Factors Predicting Trauma Patients’ Discharge Destinations
Keywords:injury, physiological deterioration, pain, discharge destination, trauma unit
Objective: To study the predictive power of the factors of age, comorbidity,
physiological deterioration and pain on trauma patients’ discharge destinations.
Design: Predictive correlational design.
Methodology: This study was conducted on a sample of 300 trauma patients treated at the trauma unit of a campus hospital between January and June 2018. The research instruments consisted of 1) a personal information form; 2) the Modifed Early Warning Sign (MEWS) scale; 3) the Critical-Care Pain Observation Tool
(CPOT); 4) a comorbidity form; and 5) a discharge destination record form. The data were analysed using Point-Biserial Correlation and Logistic Regression Analysis.
Results: More than half of the subjects (58%) were males. The subjects’ average age was 48.58 years (SD = 19.86), about one-third (30.67%) of whom were injured in traffc accidents. Almost 75% of the subjects showed minor physiological deterioration, at an average of 2.01 (SD = 1.54) on the MEWS scale, and an average score of 2.47 (SD = 1.63) on the CPOT. Nearly half of the subjects (47.33%) had comorbidity conditions.
A predictive analysis showed that physiological deterioration and increase in pain frequency signifcantly raised the likelihood of the patients’ needing prolonged hospitalisation (.05 (OR = 2.23, 95% CI: 1.69-2.94; OR = 1.25, 95% CI: 1.06-1.49, respectively). These two factors were jointly capable of predicting 31.00% (Nagelkerke R2 = .31, p < .05) of the cases.
Recommendations: It is suggested that nurses and healthcare personnel apply physiological deterioration and pain data to the process of determining whether a patient needs continued intensive care or can be transferred to an in-patient ward.
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