Accelerated Biologic Aging, Chronic Stress, and Risk for Sepsis and Organ Failure Following Trauma.

Chronic stress and accelerated aging have been shown to impact the inflammatory response and related outcomes like sepsis and organ failure, but data are lacking in the trauma literature. The purpose of this study was to investigate potential relationships between pretrauma stress and posttrauma outcomes. The hypothesis was that pretrauma chronic stress accelerates aging, which increases susceptibility to posttrauma sepsis and organ failure.

The Social Determinants of Trauma: A Trauma Disparities Scoping Review and Framework.

The drivers of trauma disparities are multiple and complex; yet, understanding the causes will direct needed interventions. The aims of this article are to (1) explore how the injured patient, his or her social environment, and the health care system interact to contribute to trauma disparities and examine the evidence in support of interventions and (2) develop a conceptual framework that captures the socioecological context of trauma disparities. Using a scoping review methodology, articles were identified through PubMed and CINAHL between 2000 and 2015.

Descriptive Analysis of Venous Thromboembolism in Georgia Trauma Centers Compared with National Trauma Centers Participating in the Trauma Quality Improvement Program.

This study was designed to compare the incidence of venous thromboembolism (VTE) in Georgia trauma centers with other national trauma centers participating in the Trauma Quality Improvement Program (TQIP). The use of chemoprophylaxis and characteristics of patients who developed VTE were also examined. We conducted a retrospective observational study of 325,703 trauma admissions to 245 trauma centers from 2013 to 2014.

A Decade Evaluation of a State Trauma System: Has Access to Inpatient Trauma Care at Designated Trauma Centers Improved?

Recently, the trauma center component of the Georgia trauma system was evaluated demonstrating a 10 per cent probability of increased survival for severely injured patients treated at designated trauma centers (DTCs) versus nontrauma centers. The purpose of this study was to determine the effectiveness of a state trauma system to provide access to inpatient trauma care at DTCs for its residents. We reviewed 371,786 patients from the state's discharge database and identified 255,657 treated at either a DTC or a nontrauma center between 2003 and 2012.

The Association of Race, Socioeconomic Status, and Insurance on Trauma Mortality.

Background: Although race, socioeconomic status, and insurance individually are associated with trauma mortality, their complex interactions remain ill defined.

Methods: This retrospective cross-sectional study from a single Level I center in a racially diverse community was linked by socioeconomic status, insurance, and race from 2000 to 2009 for trauma patients aged 18-64 years with an injury severity score more than 9. The outcome measure was inpatient mortality.

An analysis of the effectiveness of a state trauma system: treatment at designated trauma centers is associated with an increased probability of survival.

Background: States struggle to continue support for recruitment, funding and development of designated trauma centers (DTCs). The purpose of this study was to evaluate the probability of survival for injured patients treated at DTCs versus nontrauma centers.

Methods: We reviewed 188,348 patients from the state's hospital discharge database and identified 13,953 severely injured patients admitted to either a DTC or a nontrauma center between 2008 and 2012.

Methods used by critical care nurses to verify feeding tube placement in clinical practice.

Background: The American Association of Critical-Care Nurses practice alert on verification of feeding tube placement makes evidence-based practice recommendations to guide nursing management of adult patients with blindly inserted feeding tubes. Many bedside verification methods do not allow detection of improper positioning of a feeding tube within the gastrointestinal tract, thereby increasing aspiration risk.

Objectives: To determine how the expected practices from the American Association of Critical-Care Nurses practice alert were implemented by critical care nurses.

Factors influencing critical care nurses' adoption of the AACN practice alert on verification of feeding tube placement.

Background: Clinical practice guidelines are intended to bridge the research-practice gap, yet little is known about how critical care nurses adopt guidelines. Feeding tube verification practices remain variable and have led to patient harm and death.

Objectives: To examine factors influencing critical care nurses' adoption of the American Association of Critical-Care Nurses (AACN) practice alert on verification of feeding tube placement and its 4 recommended clinical practices.

"It takes a village" to raise research productivity: Impact of a Trauma Interdisciplinary Group for Research (TIGR) at an urban, Level 1 trauma center.

Background: Few interdisciplinary research groups include basic scientists, pharmacists, therapists, nutritionists, lab technicians, as well as trauma patients and families, in addition to clinicians. Increasing interprofessional diversity within scientific teams working to improve trauma care is a goal of national organizations and federal funding agencies like the National Institutes of Health (NIH). This paper describes the design, implementation, and outcomes of a Trauma Interdisciplinary Group for Research (TIGR) at a Level 1 trauma center as it relates to increasing research productivity, with specific examples excerpted from an on-going NIH-funded study.

"It takes a village" to raise research productivity: impact of a Trauma Interdisciplinary Group for Research at an urban, Level 1 trauma center.

Background: Few interdisciplinary research groups include basic scientists, pharmacists, therapists, nutritionists, laboratory technicians, as well as trauma patients and families, in addition to clinicians. Increasing interprofessional diversity within scientific teams working to improve trauma care is a goal of national organizations and federal funding agencies such as the National Institutes of Health (NIH). This article describes the design, implementation, and outcomes of a Trauma Interdisciplinary Group for Research (TIGR) at a Level 1 trauma center as it relates to increasing research productivity, with specific examples excerpted from an ongoing NIH-funded study.

Demographic differences in systemic inflammatory response syndrome score after trauma.

Background: Demographic differences in health outcomes have been reported for chronic diseases, but few data exist on these differences in trauma (defined as acute, life-threatening injuries).

Objective: To investigate the relationship between the systemic inflammatory response syndrome score after trauma and race/ethnicity and socioeconomic status.

Methods: A retrospective chart review of 600 patients from a level I trauma center (1997-2007) was conducted.

Systemic inflammatory response syndrome score and race as predictors of length of stay in the intensive care unit.

Background: Identifying predictors of length of stay in the intensive care unit can help critical care clinicians prioritize care in patients with acute, life-threatening injuries.

Objective: To determine if systemic inflammatory response syndrome scores are predictive of length of stay in the intensive care unit in patients with acute, life-threatening injuries.

Methods: Retrospective chart reviews were completed on patients with acute, life-threatening injuries admitted to the intensive care unit at a level I trauma center in the southeastern United States.

Impact of pretest on posttest knowledge scores with a Solomon Four research design.

There is a paucity of research on the effects of pretest measurement with prostate cancer screening. What effect does a pretest measurement have on posttest outcomes? This research reports knowledge of prostate cancer screening among men randomized to an Enhanced decision aid versus an Usual Care decision aid. Using a Solomon Four research design, there were a total of 198 men in 4 groups.

Racial disparities in acute outcomes of life-threatening injury.

Purpose: To critically analyze racial and ethnic disparities in acute outcomes of life-threatening injury in the United States (US).

Design: Integrative review of literature.

Methods: A search of Medline (1966-2005) and CINAHL (Cumulative Index to Nursing and Allied Health Literature; 1982-2002) scientific literature databases was undertaken to identify research aimed at correlating minority race and ethnicity to acute outcomes of life-threatening injury in the US.

Defining "disasters" with implications for nursing scholarship and practice.

Nurses have long been a part of disaster care, yet the nurses' unique approaches to disaster victims have not been reported in the nursing literature. This situation raises the questions, "How does disaster nursing differ than general nursing?" and "What defines the specialty care of disaster nursing?" An analysis of the term "disaster" and the concepts that have been used to build a theoretic base for disaster nursing are presented.