Impact of a Trauma Response Nurse Deployment to Alpha Trauma Activations in a Level I Academic Trauma Center

Background:
The Trauma Response Nurse (TRN) role is integrated into emergency departments (ED) to enhance the quality of care during trauma alerts. At this facility, an experienced surgical intensive care unit (SICU) nurse was alerted to Category-1 (Cat-1) trauma activations and arrived in the ED to help bridge the experience gap due to high nurse turnover. The goal was to provide guidance and mentorship for novice nurses managing these critically injured patients. Additionally, this role was assembled to provide increased continuity of care across procedural areas, medical specialties, and intensive care units as the TRN remained with the patient from ED arrival to transfer to definitive care.

Objective:
This program evaluation examined the outcomes of a TRN program within Cat-1 trauma activations in the ED of a Level I Trauma Center.

Methods:
A retrospective analysis was completed using an institutional trauma registry and the electronic health record (EHR) to determine the effect of a TRN. The first two years of the TRN program were evaluated by comparing ED Length of Stay (LOS) and time to definitive care between patients receiving care with a TRN present and those without.

Results:
A total of 353 patients were included in the analysis, with 193 (55%) in the TRN group and 160 (45%) in the non-TRN group. The median time to OR was lower in the TRN cohort (63 minutes) compared to the non-TRN cohort (80 minutes [p= .87]). The median ED LOS was five minutes shorter in the TRN group (77 minutes) than the non-TRN group (81.5 minutes [p=.20]). Time to ICU was 4 minutes in the TRN group (77 minutes) than in the non-TRN group (81 minutes [p= .21]).

Conclusions:
While not statistically significant, this retrospective analysis found that TRN deployment to Cat-1 traumas was associated with a clinically significant reduction in ED LOS, time to OR, and time to ICU.