الفهرس 
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Abstract
Tertiary trauma survey is performed on critical care units on admission within 24 hours and repeated prior to discharge by trauma nurse practionner for poly-trauma patients by systematic re-evaluation of trauma patients by complete physical assessment, all radiological imaging and laboratory value trends to detect any missed injuries, that missed during primary and secondary survey, also had the potential to be a clinically significant factor on patients outcome.
The aim of the Study
This study aimed to assess nurses’ performance regarding tertiary trauma Survey and Poly-trauma patient outcome.
This aim would be achieved through the following:
1. Assess the nurses’ level of knowledge regarding tertiary trauma Survey for patients with poly-trauma.
2. Assess the nurses’ level of practice regarding tertiary trauma Survey for patients with poly-trauma.
3. Assess poly-trauma patients’ outcome.
Research question:
To fulfill the aim of this study the following research questions could be formulated:
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1. What are the nurses‟ levels of knowledge regarding tertiary trauma survey?
2. What are the nurses‟ levels of practice regarding tertiary trauma survey for patients with poly-trauma?
3. What is poly-trauma patients’ outcome?
Research Design:
The descriptive exploratory study design used to achieve the aim of the study.
Methodology:
Setting:
This study was carried out in the intensive care unit (ICU) at Emergency Hospital affiliated to El-demerdash Hospital, Ain Shams University.
Subject:
A convenience sample, of all available nurses, who are working in intensive care units at Emergency Hospital were included in the study.
A purposeful sample composed of 50 adult patients from both sexes diagnosed as poly-trauma patients had recruited from the above-mentioned setting.
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Tools of data collection: Three tools were used in the current study as the following:
I) Self-administered questionnaire tool for nurses:
This tool was used to assess nurses’ knowledge regarding tertiary trauma survey for patients with polytrauma. It developed by the investigator based on a review of relevant literature and it was divided into two parts:
The first part:
Demographic characteristics of nurses (age, sex, years of experience, educational level and training courses regarding tertiary trauma survey for patients with poly-trauma.
The second part:
Questions related to nurses’ knowledge regarding tertiary trauma survey for patients with poly-trauma.
II) Nurses practices an observational checklist:
This tool used to assess nurses’ practices regarding tertiary trauma survey of patients with poly-trauma. This tool was adopted from proehl and Allen (2009).
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III) Clinical outcome sheet:
This tool used to assess poly-trauma patients’ outcome as regarding missed injury.
Results:
Results of this study showed that:
Part I:
- Half of the nurses’ age under study (50%) was below 30 years with a mean age of 30.52±3.82. In relation to gender, less than three-quarters of the nurses under study (72%) were female. Regarding the educational level of nurses, more than half of the nurses under study (52%) were having nursing technical institute diploma. Regarding years of experience, less than two-thirds of the nurses under study (62%) were having less than 10 years of experience with a mean of 9.28±2.32. As regards training courses attended, more than half of the nurses under study (58%) did not attend training courses.
- Most of the nurses under study (84%) had a satisfactory level of knowledge regarding polytrauma and (86%) had a satisfactory level of knowledge regarding diagnostic procedures and laboratory investigations for polytrauma patients.
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- More than three-quarters of the nurses under study (76%) had a satisfactory level of knowledge regarding the secondary survey.
- More than half of the nurses under study (60%) had an unsatisfactory level of knowledge regarding definition and purpose of tertiary trauma survey.
- More than two-thirds of the nurses under study (70%) had an unsatisfactory level of knowledge regarding for trauma triage.
- Most of the nurses under study (80%) had an unsatisfactory level of knowledge regarding injury severity score.
- Concerning nurses’ level of practice regarding tertiary trauma survey, more than two thirds of the nurses under study (68%) had a satisfactory level of practice regarding the primary assessment.
- More than two-thirds (70%) of the nurses under study had a satisfactory level of practice regarding secondary assessment.
- There was a statistically significant relation between the total level of knowledge regarding tertiary trauma
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survey and demographic data (age, educational level and training courses attended).
- There was a statistically significant relation between nurses’ total level of practice regarding tertiary trauma survey and educational level and training courses attended.
- There was a highly statistically significant positive correlation between nurses’ total level of knowledge and the total level of practice regarding tertiary trauma survey.
Part II:
Clinical outcome data for polytrauma patients
- Less than half of the patients’ age under study (44%) was from 30-45 years. In relation to gender, less than three-quarters of the patients under study (72%) were males.
- As regards to trauma activation type more than half of the patients under the study (54%) were type 1 (unstable patient), more than two- thirds of the patient under study (70%) had blunt trauma. More than half of patients under study (58%) did not have any medical history, the most of patients under study (80%) did not have any surgical history.
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- There was a difference between patients’ injury severity score on admission and after 24 hours.
- There was a difference between hemodynamic status and laboratory investigations findings of polytrauma on admission and after 24 hours.
- There was a statistically significance difference between hemodynamic status, radiological findings review and physical assessment of polytrauma patients on admission and after 24 hours