The The Effects of Using Clinical Nursing Practice Guidelines for Multiple Trauma Patients in the Emergency Department

Abstract

Multiple trauma patients require rapid, systematic, and accurate nursing care in emergency departments to prevent life-threatening complications and early mortality. Variations in nursing practice and assessment errors during the initial phase of care may negatively affect patient outcomes. Therefore, the development and implementation of standardized nursing practice guidelines are essential to improve the quality and safety of care for multiple trauma patients.

Objectives: This study aimed to evaluate the effects of implementing nursing practice guidelines for multiple trauma patients on (1) nursing outcomes and clinical outcomes of patients, (2) nurses’ knowledge and competencies, and (3) nurses’ satisfaction and feasibility of guideline implementation.

            Methods:This quasi-experimental one-group pretest–posttest study was conducted in the Emergency Department of Sappasitthiprasong Hospital. The participants consisted of 15 registered nurses and 60 multiple trauma patients selected by purposive sampling. The nursing practice guidelines covered triage, primary survey based on the ABCDE approach, resuscitation, reassessment, and patient transfer. Research instruments included a nursing knowledge test, satisfaction and feasibility questionnaires, and nursing outcome record forms. Data were analyzed using descriptive statistics, paired t-test, and independent t-test. Results: After guideline implementation, nurses’ knowledge scores significantly increased compared with the pre-implementation phase (p < 0.001). Nurses reported the highest levels of satisfaction and feasibility for guideline use. Regarding patient outcomes, triage errors decreased, while completion of primary survey and initial vital signs assessment significantly improved. Timely physician notification and immediate management of life-threatening conditions increased. Patients showed significant improvement in Glasgow Coma Scale scores and respiratory rates (p < 0.001). Additionally, deterioration during patient transfer and mortality within the first 24 hours after admission decreased following guideline implementation.

            Conclusions: The nursing practice guidelines for multiple trauma patients were effective in enhancing nurses’ competencies, improving the quality and safety of emergency nursing care, and promoting better clinical outcomes for patients. These findings support the integration of the guidelines as a standard nursing practice in emergency departments.

Keywords: nursing practice guidelines; multiple trauma; emergency department; nursing outcomes