Crossing the Lines: Level One Trauma Nursing at its Best!

Purpose:
The purpose of this presentation is to describe the development and implementation of a Level I trauma center's innovative design of a cross training program involving surgical intensive care and emergency department nurses.

Significance:
Survival rates in trauma are dependent on quality nursing care provided by competent staff. This program was created in the SICU and the ED to increase knowledge and skill in both areas, improve care and nurse satisfaction, and provide continuity of care across hospital units to the trauma patient.

Strategy and Implementation:
To improve the quality of trauma care, as well as expand the knowledge of nurses in these areas; a cross-training program was created by the nurse managers and clinical nurse educators in two departments at Denver Health Medical Center (DHMC) an urban public safety net hospital. The program embraced SICU and ED nurses to work concurrently in these two departments with the trauma patient population. The educators designed an orientation program to alternate ED nurses with SICU nurses for a period of training to be followed by a shared full time position in both departments. Specifically, the nurses participate in didactic learning including a critical care course, a trauma care course, ENPC, PALS, and TNCC as a required portion of their training. In addition, the nurses have preceptors in each area orienting them to the bedside clinical practices of each unit. The unit educators monitored progress and provided mentorship in both areas.

Evaluation:
Data collection reveals several positive outcomes including improved knowledge and skill of the nurses, increased nurse job satisfaction,expanded staffing options, cost savings, camaraderie between units, and increased experience level of nurses expanding options for future career advancement.

Implications for Practice:
The cross-training program at DHMC improved quality and continuity of care for trauma patients. Engaging staff nurses in inventive strategies to advance nursing practice enriches quality improvement, provides a holistic view of the patient experience, and sustains job satisfaction.