Evaluation of the impact of implementing clinical nursing practice guidelines for emergency multiple trauma patients at a tertiary hospital
Keywords:
nursing practice guidelines, multiple trauma patients, emergency phaseAbstract
This quasi-experimental study evaluated the outcomes of adopting clinical nursing practice guidelines for emergency multiple trauma patients at a tertiary hospital. Additionally, it assessed the feasibility of implementation and the level of nursing satisfaction with the use of the guidelines. The study was guided by the Soukup's evidence-based framework. The sample included 83 multiple trauma patients and 43 nurses. Data collection took place from March 1 to June 30, 2025. The research instruments comprised: the Clinical Nursing Practice Guidelines for Emergency Multiple trauma Patients, a general demographic data form, a multiple trauma patient outcome record, a feasibility questionnaire concerning guideline implementation, and a nurse satisfaction assessment form. Data were analyzed utilizing descriptive statistics and the paired t-test. Multiple trauma significantly impacts physiological changes, frequently leading to hypoxia, altered levels of consciousness, and hemorrhagic shock, which can increase the risk of mortality.
Results following the implementation of the guidelines revealed that: 1) key time metrics showed improvement: The average time from the incident scene to the hospital arrival was 9.86 minutes. The average time until specialist physician consultation was 1.78 minutes. The average treatment time until discharge was 80.25 minutes. 2) patient outcomes: The patient-focused results demonstrated that the mean values for peripheral oxygen saturation and the mean score for the level of consciousness upon discharge were significantly higher than those recorded upon admission statistically significant at p < 0.001 and p < 0.010, respectively. However, the mean shock Index showed no significant difference. 3) Feasibility and Satisfaction: The evaluation of the feasibility of implementing the guidelines and the nurses' satisfaction level were both rated at the highest level, with a mean score of 4.60 (SD = 0.541).
The implementation of these clinical nursing practice guidelines effectively improved the nursing care, access to definitive treatment, and physiological surveillance of multiple trauma patients, spanning from the incident scene through transport and hospital admission. This adoption resulted in enhanced efficiency and effectiveness, contributing to the reduction of complications, disability factors, and increasing survivability.
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