Trauma quality management process improvement


This discussion relates to trauma quality management process improvement through the incorporation of forensic nurses. For this discussion forensics will include living as well as deceased patients and events. The discussion will emphasize the value of evidence collection, documentation, mechanism of injury and complications after the primary event by all members of the health care team. Forensic trained nurses enhance the quality management process in trauma center. Forensic nurse specialist training combine’s clinical expertise, which blends nursing knowledge with the legal system. Physical, behavioral, and cognition aspects are all included during the patient assessment as they are each indicators of health. The benefits of the forensic nurse role can be seen in proper evidence collection, documentation through the chain of custody, proper terminology use, interfacing with law enforcement, and identification of unsuspected injury through application of the nursing assessment. In the trauma environment a problem-based assessment involving the history and examination is limited in scope to the specific problem that brought the patient to the emergent care setting initially. If a nurse performing this assessment identifies physical signs of past trauma or identifies subtle signs of abuse in the initial assessment she would be lead to a comprehensive assessment and involvement with other members in the trauma team. The comprehensive assessment will encompass current health problems, health promotion, disease prevention and assessment for problems associated with known risk factors. The knowledge base of a trained forensic nurse specialist allows correct terminology use during the documentation process, which allows for a smoother interface with the law enforcement. A forensically educated nurse will identify exigent evidence and work to preserve it through collection and photography so it can be utilized for future law enforcement needs. The documentation completed serves as a legal document of the evaluation and provides a baseline for subsequent evaluations. The accurate nonbiased health assessment can be used for future encounters and trend identification for recurrent injuries. Collaboration with a team promotes accurate management of trauma patients. Raising the index of suspicion and recognizing the patient’s problem is critical to opening the issues of abuse or other crimes against patients who present to trauma centers for care. The forensic nursing assessment of the patient and situation may lead to closing a circle of violence. Management of clinical forensics is important in the trauma care centers. The forensic nurse specialist has an important role in drafting policies and guidelines for the areas of: evidence identification, collection and documentation. The forensic nurse specialist provides an emergent role in developing ongoing Trauma Quality Management.


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