Date of Award

3-2019

Degree Name

Nursing (D.N.P.)

Department

College of Nursing

First Advisor

Rebecca Davis Phd, RN

Second Advisor

Tricia Thomas PhD, RN

Third Advisor

Gaby Iskander M.D, M.S

Abstract

Introduction: Rib fractures in the geriatric patient can be life altering. Across the country trauma centers are caring for an increased volume of geriatric patients aged 65 years and older (Ali-Osman et al., 2018). The geriatric patient with thoracic injury has the second highest mortality rate among the trauma population in the United States (Mentzer et al., 2017). The assessment of the patient is key to identify critical changes due to high risk of adverse events from rib fractures. Despite efforts to standardize the assessment and care provided to the patient with rib fractures, a lot of variation occurs. Research supports the provision of a standard assessment and discharge process for the geriatric trauma patient (GTP) with rib fractures to improve outcomes.

Objective: This project focused on conducting a gap analysis of process and outcomes measures in this population at the specific site of interest in the emergency department (ED), inpatient setting and outpatient setting to determine needs for improvement. Then, after the data analysis, evidenced based recommendations were given to appropriate leadership staff.

Methods: The development of a dashboard displayed key measures identifying areas of outliers for the ED, inpatient and outpatient setting.

Results: Through the development of the dashboard it was identified that when compared to the evidence the large urban hospital needs improvement in the consistent use and documentation of the incentive spirometer (IS) by the nurses, and more consistency with evaluation of the GTP using the FRAIL assessment and standard of care for follow-up post-discharge.

Conclusions: The dashboard was effective at displaying areas in need of evidence-based improvement at the organization of focus for the GTP with rib fractures.

K. Crystal Powerpoint.pdf (979 kB)
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