Skip to main content

Advertisement

SpringerLink
Log in

Rural Trauma Team Development Course Instills Confidence in Critical Access Hospitals

  • Original Scientific Report
  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Purpose

The American College of Surgeons’ Rural Trauma Team Development Course (RTTDC) was designed to help rural hospitals optimize a team approach to trauma management recognizing the need for early transfer. Little literature exists on the success of RTTDC achieving its objectives. The purpose of this study was to determine the impact of RTTDC on rural trauma team members.

Methods

RTTDC was hosted at seven rural hospitals. A pre-course 30-question Likert survey gauging confidence managing trauma patients was administered to participants. Four weeks following, participants received a post-course survey with corresponding Likert questions and 11 trauma knowledge-based questions. Chi-square, Fisher’s exact tests and general linear models were utilized. Statistical significance is set as p < 0.05.

Results

111 participants completed the pre-course survey; 53 (48%) completed the post-course survey. Results presented on a 5-point Likert scale with 1 = “not at all comfortable” to 5 = “extremely comfortable.” Participants knowing their role in the trauma team improved by 16% (p = 0.02). Familiarity with the roles of other trauma team members was significantly improved (3.4 vs. 4.15; p < 0.01). Participants comfort with resuscitating trauma patients and managing traumatic brain injury significantly improved (3.29 vs. 3.69; p = 0.01 and 2.62 vs. 3.14; p = 0.004, respectively). Comfortability communicating with the regional trauma center improved significantly (3.64 vs. 4.19; p = 0.004). Participant decision to transfer trauma patients within 15 min of arrival improved by 3.2%. Participants answered 82% of the knowledge-based questions correctly.

Conclusion

RTTDC instills confidence in providers at rural hospitals. The information taught is well retained, allowing for quality care and timely patient transfer to the nearest trauma center.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. American College of Surgeons Committee on Trauma (2015) Rural Trauma Team Development Course, 4th edn. American College of Surgeons, Chicago

    Google Scholar 

  2. Rogers FB, Shackford SR, Osler TM et al (1999) Rural trauma: the challenge for the next decade. J Trauma 47(4):802–821

    Article  CAS  Google Scholar 

  3. National Research Council Committee on Trauma (1966) Accidental death and disability: the neglected disease of modern society. National Academy of Sciences, National Research Council, Washington

    Google Scholar 

  4. Bishop GB, Potter CJ (2004) National Foundation for Trauma Care. U.S. Trauma Center Crisis Report

  5. Singh GK, Azuine RE, Siahpush M, Kogan MD (2013) All-cause and cause-specific mortality among US youth: socioeconomic and rural–urban disparities and international patters. J Urban Health 90:388–405

    Article  Google Scholar 

  6. Malekpour M, Neuhaus N, Martin D et al (2017) Changes in rural trauma prehospital times following the Rural Trauma Team Development Course training. Am J Surg 213:399–404

    Article  Google Scholar 

  7. Dennis BM, Vella MA, Gunter OL et al (2016) Rural Trauma Team Development Course decrease time to transfer for trauma patients. J Trauma Acute Care Surg 81:632–637

    Article  Google Scholar 

  8. Gonzalez RP, Cummings G, Mulekar M, Rodning CB (2006) Increased mortality in rural vehicular trauma: identifying contributing factors through data linkage. J Trauma 61(2):404–409

    Article  Google Scholar 

  9. Baker SP, O’Neil B, Ginsburg MJ, Li G (1992) The injury fact book, 2nd edn. Oxford University Press Inc., New York

    Google Scholar 

  10. US General Accounting Office (1993) Rural development: profile of rural areas. US General Accounting Office, fact sheet for congressional requestors GAO/RECD-93-40FS, Washington, pp 26–30

    Google Scholar 

  11. Peek-ASA C, Zwerling C, Stallones L (2004) Acute traumatic injuries in rural populations. Am J Public Health 94(10):1689–1693

    Article  Google Scholar 

  12. Newgard CD, McConnell KJ, Hedges JR, Mullins RJ (2007) The benefit of higher level of care transfer of injured patients from nontertiary hospital emergency departments. J Trauma 63:965–971

    Article  Google Scholar 

  13. Harrington DT, Connolly M, Biffle WL et al (2005) Transfer times to definitive care facilities are too long: a consequence of an immature trauma system. Ann Surg 241(6):961–966 (discussion 6–8)

    Article  Google Scholar 

  14. Clay Mann N, Mullins RJ, Hedges JR et al (2001) Mortality among seriously injured patients treated in remote rural trauma centers before and after implementation of a statewide trauma system. Med Care 39(7):643–653

    Article  CAS  Google Scholar 

  15. Hartl R, Gerber LM, Iacono L et al (2006) Direct transport within an organized state trauma system reduces mortality in patients with severe traumatic brain injury. J Trauma 60(6):1250–1256 (discussion 6)

