, a rural level I trauma center. Blunt abdominal trauma occurs as a result of various mechanisms. It can be safely managed nonoperatively and is considered to be the standard of care in hemodynamically stable patients. Appropriate patient education before discharge will enable patients to identify complications early and seek appropriate medical care.

No abstract