The State Major Trauma Unita new service

Susanne Jenner 28th August 2008

Index

The State Major Trauma Unit (SMTU) Goals and Objectives Multidisciplinary Team Social Work Service Conclusion References

The State Major Trauma Unit

Is part of a 40 bed unit completed 2008 Located level 3 north block RPH To accommodate:

– State Major Trauma Unit – 25 beds– State Adult Burns Unit – 10 beds– with 5 either/or beds usually SMTU.

In a disaster situation can be become one high acuity 40 bed unit.

Official Opening

Reception

Corridor (east view)

Single adjoining room

SMTU Goals and Objectives

Provision of expert care of trauma patients To expedite patients from ED To improve flow of major trauma patients in all

related clinical areas To expedite patients from ICU, HDA and

Theatres/Recovery by providing “step down” facility. To provide an ongoing Education and Research

environment for improved trauma management and patient outcomes.

Complex Trauma Patients

All Multi-system trauma patients requiring input from more than one admitting specialty

Single system injuries with complex co-morbidities.

Exclusions– Patients who require advanced organ system

support eg renal, ventilator or cardiac– Isolated spinal and neurosurgical injuries

Multidisciplinary Team

Medical– Trauma Fellows 1.6 fte– RMO’s 5 fte

Nursing 42.78 fte Case Manager 1 fte Clinical Psychologist 2 fte Social Work 1.6 fte level 7 Physiotherapy 3 fte

– 1 level 8 and 2 level 4/6 for 7 day service

Multidisciplinary team cont’d

Occupational Therapy 2.5 fte– 3 level 7s for 7 day service

Speech 1fte Dietician 0.6 fte Pharmacy 1 fte Chaplaincy ? 0.4fte Administration personnel Researchers

Social Work Service

Expectation– Provide Trauma specific SW service– 72 hour turnaround– See every patient incl ICU and HDU

Action taken to develop the role– Literature search – Identify role – Develop Psychosocial assessment specific to

trauma

Social Work role

Prioritise (using traffic light system) Complete psychosocial assessment Documentation

– Headings are used for assessment details– Action required– Plan including early discharge destination

Handover– The medical notes are used as a social work handover.

Social Work role cont’d

Sources of information contained in your assessment must be documented.

The comprehensive psychosocial assessment is intended as a guide only and contains the information required by the SMTU and assist in efficient discharge planning.

Intended outcome– Continuity of Social Work Service to the Unit

Psychosocial Assessment (headings)

Family Cultural Employment Education Financial Residence History Trauma

Psychosocial Assessment cont’d

Preliminary discharge plan Legal Pre-existing function Leisure interests Risk Factors Protective Factors Conclusion/Impression

In closing

Research programs underway Lots of QI’s Some expected and unexpected outcomes Statistical spot light

Important factor to rememberThe environment dictates service delivery ie how we

work.

References

State Major Trauma Unit, Operational Policy, January 2008 Brewin, Andres & Valentine, 2000 in Bonanno George A; Loss,

Trauma, and Human Resilience; 2004; American Psychological Association Inc Vol.59, No 1, 20-28.

Bonanno George A; Loss, Trauma, and Human Resilience; 2004; American Psychological Association Inc Vol.59, No 1, 20-28.

Australian Centre for Posttraumatic Mental Health; Australian Guidelines for the treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder; February 2007.