    Article  Google Scholar 

  16. Young JS, Bassam D, Cephas GA et al (1998) Interhospital versus direct scene transfer of major trauma patients in a rural trauma system. Am Surg 64(1):88–91 (discussion 2)

    CAS  PubMed  Google Scholar 

  17. Nathens AB, Jurkovich GJ, Rivera FP, Maier RV (2000) Effectiveness of state trauma systems in reducing injury-related mortality: a national evaluation. J Trauma 48(1):25–30 (discussion 1)

    Article  CAS  Google Scholar 

  18. Sampalis JS, Denis R, Lavoie A et al (1999) Trauma care regionalization: a process-outcome evaluation. J Trauma 46(4):565–579 (discussion 79–81)

    Article  CAS  Google Scholar 

  19. Celso B, Tepas J, Langland-Orban B et al (2006) A systematic review and meta-analysis comparing outcome of severely injured patients treated in trauma centers following the establishment of trauma systems. J Trauma 60(2):371–378 (discussion 8)

    Article  Google Scholar 

  20. Garwe T, Cowan LD, Neas B et al (2010) Survival benefit of transfer to tertiary trauma centers for major trauma patients initially present to nontertiary trauma centers. Acad Emerg Med 17(11):1223–1232

    Article  Google Scholar 

  21. Kappel DA, Rossi DC, Polack EP et al (2011) Does the Rural Trauma Team Development Course shorten the interval from trauma patient arrival to decision to transfer? J Trauma 70(2):315–319

    Article  Google Scholar 

  22. Whedon JM, von Recklinghausen FM (2013) An exploratory analysis of transfer time in a rural trauma system. J Emerg Trauma Shock 6(4):259–263

    Article  Google Scholar 

  23. American College of Surgeons (2014) Resources for optimal care of the injured patient 2014/resources repository. http://www.facs.org/quality%20programs/trauma/vrc/resources. Accessed 28 June 2017

  24. Emick DM, Carey TS, Charles AG, Shapiro ML (2012) Repeat imaging in trauma transfers: a retrospective analysis of computed tomography scans repeated upon arrival to a level I trauma center. J Trauma Acute Care Surg 72(5):1255–1262

    Article  Google Scholar 

  25. Sharp GL, Cutler BL, Penrod SD (1988) Performance feedback improves the resolution of confidence judgements. Organ Behav Hum Decis Process 42(3):271–283

    Article  Google Scholar 

  26. Evans DE, Wood DF, Roberts CM (2004) The effect of an extended hospital induction of perceived confidence and assessed clinical skills of newly qualified pre-registration house officers. Med Educ 38(9):998–1001

    Article  Google Scholar 

  27. Zhu TH, Hollister L, Scheumann C et al (2016) Effectiveness of the Rural Trauma Team Development Course for educating nurses and other health care providers at rural community hospitals. J Trauma Nurs 23(1):13–22

    Article  Google Scholar 

  28. Ali J, Cohen R, Adam R et al (1996) Attrition of cognitive and trauma management skills after the advanced trauma life support (ATLS) course. J Trauma 40(6):860–866

    Article  CAS  Google Scholar 

  29. Baruch Y, Holtom BC (2008) Survey response rate levels and trends in organizational research. Hum Relat 61(8):1139–1160

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Trauma, Emergency General Surgery and Critical Care Surgery, Department of Surgery, University of Nebraska Medical Center, 983280 Nebraska Medical Center, Omaha, NE, 68198-3280, USA

    Zachary M. Bauman, John Loftus, Alex Hodson, Ashley Farrens, Valerie Shostrom, Jessica Summers, Paige E. Phillips, Charity H. Evans & Lisa L. Schlitzkus

Authors
  1. Zachary M. Bauman
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. John Loftus
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Alex Hodson
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ashley Farrens
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Valerie Shostrom
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Jessica Summers
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Paige E. Phillips
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Charity H. Evans
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Lisa L. Schlitzkus
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All authors contributed substantially to this research project. All authors were fully involved in this research project and collectively designed, conducted and interpreted the data. Furthermore, all authors reviewed and approved the decision to submit this manuscript for publication in its current form. The institution providing the patient population and data collected was the University of Nebraska Medical Center, Omaha, NE.

Corresponding author

Correspondence to Zachary M. Bauman.

Ethics declarations

Conflict of interest

There are no conflicts of interest or financial interests to disclose for any of the contributing authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bauman, Z.M., Loftus, J., Hodson, A. et al. Rural Trauma Team Development Course Instills Confidence in Critical Access Hospitals. World J Surg 44, 1478–1484 (2020). https://doi.org/10.1007/s00268-019-05359-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-019-05359-3

Search

Navigation