ABSTRACT
In Sweden trauma is the most common cause of death in people under the age of 45.
More than 4500 people each year die as a result of external injuries. On a demographic level preventive measures are being taken to reduce morbidity and mortality caused by trauma.
During the year of 2005 the costs added up to 21 billion Swedish crowns, and this figure only covers the costs of traffic accidents. In Stockholm County there's one main trauma center which is situated at Karolinska University hospital. This hospital handles the treatment of the most severe traumas, called trauma- one and trauma- two. Remaining hospitals in the county are capable of treating minor trauma, so called trauma- three. The care and treatment plan of a patient injured by trauma is built on the structure called ABCDE (Airway-Breathing-Circulation-Disability-Exposure) which is a part of ATLS. This structure is used to quickly discover, estimate and treat possible injuries. It also provides a way for the entire traumateam to work together from concise guidelines. With all personnel using the same tool/structure for examination and prioritizing the treatment of the patient it not only secures that each profession acts their part, but also increases patient safety. Each hospital relies on their own traumateam, however the constitution of the professions included in the team may differ between hospitals. Within the team communication is of the essence, both within the team and with the patient. In this team the nurse's competence of person-centered care and patient safety comes well to use. When the care provided is person-centered the traumateam can use the patient’s own knowledge and recourses which increases safety for both patient and personnel.
The aim of the study was to describe the experience of patients receiving nursing care in the emergency room after injury by trauma.
This study is a qualitative descriptive interview study where semi structured interviews were conducted. In total there were six interviews. The interviews were audio recorded and transcribed before they were analyzed. Content analysis was performed in which meaning units were condensed, coded and divided into subthemes, themes and general theme.
The result showed one general theme, two themes and five subthemes. The general theme was Patient´s experiences of the nursing care in the emergency room after trauma. The themes were Being a patient in an emergency room and To feel included and experiences of personal treatment. The experiences of communication and the way information was given were mixed. Patients experienced being in focus but not receiving eye contact from the personnel. Emotions that emerged were such as safety and anxiety along with tranquility. The severity of the situation was amplified by the large number of personnel present in the emergency room during nursing care. Some equipment’s and examinations were experienced as more emotional, these were the stiff neck collar and the log-roll. The stiff neck collar for some, felt uncomfortable and unpleasant. The log-roll though was pursued in a very secure and well-practiced manner which resulted in a feeling of routine and safety.
The result showed in this study indicates that personal treatment, communication and a high degree of inclusion are the three most important aspects regarding patients experiences of nursing care in the emergency room after trauma. These three aspects are formulated in that the patients experiences being in focus, receiving information about present and future actions and examinations and also given the opportunity to feel included in the situation.